FDA is proposing a study which I call “less is more.” The study is long overdue. They are concerned that too many risks are being presented in television ads and perhaps this confuses consumers. The basic lesson of advertising is to focus on the main point or compelling benefit if you want people to remember it. That lesson also applies to risk.
Consumers deserve to know about any significant risk of a drug they are taking or may take. Current DTC ads are risk heavy and loading ads with the many potential risks and side effects obscure what really are the most important. So if something minor happens to one in ten thousand people, is that worthy of being mentioned?
I have always been an advocate of presenting the odds of serious risk. FDA needs to provide guidance in consumer terms. If I have several friends who got a side effect, then that is worth mentioning. If I have to dig in the medical literature to find the one person having a side effect it is not. FDA is considering doing what any reasonable person would do. That is, discuss risk in the context of its frequency and seriousness.
We do not require auto makers to say you may die driving their car. We do not require airlines to discuss the risk of a crash. Yet drugs seem to be treated as something deserving of the mention of anything that may happen if taken. It is about time consumers were given some better information. If it kills one in a five hundred thousand do I really need to be told that in an ad?
I hope this study can provide some data that will help. This falls in the category of better late than never. There is, of course, a lot of general literature on advertising recall, and perhaps FDA could make sensible conclusions based on the existing vast history on advertising concepts. That would say consumers watching ads can remember very little, so less is more.
I know FDA is filled with bright people so I assume they know this concept. What is frustrating is their pace in advancing sensible regulation. By the time they finish this study it will be twenty years since television ads were presented to consumers. If consumers are risk confused now, they were in 1997 as well. FDA has told me numerous times how busy they are, so it is no surprise they are just getting to this study. It is a sad commentary, however, on their staffing and/or their priorities.
I guess we must be thankful FDA took some regulatory liberties and allowed the 60 second ad in 1997. So despite the nearly two decades it took to get here, the study is important for industry and its customers.
Bob Ehrlich, CEO, DTC Perspectives
Programmatic advertising, the automation of media buying and selling using technology and data for hyper-targeting, is one of the ad worlds’ hottest trends. Research firm eMarketer recently estimated that digital display ads bought programmatically in the US grew 137% to more than $10 billion in 2014, and now account for 45% of all display ad sales. eMarketer expects programmatic spending to increase another 47.9% this year and by 2016 to reach $20.41 billion, or 63% of U.S. digital display ad spending.
Why the tremendous growth in programmatic? With the rapid increase in digital media over the past decade, there was simply too much inventory for humans, both buyers and sellers, to keep track of. Previously, the inventory that was hardest to monetize was aggregated into popular exchanges, bought and sold through real-time-bidding (RTB).
Buyers were purchasing “remnant” inventory via RTB. Premium inventory on premium sites was still limited. Enter “programmatic direct” or “automated guaranteed” – as the Interactive Advertising Bureau calls it – which allows advertisers to buy guaranteed premium inventory in advance from desired publishers. While programmatic direct made up only 8% of all programmatic sales in 2014, according to eMarketer, it’s expected to reach 42% by 2016.
And that’s where pharma advertisers should take notice. While RTB-based programmatic buying focuses on audiences, usually through some kind of cookie-based tracking, often behavioral in nature, programmatic direct brings the focus back to the editorial environment of context and content where pharma brands like to be.
DTC advertising, after all, has lagged behind every other category, as per Nielson reports citing a 22% decline in display ad spending from 2012 to 2014. For an industry specifically dubbed “direct-to-consumer,” DTC has often appeared to be neglectful of where consumers are actually looking for product information – online! eMarketer, after all, noted that since 2013, consumer digital use has even surpassed TV viewing.
The situation is compounded when you consider how quickly consumer mobile use is growing. comScore reportedin August that mobile use had overtaken desktop use. And while 44% of programmatic spending in 2014 was already on mobile, eMarketer projects that number will also surpass desktop this year.
DTC, alas, is also lagging in mobile. Funmobility’s Mobile Advertising Trends Report 2014 found pharma dead last in mobile spending amongst nine categories, and concluded: “This provides a gap in marketplace saturation that savvy advertisers can capitalize on.” The solution? “Preferentially target mobile ads to tablets, not smartphones. Tablet owners tend to have more disposable income, are 3x more likely to make a purchase based on a mobile ad, and use their devices primarily for web browsing – which is the behavior that health and pharmaceutical ads need to encourage, in order to educate users about their product.”
Of course, most pharma marketers are already vying for standard destinations and portals. But they can add programmatic strategically to improve the efficiency of their media plans, find relevant patients with larger reach, and get access to targeted consumers at lower cost. Here are some possibilities:
With safety being paramount to the placement of any campaign, the proliferation of brand protection services offiers pharma marketers the ability to verify context, block non-human traffic, optimize for viewability, and more.
So, for pharma media planners feeling the pressure from increased CPMs caused by lack of quality inventory and too much competition for premium inventory, adding programmatic placements to the media plan may well be the perfect prescription.
Widespread conservatism within the industry, due to regulatory burden, compounds the issue. Unorthodox innovation initiates a waterfall of time-consuming MLR reviews, which can lead to the dilution of the concept itself in order to gain approval. That new thing you were so excited about? Not only has it lost some of its luster, but the window for launch has been delayed to the point that it is no longer considered breakthrough. To make matters worse, the annual planning cycle compresses your once innovative idea to a four-month flight.
Marketers should never veer from paving new ground. It is essential that we identify and execute new marketing strategies that best align to our brands, can be effectively measured, and also meet the restrictions unique to our industry. In a time where technology, platform and content evolution is happening faster than ever in leading consumer and HCP channels such as mobile, social and point-of-care, it’s critical that marketers understand the challenges of adopting new strategies and utilize a tactful, big-swing approach to overcome each of them. That said, a methodical approach to prioritizing should be considered so that the new path leads to meaningful success.
Herein lies the innovator’s dilemma. How do pharmaceutical marketers embrace innovation successfully while adhering to the constraints unique to our industry?
For all of us, a brand’s life cycle is finite. FDA approval process and patent law has given us a clear start and end point. We’re all under pressure to use this time and our yearly budgets as efficiently as possible. Unfortunately, the default is to reinvest in tactics that have worked well in the past. While this is not 100% unwise, there are steps to be taken to reset our baseline for success.
As new technologies, channels and strategies surface in our industry, all marketers will inevitably face the innovator’s dilemma. Take confidence in knowing that innovation can truly change the success of your brand. If we as an industry can take an approach to adoption that is thoughtful, sustainable, and scalable, the pay-off will be tremendous for all groups involved.
When determining the role of content marketing for Rx brands in the healthcare industry, our hands may be tied a bit, but it can still be a valuable tool when used correctly. The greatest opportunity for Rx brands is in content with broad appeal, because content has to compete for attention on a level playing field with everything from information to community to entertainment. This means that therapies addressing conditions with larger patient populations are most likely to have success with content marketing.
Given that content can travel across the Internet, many pharmaceutical marketers aren’t comfortable with models that distribute branded content into places their legal teams aren’t able to approve ahead of time. For many, this will mean that initial content marketing tests are best conducted with unbranded communications. Before you start producing content though, developing and agreeing upon a sound strategy is key.
It is important to focus on information patients, KOLs and caregivers want from you. Not trying to be everything for everyone is difficult to accept, but having focus can still allow your voice to be heard.
The recent campaign by Shire Pharmaceuticals does just this. The campaign focuses on driving education and awareness around Binge Eating Disorder (B.E.D.), a condition officially recognized in 2014 by the American Psychiatric Association. When treated, Shire benefits with approval of their drug Vyvanse being the only medication approved to treat moderate to severe B.E.D. in adults in the US. Because of this unique situation, they are in a position to drive the conversation around B.E.D. among patients in a landscape where they are one of the few voices.
When you are in a position to drive a conversation it is easy to be heavy-handed and talk only about your company or brand. This is one of the biggest mistakes Rx brands can make in this area. Eisai Pharmaceuticals developed a content and social campaign around their weight-loss drug Belviq. They have developed a social strategy under their corporate name, which is a step in the right direction, but it is clearly focused only on their own agenda.
It is no surprise that the above message has very little engagement as the entire program is focused on promoting their support and savings programs. Consumers can sense when they are being sold to versus having a conversation with, and will act accordingly.
While consumers hate being sold to, they do appreciate and trust authorities. Focusing your information to the right audience is important, but proving to be the authority on that information is what will gain traction and trust with your audience. Biogen Idec recently announced a partnership with two athletes who will act as patient advocates for the company’s multiple sclerosis campaign, MSInspiration.com. Both Tyler Campbell (former NFL prospect) and Chris Wright (former NBA player) suffer from the disease and take Biogen’s MS infusion treatment, Tysabri. The goal of MSInspiration.com is to drive MS sufferers to submit their own inspirational stories just as both Tyler and Chris have. Chris Wright (@self_madeest89) is regularly promoting the site as well as his own foundation while Tyler Campbell’s Hall of Fame father Earl (@earlccampbell) also actively promotes the effort.
This is a great example of a brand knowing they cannot always be the face of a content campaign and get the results they want. Instead they align themselves with an authority figure that can help get the message out.
A common hurdle most pharma content marketing campaigns face is keeping content fresh. A large part of this can be attributed to the seemingly insurmountable challenge that regulatory bodies can present in approving content at a pace that will keep patients engaged. With legal reviews, what goes in is not always what comes out, and unique and creative content is usually the first thing to hit the cutting room floor. Knowing this variable isn’t going away, it stresses the importance of thinking strategically about what role content marketing plays for your brand and if it is a channel worth pursuing. If you are not able to produce the content that is truly meaningful to your target audience, an alternative channel or platform may be a better option.
While there is no doubt that content marketing can have a large impact for Rx brands when done right, it is not always a feasible option for everyone. Before content development begins, it is important that the appropriate marketing teams think strategically about the role it plays and quantify the value to determine its worth.
We’ve been expanding our discovery of the target patient beyond their clinical profiles, disease conditions and standard demographics, and digging into the attitudes and behaviors of the target as a member of a generation. Baby Boomers (and Generation Xers and Millennials, and every other generation as well) have shared the same formative experiences, historical events and life stage milestones, developing generational attitudes and behaviors to culture, consumption, life, work, love – and health. We take these generational mindsets and apply them to the health and wellness experience of the target audience, especially when our Strategic Planners brief our creative teams on DTC television and digital marketing projects.
In one recent briefing on a specific disease condition, Tonic’s strategists ensured that the creative teams were steeped in Gen X’s favorite TV shows and music, their undeserved reputation as directionless slackers, their focus on family, as well as a typical day-in-the-life of a busy Gen X working mom. Our creative teams learned that the Gen X woman is a fan of the TV show “Parenthood”, is sentimental about Bon Jovi’s “Livin’ on a Prayer”, doesn’t think her post-college job at the thrift store meant she didn’t have a plan, has her work-life balance planned down to the minute, and puts her family first. All of this helped build a textured portrait of a very demanding patient who needs a treatment solution that meets their clinical needs and is easy to take, as well as one that doesn’t interfere with the hard-won and finely calibrated lifestyle and family life that Gen X values so greatly
Whether the brief is for Baby Boomers with diabetes or COPD, or Millennials or Gen Xers with allergies or HIV, Tonic strategists ground the creative teams in the experience of the generation with pop cultural references like hit songs and popular movies as well as news events and historical timelines. These shared experiences have shaped the values and beliefs of the generation and when these are extended to, say, how a person with allergies feels about their medicine or someone with HIV feels about talking to their physician, the stage is set for powerful insights that can inspire vibrant and resonant creative ideas.
“The more detailed the picture of the target is, the more the content we make for them will get their attention,” says Tonic’s Chief Creative Officer, Phil Silvestri. “Knowing the target is a Boomer or a Millennial helps us bring their broader lives into the creative, making it mean more to them.”
The creative teams have been reinvigorated and inspired, producing fresh creative ideas that are resonating with target audiences from all generations.
The experience of encountering advertising tailored to one’s behaviors or interests on the internet has become ubiquitous in a very short time. We’ve all had that experience – shopping for a particular shoe on Zappos or gadget on Amazon, not buying it, then having an ad for that shoe or that gadget magically appear in a whole variety of other websites during the course of our browsing over a period of days or even weeks. Or, perhaps, buying that shoe or gadget, and then encountering ads for similar shoes or gadgets, or shoe/gadget accessories.
It isn’t magic, of course – it’s programmatic buying, bringing together technology and data to serve media to specific audiences by using exact or inferred behaviors. The reason it has become so prevalent so quickly is because it works. Programmatic buying offers consumer marketers of all stripes the opportunity to narrow their audience focus, increase the efficiency of their campaigns, and optimize their campaigns; rather than scattering the seeds of a campaign the old fashioned way, those seeds can be planted only in what has proven to be the most receptive earth, thereby optimizing the campaign, saving marketing dollars, and increasing the potential return of the dollars that do get spent.
Unfortunately, those of us in healthcare have largely missed out on this thrilling media revolution. We’ve missed out because we are stuck behind a privacy barrier that strictly limits what we can learn about the medical history of any consumers we might want to reach through media. In other categories like CPG, finance, and travel, advertisers can use actual purchase behavior and sales data to identify and target more qualified audiences. Purchases can be tracked and used to inform the media that is served to an individual in the future. But this type of precision-based, one-to-one audience targeting is not permitted or possible in health care; the data is unavailable for marketing purposes due to HIPAA regulations, which protect patient privacy and prevent the abuse of sensitive, potentially identifiable medical data.
But a pathway exists around this obstacle, and that pathway is called predictive targeting. By using tools that are already at hand, plus some cutting-edge mathematics, we can identify an audience’s predictive health behaviors by connecting other more commonly used, non-health related consumer data variables – demo, geo, media consumption, lifestyle, et cetera – to health behavior data. Once the correlations between the consumer data variables and health behavior data are found, we can then segment audiences according to their respective propensity – or likelihood – to treat within a condition or on a brand – as opposed to their actual treatment behavior. This exceeds the demands of HIPAA – since there is no way to connect actual, identifiable health data to a specific individual – and represents a privacy-compliant way to target audiences more efficiently.
So how does predictive targeting work, more specifically? Crossix Solutions, a healthcare data analytics provider, connects its patient-level healthcare data – past treatment, physician visits, brand conversions, adherence, and the like – for millions of individuals through its proprietary network of data tracked by pharmacies, payers, and other entities that play roles along the transactional chain. And data analytics providers, including Crossix, also have access to more traditional, consolidated consumer data – demographics, household income ranges, spending within specific categories, interests, media and shopping habits, online behavior. By studying these two data sets in concert – tying patient healthcare data to consumer data, all behind firewalls that keep individual identities private – correlations can be determined between them. The output of this data modeling process is a propensity score algorithm – a formula that translates all of those correlated consumer variables into a probability of treatment for a particular condition or on a specific drug brand.
Putting it into action
What makes this so empowering for the pharmaceutical brand manager is how it mitigates the privacy issue from the targeting equation. The initial development of a propensity score algorithm happens behind secure firewalls, so the marketer will never actually see any of that individualized healthcare data. And once a propensity score algorithm is developed, marketers can use it to target media to audiences based solely on the correlated consumer data variables – demographics, interests, shopping habits, the lot – still not knowing a thing about the target’s treatment history, prescription purchase activity, or anything else that’s HIPAA-protected. We can use what we are permitted to know to infer what we aren’t, and infer it with a great deal of empirical evidence.
For example – based on its analysis of the relationship between consumer and healthcare data, a company like Crossix might find that women who are married with three children, have college degrees, spend time on Facebook, shop for athletic wear, have a household income of about $100,000, like to travel domestically, and use the internet frequently have the highest correlation with household treatment of ADHD. And beyond that highly specific peak correlation, a propensity score algorithm can segment or rank audiences based on their relative propensity or likelihood to perform a specific health-related action. So for a particular branded ad campaign, if the total universe available to serve digital media is, say, 50 million consumers, a propensity score algorithm can determine which of those 50 million exhibit the combination of correlated/weighted variables with the highest propensities for the behavior in question. It may, for instance, find that only 12 million among those 50 million are the real target. Thus, DTC advertisers can design media buys in a more granular, evidence-based fashion, leading to greatly enhanced campaign efficiency and effectiveness, while reducing media waste.
Intouch Solutions and Crossix recently employed the predictive targeting model with a top-ten pharma client’s brand, in a target disease state with about 200,000 patients in the United States. We developed propensity score algorithms as described above, tying various consumer data points to health behaviors. Then we used those algorithms as the basis for audience-targeted online media buying. And we optimized the campaign using those algorithms daily. In doing this we demonstrated that audience-based media buying can be more effective and cost-efficient than contextual/content-based media buying.
Did it work? We used Crossix’s health data to measure campaign performance at the script level – Crossix analyses de-identified data from actual prescription transactions and determined how many individuals exposed to the ad visited the doctor or began treatment with the client’s brand as a result of their ad exposure. As the campaign test ran, we discovered that physician visits of people exposed to the audience-targeted campaign components vs people exposed to the contextual/content-focused components were nearly three times higher, and the estimated cost per patient start was about one-twentieth as much for the audience-targeted components as it was for the contextual parts of the buy.
So yes – it worked. In fact, these experiments in predictive targeting have shown such promise that the tool has rapidly become a part of Intouch’s standard media conversation, and these pilots have now become the norm. And while a conversation about “individualized healthcare data” clearly piques the interest of clients’ regulatory teams, once we explain the process of developing predictive algorithms and prove the strong separation between identifiable healthcare data and actual targeting activities, Intouch has seen no resistance.
All this is not to say that the age of traditional endemic or contextual media buying is over. Predictive targeting will not replace those tools any time soon – patients will always go to contextual locations, so it’d be silly to abandon them altogether. But predictive targeting does offer healthcare marketers a whole new way to plan and optimize their media buying, a way that is both data-driven and data-proven. Plenty of ink has been spilled over the past year or two about so-called “big data” and how it might impact the business of healthcare marketing. But predictive targeting is not a “maybe” proposition. It’s a real tool that brands can use today to more accurately find their intended audiences and serve them the most relevant media, based on those patients’ statistically established propensities for performing the behaviors the media is designed to encourage. The tale of “big data” in healthcare marketing may largely remain to be written – but predictive targeting is already an exciting part of this evolving story.
About the Authors:
As Executive Vice President, Angela Tenuta leads client services for Intouch Solutions, a digital-centric marketing agency focused on the pharmaceutical industry. With 18 years’ experience in pharmaceutical marketing, Angela is driven by the prospect of creating programs that inspire meaningful connections between pharma, patients and HCPs. Since joining Intouch in 2006, Angela has led teams through many pharma digital “firsts” including the first pharma e-CRM campaign, first pharma Yahoo! homepage takeover, the first pharma CPA campaign, and the first digital sales aid. Prior to joining Intouch, Angela rose through the ranks of Draftfcb, spending nine years in client service roles there. Connect with her on LinkedIn, email her at firstname.lastname@example.org, or call her at (312) 540-6905.
Shannon Gallagher serves as Vice President, Analytics Services at Crossix Solutions, where she leads the ongoing expansion of Crossix services and capabilities at the intersection of pharmaceutical and consumer healthcare. A veteran consultant in market research and data analytics for the pharmaceutical, healthcare and CPG sectors, Shannon is passionate about Crossix’s unique position to harness Big Data to empower better communication to the patient as a consumer. Prior to joining Crossix, Shannon spent 10 years working at Nielsen in Innovation Analytics, consulting on new product development for Rx and OTC/CPG manufacturers. Connect with her on LinkedIn, email her at email@example.com, or call her at (212) 994-9367.
But the pharmaceutical industry lags behind. Few pharma marketers focus on the mobile environment beyond a couple of apps or the e-detail for sales representatives or HCPs, despite the fact that mobile devices are the primary means of communication for most people on this planet. To get the most benefit from the new multiscreen environment, marketers need to carefully consider their audiences and how they interact with all their devices. I call it “creating content for distracted use” because in this multiscreen environment, the common experience is one of distraction.
Consumers use smartphones while they watch TV, or check email and access the Internet on a tablet while they wait for an appointment or for a train. It is critical to ensure consistency of brand and message along these distraction points. Your brand and content should be consistent and relevant on all of these platforms. In fact, I would suggest these are the two most important factors to consider when you are thinking about engaging consumers. Studies are available to help marketers understand the rate and frequency of individuals’ interactions with their mobile devices at different times of the day. They follow a familiar cycle of content consumption. We all wake up in the morning and reach for our phones. We check email, social media and news sites. At work we interact primarily with desktops, laptops and tablets, and then we revert to smartphones and tablets in the evening. Multiscreen and distracted use are the norm in today’s marketing world.
Knowing when consumers are using specific devices allows us to more accurately render our brand or content in a way that is most relevant to the audience. For example, you could air a TV commercial during prime time to raise awareness about a drug and provide information on a responsive website that can be viewed on a cell phone, or run a banner ad with a similar video and a call-to-action with a coupon for tablets. In this way, the consumer viewing the TV ad can continue to consume information on a nearby mobile device and engage with a brand a second time for reinforcement.
Consumers can visit a website on a desktop computer at home before heading to work, continue looking at content on their smartphone or tablet during the day, and resume use of the desktop when they return home in the evening. The content and brand experience should be familiar and consistent across platforms. It should be seamless from one screen to another. We typically see bounce rates (people leaving a site after opening the home page) of about 80% on websites that are not responsive or enabled for mobile devices.
The primary aim of creating multiscreen campaigns is having the ability to create truly engaging content for various mobile devices. With the advent of advertising units in the HTML5 format, brands can create relevant and compliant content, using video and imagery that is immersive, educational and engaging. For DTC, this new format will provide more opportunities to engage a consumer in an increasingly mobile world.
Developing cross-screen advertising is not as simple as just adding a few mobile placements to your ad buy. Multiple operating systems, device sizes and new protocols are emerging, and marketers may need help navigating the path to multiscreen success. Fortunately, a number of technology vendors have developed the capability to create branded pharma ad units for the mobile platform. However, employing sophisticated tactics to attract mobile users reaps big rewards for the DTC marketing and media budget. We have seen click-through rates of up to 20% for some ad units on mobile devices. Compare that with the measly 0.003% on the web alone.
Multiscreen marketing can make a huge impact on the pharmaceutical industry if it is done right. Every mobile platform has its own set of rules, but all can be part of an effective marketing initiative. When you define the goals of a campaign, you also should determine how every available digital platform plays a role and fits into the bigger strategic picture. As you look at marketing in the multiscreen environment, think about consistency of brand, content and message, design for distracted use, and above all think holistically about a coordinated campaign. The days of siloed media are over. Ubiquitous mobile media is the path to engagement for your brand.