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Direct-to-consumer (DTC) advertising can be immensely powerful. But today, its often used in ways that dilute its power. Used at the wrong times, in the wrong ways, with the wrong strategy, DTC can fail to deliver, resulting in our status quo: skyrocketing spend and stagnant prescriptions.

How can DTC be used in your marketing plans for brand success? In this article we pinpoint the problems of todays DTC, examine the single most important way to improve your DTC campaign, and describe the essential steps towards creating your killer DTC push.

Down, But Not Out

The pharma industry is a great believer in doing whats worked in the past, even when evidence shows it no longer works. Take the glut of sales reps in the field. Companies found success for years with direct sales, and so continued to send reps to physicians, even as physicians restricted access, reduced prescriptions, and generally soured on the pharma experience. The same phenomenon is happening with DTC advertising. What was once a sure way to boost prescriptions and reputation has become less and less effective. A crowded market, the evolution of technology, and a public souring on the pharma industry has resulted in stagnant response.

While spending has grown and continues to grow, prescriptions are staying flat.

But does this mean that pharma should eliminate DTC advertising? In a time of economic freefall, when dollars are increasingly scrutinized and reduced, should pharma push DTC aside and focus on other means of advertising? No, and heres why. While DTC has reduced its impact, it still retains power. The key is for pharma to discover how to enhance that power, how to wisely invest decreasing funds into the appropriate places and with the best messages in order to capture an audience and their needs.

Timing The Crucial Consideration

The most important way to capitalize on DTC is through timing. DTC advertising is a powerful force when used for new product launches, particularly in the first year or two after launch. It is highly effective for developing awareness and recognition for new drugs, and as such the spend should be used as a short-term measure to help drive market penetration. This type of promotion is extremely useful in accomplishing what we all need during launch: the communication of key product attributes to the patients in the target disease area. DTC also works best in disease areas where patient awareness and choice is a critical factor in prescribing.

A few case studies will illustrate. Crestor was introduced into a crowded U.S. dislipidemia market in 2003 and used DTC advertising to help deliver its message as being a more efficacious product compared with the leading statins currently in use. DTC spend was high at launch to drive initial sales and market share, and did just that. Over time, DTC spend was reduced: as a proportion of sales DTC spend peaked at 23.3% in year two, before falling to 12.5% in year three.

In another example, Cialis was the third entrant into the U.S. erectile dysfunction market, dominated by Pfizers Viagra, and used DTC advertising to explain its differentiated positioning and unique 36-hour action. The drug achieved sales of $552 million in its fist full year on the market (2004), on the strength of DTC but also an innovative marketing campaign tool. Lilly utilized a voucher for a free trial of Cialis, followed by a second trial of Cialis or a competitor if not satisfied, under the Cialis Promise. In addition, training and support materials were included alongside regulatory labeling. Cialis generated global sales of $971m in 2006, a year-on-year increase of 30%, even in the face of quickly increasing competition in the erectile dysfunction market.

These are cases when the power of DTC was harnessed at launch for impressive results. But then there are the notable cases where companies go wrong. Rozerem was approved by the FDA in July 2005 as an anti-insomnia pill with a different working mechanism than other sleeping aids. Upon launch, Takeda marketed to doctors so they were familiar with its differences from Ambien and Lunesta. In 2007 they launched a DTC campaign that garnered much attention for its quirky ads featuring a sleepless man, Abe Lincoln and a talking beaver, with the tagline Your dreams miss you. Despite high levels of awareness of the drug and high likeability of the ads (12% of adults surveyed by Ad Track, USA TODAY's weekly consumer poll, said they like the Rozerem ads "a lot"), Rozerem had less than 3 percent of the $3.6 billion U.S. market, according to industry sales figures reported by IMS Health. Takeda has spent $100 million on the direct mail and TV campaign, more than the drug has generated in revenue according to figures released by TNS Media Intelligence figures.

One of the problems? Rozerem represented a new offering in the sleeping aid market, one that could potentially eradicate dangerous side effects of Ambien and Lunesta and provide more normal sleep. But the DTC campaign began years after launch, years in which Ambien and Lunesta gained further hold of the market, and did not fully explain the differentiation of the drug. As such, consumers have stayed away.

Steps for Success

Timing is essential, as the cases of Crestor, Cialis, and Rozerem demonstrate. But there is so much more to consider as well. What are the other ways in which companies can better plan their DTC campaigns to create product wins?

• Be Realistic. Marketers need to understand their consumer marketing strengths and weaknesses, as well as where the brand fits within the company portfolio. Doing this will reveal realistic expectations for marketing and DTC, along with return on investment.


• Be Prepared. Know how consumers think and act when it comes to your disease area. A thorough and upfront assessment of the disease and brand can help identify knowledge gaps, opportunities and potential areas of trouble. Doing this will help better understand targeting opportunities and priorities to make DTC push the brand forward.


• Plan, and Do it Right. A comprehensive and tough planning process can help prioritize target opportunities, and identify the best bangs for the buck. Planning isnt complete or effective without continually checking to make sure objectives, strategies and tactics are on track. And it isnt complete unless chosen messages and vehicles (including DTC) are relevant and meaningful.


• Measure. Set up useful and significant metrics to track performance. The best metrics will allow companies to best manage their campaigns, as well as to continually improve. And DTC advertising planned and conducted with effective measurement will be far more effective.


• Redefine Your Terms. While many pharma companies view DTC as focused strictly on television and direct mail, these traditional means are waning in their influence. The best DTC today is about creating value-added relationships through a wide spectrum of media, all based on the unique wants and needs of each segment. Its about speaking to targets in their language in traditional and new media, exploring new ways to get consumers involved and speaking to other consumers on the brands behalf. By casting a wider net, DTC can be extremely useful and powerful.


• Pay Attention to Detail. To make sure your strategies actually deliver, marketers must stay focused. Ensuring the elements of the DTC campaign are well coordinated, and every detail attended to, will help ensure effective execution.


• Pay Attention to Time. As mentioned before, perhaps the most critical key for DTC success is timing. To ensure this complex and time-sensitive initiative will work, dont underestimate how time-consuming the planning process will be, and how many rounds of creative back and forth will be needed. Starting at least two years before launch is a great way to cover all the bases.


• Select Resources Wisely. If youre using an advertising agency, the organizational and cultural differences between companies could work to your advantage or detriment. Take the time to get to know your partners and how they collaborate, and select only those that will enable each of you to do your best work.


• Build in Time to Adapt. No matter how long you plan, and how comprehensive that plan is, youll need to hone and improve your DTC campaign. Plan for this by allowing time to review whats working and whats not.

Conclusion

Spend on DTC advertising is at an all-time high, but prescriptions are the same as they were a decade ago. The power of DTC is getting squandered with poor timing, a lack of planning, and an inability to see past traditional media. With this shortsightedness, companies are paying more, but getting squashed by competition and a skeptical public. But DTC can still power a brand forward. Brand launch can be a rousing success with the help of DTC. And a campaign that is realistic, prepared, planned and measured, that builds in time for adaptation, and uses all the resources available to pharma marketers, can push past stagnant sales and boost prescriptions.

For help in understanding when and where to implement DTC advertising to be effective, please contact the author Dr Andree K Bates at Eularis www.eularis.com