PERQ/HCI’s Journal Ad Review of medical/surgical journals for the full year 2005 doesn’t make for good reading—advertising spending was only marginally above the prior year-ago period (up 1%). An even more disturbing story concerning the lack of growth is evidenced by the fact that since 2000, ad spending in medical/surgical journals has only increased by 4%. This lukewarm performance has undoubtedly been influenced in part by the rapid ongoing expansion of pharmaceutical sales forces during much of the five-year period noted and by direct-to-consumer ad expenditures that are now running at approximately eight times those of medical/surgical journals.
When compared on an ad page basis, 2005 was 1% lower than 2004. Among the top five medical/surgical journals (ranked by ad dollars), all but one reported a decline in ad pages during 2005, the exception being Family Practice News, which posted an impressive 14% gain in pages. 
Overall, ad pages for the top five journals dropped from 15,168 in 2004 to 14,637 in 2005 for a decline of 4%. A review of the companies, products and therapeutic classes that make up the top 25 lists follows.
The top advertisers
After slipping to 2nd place behind Forest at mid-year, Pfizer regained the top spot for full-year 2005—even though ad outlays declined by 30%when compared with 2004. Lipitor, Caduet, Celebrex and Viagra were among the major products advertised by Pfizer. Forest, which ended the year unchanged in the number two spot, increased spending by 6% over 2004, while a 47% boost in spending, due largely to Effexor XR, advanced Wyeth from 7th to 3rd. Lilly retained 4th place, Sanofi-Aventis edged up one spot to 5th and AstraZeneca dropped from 3rd to 6th following a 14% reduction in ad outlays due primarily to a lower print budget for Crestor.
The Merck/Schering-Plough partnership that markets Vytorin and Zetia moved up three spots to 7th, GlaxoSmithKline slipped from 5th to 8th and Merck advanced from 11th to 9th as spending increased for Zocor and in support of Fosamax Plus D. Ortho-McNeil slipped from 9th to 10th following a 10% cut in spending, while Sepracor—one of six companies new to the top 25 list—jumped from 64th to 11th due to heavy ad support for Lunesta.
Others new to 2005’s top list are: Boehringer Ingelheim, up from 26th to 16th on a 59% boost in spending, due largely to Aptivus, a new HIV-1 protease inhibitor; and Roche GSK, the partnership formed to promote Boniva (17th). Shire US moved up from 29th to 19th as spending increased by 47% due in part to Equetro, a new mood disorder product. Ortho Biotech advanced from 40th to 21st as ad support for Procrit was more than twice that seen in the year-ago period. The Takeda/Lilly partnership that promotes Actos climbed from 32nd to 23rd while the Genentech Bio Oncology and OSI Oncology joint venture jumped from 94th to 25th as ad outlays were increased for Tarceva.
Companies dropping out of the top 25 include Novo Nordisk, down from 23rd to 27th; the Bristol-Myers Squibb/Sanofi partnership that promotes Plavix, down from 20th to 29th; and the Bristol-Myers Squibb/Otsuka joint venture that markets Abilify, down from 21st to 32nd. Others dropping out of the top group include the Wyeth/Amgen partnership, down from 25th to 37th as ad spending was reduced for Enbrel; Purdue Pharma, down from 19th to 45th following a 60% cut in ad spending; and King Pharmaceuticals, down from 17th to 55th as ad outlays were reduced by 70%.
The top products
Wyeth’s Effexor XR advanced from 6th place to the number one spot, following an 88% increase in ad spending. Namenda, the most heavily advertised brand in 2004, slipped to 2nd place as ad outlays were reduced by 30%. Cymbalta, the relatively new SSRI/SNRI from Lilly, climbed from 8th to 3rd on a 104% boost in spending. Combunox, a new oxycodone HCl and ibuprofen combination from Forest, was 4th, and Lunesta, Sepracor’s new non-barbiturate sedative, ranked 5th.
Lipitor slipped from 4th to 6th even as ad spending increased by 6%, Vytorin climbed from 19th to 7th as ad outlays grew by 152%, while Caduet, Pfizer’s Norvasc/Lipitor combination, fell from 3rd to 8th. Forest’s Lexapro dropped from 2nd to 9th as ad expenditures were reduced by 50%, while Lyrica, a new diabetic peripheral neuropathy (DPN) drug from Pfizer, was 10th. Other products that made the top group are Boniva (14th), a new bisphosphonate that is being marketed by Roche/GSK, and Rozerem (21st), Takeda’s new insomnia drug.
Previously marketed products entering top 25 include: Forest’s Campral, an alcohol deterrent that jumped from 155th to 12th, Ketek (43rd to 15th) and Actos (30th to 18th). Spending increases in the 120–125% range moved Procrit up from 56th to 19th, while Prevacid climbed from 60th to 20th. Tarceva rocketed from 753rd to 22nd, and Reyataz, BMS’s antiviral agent, advanced from 31st to 23rd on just a 6% hike in outlays.
Some of the brands that made 2004’s top list but are missing from 2005’s group include three AstraZeneca products—Seroquel (26th), Nexium (27th) and Crestor (39th). Three Pfizer brands are also missing —Geodon (32nd), Relpax (70th) and Norvasc, which has gone generic.
The top therapeutic categories
While ad spending in the SSRI/SNRI drug class registered only a marginal gain during 2005, this category, which includes a number of major advertisers such as Effexor XR, Cymbalta and Lexapro, easily retained 1st place with a 7% share of all ad expenditures. Cytostatic Drugs—Other moved up from 3rd to 2nd due largely to higher ad spending for Tarceva, while Non-Barbiturate Sedatives—Other climbed from 10th to 3rd due primarily to heavy ad support for Lunesta. Antipsychotics—Other advanced from 6th to 4th even though ad expenditures declined by 7% and Alzheimer’s-Type Dementia dropped from 2nd to 5th as spending in the category declined by 22%.
A significant decline in spending for Crestor was largely responsible for the drop from 4th to 6th for Cholesterol Reducers Rx—Statins, while higher ad outlays for Vytorin helped advance Cholesterol Reducers Rx—Others from 8th to 7th. Seizure Disorders advanced from 9th to 8th as spending for the class increased by 15%. Codeine & Combination Non-Injectables, one of the five drug classes new to the top 25, jumped from 67th to 9th due largely to Forest’s new entry, Combunox.
Others moving into the top group include Bisphosphonates, up from 47th to 13th, and Specific Antagonists, up from 78th to 16th as a result of strong ad support for Forest’s Campral and Shire US’s Fosrenol. Higher ad spending for Actos and Avandia drove Insulin Sensitizers from 26th to 23rd, while Orthopedic Supplies—Other advanced from 29th to 25th following a 31% increase in ad outlays. Drug categories dropping out of the top 25 include COX-2 Inhibitors, Sexual Dysfunction Disorders, Quinolones-Systemic, Biological Response Modifiers and Anti-Platelets. 
Eugene M. May is director of marketing research at ACNielsen HCI