The pharmaceutical industry’s character—its products,messages, promo channels and even its audiences—have been determined bygovernmental regulation and trade conventions practiced by media andmanufacturers. The advent of DTC represents a drastic change for the industry.
In the early 1900s, pushed by the AMA’s campaign againstfraudulent patent medicines which held an appalling position in healthcare, thepassage of the Food and Drug Act of 1906, and the muckraking journalism thatexposed the dangers of unregulated medicines, the industry accepted an MD-onlypromo approach. If a product advertised to the public it could not advertise inAMA journals. The AMA also acted as an unofficial drug approval agency beforethe FDA was created through its Council on Pharmacy and Chemistry and itspublication, New and Non-Official Remedies.
Throughout much of the last century, this approach, at onetime called “ethical drug” advertising, concentrated on selling to MDs only, asopposed to public advertising by “proprietary” drug companies. Early on,companies made a choice between these two approaches. A number split intoMD-only Rx divisions and non-Rx divisions that advertised to the public onnon-Rx products for colds, indigestion, headache, etc. Others went entirelyproprietary.
This MD-only arrangement ended with the arrival of DTC inthe early 1990s. FDA regulation did not prohibit consumer advertising of Rxproducts. It only required burdensome disclosure regulations and fair balancerequirements. Certain manufactures saw a marketing opportunity even with theseburdens and took the first step in breaking the MD-only convention with “diseaseawareness” ads to create a favorable environment for product launches andbranded print ads, with the added expense of extra pages of summary text. Sincethen, there has been an expansion of DTC into TV and the broader use indifferent channels.
With DTC, it is clear to all that the industry has undergonea fundamental change in its marketing strategy. The consumer audience has beenadded to the professional prescriber—a 180 degree shift. If we are to judge from the past, thischange could lead to a divide among Rx companies into DTC and non-DTCcompanies. We saw this when the ethical drug category was created and,interestingly, we saw it with the marketing by professional-oriented companiesfor extended periods in the past of non-prescription products to MDs andpharmacists only for brands like Coricidan, Maalox, Robitussin and Tylenol.This approach made these brands market leaders and very profitable without theexpense of consumer advertising.
What will also prompt this decision at some companies is thesizable expense that DTC represents. Small- to mid-sized companies can’t keepup with the millions that Big Pharma pours into DTC. They will look for analternative. Additionally, they can play on MD negatives toward DTC and alsothe erosion that DTC has caused in the Rx industry’s status with the public.They will find it practical and profitable to stand aside from DTC and presenttheir brands to the MD on the selling point that they are “MD-only.”
William Castagnoli was co-founder of Medicus and a formerexecutive director of the Medical Advertising Hall of Fame
From the May 01, 2008 Issue of MM+M - Medical Marketing and Media
