Anyone hoping for a reversal of fortunes in the brutal journal publishing sector will remain disappointed. During the first half of 2008, PERQ/HCI’s Journal Advertising Review reported a 13% decline in advertising spending for medical/surgical journals when compared to the same period in 2007. In fact, this year was the lowest first-half spend level observed since 2003.
It gets worse. On an ad page basis, the decline was even greater with first-half results dropping 16%. The top five journals (with rank based on dollars) did slightly better as evidenced by a decline in advertising pages of only 13%. 
Changes among the top five journals include the New England Journal of Medicine moving into first place from the number two spot a year ago and the Journal of Clinical Oncology replacing Medical Economics in the top five. American Family Physician held steady in the third spot.
The Top Advertisers
Pfizer Laboratories continues as the number one advertiser in medical/surgical journals even though ad outlays were reduced by 52%. This decline can be traced to spending cuts across a number of familiar products such as Lipitor, Caduet, Chantix, Geodon and Viagra. Forest Pharmaceuticals moved up from 7th to 2nd due to the introduction of their new beta-blocker, Bystolic, while Eli Lilly advanced from 4th to 3rd as ad expenditures were increased for Cymbalta, Zyprexa, Evista and Strattera. A 16% boost in spending, due largely to higher ad outlays for Symbicort and Crestor, moved AstraZeneca from the 9th spot to 4th and Novartis climbed from the 10th position to 5th due in large part to spending on Exforge, a new combination product used to lower high blood pressure.
A 39% increase in ad expenditures, due largely to Triclor, advanced Abbott from 12th to 6th while a 36% reduction in ad outlays dropped Merck from 3rd to 7th. The Merck decline comes primarily from spending cuts on Zostavax and Gardasil. 
Janssen Pharmaceutica jumped from 16th to 8th as ad outlays were increased for their antipsychotic, Invega. A 61% cut in spending, due primarily to Effexor XR, dropped Wyeth from 2nd to 9th and Novo Nordisk slipped from 6th to 10th following a 47% cut in spending due to lower expenditures for Levemir Injection and NovoLog 70/30.
Shire US moved up from 14th to 11th as ad outlays were increased for Vyvanse, Ortho-McNeil climbed from 35th to 12th due largely to Topamax and Doribax injection which is indicated for the treatment of complicated intra-abdominal infections and urinary tract infections, while Takeda slipped from 5th to 13th as ad spending was reduced on Rozerem. Boehringer Ingelhiem dropped from 20th to 14th even though ad expenditures were cut by only 3%.
Companies new to the top 25 include a number of joint ventures such as Genentech/Biogen Idec, which markets Rituxan (up from 48th to 17th); Takeda and Lilly, which promote Actos (up from 103rd to 18th); and Sucampo/Takeda, which markets Amitiza (up from 29th to 19th). Daiichi Sankyo was 20th, while Amylin/Lilly moved up from 31st to 22nd due largely to Byetta. Bayer HealthCare advanced from 27th to 24th and Jazz Pharmaceuticals climbed from 151st to 25th, due largely to ad outlays for new antidepressant, Luvox CR. 
The Top Products
Forest’s newly marketed beta-blocker, Bystolic, was the most heavily advertised product while Lilly’s Cymbalta advanced from 3rd to 2nd following a 43% boost in spending. Pfizer’s Lipitor, which previously held the number two spot, is now 3rd as ad outlays declined by 23%, and Forest’s Lexapro climbed from 6th to 4th even though ad expenditures were cut by 22%. A 24% increase in spending moved Pfizer’s Lyrica from 12th to 5th, while Takeda’s sleep aid, Rozerem, fell from 4th to 6th following a 45% budget cut.
Janssen’s relatively new antipsychotic, Invega, climbed from 18th to 7th as ad spending increased by 32%, Vyvanse, an ADHD medication from Shire, jumped from 156th to 8th, Levemir Injection, from Novo Nordisk has slipped from 7th to 9th and Selzentry, a new Pfizer product indicated for combination antiretroviral treatment, was in the 10th spot. 
Heavy spending increases moved Rituxan from 47th to 11th and Actos from 161st to 12th. Azor, a new combination antihypertensive from Daiichi Sankyo, was 13th. Byetta, the type 2 diabetes product from Amylin/Lilly, moved up from 30th to 14th following a 24% boost in spending while Seroquel, from AstraZeneca, advanced from 22nd to 15th.
Other products new to the top 25 include AstraZeneca’s Symbicort, which jumped from 398th to 16th, OrthoMcNeil’s Topamax, up from 52nd to 18th, and AstraZeneca’s Crestor which climbed from 66th to 19th. Also moving up were Abbott’s Tricor (61st to 21st), Lilly’s Zyprexa (46th to 23rd) and Pfizer/Eisai’s Aricept (42nd to 25th). A new cancer drug from Pfizer, Sutent was 24th.
Products no longer in the top 25 include Effexor XR, Benicar, Herceptin, Lunesta, Novolog 70/30 and Mirapex. Also missing from the top group are Merck’s Zostavax, Gardasil and Januvia and Pfizer’s Exubera, Chantix, Caduet and Geodon.
The Top Therapeutic Categories
While ad spending for SSRI/SNRI declined by 17% during first-half 2008, this drug class still continued as the most heavily advertised with a 6.2% share. Cytostatic Drugs-Other held onto 2nd place with a 5.8% share, while Antipsychotics-Other moved up from 4th to 3rd even though ad spending was reduced by 19%. 
Ethical Drugs Miscellaneous-Other climbed from 8th to 4th due in large part to higher ad outlays for Celgene’s Revlimid and Shire’s ADHD product, Vyvanse. Beta-Blocking Agents jumped from 68th to 5th following the introduction of Forest’s new product, Bystolic.
Cholesterol Reducers Rx-Statins were unchanged in 6th place, even though ad spending for this drug class increased by 11% due to higher ad support for Crestor. Cancer Therapy Products retained 7th place, Diabetes-Insulin fell from 3rd to 8th as Novo Nordisk reduced spending for Levemir and Novolog 70/30, while the Alzheimer-Type Dementia drug class moved up from 10th to 9th, even as ad expenditures were down 2%.
Drug classes new to the top 25, in addition to the previously mentioned Beta-Blocking Agent class, include Angiotensin II Antagonists-Combo, up from 71st to 14th, HIV-Protease Inhibitors, up from 29th to 15th and Institutional Advertising-General Non-Drug (45th to 17th). Also moving up were Fecal Softeners w/o Stimulants (40th to 23rd) and Beta Agonists, Aerosol (52nd to 25th). 
Drug classes no longer in the top 25 include Antivirals-Other, down from 16th to 32nd, Biological Response Modifiers, down from the 17th spot to land in 33rd and Angiotensin II Antagonists-Alone (18th to 35th). Also missing are Proton Pump Inhibitors, down 12 spots from the 14th to 36th and UT Antispasmodics, down from 13th to 37th. 
Eugene M. May is director of marketing research at ACNielsen HCI