Global Medical Advertising: Translation vs. Transcreation
Imagine you have an effective and punchy advertising campaign in English which you want to bring to France. You get your tagline translated but you find out one of the words is also slang (with an altogether different and rude meaning) and a word that is part of the claim does not have an equivalent term in French. What do you do? Transcreation comes from “translation” and “creation” and adapts the message into another language while maintaining its intent, style, tone and context.
As with any type of creative copy, transcreating medical marketing material requires someone with flair, who understands the local culture and who can write engagingly while reflecting the nuances of the target market. And, of course, they need to understand the medical terminology. But that's not all—transcreating medical copy is complex because there are very specific local regulations in place for medical advertising.
Before gaining marketing approval, medicines go through rigorous clinical trials to ensure that the final product is both safe and effective. Advertising is therefore based on documents such as Prescribing Information (US) or the Summary of Product Characteristics (Europe), which details what the product is licensed for, how it is administered, and any warnings or side effects1, 2.
Gained in translation
Most countries require medical ads to include a statement that encourages the consumer to seek more information or advice from the package insert or healthcare professional. Here are some back-translations of messages that are used in some countries12:
Portugal: “Read the information on the label or in the leaﬂet and consult a doctor or a pharmacist in case of doubt.”
Poland: “Read the instructions on the package leaﬂet or on the outer packaging carefully.”
Argentina and Australia: “Read the instructions for use carefully and consult a doctor in case of doubt.”
Brazil: “Seek medical advice if symptoms do not disappear.”
Canada: “This product may not be right for you. Always read and follow the label.” .
Documents like these set boundaries for what can be claimed in any promotional material, and transcreation of medical advertising must therefore be done with extreme precision to avoid distorting very specific product claims. Even the subtlest difference in translation can change the product claim completely. For example, the English word “comfortable” can be interpreted in Finnish as “pain-free” or “pleasant,” and you need to be aware of the supporting data to choose the correct translation.
What local regulations have to be considered for medical advertising? The ad needs to be in accordance with general advertising law, as well as specific laws for medical advertising. Self-regulation by the pharmaceutical industry plays an important role in the form of codes of practice. The World Health Organization's “Ethical criteria for medicinal drug promotion” outlines the principles used by most countries in their legislation3.
In Europe, there is a common framework: the European Medicines Agency (EMA) grants marketing approval to all the relevant countries, and while advertising is controlled by each member state, there are common guidelines and regulations, such as EU directives4, 5 and the EFPIA Code of Practice6 and the National Codes of Conduct7.
Despite the regulations being derived from similar principles in most countries across the globe, they can be interpreted differently. Take the marketing of prescription drugs, for example: in the US and New Zealand, it's permitted to promote them to consumers, whereas in most other countries, including those in the EU, they are only allowed to be marketed to healthcare professionals.
However, some of those countries that don't permit prescription drugs to be promoted to the general public do allow help-seeking and disease-awareness advertising that's aimed at consumers. South Korea allows awareness campaigns for communicable epidemic diseases such as diarrhoea, while Japan permits campaigns that encourage people with a particular medical condition to consult their doctor8.
Too misleading for Polish TV
A TV commercial for Gripex HotActive by US Pharmacia was banned from TV in Poland. The slogan was “Gripex HotActive is a combination of ingredients ready to be absorbed, immediately after drinking it fights all these symptoms.” The Main Pharmaceutical Inspectorate questioned the ad because it showed a journalist surrounded with names of symptoms that disappeared immediately after drinking the product. The journalist got back to work within seconds, and this was found to be misleading. See the banned ad here.
In Hong Kong, a medicine's therapeutic indication dictates how it can be advertised: medicines aimed at major diseases are not allowed to be advertised to the general public, whereas medicines for the treatment of more minor conditions such as headaches and common colds are8. In the UK, it is acceptable to promote government-controlled vaccines directly to consumers1. These campaigns cannot mention product names, but they are allowed to include the drug company's name and contact details for additional information purposes. In Portugal, Lilly Portugal has set up campaigns, such as “Depression hurts. But it can stop hurting.” (http://saiadoescuro.pt).
Ads can be deemed non-compliant for many reasons: for example if they play down the drug's potential risks, fail to mention the main contraindications, exaggerate the effectiveness of the drug or include misleading or unsubstantiated claims. While these issues seem universal10, 11, the rules regarding comparisons vary greatly among different markets. For instance, China prohibits any statements that include safety and efficacy comparison with other drugs9, while in Japan, pharmaceutical ads are not allowed to make price claims or superiority claims, or mention the specific benefits, the quality of the manufacturing process or the effectiveness of the drug8. This has led to celebrities being used in Japan to promote medicines instead, as a way of endorsing the product.
In the UK, however, it is strictly forbidden for celebrities to promote any type of medicine1. Many countries have regulations restricting the use of hanging comparisons, where there is no mention of what the product is being compared to, which means that translating expressions such as “only,” “ultimate,” “perfect” and “optimal” needs to be approached with caution.
Many countries have specific information and phrases that must be included in a medical ad. In some instances, there are specific details on legibility which affect the speed at which the information is given (in TV/radio commercials), or the size of the text in printed advertising.
In summary, the compliance of any medical marketing material that is brought onto a new market should be considered on many different levels. Is the type of material appropriate? What is it allowed to state? What information needs to be included? Are all the claims 100% accurate? This is all before you even consider the style.
This is no easy feat, but medical-writing expertise in all applicable markets, together with exceptional copywriters, will help ensure your advertising hits the target.
Joanna Laurson-Doube, PhD, is group account director at Mother Tongue Life, the medical arm of transcreation agency Mother Tongue Writers.
1. “The Blue Guide, Advertising and Promotion of Medicines in the UK”, Third Edition, August 2012, Medicines and Healthcare products Regulatory Agency
3. "Ethical criteria for medicinal drug promotion”, 1988, ID: 924154239X, World Health Organization
8. “Pharmaceutical Advertising in Korea, Japan, Hong Kong, Australia, and the US: Current Conditions and Future Direction”, 2011, Paek et al.
9. “Regulation of Drug Promotion in China” 2013, Ma and Lou
10. “Content analysis of false and misleading claims in television advertising for prescription and nonprescription drugs.” 2014, J Gen Intern Med, Faerber and Kreling
11. “Analysis of medicine advertisement produced in Brazil” 2007 Pharmacy Practice, Pharmacy Practice (Internet) vol.5 no.3 Redondela July-Sept. 2007, Wzorek et al.
12. “Advertising of non-prescription medicines to the public - A signiﬁcant contributor to healthcare” 2008, World self-medication industry