Falling Leaves: Journal Ad Review

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The first six months of 2006 produced little cheer for medical publishers, with spending in medical/surgical journals flat compared to the first-half 2005, according to PERQ/HCI's Journal Ad Review. In fact, the last significant increase occurred during the first half of 2004. Worse still, in terms of constant dollars, first-half ad spending in medical/surgical journals has actually registered a slight decline in the past five years.

As for the specialty titles, only three of the eight markets reported an increase in ad spending during the first half of 2006: Ophthalmology (20.1%), Nursing (1.8%) and Pharmacy (1.6%). Specialty segments in decline were Optometry (-5.4%), Radiology (-4.7%), Hospital Management (-4.2%), Dental (-3.5%) and Laboratory (-1.7%). Total dollar volume of the eight specialty markets was down 0.3%compared to the first-half of 2005, while the number of pages declined 0.6%.

The New England Journal of Medicine displaced Journal of the American Medical Association as the top medical/surgical journal, ranked by dollars. American Family Physician, American Medical News and Medical Economics make up the top five.

The leading advertisers
During the first six months of 2006, Pfizer regained the number one spot in medical/surgical journal advertising, increasing outlays by 63%. The gain was driven in large part by Lyrica, a new product for diabetic peripheral neuropathy, higher ad spending for Caduet and strong ad support for Celebrex. Wyeth advanced from 7th to 2nd following a 116%boost in ad spending due almost entirely to Effexor XR. A 45% cut in ad expenditures dropped Forest from 1st to 3rd, while Merck climbed from 10th to 4th as ad outlays increased by 45% due largely to Zostavax, a vaccine for the prevention of herpes zoster (shingles) and Gardasil, a vaccine against HPV, the virus which causes cervical cancer. Lilly slipped from 3rd to 5th following lower ad expenditures for Cymbalta, while Sanofi-Aventis fell from 4th to 6th on a 29% cut in ad outlays.

Novo Nordisk climbed from 24th to 7th due largely to the introduction of Levemir, a long-lasting basal insulin, Sepracor advanced from 11th to 8th as ad outlays increased by 32% and AstraZeneca slipped three spots to 9th with spending down on a number of brands including Crestor. Takeda, one of seven companies new to the top 25, ranked 10th due largely to the introduction of insomnia preparation Rozerem.

The leading products
Wyeth's Effexor XR was by far the most heavily advertised brand during the first six months of 2006, with a 190% increase in ad outlays. Pfizer's Lyrica, which began advertising in the fall of 2005 and has, on occasion, used 8 page ads, was 2nd, while Forest's Namenda slipped from 2nd to 3rd following a 9% budget cut. Takeda's Rozerem, another recent introduction, ranked 4th and Lilly's Cymbalta, the most heavily advertised product in the year-ago period, was 5th.

A 43% boost in spending moved Pfizer's Caduet from 12th to 6th, while Pfizer's Lipitor dropped from 4th to 7th as ad outlays were reduced by 14%. Sepracor's Lunesta retained 8th place even as spending was cut by 19%, Forest's Lexapro slipped from 11th to 9th with ad expenditures unchanged from the year-ago period and Celebrex, which was supported by a major budget increase, jumped from 246th to 10th.

Sepracor's metered-dose inhaler, Xopenex HFA, another relatively new entry, ranked 11th while journal advertising that promoted both Abilify tablets and oral solution took 12th place. Abilify is currently being supported with 8-page ads. Even though ad expenditures for Risperdal were reduced by 9%, the Janssen brand still advanced from 17th to 13th. Benicar/Benicar HCT family ads began appearing in the fall of 2005 and for the first half 2006 ad outlays were sufficient to place the brands in 14th place. While Prevacid only maintained it's year-ago ad spend level, the brand, nevertheless, advanced from 20th to 15th.

Newly introduced products in the top 25 list include Byetta (16th), Levemir (18th), Zostavax (21st) and Gardasil non-branded (23rd).

The leading therapeutic categories
Once again, SSRI/SNRI's was the most heavily advertised drug class, accounting for just over 8% of all ad spending in medical/surgical journals. Effexor XR ads account for over half of the total. Cytostatic Drugs—Other continued in 2nd place while Diabetes—Insulin jumped from 32nd to 3rd, due in large part to Byetta, Novolog Mix and Levemir. Antipsychotics—Other was unchanged in 4th place even though ad expenditures for the class increased by 24%, due in part to higher spending on Zyprexa, and Non-Barbiturates Sedatives slipped from 3rd to 5th, even as ad spending grew by 7%.

A 137% boost in spending moved Seizure Disorders from 20th to 6th, Alzheimer-Type Dementia repeated in 7th place and Vaccines—Other climbed from 103rd to 8th, due in large part to outlays for Zostavax and Gardasil. Ethical Drugs Miscellaneous——Other advanced from 13th to 9th on a 39% boost in spending, while Cholesterol Reducers Rx—Others fell from 5th to 10th due largely to spending cuts on Vytorin. The upward move of Calcium Blockers from 17th to 11th was driven by higher ad spending for Pfizer's Caduet.

Antivirals-Other, one of the eight therapeutic classes new to the top 25, climbed from 27th to 12th due in part to higher ad outlays from Bristol-Myers Squibb's Reyataz. Other new entries include Angiotensin 11 Receptor Blockers, up from 36th to 16th due to Benicar and Benicar HCT promotion, COX-2 Inhibitors, up from 150th to 17th as ad spending was reinstated for Celebrex, and Morphine & Opium Non-Injectables up from 33rd to 18th as ad outlays were increased by 73%.

Specialty Journals
During the first half 2006, ad spending in ophthalmology journals grew by 20.1%. This follows a 2.5% gain in the prior year-ago period. The top two advertisers, Alcon Laboratories and Allergan, were largely responsible for the sharp boost in spending as evidenced by ad budgets that were increased 37% and 63%, respectively. Bausch & Lomb moved up from 4th to 3rd following a 76% increase in ad expenditures, while Advanced Medical Optics slipped from 3rd to 4th following a 5% cut in spending. Ista Pharmaceuticals edged up from 6th to 5th as ad spending was increased for Xibrom (bromfenac ophthalmic solution) and Vitrase (hyaluronidase injection).
At the product level, Allergan had the four most heavily advertised products. Lumigan, Alphaga, Acular LS and Zymar. Alcon's entries in the top 10 included Nevanac ophthalmic suspension (5th), Vigamox, a fourth-generation fluoroquinolone antibacterial agent, up from 7th to 6th, and the Acrysof ReSTOR Lens, up from 115th to 9th.

Ad spending in nursing journals grew by 1.8%, following a similar increase in the year-ago period. The top three advertisers, Nurses Services Organization, Supplement Health Care Services and Cross County Travcorps maintained their respective positions during the first six months of 2006. American Mobil Healthcare advanced from 7th to 4th following a 22% hike in ad expenditures while TravelNurse.com climbed from 9th to 5th as ad outlays were increased by 25%.

The most heavily advertised product/service was again Liability Insurance for Nurses from Nurses Service Organization with just over 4% of all expenditures in this market. Supplemental Health Care Recruitment retained 2nd, while Cross Country Travcorp Recruitment repeated in 3rd. American Mobil Nurses Recruitment advanced from 5th to 4th and Travel Nursing.com moved up from 7th to 5th. These three recruitment services each increased ad outlays by 20-25%.
Ad spending in pharmacy journals was up just 1.6%, reversing a 5.5% decline in the year-ago period. Pfizer is once again the top advertiser, as ad outlays increased by 93% due largely to the recent introduction of Lyrica and renewed support for Celebrex. Wyeth jumped from 25th to 2nd as ad budgets were increased for Effexor XR and Tygacil IV and GlaxoSmithKline climbed from 18th to 3rd following a 124% increase in spending. The Bristol-Myers Squibb/Otsuka partnership that markets Abilify moved up from 49th to 4th while Sanofi-Aventis advanced from 27th to 5th as spending increased by 182%.

Four of the products/services were new entries, including Abilify (1st), a Teva & Ivax Company Ad (5th), Abbott's rheumatoid arthritis drug, Humira (7th) and Pfizer's Lyrica (9th). Remaining in the top 10 list and advancing from 6th to 4th was a Mylan company ad.

Ad spending in laboratory journals was down 1.7%, following a decline of 5.0% in the year-ago period. Roche Diagnostics advanced from 2nd to 1st with an 11% increase in ad outlays while Olympus America slipped to 2nd place following a budget cut of 19%. Only two other companies carried over from a year ago: Bayer Healthcare Diagnostics Division, up from 6th to 4th and Wescor, down from 9th to 10th.

This market is subject to significant change at the product level and the first half 2006 was no exception: only Olympus Hospital Laboratory Products, which repeated in 1st, and Roche Diagnostics' Elecsys proBNP Assay, down from 2nd to 7th figured a year ago. Inova Diagnostics' newly advertised CCP3 Assay is 2nd, Roche Diagnostics' Modular Pre-Analytics & Modular Analytics climbed from 171st to 3rd and Wampole's Athena Multi-Lyte jumped from 324th to 4th.

Ad expenditures in dental journals fell by 3.5%, following a gain of 4.1% in the year-ago period and an increase of 5.7% the year before. 3MESPE which advanced from 7th to 1st following a 60% boost in spending. Sirona advanced from 8th to 2nd as ad outlays increased by 48%, while Ivoclar Vivadent moved up from 4th to 3rd even though spending dropped by 10%. Brasseler USA, new to the top group, climbed from 13th to 4th as ad expenditures increased by 38%. Meanwhile, Ultradent slipped from 3rd to 5th following a 41% budget cut.

At the product level, the CDR Wireless System from Schick Technologies advanced from 14th to 1st following 61% boost in spending while IPS. E.MAX metal free esthetics, a newly advertised entry from Ivoclar Vivadent, placed 2nd. Other newly advertised products in the top 10 include Ultradent's Opalescence PF Tooth Whitening agent (4th) and Trident's Snap on Smile Cosmetic Restoration (9th).

After reporting a gain of 6.8% during the first half 2005, spending in hospital management journals fell 4.8%. Siemens Medical Systems repeated in 1st, even though spending was cut by 39%, while Wellspring Partners moved up from 5th to 2nd as ad outlays were increased by 13%. Press Ganey jumped from 40th to 8th following a 228% boost in spending, GE Medical Systems slipped from 3rd to 4th and Premier Inc. climbed from 16th to 5th as ad expenditures increased by 45%.

The most heavily advertised product/service was Press Ganey Publisher Services, up from 48th to 1st on a 292% increase in ad outlays. The only carryovers from the year ago top 10 were GE Healthcare Financial Services, up from 3rd to 2nd and Wellspring Partners/Financial services which repeated in 5th place. Siemens Medical Solutions moved up from 22nd to 3rd following a 130% boost in spending.

Spending in radiology journals dropped 4.7%, having fallen 0.6% in the year-ago period and 4.4%during the first half 2004. A 26% increase in spending moved GE Healthcare from 2nd to 1st while Siemens Medical Systems slipped from 1st to 2nd following a 16% cut. Toshiba advanced from 5th to 3rd after a 13% increase in spending and Hitachi Medical Corporation climbed from 11th to 4th (up 34%).

All but three of the products/services are new to the top 10. GE Healthcare's Omniscan injection took the top spot with IBM Information Based Medicine a close second following a 301% increase in spending. Bracco Diagnostics Isovue Injection jumped from 168th to 3rd as ad outlays increased by over 800%. Toshiba's Aquilion 64 CT system moved up from 21st to 4th and the newly advertised Signa HDx Technology system from GE Healthcare ranked 5th.

Ad spending in optometry journals fell 5.4% following a year-ago loss of 4.5%. Alcon retained the top spot even though outlays only rose 3%, while Bausch & Lomb moved up from 3rd to 2nd on a 67% boost in spending. CIBA Vision advanced from 4th to 3rd as expenditures rose 52%. The Essilor Group, which markets a variety of lens products, slipped from 2nd to 4th as spending declined 18% and Marchon Eyewear repeated in 5th place following a 30% boost in outlays.
At the product level, this market continued to be subject to considerable change. In the first half of 2006 only one of the top 10 carried over from the year-ago period. Newly advertised products include Alcon's Opti-Free Replenish Solution, which took 1st place with a 2.2% share of all spending, Bausch & Lomb's Pure Vision Toric Contact Lenses (2nd) and Essilor's Varilux Progressive Lens (3rd). Also new are CIBA Vision's Focus Dailies with Aqua Release (4th) and Cooper Vision's Biomedics XC Two-Week Lens (6th).

Eugene M. May is director of marketing research at ACNielsen HCI
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