PR View by Charlotte Wray

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The question of public relations versus other marketing spends is probably a debate that never will go quietly into the night. PR, it seems, is destined to require continual defense and explanation, even as the discipline gains recognition as a critical component of marketing. Why this is remains unclear, but perhaps, like the shoemaker whose children have no shoes, and the architect whose house is in disrepair, we as communicators are simply not effective at promoting our own industry.

This article takes a broad look at the current state and art of public relations and specifically focuses on one area of public relations - healthcare - against the backdrop of key market events and drivers.


To start, there is no denying that the economic downturn - yes, recession - has impacted our industry, just as it has our corporate clients. Account losses and reassignments, lay-offs, and reorganizations thought not widespread, are increasingly being reported.

Strong agency leadership is required to stabilize, and certainly to grow, billings, and PR budgets are under more scrutiny than ever before.

In healthcare public relations, the added variables of regulatory delays and data setbacks are fueling the instability. The lamentable number of 2007 FDA-approved new molecular entities (17, the lowest number in 25 years) may well be undercut in 2008. In addition to outcomes, clinical trial design is under increasing examination; endpoints are being re-evaluated with the advent of novel, targeted therapies that treat disease in small populations. As important, the number of developmental compounds facing discontinuation or delay is affecting budgets and staffing for many agencies. For the first time in many years, it is a buyer's market, with many accomplished and experienced public relations professionals facing unemployment.

Paid vs. Earned Media Trends

A look at how clients are spending their consumer advertising dollars provides insight into what the future will hold for public relations.

Spend by channel has profoundly changed in recent years, and the trend is progressive. Early this year, Nielsen reported that, for the 4th consecutive year, Internet advertising outpaced that of all other channels. In second place are national magazines, but this sector is facing significant challenges.

And network TV and radio, as well as national and local newspapers, historically a key channel for conveying public relations messages, the spend continues to decline. Anyone who reads the New York Times in hard-copy form sees the impact: thinner sections, more prominently placed advertisements, etc.

This is indeed a cautionary tale for PR practitioners. It now seems likely that the future media landscape no longer will include printed newspapers as a venue for message communication. And radio, for so long an effective and economic channel for delivering PR messages, also faces unprecedented declines in listenership, share of voice and ad revenues.

So where are ad dollars going? It is no surprise that Internet spending is up, but the percentage of increase year to year may surprise some:

online advertising rose 18.9% from 2006 to 2007. The online medium abounds with opportunities to communicate, educate and influence opinion. From social networking sites to blogs to online patient advocacy organizations, public relations has begun to effectively deliver messaging across the Internet, but healthcare public relations lags behind, due to regulatory barriers and client reluctance to widely embrace the new medium.

So the trends are clear and present. This is the time to take a breath and look at what PR can deliver during this challenging time for marketing. A solid understanding of these factors will inform decision-making on behalf of clients seeking strategic public relations programming.

PR In the Marketing Mix: What Has and Has Not Changed Several factors continue to make a case for the economy of PR. First, the ROI of a PR campaign compared to its advertising counterpart remains unchallenged. Even the most expensive national public relations campaign is small marketing peanuts compared to consumer advertising.

And PR can deliver both as part of a fully integrated campaign or as stand-alone programming in the absence of advertising, promotion, sampling or any other marketing program.

For pharmaceutical marketing communications, direct-to-consumer advertising must remain a viable option in the marketing mix. But criticism of direct-to-consumer advertising is not likely to diminish in

2008 and in fact may escalate. Most recently, the House Committee on Commerce and Energy took up the issue in a May 8th hearing on DTC, directly challenging the marketers of Vytorin, Procrit and Lipitor to defend the value and spend. So for marketers putting together their brand budgets, the major decisions on dollar allocation center on the big-ticket items like advertising, while PR is the engine that consistently delivers results in measurable, impactful ways.

Credibility Factor

The credibility of editorial message delivery also remains unchallenged, and in fact, has increased with the growth and legitimization of

peer-to-peer communication.  The magazine editor's pronouncement must be validated through reader acceptance; the blog expresses and coalesces opinion around a central issue.

In healthcare public relations marketing, the advent of peer-to-peer empowerment manifests itself in several ways. As patients become educated consumers of healthcare, the physician no longer dictates treatment in a vacuum. The interaction requires a dialogue in which the patient may challenge or question a treatment approach, often presenting information during the office visit generated by a public relations campaign.

Today, the complex array of players in healthcare delivery demands that patients play an activist role. From complicated health insurance company coverage policies to prescription medication directions to the daunting Medicare Part B application process to navigating clinical trial entry options, today's healthcare consumers must approach the purchase of any healthcare item as they would a car, mortgage or other large purchase.

On the physician side, peer-to-peer influence is just as important in shaping opinion. Sermo, the online physician networking community, has become instrumental in driving medical opinion through commentary on practice experiences. Launched in 2006, Sermo has created a new channel for healthcare companies to engage directly with prescribers. Through real-time exchange on the latest medical and clinical insights and observations, physicians aggregate their observations from daily practice and challenge or corroborate one another's opinions. This new "grand rounds" approach has accelerated awareness of medical trends and insights on medications, devices and treatments, which physicians then apply in practice to achieve better patient outcomes.

As a designated Sermo partner, Rx Mosaic Health has been able to apply insights drawn from the community discussion to build targeted communication strategies for clients, achieving highly targeted and measurable results.

So whether the audience is patient or professional, public relations has the opportunity to shape and deliver content to target audiences that are seeking and receiving information across new venues, and who, more than ever, are receptive to content that is credible and meaningful.

Smart PR Programming During a Recession

With all indicators showing that the recession will be with us through at least 2008 and likely into 2009, public relations practitioners must be responsive and flexible in meeting client needs.

Campaigns need to be targeted and directly aligned to audiences, and deliver return-on-investment against agreed-upon metrics. PR budgets are likely not to grow significantly, but must work just as hard to deliver results.

All in a day's work for today's public relations practitioner.

Charlotte Wray is president of Mosaic, an Omnicom agency 
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