In a Bind

Pharma’s turn to specialty drugs hasn’t been good for print. Ad pages in medical/surgical journals fell steeply in 2012, despite the pickup in FDA approvals. Larry Dobrow reports the full-year numbers by advertisers and brands

On the surface, the numbers look grim.  Let’s get that out of the way up front. Ad pages in medical/surgical journals fell precipitously in 2012, with companies buying 16,100 fewer pages than they did in 2011 (a 21.2% decline). Ad dollars, similarly, were down to $328 million, a $77.7 million drop (19.2%) from 2011.

More opposite-of-good news comes in the form of numbers from individual publishers: the top five multispecialty journals (as ranked by ad revenue) each shed more than 20% of its 2011 ad-page total. Single-specialty publications didn’t pick up the slack: some 30 of the 37 markets tracked by Kantar Media posted losses.



And it’s tough to point fingers at the usual bogeyman. The FDA approved 39 products (37 drugs) in 2012, its highest total in 16 years and, according to Kantar VP/general manager, healthcare research Dave Emery, far higher than the 23.5 annual average of the previous decade. Granted, some of the big approvals didn’t arrive until late in the year—the Bristol-Myers Squibb/Pfizer anti-coagulant Eliquis received its nod the day after Christmas—but all in all, nobody can accuse the FDA of having dragged its feet.

So why aren’t Emery and other smart-minded analysts and observers sounding the doomsday alarms? Probably because they view the declines more as signs of a changed landscape than as another harbinger of the ground crumbling beneath print’s feet. They also see a host of explanatory—if not exactly exculpatory—factors.

Calling 2012 “a bad year,” Compas Inc. VP/media Steve Selinger notes how hundreds of ad pages flew off the patent cliff and that most of the launches that spewed forth from the pipeline were niche products. “Since they require a great deal of explanation, that’s going to hurt the print side, because it’s expensive to do that.”

Stephanie Hanaway, VP of the Association of Medical Media for 2013, also points to the patent cliff but, like Selinger, she notes the continued proliferation of ad and marketing channels.

“Since no corporation increases its promotional budget every time a new channel emerges, then the budgets get spread around more broadly,” says Hanaway, who is also director of publications and publisher for the American Academy of Family Physicians (AAFP).


The top five medical/surgical journals from 2011 (via ad dollars) held onto the top five slots in 2012, albeit reshuffled. The New England Journal of Medicine reclaimed the top spot from the Journal of the American Medical Association, which slipped to fourth. American Family Physician rose from fourth to second, while Monthly Prescribing Reference and Medical Economics remained at three and five, respectively. All saw backslides in revenue and ad pages versus 2011, however, the losses were as follows: 35.2% revenue/37.3% pages for NEJM, 18.6%/22% for AFP, 30.9%/35.7% for MPR, 45.1%/48.7% for JAMA, and 16.3%/20.4% for ME. Not a single one of the top 11 journals (via ad dollars) saw a revenue increase in 2012.

Specialty titles fared only slightly better. A handful of journals saw page and revenue jumps, led by The ASCO Post. The pub was up 102.2% in ad pages, from 2,460 to 4,974, and 91% in revenue, eye-poppingly impressive in this ad climate. Impressive gains were also made by HemOnc Today, with 40+% growth in both pages and revenue. That said, they were the exceptions rather than the rule, as a wide range of specialty publications—Neurology, which shed 551 pages; Internal Medicine News, which shed 346; Arthritis & Rheumatism, which shed 207—struggled to match their 2011 numbers.

Selinger, of Compas, looks at this data, ugly as it may be, with eyebrow arched. “Radio killed all print, of course. All print died when TV came out,” he cracks, before adding, more seriously, “It used to be that print was the only way you could really effectively communicate content. And still, when you get to serious stuff—scientific material, clinical material—you really want that in print.”

Kantar’s Emery, too, sees a silver lining of sorts. “Perhaps more significantly but not apparent in the ad numbers, [medical publishers] with a variety of revenue streams—traditional online and print advertising, emerging mobile options, projects and custom work (especially increasingly in the digital space), reprints, subscriptions and in some cases events—are doing fine overall, propped up by solid growth outside of print.” He adds a caveat: “Or so we’re told.”


Emery hesitates to pick winning or losing companies. He notes how Forest kept its top overall position and increased its digital presence, but still spent 45% less than it did in 2011. Pfizer ranked second but cut spending 6.3%, and third-ranked Johnson & Johnson was more or less flat. Overall, the 585 pharma firms in Kantar’s coverage universe spent $327.6 million in 2012, down from $427.3 million in 2011.



The product list was impacted by patent problems. Lilly’s anti-depressant Cymbalta, 2011’s second most-advertised product (by overall dollars), vanished, along with $15 million in spending. Last year’s most-advertised product, Forest’s anti-depressant Vibryd, saw its outlay drop 37%, though it still crossed the $10-million threshold. Emery notes that enhanced ad spending for five products in the top 10—Pfizer’s pain pill Lyrica, Purdue’s sleep drug Intermezzo, Janssen’s cancer med Zytiga, Novo Nordisk’s diabetes injection Victoza and Abbott’s RA biologic Humira—added $11 million to the market.


There was no automatic correlation between print and online presence. Kantar’s Evaliant online advertising tool reveals that Janssen’s Xarelto reigned online (in terms of website occurrences) and offline, but several top online brands didn’t crack the top 100 for print.

CLICK TO SEE THE TOP 10 ONLINE BRANDS (by ad occurrences and sites used)

Asked what this means for the business, the general consensus is:  not much. “Smart marketers have always pursued every effective channel,” shrugs AAFP’s Hanaway. Emery agrees: “Physician consumption of journal media is evolving, as are the journals.”

The future

That is how most everyone in the business is thinking about the so-called print apocalypse. For communicating content, there used to be print and print alone; now there are any number of ways to do so.

So while Selinger doesn’t expect great things in the next two years, he views content as relatively venue-agnostic. “It’s all about the content. So long as publishers have that content, that’s what matters.”

“The reader’s relationship with the journal brand, the relevance and usefulness of well-written and -edited content and the environment these factors create for effective promotional messaging,” Emery adds, “exists independent of the platform on which it is delivered.”