Journal Ad Review: Down But Not Out

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It is, perhaps, difficult to imagine right now, but as recently as 2006 medical surgical journal revenues were still on the up. Not much of an up, perhaps—in 2006, ad spending had climbed a mere 2% to $521 million—but it sure was better than what was to follow.

The full year 2007 saw a 4% reverse, the first decline in many, many years. In 2008, revenues really started to tumble, down another 12% to around $437 million. But if 2008 was a landslip, then 2009 turned into an avalanche. Last year, medical/surgical journals reported total ad revenues of just $345 million, down a whopping 21% over the previous year. Which all adds up to the sector having lost more than one third of its ad income (34%) in only three years.

It's been a staggering demise for medical/surgical publications, and while some in the industry are still claiming that such trends are cyclical, it's hard to imagine a similarly spectacular swing restoring the balance anytime soon.
Look at 2009 from the perspective of the number of ad pages and you'll get the same story, in fact slightly worse than dollars, down 23% to 67,282—that's a loss of almost 20,000 pages since 2008 and more than 35,000 pages in the past two years.

When it comes to individual titles in the marketplace, the losses were largely indiscriminate, with a couple of exceptions.

Of the top five medical/surgical journals by dollar revenues, only the retaining number one, The New England Journal of Medicine, posted an increase in pages. And in this case, that amounts to 0.9%, or little more than two extra pages a month, to total 3,218 for the year.

However, it's a handsome return compared to the other “big four”—Journal of the American Medical Association (JAMA) was down 12.8% to 1,669 pages; American Family Physician showed a deficit of 13.2% to 1,220 pages; Monthly Prescribing Reference (MPR) dropped 27.6% to 1,080 pages; and Family Practice News felt a reversal of 11.4% 1,052 pages.

The biggest loser in the top 50 was American Medical News, which plummeted 46% to 586 pages.
Some of the specialties fared better, with oncology titles continuing to add pages. Some of the star performers included Circulation (up 31% to 538 pages), Oncology Net Guide (up 28% to 421), Journal of American Society of Nephrology (up 10% to 537 pages), Oncology Times (up 8.1% to 928 pages) and HemOnc Today (up 6.5% to 914 pages).

The biggest advertisers
So, who is still advertising in medical/surgical journals and what are they promoting? Forest Laboratories skyrocketed to become the number one advertiser in this space with  ad spend up an incredible 30% to $37.2 million—and thus accounting for almost 11 % of the entire market on the back of just four products: Lexapro, Savella, Bystolic and Namenda.

The only other big gainers in the Top 25 were Genentech (up 36% to $9 million) and Amgen (up 44% to $4.8 million). For the rest of big pharma, ad outlays dropped dramatically—really dramatically—almost across the board.
Both AstraZeneca (down 50% to $6 million) and Ortho McNeil's Janssen Pharmaceuticals (down 48% to $8.5 million) pared back significantly, as did Eli Lilly (down 43% to $15.7 billion), Wyeth (now Pfizer, down 37% to $11.5 million) and Merck (also down 37% to $7.5 million). Not far behind in the budget-cut stakes were fellow big guns Sanofi-Aventis (down 30% to $6 million) and Abbott Laboratories (down 28% to $8.4 million). These numbers are enormous and you don't have to look too much further than this clutch of the biggest pharma companies to see where most of the cuts are coming from.

The most advertised categories
Cytostatic Drugs—Other limped across the finishing line to take the top spot as the most advertised therapeutic category on the back of a marginal 1.8% increase in ad expenditure to $26.8 million. It was a tight race, however, due mainly to the fact that perennial number one, SSRI/SNRI products, had dropped a jaw-dropping 31% in outlays to $26.5 million. Aside from the top two, some categories saw big gains, while others experienced heavy cuts.
Among the big gainers were Antidepressants (up from $0.3 million to $10 million), Proton Pump Inhibitors (up 68% to $7.4 million), Urinary Tract Antispasmodics (up 58% to $5 million) and Transplant/Immunosuppressives (up 134% to $4.5 million). Faring less well were Statins (down 24% to $10.8 million), Beta-Blocking Agents (down 33% to $9.2 million), Antipsychotics—Other (down70% to $6.6 million) and Dermatological—Other (down 43 to $4.7 million).

The most advertised brands
It's all about Forest Laboratories when it comes to the most advertised brands. Forest manufactured the three most advertised brands in medical/surgical journals in 2009, and four of the top eight. Topping the list with a huge additional outlay last year is Lexapro for anxiety and major depressive disorder (up 41% to $13.5 million).
In second place, but some distance behind, is Forest's newly launched Savella Tablets for the treatment of fibromyalgia (debuted at $10 million), followed closely by the company's beta-blocker Bystolic, which was launched in 2008 to treat hypertension. Forest's other product is its staple Alzheimer's treatment Namenda (flat at $4.9 million).

The most advertised non-Forest product was the antidepressant Pristiq from Wyeth (now Pfizer, down 20% to $7.4 million). Still doing the rounds is Pfizer's Lipitor (down 19% to $6.6 million) and Merck's Type 2 diabetes treatment Janumet/Januvia (up 38 % to $6.1 milllion).

Outside of the top six, ad expenditures tail off sharply, with a clutch of products all accounting for between $3.5 million and $5 million in outlays. These include: Eli Lilly's Humalog for Type 1 diabetes (up 39% to $4.9 million); Novo Nordisk's Levemir for Type 1 and Type 2 diabetes (down 11% to $4.8 million); Tap Pharmaceutical's newly launched Kapidex to treat heartburn ($4.4 million) Eli Lilly's Cymbalta for serious depression (down 73% to $3.8 million); Amylin/Lilly's Byetta for Type 2 diabetes (down 27% to $3.6 million); and Genentech's oncology drug Avastin (up 61% to $3.5 million).

As medical/surgical journal publishers continue their quests to both survive and to develop new and supplementary revenue channels (read: digital) it remains to be seen whether they can recover from the latest round of red ink. But there are some encouraging signs at the start of 2010, with sizable gains reported, particularly in the primary care space.
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