Make no mistake about it. The current course of medical journal advertising is continuing on a downward spiral. The chronic economic downturn has taken its toll on the medical publishing industry. However, in the medical/surgical sector, there are some signs that there is light at the end of the tunnel.

But first, the stark facts. According to PERQ/HCI’s 2009 Journal Advertising Review [Jan.-June 2009] med/surg ad dollars declined 32% to $155 million, down from $228 million in 2008 and $258 million in 2007. Medical/surgical advertising pages declined 34%.

In the total healthcare publication universe, ad spending dropped 28% to $291 million dollars down from $403 million in 2008, while total healthcare pub ad pages declined 31%.

Among the changes in the top five medical journals; the Journal of Clinical Oncology replaced American Medical News in the fourth-place slot. The New England Journal of Medicine held on to the top spot followed by the Journal of the American Medical Association and American Family Physician. Family Practice News rounded out the top five.

The Leading Advertisers
Forest Pharmaceuticals knocked Pfizer out of the top spot as the leading advertiser in medical/surgical journals. Despite the good news, Forest’s journal advertising spending dropped 32% while Pfizer’s ad spend declined 61%. Wyeth moved from the number nine spot in 2008 to the number three position with a 15% increase in journal ad spending. Abbott, ranked number four, realized a 2% increase in its ad spending. Fifth-place Lilly journal advertising spending dropped 63%. Genetech/BioOncology, made a substantial jump from number 17 in 2008 to number 10 with a 15% increase in ad expenditures. Merck, which saw ad expenditures decline by 58%, dropped from 7th place in 2008 to number 13.  

The Top Products
Forest also garnered the top two most advertised products with its antidepressant  offering Lexapro and Bystolic, an antihypertensive. Wyeth’s antidepressant Pristiq, which wasn’t in the top 25 last year, took the number three position while Pfizer’s cholesterol-lowering agent Lipitor (scheduled to come off patent in 2010) dropped from the number three slot to number four. Forest’s Alzheimer’s drug Namenda, Amylin/Lilly’s, type 2 diabetes drug Byetta and Genentech/Biogen Idec’s Rituxan, used to treat non-Hodgkin’s lymphoma and rheumatoid arthritis, moved into the top 10. The Top Therapeutic Categories
Cytostatic Drugs-Other, took the number one slot supplanting SSRI/SNRI, which now holds the number two spot, as the leading drug class. Rounding out the top 5 most advertised therapeutic categories: ethical drugs misc- other; diabetes insulin and cancer therapy products. The diabetes insulin class moved up from number eight to the number four position while antipsychotics dropped from the third place slot in 2008, to number 13 while beta blockers fell from number five to number nine.     
Bright Spot
Industry insiders say that despite a rough year, there are some signs that things might be turning around. “I think maybe we hit the bottom of the trough. But in the last couple of months, July, August, September, anecdotally, things seem to be picking up, especially in primary care,” says Dave Emery, VP, sales/client services, healthcare media, at PERQ/HCI.

Putting the 2009 data into perspective, Emery notes that there may be an incorrect perception in the market—among advertisers and others—that journals have become less relevant, less widely used and that readership is declining. “The data doesn’t support this position. Over the past five years, a period in which pharma’s investment in journal advertising has declined, there’s been no discernable change in reading frequency and thoroughness for the top primary care publications. The story is similar across various specialties,” says Emery. He notes that there is a compelling argument that journals are underutilized by many marketers.

Further assessing the state of the industry, Emery points out that consolidation and cost trimming has increased among pharma companies. In addition, the total amount of money being spent on advertising promotion has decreased and the percentage of that that’s going into print journals has gone down. “Some of that has shifted over to online but I think that’s still very much a nebulous area,” said Emery, who added, “you’ve got people putting money into their own websites and you’ve got people buying ads on Google and people sponsoring things on Medscape that don’t necessarily show-up as advertising per say.” Emery asserted that money is still being spent to reach the physician, but it’s not necessarily going into the traditional print publishers pockets. Emery added that oncology continues to be a really strong market.

Responding to the current PERQ/HCI scores, Jennifer Day, president, Association of Medical Media (AMM), says that she does not regard the drop in ad dollars and pages to be a phenomenon unique to the healthcare space. She notes that the current decline is impacting the entire B-to-B space, down 26.5% in dollars and 30.2% in pages.

“I think what we’re seeing is a strong proliferation of new channels—online, audio/video, mobile and social networking. And, all of these segments are adding to the array of options—in addition to print.  Having said that, it is the print channel that delivers the largest audience for the least amount of dollars,” says Day.  

Alan Imhoff, president and publisher of International Medical News Group, says that the 32% decline year over year is nothing to laugh at. “But I think we need to keep it in context. In the past, healthcare, particularly professional promotion of pharmaceuticals, was not really impacted by the ups and downs of the larger economy—it certainly is now.” Imhoff notes that those same big declines in promotional dollars are being seen in all kinds of industries, including consumer goods, and not just in print. But TV and even web-based promotion have been deeply impacted by what Imhoff referred to as a near depression. “So, that’s a big part of it,” says Imhoff. “You add in a long dry spell for new products and the growing focus on online promotion and you get a year like 2009.”

And how much growth will the industry see in emerging media, social networking and e-detailing going into 2010? “We are already seeing a major uptick in the second half of this year—and I see this growing exponentially across all channels within the marketing/advertising space, educational programs and events,” says Day.

“When it comes to which channel we deliver it in, my answer is simple, who cares, print, online, live events, mobile channels, you name it. We need to deliver it however our readers and customers want it,” says Trevor Deal, publisher, Mayo Clinic Proceedings and The Journal of Family Practice.

Despite the dismal numbers, Lee Maniscalco, CEO of Haymarket Medical, is optimistic that ad spending will increase. “Physicians still rely on magazines as their primary source for clinical information and while PDA usage among physicians has increased for CME, drug look-up and script writing, the only viable advertising model seems to be for messaging, not general product advertising,” he notes. “Conversely, web-based advertising simply works better given its size, clarity and ease of use; however, the hectic nature of a physician’s practice is not conducive to regular daily usage, particularly for clinical practice.” Maniscalco says that print will come back as part of an integrated approach to reaching clinicians and that it has a unique place in the media mix, because it allows pharma to deliver significant amounts of clinical information in the ad itself, without making clinicians “click” or take some other action, to get more information.