Prescription For Change
Alex Frangos - Wall Street Journal
April 23, 2001
Drug companies are slowly starting to warm up to the Web as a place
to
advertise
(Copyright (c) 2001, Dow Jones & Company, Inc.)
With health information such a major draw on the Web, drug companies would
seem to be a natural fit for online advertising. And, indeed, the ads are out
there -- but they're not always obvious.
In the first half of last year, only 4%, or about $54 million, of the
industry's consumer-ad spending went to online pitches such as banner ads and
e-mail marketing, according to Cyberdialogue, a New York-based Internet
market-research firm.
However, that number doesn't include a category of ads that's fast becoming
popular among drug companies. Increasingly, say health-care analysts, the
companies are focusing their online efforts on creating content rather than
straightforward advertisements. So, drug makers are forming partnerships with
third-party sites to supply them with information on diseases and other medical
conditions; sometimes the drug companies create sites of their own that
discuss, say, baldness or multiple sclerosis.
But there is a sales pitch there, even if it's buried. The sites -- whether
third-party or proprietary -- almost always contain a link to a site that does
hawk the drug company's product. The usual come-on: Find out about a possible
treatment for the disease you've just read about.
Drug companies are taking this tack for a number of reasons. For one, it
dovetails nicely with their television campaigns. In 1997, the Food and Drug
Administration loosened rules to allow drug companies to promote prescription
drugs on TV without detailing all the side effects -- as long as the companies
referred viewers to a magazine ad or toll-free number where they could get the
whole story. Now, some of those TV ads direct viewers to Web sites.
Another reason for the drug companies' reluctance to advertise aggressively
online is uncertainty over consumer reaction. While people clearly use the
Internet to find out about diseases and treatments, they're choosy about whom
they trust. Cyberdialogue says that 16% of patients who requested a specific
drug from their doctor learned of the drug on the Internet. Television, by
contrast, came in at just 11%. (The top category, at 27%, was friends and
family.) At the same time, according to research firm Jupiter Media Metrix
Inc., only 11% of patients said they would trust information from a
pharmaceutical company's Web site.
Thus, drug makers are making promotional deals where they supply information
but their corporate identity gets played down.
One popular option: sponsorship deals with third-party health sites such as
WebMD Corp. and DrKoop.com Inc. In these deals, pharmaceutical companies
provide the sites with content on diseases; in return, the drug makers get
banner ads and prominent links to their material on the site -- and, more
important, an appearance of neutrality that ads can't provide.
"For a pharmaceutical company, there is a lot of value in being linked
to WebMD," says Pat Fili-Krushel, CEO of WebMD's consumer division.
"We reach millions of health-care users on a monthly basis, and they want
to get their specific message out to those users."
For example, if you click on pain management in WebMD's menu, you'll find a
listing of the site's proprietary articles -- and then a highlighted box that
links to a "chronic pain resource center," from "our
partner," Medtronic Inc. The resource center, which is located on WebMD's
site and within its frame, contains a number of articles about pain management
-- as well as a pitch to prospective candidates for Medtronic's pain therapy.
WebMD says that its site follows strict guidelines set out by hi-ethics, a
consortium of online health sites charged with creating privacy and disclosure
standards. "It is always clear if you are in WebMD content or if you are
in a sponsor's content," says Ms. Fili-Krushel.
Sponsor content, for example, must prominently display the company's logo
and copyright information. Moreover, Ms. Fili-Krushel says, the content drug
companies provide is preapproved by the FDA.
But drug companies aren't relying solely on other sites to get their message
across. Some companies are starting their own Web outposts -- and trying out a
wide range of pitches.
Among the subtlest: "soft sell" Web sites, which provide
information on a disease without mentioning the drug. For example, Merck &
Co., the Whitehouse Station, N.J., drug maker, runs television ads describing
hair loss and encourages men who are worried about it to visit thinhair.com.
Neither the commercial nor the site mentions Merck's baldness treatment,
Propecia; instead, the site offers information on hair loss. But it prominently
displays a banner ad that says, "If you would like information on one such
treatment, click here." The link leads to Propecia.com.
Soft-sell advertising has a number of advantages for the drug companies. Not
mentioning the drug directly gives the impression that the site is independent,
which increases consumer confidence in the site's reliability. Because it
provides information on the disease, not the drug, it caters to consumers'
innate interest in researching their conditions before they seek treatment.
Further, without the drug's name in display, the company doesn't have to follow
FDA rules that require the disclosure of the drug's side effects and dangers.
The FDA has no special rules on drug advertising online and has no
jurisdiction over any publication that doesn't mention a drug by name, such as
thinhair.com. (When a drug name is mentioned -- on Propecia.com, for instance
-- the advertiser must follow the same standards that govern print advertising.
Promotions must be truthful, provide fair balance about benefits and risks and
include a summary of the drug's labeling information.) Still, the FDA warns
consumers to proceed cautiously when it comes to health information online.
"I would be aware of who the sponsor is," says Melissa Moncavage,
public-health adviser in the FDA's division of Drug Marketing, Advertising and
Communications. She says consumers should take note of "who is writing the
information, how old the information is and especially of messages that seem
too good to be true."
Some consumer advocates and doctors are worried about these types of sites.
Larry Sasich, pharmaceutical expert for the Washington, D.C., watchdog group
Public Citizen, says drug-company sites that try to educate patients about a
condition are dangerous. He says people who go online for health information
often are not discerning enough to see the difference between an unbranded
pharmaceutical site and genuine third-party health information. The "line
between science and promotion has been blurred," he says.
Richard Roberts, president of the American Association of Family Physicians,
in Leawood, Kan., and a professor of family medicine at the University of
Wisconsin in Madison, says pharmaceutical promotion online suggests patients
take a "caveat browser" approach. "Making people aware of
conditions is potentially a good," he says, but that is balanced by the
potential for "promoting inappropriate or unnecessary services." He
wouldn't comment directly on thinhair.com.
Merck spokesperson Chris Fanelle says the company doesn't see it that way.
According to her, thinhair.com is a help-seeking ad, meaning it raises
awareness for people who might not know treatment is available. In terms of
people thinking thinhair.com is an independent site, Ms. Fanelle says Merck
voluntarily puts its logo on the site to let consumers know the source of the
information.
An extension of the soft-sell approach is so-called community-awareness
sites, which offer coupons, quizzes, polls, graphics and chat rooms on specific
diseases or drugs. The goal is to educate consumers about a condition and show
how it can be treated with the pharmaceutical company's drug.
One such site, mswatch.com, caters to multiple-sclerosis sufferers, their
families, and their caregivers. Teva Neuroscience Inc., the maker of Copaxone,
one of the three major MS drugs on the market, produces the site in conjunction
with New York Internet health-systems provider Softwatch Inc. According to
Teva, the site has 27,000 registered users.
The site includes a discussion board, a library with background info on MS,
advice on how to manage symptoms, latest news in the MS field and a diary area,
where patients upload their daily treatment regimen. The company conducts
semiannual surveys of the site's registered users, which serve as a focus group
that provides insights to the company on what MS sufferers want and need. In
the competitive MS drug market, knowing your customer can help edge out the
competition. There are three similar MS drugs produced by different companies;
in addition to Copaxone, there's Beta Seron, by Berlex Laboratories Inc., a
subsidiary of Schering AG of Germany, and Avanex, by Biogen Inc. Studies show
little difference in effectiveness, so competition for customers is fierce.
(The other two drug makers also have sites.)
At the bottom of every page is the Teva logo and copyright, and the
"Managing MS" section contains an article on using Copaxone. Atul
Singh, head of e-business for Teva Neuroscience, says mswatch isn't intended to
promote the drug, per se. "The focus here is on education," he says.
"On the mswatch site we don't say that Copaxone is the best drug. We
provide more information on the disease than on the therapy."
Asaf Evenhaim, the president of Softwatch, says the goal of
community-oriented sites is to "provide value to your customers and
benefit from the Web as an effective environment to build those
relationships."
One user of the site, Cindy Pavich, thinks the world of mswatch, even though
she uses Avanex, one of Copaxone's rival drugs. The 40-year-old
insurance-claims adjuster from Utah was diagnosed with MS two years ago and
says she found out about the site from an ad in Inside MS, a magazine for
people with the disease. She checks the site daily and participates in the chat
for newly diagnosed patients every evening. When the maker of Avanex opened its
own community site, Ms. Pavich checked it out but decided to stick with
mswatch. "I've made friends here," she says. "This is my
support."
Some critics urge caution, however. The Multiple Sclerosis Society of
America, a national nonprofit organization dedicated to helping MS sufferers
and the publisher of Inside MS, says people need to be careful of health
information on the Internet. "Before people make any kind of decision on
their medical future they need to go to vetted sites that have no particular ax
to grind," says Arney Rosenblat, spokesperson for the New York-based
group.
Ms. Rosenblat's suggestion? Her group's own site, nmss.org.
---
Delivery Systems
How much drug companies spent in various advertising outlets in the
first half of 2000 -- and how much they got out of it
Per-Patient
Ad Spending Cost*
TV $833 million $152
Print 460 million 318
Internet 47 million 54
*The estimated cost of using each medium to get one patient to ask his
or her doctor for a particular prescription
Source: Cyberdialogue
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