After showing virtually no growth in medical/surgical spending during the first six months of 2006, PERQ/HCI’s Journal Ad Review reported a slight boost during the second half of the year that resulted in a full year 2006 increase of 2% over 2005. On an ad page basis, the gain was 1%. While both dollars and pages were up, the figures show that journals have yet to stage a strong break-out from the marginal gains observed in recent years—since 2000, year-on-year ad spend has remained relatively flat (see chart on page 52).

A review of the top five medical/surgical journals (ranked by dollars) indicates that only American Medical News registered an increase in ad pages (up 11%) and with the exception of New England Journal of Medicine (down 2%), the other three publications had double digit declines when compared with the year-ago period. Overall, total ad pages for the top five journals declined by 7% when 2006 is compared to 2005 and their share of all medical/surgical ad pages fell from 13.2% to 12.3%.

The leading advertisers
Pfizer was clearly the number one advertiser in medical/surgical journals during 2006 as share of spending topped 11% following a 16% boost in ad outlays. Among the six Pfizer products that spent at a rate to place them in the top 25 was Chantix, a new smoking deterrent agent. Wyeth moved up one spot to 2nd place due largely to higher ad expenditures for Effexor XR which was the most heavily advertised product.

A 71% increase in spending advanced Merck from 9th to 3rd following the introduction of two new vaccines, Gardasil and Zostavax, and Januvia, a once-daily pill for type 2 diabetes. Forest dropped from 2nd to 4th following a reduction in ad outlays for Namenda, Campral and Combunox while Lilly slipped from 4th to 5th following an 18% cut in spending for Cymbalta.

There were six companies that were new to 2006’s top list including Takeda which climbed from 26th to 6th as ad outlays were increased for their insomnia preparation, Rozerem, and Novo Nordisk which increased spending for NovoLog 70/30 and also placed considerable ad support behind Levemir, a new long-lasting basal insulin (27th to 7th). AstraZeneca dropped from 5th to 8th following ad reductions on a number of key products, Novartis advanced from 12th to 9th as spending increased by 56% and Sanofi-Aventis fell from 6th to 10th due largely to lower expenditures for Ketek.

Bristol-Myers Squibb advanced from 14th to 11th following a 58% boost in spending due to relatively new introductions like Emsam (for depressive disorders), Orencia (for severe rheumatoid arthritis) and Baraclude (for hepatitis B virus).

Janssen Pharmaceutica edged up from 13th to 12th, GlaxoSmithKline dropped from 8th to 13th after reducing ad outlays by 31% and Sepracor fell from 11th to 14th as expenditures declined by 19%. Abbott Laboratories’ advance from 22nd to 15th was driven largely by Humira and Tricor.

Cephalon, new to the top 25 jumped from 31st to 18th following higher advertisement outlays for Provigil and OraVescent (non-branded). Others new to the top group were the Bristol-Myers Squibb/Otsuka partnership, up from 32nd to 20th as ad spending increased for Abilify, an antipsychotic agent, Sanofi Pasteur, which promotes the Adacel vaccine, up from 37th to 23rd and the Amylin/Eli Lilly partnership (24th) that markets Byetta for type 2 diabetes.

Companies no longer in the top 25 include the Merck/Schering-Plough joint venture that promotes Vytorin and Zetia, down from 7th to 85th, Roche Laboratories, down from 15th to 30th and the Roche/GlaxoSmithKline partnership that markets Boniva, down from 17th to 42nd. Also, gone from the top group are Takeda/Eli Lilly that promotes Actos, 23rd to 40th; Ortho Biotech which advertises Procrit, 21st to 49th; and Genentech BioOncology/OSI Pharmaceuticals.

The leading products
Effexor XR accounted for almost 5% of all ad spending in medical/surgical journals following an 88% boost in spending while Takeda’s relatively new insomnia product, Rozerem, jumped from 21st to 2nd following a 175% increase in ad outlays. Cymbalta retained 3rd place, Forest’s Namenda slipped from 2nd to 4th as spending was reduced by 29% while Pfizer’s Lyrica advanced from 10th to 5th following a 46% increase in ad outlays.

Higher spending for Caduet moved it from 8th to 6th while Lipitor slipped one spot to 7th on a 10% cut in ad spending. Lexapro edged up from 9th to 8th, Janssen’s Risperdal climbed from 16th to 9th as ad expenditures increased by 36% and Lunesta dropped from 5th to 10th.

Previously unadvertised in medical/surgical journals were Merck’s Gardasil vaccine (11th), Novo Nordisk’s Levemir (13th) and Pfizer’s Chantix (15th). Byetta, from Amylin/Eli Lilly was 17th, Merck’s Zostavax vaccine was 21st, Sanofi Pasteur’s Adacel vaccine was 23rd while Pfizer’s Detrol LA was 24th.

Previously advertised high-climbers include Abilify, up from 49th to 12th, NovoLog 70/30 (66th to 14th), Humira (90th to 19th), Acomplia (non-branded) (75th to 20th) and Benicar (30th to 22nd). Completing the top 25 are Prevacid (19th to 16th) even though ad outlays moved up only 2%, Celebrex (24th to 18th), following a 24% increase and Reyataz, down from 23rd to 25th as ad spending was reduced by 5%.

Products missing from the top 25 include two from Forest—Combunox and Campral–and two from Merck/Schering Plough—Vytorin and Zetia. Also missing is Topamax (from Ortho-McNeil) and Procrit (from Ortho Biotech). Others dropping out of the top group include Ambien, Boniva, Ketek, Actos, Tarceva and Spiriva HandiHaler.

The leading therapeutic categories
SSRI/SNRI’s remained the most heavily advertised drug class as spending increased by 21%. This gain can be attributed to higher ad spending for Effexor XR. Cytostatic Drugs-Other stayed in 2nd place while Antipsychotics-Other moved up from 4th to 3rd due to higher ad outlays for Abilify, Risperdal and Zyprexa. The first of seven therapeutic categories new to the 2006 top 25 was Diabetes-Insulin which jumped from 30th to 4th due largely to Levemir, Byetta and NovoLog while Non-Barbituates Sedatives slipped from 3rd to 5th.

New to the top group was Vaccines-Other which was driven higher (50th to 6th) by products like Gardasil and Zostavax. Ethical Drugs Misc.-Other moved up from 11th to 7th, Seizure Disorders stayed in 8th place, Alzheimer-Type Dementia dropped from 5th to 9th due largely to lower spending for Namenda while Cholesterol Reducers Rx-Statins dropped from 6th to 10th following cuts for Crestor and Lipitor.

Calcium Blockers (11th), Antivirals-Other (12th) and Cancer Therapy Products (13th) all moved higher when compared to a year ago while Proton Pump Inhibitors slipped from 10th to 14th due largely to lower ad outlays for Nexium and Crestor. Biological Response Modifiers, new to the top 25, advanced from 29th to 16th as spending was increased for Humira while Morphine & Opium Non-Injectable, also new to the top group climbed from 35th to 18th. Other therapeutic categories that moved into the top 25 were Biologicals-Vaccines (53rd to 21st) due mostly to Sanofi Pasteur’s Adacel, UT Antispasmodics (51st to 24th) and a new Smoking Deterrent Rx category (25th).

Drug classes no longer in the top group include Cholesterol Reducer’s Rx-Others; Codeine & Combinations, Non-Injectable; Bisphosphonates and Anti-Migraine. Also missing were Specific Antagonists, Interferon and Erythropoietin.

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