Pharmaceutical marketers spent $4.47 billion last year on direct-to-consumer (DTC) advertising, most of it on television, according to Nielsen-Monitor-Plus and IMS Health. They considered this staggering sum an investment in their products as they reached out as broadly as possible in the hopes of capturing new customers with specific health conditions. 
But TV’s eroding audiences, skyrocketing CPMs and lackluster returns have begun forcing brand teams to take another look at these investments. Adding to their concerns are pharmaceutical guidelines, diminishing ROIs and eroding consumer confidence—all of which have marketers allocating greater resources to more targeted media such as cable TV and the Internet. 
Direct-to-patient (DTP) advertising offers a solution to these challenges. DTP is any Rx marketing, advertising, online or promotional campaign or program that targets current or potential patients with specific treatment needs and is delivered through controlled distribution channels and environments. DTP attempts to reach and persuade a targeted audience of diagnosed sufferers, many of whom actively seek information about their conditions and treatment options. In fact, as companies recognize the power of DTP to move people and products, they are putting more dollars into these patient-centered programs.
Interestingly, while marketers have traditionally used television as a DTC approach to reach their customers, demographics would argue against this medium. Viewers of network TV are generally older, less affluent and less educated than those who don’t watch TV. More passive about healthcare remedies, they also tend to rely on the doctor’s word, making them relatively unreceptive to marketing messages.
Those who use other, more recently developed media, especially online, tend to be younger, proactive information-seekers. These are people who research and discuss medical conditions with their doctors, ask for the newest and best therapies and take more decisive roles in their own—and their loved ones’—health treatments. They are also most apt to access marketing messages and brand information. 
But not all products are candidates for DTP programs. In order for DTP to be successful, marketers must evaluate the product, the market and the audience to determine if DTP makes sense—and can make a difference. Let’s look at the factors that need to be in place when considering whether or not to launch a DTP campaign. 
DTC vs. DTP: Consider the numbers
While the role of DTC and/or DTP advertising varies from category to category and product to product, the number of diagnosed patients for a particular disease state is an overriding factor in the decision of which direction to pursue. In the case of conditions that affect millions, such as diabetes and hypertension, DTC can help not only educate those who are diagnosed but also create awareness among those who do not know they have the disease. On the other hand, with a disease that afflicts far fewer patients—such as non-Hodgkins lymphoma (with an estimated 56,000 diagnosed in 2005)—a DTC campaign would be far too costly and inefficient an investment. Instead, using a mix of DTP vehicles, such as e-marketing, online forums, relationship programs and physician office materials, would be a far more sensible use of promotional dollars, generating far better ROI.
Differentiation is key
When all the products in a category are virtually identical—for example, “me-too” products—and when neither the patient nor the doctor has a strong preference for any particular drug, differentiation is the key. Here brand success depends on the ability to:
  • Create a clearly defined, differentiated position in the marketplace. 
  • Understand trigger points (copy, visuals, media) that patients respond to.
  • Deliver powerful and highly differentiated creative that reaches patients on an intellectual and emotional level.
  • Respond quickly to patient requests. Delivering patient-requested information builds brand equity and provides an advantage when compared with competitors who are slow to respond. 
  • Develop ongoing relationship-based programs that build compliance, persistency and brand loyalty. This is especially important within chronic disease conditions.
DTP depends on the patient
DTP also works best with a target audience of “empowered” patients; that is, active, diagnosed treatment-seekers. While some cancer patients, for example, are passive and rely on their doctors to recommend particular treatments, many of those diagnosed are transformed—in attitude, intent and behavior—into proactive, health-conscious patients. These are prime DTP targets, open to finding out about their healthcare options and assertive in taking a leading role in their own, or their loved ones’, treatments options. 
The environment must support DTP 
Finally, whether through targeted magazine supplements, cable TV programs focused on specific disease conditions or signage in patient-trafficked areas, the environment in which the message is read must reach a specific patient population with a specific disease condition—not a huge population, among whom only a few have the condition. 
Alas, even if all these factors are in place and a DTP program is on the agenda, marketers have no guarantee of success. Tactically, a DTP program needs six basic ingredients to be effective. 
  1. Creativity–Creativity matters. Without powerful headlines and graphics, even the most persuasive messages won’t be seen or read. Try a variety of approaches and then test, test and test some more until you know your message will get through loud and clear. In view of the amount of information and media options now available, the creative must also be delivered in a variety of platforms, many of which are dynamic and more compelling, engaging and attention-getting than some of the more traditional channels that were utilized exclusively several years ago.
  2. Multiple channels–Use a variety of media to reach patients where they live and work. Reach out to patients with every medium at your disposal and be strategic about your selections. Highly targeted print vehicles are among your most effective tools. Cable TV is more cost effective and more targeted than network TV. And don’t forget the basics: Patient education brochures are still a key foundation element. Your media choices should allow you to “surround” the patient, to be everywhere the patient looks for information—in the physician’s office, in treatment centers, online, in targeted print vehicles such as special cancer supplements, through signage at local events and the like. 
  3. Integration–Integration is essential. Every piece of your promotion must have a single, powerful message that reminds people of your product’s benefits and advantages. The campaign concept must be carried through in every medium you use, from print to broadcast to outdoor. Once you’ve created the message and content, use it in everything you create. Furthermore, wherever possible, integrate some element of the DTP campaign with the professional in order to increase the potential for doctor-patient dialogue. 
  4. Interactivity–Be Internet savvy. Online marketing programs are providing more effective ways of capturing response, generating relationships and measuring ROI. Prior to developing a Web site targeting patients, specific online objectives should be established. Ultimately, a Web site plan, complete with objectives, strategies, tactics, creative elements, scheduling, budget, resources and online advertising, should be a primary component of the overall marketing plan. Consider key elements of the site’s presentation and function, keeping in mind that active Internet users have high expectations regarding a Web site’s deliverables. This will force brand teams to master the patient’s online experience. The Web site should be a primary marketing tool warranting daily management and tracking in order to drive results and monitor necessary upgrades. The results will not only capture patient information but also strengthen brand loyalty, develop closer relationships and provide marketers with immediate feedback and ROI. 
  5. Relevance–While marketers have traditionally used brochures and other reading material to keep patients involved, many are now moving to more patient-driven programs that meet the needs of individual patients. With wide differences in geographic, psychographic, demographic and socioeconomic orientation, a one-size-fits-all approach simply does not work in today’s busy and heterogeneous world. Pharmaceutical marketers need to gather as much customer insight as possible in order to deliver messages that resonate and fulfill patients’ needs. Many marketing textbooks and publications point out that successful marketing requires that companies understand target audience profiles and needs, and provide information or solutions that meet those needs. This, ultimately, generates stronger relationships and greater brand equity. Developing well-conceived patient relationship–oriented programs requires soliciting input and feedback from patients to identify their needs and creating customized programs with the specific information they need and have asked for. In addition to building loyalty, such programs also increase compliance. And the more relevant or specific a marketing message can be, the stronger the connection to that patient will be. This addresses the issue of vanishing mass media and explains the movement to more one-to-one marketing. 
  6. Measurability–Demand ROI. With crushing pressures on profitability, cost reduction and cost efficiencies, demonstrating return on investment is a must—it is another reason that DTP is growing in importance. DTP reaches the right people with the right message at the right time in the right environment and avoids the waste. When evaluating the success of your program, accept nothing less than demonstrated returns on your investment. 
Richard Blocki is director of the DTP/DTC division at Chicago-based agency AbelsonTaylor