Retro Relpax Web Site Features Woman Mopping the Floor. Inspirational? Not!

Retro Relpax Web Site Features Woman Mopping the Floor. Inspirational? Not!

The "DDR on DTC" column in the August 2012 issue of MM&M magazine ripped into a print ad that showed a woman migraine sufferer being able to mop the floor after taking the Pfizer anti-migraine headache drug Replax.

"DTC ads used to be over-aspirational," said the author, Deborah Dick-Rath, "we saw relieved arthritis sufferers running marathons or playing Frisbee. With Relpax, the insight seems to be that sufferers just aspire to do such everyday activities as mopping the floor...We hope that Relpax is a success for Pfizer and that migraine sufferers find relief. We also hope they get (strictly aspirationally) excused from swabbing the deck" (see "DDR on DTC: Relpax").

Here's the ad that DDR reviewed:

This is probably the result of Pfizer's conservative view of what modern women aspire to at 11:00 Am in the morning (note the clock).

I couldn't find this ad in a recent issue of People Magazine, which is the publication in which DDR found the above ad. Instead I found this much more politically correct, although still not too inspirational, ad:

In this version, two hours after taking Replax, the migraine sufferer is able to go out and do whatever her business is -- probably commuting to work given that the clock is showing 8;00 AM (or is it PM?).

Perhaps Pfizer read DDR's column and revised the print ad campaign, at least as far as image is concerned. Surprisingly, however, the Replax.com Web site still portrays the woman mopping the floor:

It appears that it takes longer to swap out a Web image that a print ad image.

Pfizer is asking Replax.com visitors to tell their "stories" by submitting photos or video. "Tell us about your experience with migraines by submitting a story," says the promo page (here). "Your story can include a photo or video. If chosen, your submission could be featured on RELPAX.com."

I don't imagine a single submitted photo or video will feature a woman mopping the floor. Do you?

You can tell that pharma marketers are getting desperate when they have to beg consumers to submit stories to compensate for the fact that their image of the modern consumer dates back to the 1950's.

Bogus Predictions of Pharma Industry Online Ad Spending

Bogus Predictions of Pharma Industry Online Ad Spending

Here's a headline, versions of which I have been seeing for years: "Pharmaceutical Advertising Spending Shifts to Digital." That's how Business 2 Community -- "an independent online community focused on sharing the latest news surrounding Social Media, Marketing, Branding, Public Relations & much more" -- describes the latest data from eMarketer, which predicts that "pharmaceutical" online marketing will increase by a staggering 23.3% in 2012 vs. 2011 (see here and chart below).

First, eMarketer's data are not specifically focused on the pharmaceutical industry. The data includes ALL healthcare industries, including doctors, hospitals and "other entities that deliver health services such as health maintenance organizations (HMOs)" and, I presume, health insurance companies. What percent of the $1.58 billion in online spending predicted for 2012 is pharma specific? Probably over 50%, but not 100%. Perhaps 75%? Your guess is as good as mine (or eMarketer's).

So the headline above is misleading. It should read "Healthcare Advertising Shifts to Digital." But is it really?

Another problem is that eMarketer's predictions about online healthcare ad spending have been "all over the map" by which I mean wildly inaccurate and meaningless. In 2007, for example, eMarketer predicted that the spending on online HC marketing would be $2.20 billion in 2011 (see here and chart below). But the eMarketer chart above now indicates the number is closer to $1.28 billion, which is quite a difference.

So, why should we believe eMarketer's prediction that online HC ad spending will increase by 23.3% this year? You tell me.

AZ Posts "Reminder Drug Ad" to Its Corporate Blog

AZ Posts "Reminder Drug Ad" to Its Corporate Blog

Last week I reported that AstraZeneca (AZ) posted an ad for CRESTOR on its "AZ Health Connections" corporate blog (see "AstraZeneca's Timely CRESTOR Branded Blog Post: Did It Violate Its Own Policy?"). The post included the indication for CRESTOR and also the "Important Safety Information" (ISI) that is required by the FDA whenever a drug company talks about a brand and its approved indication.

I wrote about that only because it was the first time -- to my knowledge -- that a pharma corporate blog promoted a branded product and I wondered if such posts violated AZ's own posting policies (turns out that it may or may not depending upon what you mean by "may" -- see the post for details).

Today, I noticed an AZ Health Connections blog post that talked about another AZ drug - ARIMIDEX, which is approved for "adjuvant treatment (treatment following surgery with or without radiation) of postmenopausal women with hormone receptor-positive early breast cancer."

This time, however, the post (find it here; see screen capture above) did NOT mention the approved indication. It is, by FDA definition, a "reminder ad." According to the Pharma Marketing Network Glossary:

Reminder advertisements are identified as an exemption to the advertisement regulations, including provisions to provide a brief summary. Reminder advertisements " . . . call attention to the name of the drug product but do not include indications or dosage recommendations for use of the drug product. . . . and, optionally, information . . . containing no representation or suggestion relating to the advertised drug product." Reminder advertisements cannot make a representation about the product or suggest a use for the product.

The AZ Health Connections post does "call attention to the name of the drug," but it also directs readers to ARIMIDEX Direct, which is a program that "allows eligible patients to receive ARIMIDEX delivered to their homes for $40 a month, including shipping and handling." Sounds like a good deal, although I did not investigate what the eligibility requirements were.

AZ deserves credit for reaching out to the online community to learn more about how it can make its drugs more accessible. Recall that AZ was the first pharma company to host a Twitter chat "to raise awareness about helping patients save money through prescription savings programs" (see "OMG! AstraZeneca Hosts Twitter Chat & World Does NOT End!").

PhRMA "forbids" Reminder Ads, But Not on Internet!
AZ's post raises some interesting questions regarding the promotion of Rx drugs on the Internet that neither the FDA nor the pharma industry has addressed. For example, PhRMA's "Guiding Principles for Direct-to-Consumer Advertising" (here) prohibit reminder ads on TV but NOT on the Internet:

Principle #10: "DTC television advertising that identifies a product by name should clearly state the health conditions for which the medicine is approved and the major risks associated with the medicine being advertised." [Alos see "Reminder Ads - Pharma's Dodo?"]

AZ, I believe, is a signatory to these voluntary guidelines. Since these guidelines only apply to TV advertising, AZ is not in violation. It's still the "wild west" on the Internet with regard to reminder ads; i.e., It's perfectly fine to run "reminder ads" on the Internet. This is usually the case when pharma companies buy Adwords (paid search ads) from Google, especially after the FDA came down on Adwords that included the indication with the brand name.

Another interesting issue is how pharma companies can manipulate "natural" (aka "organic") Google search results to display what is essentially a branded product ad that includes the brand name and indication, but no ISI.

Search Google for "arimidex" as I just did and you will find this:

The #4 (or #3, depending on how you count) search result leads you to the home page of the www.arimidex.com Web site. Note that the search result looks like an ad with copy that mentions the indication of the drug: "Learn about IN YOUR CORNER, an online breast cancer support resource for women with early breast cancer and the people who care about them."

How did that copy get there? Simple, AZ included the following "meta tags" in the "header" of the HTML code that generates the home page:

Google mindlessly reads the META NAME tag to display the description of the site in the search result. The information contained in that tag, of course, was written by AZ with the full realization that a Google search will include it in the search result. From there, it is only necessary to ensure that the site gets good placement in the natural results list and BINGO! You've got a branded "ad" that mentions the drug name and the indication WITHOUT the required ISI.

P.S. The Arimidex search result shown above may actually be what's called "paid inclusion," which refers to a sponsored "organic" search result (see, for example, "Paid Inclusion: Too Hot for Pharma Marketing?").

As Pharma Spends More on Digital, External Digital Agencies Receive Poor Ratings from Marketing Executives

As Pharma Spends More on Digital, External Digital Agencies Receive Poor Ratings from Marketing Executives

Pharmaceutical brand teams are generally dissatisfied with their outsourced digital marketing, according to a study by Cutting Edge Information (see press release).

In surveys and interviews, executives acknowledged the challenges that their industry presents to external communication agencies, not the least being the lack of clear regulatory guidelines for pharmaceutical digital marketing. Despite that, pharmaceutical brand teams' opinions of agency performance are generally negative. Across all activity categories, only 21 percent of responses were "good" while 35 percent were "poor." No respondent ranked their experience with outsourced digital marketing as "very good." This is based on 34 responses.

It seems that familiarity breeds contempt -- the poor rating of digital agencies comes at a time when pharma marketers have increased the proportion of marketing dollars spent on digital.

Data from the summary report claims that "traditional digital marketing" (Web sites, web display ads/banners, email, search) represented 26.6% of the overall pharma marketing budget in 2011 compared to 23.7% in 2010; a 12% increase. These absolute percentages are similar to what PwC/IAB reported for all industries (see, for example, this chart). But my analysis suggests only 11% of pharma's total DTC marketing budget is devoted to "traditional digital marketing" (see "Ad Dollars Follow Eyeballs to Web").

Social and Mobile marketing are not "traditional digital marketing" according to Cutting Edge's definition. While the share of marketing dollars spent on traditional digital marketing has increased 12% from 2009 to 2011, the share for Social and Mobile digital "channels"/technologies (which is it?) have increased by 99% and 288%, respectively, according to Cutting Edge data (see chart below created from Cutting Edge data).

The report cites this caveat about the data: "this data does not suggest that actual spending by pharmaceutical companies on print media declined 26% between 2009 and 2011 but that print media is taking on a less significant role as a percentage of the total marketing mix." The same is true for the increase in share of social media and mobile: these "channels" are taking on a MORE significant role, especially since there are data suggesting that the OVERALL pharma DTC (direct-to-consumer) marketing budget decreased from 2009 to 2011 (see this chart).

Pharma Marketing Vs. Insurance Marketing: What Pharma Can Learn from Geico

Pharma Marketing Vs. Insurance Marketing: What Pharma Can Learn from Geico

Often, when proponents of pharma eMarketing get together at industry conferences, or cry into their beers at receptions afterward, they lament the fact that the drug industry isn't doing as much as other industries in the "e" arena. Sometimes, they cite eMarketing campaigns of companies like Procter & Gamble (P&G) and ask, Why aren't drug companies doing that?

The responses to that question generally fall into the category of "It's Regulations, Stupid!" That is, FDA regulations are hampering what pharma marketers can do online. The packaged goods industry -- of which P&G is a member -- is not regulated like the drug industry is regulated. True that!

So, let's look at another industry that IS regulated: the insurance industry. Where do insurance marketers spend their dollars and how does that compare with pharma? It just so happens that I came across some data that might shed some light on that (see the chart below; click on the chart to enlarge).

The data come from Kantar Media. The Internet data does NOT include search advertising. The insurance data is for the first three quarters of 2011 (total spend = $3.56 Bn) whereas the data for pharma is for 2010  (total spend = $4.3 Bn). To compare apples to apples, in 2010 the insurance industry media spend pie looks like this: TV, 54%; Print, 6%; Internet, 21%.

No matter how you look at it, the insurance industry favors Internet over print whereas the opposite is true for pharma. Why?

Here's what I have learned from personal experience. In my family -- and probably in your family too -- health decisions and purchases are generally the domain of my wife, whereas insurance decisions and purchases are my responsibility. It's no secret that pharma marketers target mostly women. My wife reads magazines like Prevention, etc. that feature a lot of drug ads. I don't read these magazines. While I have seen print ads for insurance companies, they haven't made much of an impression on me, whereas TV ads have.

So, from my personal experience, it's logical that both industries allocate a big portion of their media spend on TV advertising, but only the drug industry spends a lot on print advertising.

What's surprising, however, is the insurance industry's 28% of total media spend on the Internet (versus 5% for the pharma industry).

Coincidentally, yesterday I received an e-mail message from Geico about their "Family Pricing Program" for my son Greg. (We are Geico customers, having both our car and home insurance with them.) The message said:

"If Gregory is getting ready to graduate, preparing for a new job, or looking to establish a little independence, our Family Pricing program allows you the freedom of moving Gregory to his own policy while he continues to receive the same great rates you're currently receiving."

That spooked me a bit because Greg just started his first full-time job after graduating and I mentioned to my wife that soon it will be time for Greg to get his own insurance policy! I tweeted:

"Got email from Geico about transferring my son 2 his own car insur plan now that he has a job. How'd they know I was just thinking that?"

Of course, they didn't know what I was thinking, but it was nice to know that they anticipated what I may be thinking! Geico knows a lot about me and my family. They know our ages, our sex, our driver's license numbers, our driving records, what kinds of cars we own, etc. I had to give them that information to get insurance. No big deal.

So, it would be easy for Geico to anticipate that Greg recently graduated and that he may have a new job. Further, they know from experience that parents want to get their kids off their insurance plans ASAP.

After I posted that tweet, I received this response from "Shay" tweeting from the @GEICO_Service Twitter account:

"We would be more than happy to give him a quote! He can go to geico.com or give us a call at 1-800-861-8380. -Shay"

That was a pleasant note that makes this whole experience even more personal than if I just got an e-mail message.

When I complained that Greg was likely to push back on the idea of paying his own insurance, Shay reassured me that "We will do everything we can!" and added: "Thank you so much for being part of the GEICO family!"

I don't think I can leverage this new found "family" relationship to get an even better deal from Geico, but the experience made me an even better fan of Geico -- I was already impressed with their online services. Hopefully, if we ever need to make a claim, I will be equally impressed.

Can the pharmaceutical industry do something similar? I'm not sure. The first hurdle for pharma is breaking away from print. As I said, pharma marketers may depend upon print to reach their core audience -- women. But they may be ignoring social media's ability to reach that core -- listen, for example, to this podcast: "How to Score With Women (as a Marketer) via Social Media."

Keep in mind, however, that social media marketing is virtually "free" compared to print advertising, which is something the packaged goods industry is learning (see "The Coming Pharma Digital Depression"). Given that, even if pharma moves big time into social media marketing, I'm not sure the spend pie would look much different. The insurance industry probably spends a lot more on internet display advertising and e-mail direct marketing than does the pharma industry. These activities are much more expensive than paying Shay to reach out to me via Twitter!

ePharma, the "Ron Paul" of Pharma Marketing - We Are the 1%

ePharma, the "Ron Paul" of Pharma Marketing - We Are the 1%

At yesterday's ePharma Summit conference session on "Jumpstarting Digital Capabilities in Pharma: Learning from Other Industries," the presenter, Pete Mehr, Chief Healthcare Strategy Officer at Merkle, Inc., asked the audience "If you agree with the general thrust of this conference, how come it hasn't happened?"

By "general thrust" he meant that pharma must get more involved in eMarketing and catch up with the rest of the world. "The tools are there. So how come the change is so hard?"

Unfortunately for Mehr, he was standing right in front of me when he asked that question, so I just had to respond.

"We are the one percent," I said.

Of course, that was meant partly as a joke and I knew it would not lead the discussion where Mehr wanted it to go. So, I did not get a chance to explain what I meant.

What did I mean? It relates to what I often think while attending these conferences; namely, we are preaching to the choir and that choir is a small minority within the pharma marketing biosphere. But in the bizarro world of pharma marketing, that choir is not the "richest" as it is in the real world, but the poorest.

eMarketing is only a small percentage of the pharma marketing spend and it always has been and it may always be. It's the "Ron Paul" of candidates seeking marketing dollars. It's nice for Republicans to have Ron Paul and his creative ideas, but the big wigs would not like to see him rise beyond single digits. Same with pharma marketing's "Ron Paul" -- eMarketing.

Although there was one pharma marketing big wig at the conference -- Charlotte McKines, Global VP, Marketing Communications and Channel Strategies, Merck & Co. -- she was the exception that proved the rule.

I don't know if the ePharma Summit audience understood what I was getting at, so I decided to write this post. Tell me what you think.

New Big Pharma Economies of Scale: Less Patients Needed to Reach Blockbuster Sales

New Big Pharma Economies of Scale: Less Patients Needed to Reach Blockbuster Sales

"Meet the new blockbuster," reports the Wall Street Journal; ie, drugs that treat intractable diseases afflicting "small numbers of patients shown by testing to likely benefit from the drug. Such targeted therapies can be brought to market faster and at less cost, and health plans will pay high prices even for long courses of treatment" (find the article here).

One such drug is Pfizer's Xalkori (crizotinib), a "newly approved for a rare form of lung cancer, for which Pfizer plans to charge $115,200 a year per patient."

At that rate, Pfizer needs only about 9,000 patients worldwide to generate $1 billion in annual sales of Xalkori. In comparison, 1,671,000 Lipitor patients are required to generate the same sales figure. I demonstrate this in the following chart, which requires a logarithmic scale to represent both these numbers visibly on the same chart (see chart below).

Meet the New Big Pharma Economies of Scale: A smaller market can provide blockbuster sales as long as health plans back expensive therapies.

The catch is having diagnostic tests that pinpoint patients most likely to benefit.

Pfizer seems confident it can do this. "There's been a change of paradigm," said a Pfizer researcher. "The new school of thought is, 'If you find the patients that the drug will work in, and if you see enough benefit, we will find a way to get this to market.'"

The new drug development "paradigm" requires a new marketing paradigm as well. That marketing paradigm will focus almost exclusively on medical specialists such as oncologists.

Under the new marketing paradigm it will be difficult to justify broadcast direct-to-consumer (DTC) advertising (eg, TV) because it will cost too much to reach the small group of potential patients with such a broad brush (my guess is that pharma marketers only spend a lot on broadcast DTC when the target audience is greater than 10% of the adult population).

The Internet and especially social media is ideally suited to marketing to a small community of patients such as Linnea Duff who took crizotinib in a clinical trial. Linnea was featured in the Wall Street Journal article. Not mentioned in the article, however, was the fact that Linnea writes the "life and breath: living with lung cancer" blog, which she started during her clinical trial experience. The blog prominently features a "Pfizer Video" (see here).

I don't know if Pfizer paid Linnea to include the video on her blog -- she doesn't say one way or the other, although she did NOT include this equally nice video from the Massachusetts General Hospital (MGH), which ran the clinical trial in which Linnea participated. That video is available on YouTube (here).

I wish Linnea the best of luck -- she is still terminally ill and is "happy each day that she is given" as a result of her treatment.

Her story, however, is a powerful marketing tool and I am sure the future of pharma marketing will include many such patient stories that can circulate online among close-knit patient communities that previously were "orphans"; ie, neglected by the pharmaceutical industry.

[This post originally appeared in Pharma Marketing Blog. 

Make sure you are reading the source to get the latest comments.]

Pharma Even More Digitally Feeble When it Comes to Healthcare Providers!

Pharma Even More Digitally Feeble When it Comes to Healthcare Providers!

"More than 60 percent of brands’ HCP digital efforts result in Challenged or Feeble Digital IQs," according a new Digital IQ INDEX® ranking created by think tank L2 in partnership with Vue Group. The results are shown in the following chart:

This is in stark contrast to the May 2010 Digital IQ Index™ for Pharmaceuticals that analyzed direct-to-consumer (DTC) digital efforts. That analysis found that 31 percent of brands were digitally "Challenged"o r Feeble" (see "Is Your Brand a Digital Genius or a Feeble-Minded Idiot?").

The report also concludes that "most brands are not purchasing HCP-targeted search terms, investing in mobile, engaging in email marketing, or investing in display advertising on physician portal sites." For more information, including a table of IQ scores for 70 brands, download the report here.

The report laments the limited investment and adoption of digital technology to reach physicians and provide them product information on-demand and on their own schedule. For a A Lilly case study on reaching physicians via the Web, see this Pharma marketing News article: "Pharma TeleWeb e-Detailing" (use code 'TWEB' to download it free).

Ad Dollars Follow Eyeballs to Web

Ad Dollars Follow Eyeballs to Web

Internet advertising revenue in the United States totaled $26.0 billion for the full year of 2010, whereas ad revenue earned by newspapers was $22.8 billion, according to a PwC/IAB report (see here). Here's the distribution of ad revenue charted by category:

Here's the trend in annual Web ad revenue from 2000 through 2010:

Search continues to get the largest share of online revenue, although this share decreased to 46% in 2010 from 47% in 2009. Still, search revenue totaled $12.0 billion in 2010, up over 12% from $10.7 billion in 2009. Display-related advertising revenues -- which includes revenue from display banners, rich media, digital video, and sponsorships -- totaled $9.9 billion or 38% percent of 2010 revenues, up 24% from the $8.0 billion reported in 2009. Digital video ad revenue accounts for 5% ($1.4 billion) of the total Web ad revenue.

From these data, you might assume that the drug industry spends 25% of its ad dollars on Web advertising. That could be a false assumption. It's generally believed that the drug industry Web advertising slice of total ad spend is much less than 25%.

Finally, according to PwC/IAB, here's the percent of total Internet ad revenues from different industries:

GUESSTIMATING Total Pharma Web Ad Spending
Pharma & Healthcare are near the bottom of this chart. 5% of $26.0 billion is $1.3 billion, which is what the Pharma/Healthcare industry spends on Internet advertising (INCLUDING search) according to PwC/IAB. Let's say 80% (ie, $1 billion) of that is Pharma-related. Pharma spends about $4.5 billion in direct-to-consumer advertising. It may spend the same in advertising to physicians -- not counting samples and sales rep expenses. If my guesstimate is correct, then $1 billion accounts for about 11% of the total pharma ad spend.

Pfizer is Responsible for 18% of My Spam Email!

Pfizer is Responsible for 18% of My Spam Email!

This @pfizer_news tweet recently came to my attention:

"Pfizer, MHRA and partners anti-spam investigation FB page: http://on.fb.me/g5ULdX #realdanger"

I have been following Pfizer's campaign against counterfeit drugs for some time (see, for example, "Was a Rat Harmed in the Filming of This Pfizer Commercial?"). This "anti-spam investigation" is the latest phase of that campaign.

The Facebook page offers the report "You've Got Life-Threatening Mail" (find it here), which summarizes a study that involved 65 members of the public who volunteered to donate all their spam emails to the security teams at Pfizer and the MHRA (Medicines and Healthcare products Regulatory Agency -- UK's version of the FDA).

According to the introduction of this report "Spam – or unsolicited mail – is a common way fraudsters target members of the public with black market medicines. In fact, nearly 25% – that’s 15 billion messages – of all spam emails advertise medicines."

"Gareth" -- just one of the "Spam Donors" (watch out for typos there!) -- received 87 spam emails, of which 18% offered medicine. Poor "Dawn" received 228 spam emails, 9% of which offered medicine.

I decided to look in my own spam folder to see if I received any offers for Rx products. That folder currently contains over 4,000 emails (1 week's worth). I searched this folder for any email that mentioned "cholesterol" and found about 27:

I picked one with the subject line "Cholesterol is not just a number." Here's how that message looked:

I wanted to "GET THE FACTS," of course, so I clicked on that and here's the Web site that link lead me to:

The first item on the list -- "Learn About Cholesterol and a Cholesterol-Lowering Treatment" -- brought me to (you guessed it!) this LIPITOR Web page:

It took me a few clicks, but I found that Pfizer is one of those companies responsible for some (OK, maybe NOT 18%) of the SPAM email that I get!

It's ironic that Pfizer is trying to alert consumers about the dangers of spam email when they themselves are responsible for some of this spam. Of course, LIPITOR is not a dangerous counterfeit medication that is offered without a prescription via lipitor.com. Technically, therefore, Pfizer's spam would not qualify to be included in its report on "Life-threatening Mail." But it's still SPAM paid for by Pfizer!

I did a little more investigation to see if I could find out where my spam cholesterol email was coming from.

In the box at the end of the email is a "dotmedia" logo. That lead me to this site. But a note at the bottom of my spam email said "You are receiving this email from InterG Media." The top Google search result on "InterG Media" lead me to this WHOSIS domain registration data:

REGISTRANT CONTACT INFO
InterG Media
Domain Admin
1154 N. Sycamore Ave.
Suite 11
Los Angeles

BILLING CONTACT INFO
Adknowledge
Domain Admin
4600 Madison Ave.
1000
Kansas City

I ignored the REGISTRANT CONTACT and went straight to BILLING CONTACT INFO to find "Adknowledge," the entity that pays the bills. On its website (here) I discovered that Adknowledge claims to be the "leading long tail marketplace." Here's more "About" them:

"Adkowledge, the fourth largest advertiser marketplace, specializes in performance-based marketing solutions utilizing its powerful predictive technology and completely anonymous consumer response patterns to connect advertisers with consumers across multiple channels, including email, search, domains, and social networks. With over 60 terabytes of anonymous consumer behavior data, our proprietary targeting systems run over 20 billion calculations per day to determine what ad to show to each consumer. Over 10,000 advertisers use the Adknowledge ad network to promote their offers."

OK. From this, here's how I see Pfizer being a perpetrator of SPAM.

Obviously, the money to pay for my SPAM email has to come directly or indirectly from the marketers of the products advertised, which includes LIPITOR/Pfizer. I don't think Pfizer is paying InterG Media, the entity that supposedly sent me the email. InterG Media is probably just the technical geniuses behind Adknowledge's "predictive technology." No, someone hired Adknowledge -- maybe it was Pfizer itself or maybe it was a "media buyer" hired by Pfizer (or its LIPITOR ad agency of record) to send ads to consumers via the Internet.

What's the lesson learned? When you get SPAM email -- "threatening" or not -- you have to find the "long tail" back to who pays the piper. As Deep Throat said "follow the money."

Viagra Website Goes Dark!

Viagra Website Goes Dark!

No, Viagra.com hasn't been the target of "distributed denial of service" attacks by "unknown hackers," nor has Amazon pulled the site from its servers following political pressure from Senator Joe Lieberman, who chairs the Senate Homeland Security Committee. And Lieberman did NOT call for organizations hosting Viagra.com to terminate their relationship with the website.

All that's not likely to happen because here in America we value the freedom of information and believe the first amendment applies to corporate speech as well as to individual speech.

But Viagra.com has moved to the dark side and has become the first Rx drug site to use a black background, as far as I am aware (see screen shot below).

Several weeks ago, I noticed a similarly dark Viagra print ad in a magazine (see "Be a Macho Man! Ask Your Doctor for Viagra!"). The Viagra.com web site continues the "macho" theme as well.

Man, I'd love to be like one of these guys! Own a private plane and even know enough to work on its engine as well as not panic when my OLD car's water temperature gauge goes into the red zone while I'm driving  through the desert! Who knew such guys had ED (erectile dysfunction)?

ED guys don't have to ask mechanics for help on the road, but they DO have to ask their physicians for help getting an erection (ie, a prescription for Viagra). That's the best advice Viagra.com can offer!

P.S. Delving a bit deeper into the Viagra.com Web site, I find that "ED is More Common Than You Think" in the "Common Questions" section. There, Pfizer claims that "MORE THAN HALF OF MEN OVER 40 HAVE SOME DEGREE OF ED." I've often taken issue with this statement, so I researched the source that Pfizer cites for this: The Massachusetts Aging Men Study, which found that 52% of respondents claimed they had some degree of ED. Another analysis of this study concluded "Men who worked in blue-collar occupations were one and a half times more likely to develop ED compared to men in white-collar occupations" (see here). So why aren't blue-collar men depicted in Viagra ads instead of professional-looking guys and guys who own their own private planes? I doubt many blue-collar types are able to afford their own private airplane these days. What kind of world does Pfizer think we live in????

New Media, New Ways to Track You. Online Ad Technology is One Step Ahead of Lawmakers and Regulators

New Media, New Ways to Track You. Online Ad Technology is One Step Ahead of Lawmakers and Regulators

Citing privacy concerns, the Energy and Commerce Subcommittee on Commerce, Trade and Consumer Protection will hold a hearing tomorrow (December 2, 2010) on the feasibility of establishing a "Do Not Track" registry for the Internet.

Today, the Federal Trade Commission (FTC) will release its much-anticipated privacy report calling for a "do-not-track" tool for Web browsers (see "New Media Privacy Issues & Online Health Marketing" media advisory).

Also today, privacy wonks are meeting in Washington, DC at the National Press Club conference "The Future of Online Consumer Protections." Topics for discussion include:

• Protecting consumers while they surf the web: How to make a "Do Not Track Me" list work and other ideas.
• How costs can be cut with electronic medical records while still maintaining patient privacy.
• Is online health and drug marketing deceptive? Does it invade consumers' privacy?

One of the people presenting at that meeting is Jeff Chester, Founder and Executive Director of the Center for Digital Democracy (CDD). CDD and other privacy groups recently submitted a brief to the FTC citing "unfair and deceptive" online health and drug advertising practices (see, for example, "Center for Digital Democracy Challenges FTC to Reign In Online Pharma Marketing" and here).

Chester will be a guest on my Pharma Marketing Talk BlogTalkRadio show next Thursday and I'm currently hosting a survey on the issues (see below).

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New Media Tracking Technologies: Implications for Online Consumer Privacy
A conversation with Jeff Chester, Founder and Executive Director of the Center for Digital Democracy, about his organization's recently filed brief with the FTC requesting an "Investigation, Public Disclosure, Injunction, and Other Relief" regarding the array of sophisticated and non-transparent interactive marketing applications utilized by healthcare companies and the pharmaceutical industry to promote drugs online.

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While lawmakers and regulators are focused on "do not track" laws and web browser fixes, online advertising technology is already being "unleashed" that will make such laws, regulations, and fixes obsolete before the ink is dry. That's because these laws all focus on Web tracking cookies, which according to BlueCava CEO David Norris, "are a joke."

BlueCava and other companies are developing "digital fingerprint technology to identify how we use our computers, mobile devices and TV set-top boxes," according to this Wall Street Journal article. Here are some excerpts:

Device fingerprinting is a powerful emerging tool in this trade. It's "the next generation of online advertising," Mr. Norris says.

It might seem that one computer is pretty much like any other. Far from it: Each has a different clock setting, different fonts, different software and many other characteristics that make it unique. Every time a typical computer goes online, it broadcasts hundreds of such details as a calling card to other computers it communicates with. Tracking companies can use this data to uniquely identify computers, cellphones and other devices, and then build profiles of the people who use them.

Tracking companies are now embracing fingerprinting partly because it is much tougher to block than other common tools used to monitor people online, such as browser "cookies," tiny text files on a computer that can be deleted.

It's tough even for sophisticated Web surfers to tell if their gear is being fingerprinted. Even if people modify their machines—adding or deleting fonts, or updating software—fingerprinters often can still recognize them. There's not yet a way for people to delete fingerprints that have been collected. In short, fingerprinting is largely invisible, tough to fend off and semi-permanent.

Blue Cava also is seeking to use a controversial technique of matching online data about people with catalogs of offline information about them, such as property records, motor-vehicle registrations, income estimates and other details. It works like this: An individual logs into a website using a name or e-mail address.

The website shares those details with an offline-data company, which uses the email address or name to look up its files about the person.

The data company then strips out the user's name and passes BlueCava information from offline databases. BlueCava then adds those personal details to its profile of that device.

As a result, BlueCava expects to have extremely detailed profiles of devices that could be more useful to marketers. In its privacy policy, BlueCava says it plans to hang onto device data "for the foreseeable future."

Pretty scary, huh?

Is Your Digital Marketing Solution Mentioned in the CDD Brief? It Should Be!

Is Your Digital Marketing Solution Mentioned in the CDD Brief? It Should Be!

After a day of cooking, I spent the remainder of the Thanksgiving Holiday weekend reading and highlighting sections of the 144-page brief that the Center for Digital Democracy (CDD) filed with the FTC on Thanksgiving eve (see "Center for Digital Democracy Challenges FTC to Reign In Online Pharma Marketing").

This document -- now in the public domain (find it here) -- is perhaps one of the BEST reviews of healthcare-related digital marketing techniques that I have ever seen! I recommend that ALL pharma marketers read it to learn which companies to contact to help them do a better job reaching online consumers and physicians.

There were several companies and products mentioned that I have not heard of. In that regard, this brief -- negative though it may be -- is a promotional boon for these companies, IMHO. You can't buy this kind of publicity and as a recent article in the New York Times proves, even negative publicity can help you get top listing in Google searches (see "A Bully Finds a Pulpit on the Web").

I compiled a list of more than two dozen innovative online marketing products/solutions mentioned in the CDD brief. My list includes the product name, company/site name, description, link to online information, and the paragraph number in the brief where you can find what the CDD has to say about it (download the list here).

If your company is NOT listed, I suggest that you (1) contact CDD and ask them to amend their brief to include your solution and/or (2) file your own brief with the FTC.

Of course, CDD does not view these solutions as "innovative." In fact the CDD thinks they are "unfair and deceptive":

"The companies named in this complaint, as well as others involved in real-time tracking and bidding -- including those that provide data optimization services for profiled targeting -- are engaged in unfair and deceptive practices."

I must admit that one or two of the services were a bit scary. QualityHealth's "Focus on Formulary" solution, for example, claims to be "sophisticated technology" that "links consumer marketing with brand formulary access." It designs "targeting messaging directly to millions of profiled consumers based on prescription coverage." CDD says: "Few consumers likely realize, however, that they have consented to become the subjects of a 'proprietary profiling technology' that “captures… valuable information across over 100 individual data points,” including 'consumers’ conditions and preferred treatments'; 'doctor relationships and plans to visit the doctor'; and 'insurance and formulary coverage.'"

ConditionMatch (offered by Good Health Media) claims to use “cutting edge behavioral targeting technology…[and] identifies groups with common sets of conditions/health-related characteristics by geographic region via insurance claims and individual ‘opt-in’ data.”

Both sound like they may have HIPAA privacy issues.

There is no lack of innovation regarding the names given to some of these solutions, such as:

• ActuatoRx Geo-Medical Targeting
• Acquire2Convert
• Healthographics
• Pluck
• Intent Targeting Advertising
• Target 2 Measure
• BuzzScape
• Social Operating System
• Bizo Targeting Platform
• Quantemo Engagement Index
• Subconscious Resonance Testing
• Evoked Response Potential

The CDD does not analyze whether or not the claims made by the companies it cites are credible or designed to hookwink gullible pharma marketers into purchasing their solutions. For example, are there any pharma marketers who are convinced that "Pluck," which is designed to engage consumers in conversations with brands, is a viable solution for Rx products?

Which leads me to wonder why the CDD focused exclusively on healthcare marketing as a target for its critique. Many of the marketing tactics cited by CDD probably were first developed for the consumer goods industry and then renamed/rebranded to appeal to healthcare marketers as well. The CDD has helped accelerate the process!

Online Behavioral Tracking Becomes More Sophisticated, Annoying -- Soon Illegal?

Online Behavioral Tracking Becomes More Sophisticated, Annoying -- Soon Illegal?

A few months ago, I searched for and bought a futon on Overstock.com. For weeks afterward I kept seeing ads for Overstock.com futons pop up on almost every web site I visited. This, I realized, was the result of tracking "cookies" -- small programs -- that I "allowed" overstock.com to place on my computer. Too bad the technology (or programming) wasn't advanced enough to know that I already purchased my futon, had it delivered, and assembled it.

These days, however, tools that track users' whereabouts on the Web are more intrusive, more sophisticated and are "facing increased regulatory and public scrutiny and prompting a flurry of legal challenges," according to a Wall Street Journal article (see here).

"Since July, at least six suits have been filed in U.S. District Court for the Central District of California against websites and companies that create advertising technology, accusing them of installing online-tracking tools that are so surreptitious that they essentially hack into users' machines without their knowledge. All of the suits seek class-action status and accuse companies of violating the federal Computer Fraud and Abuse Act and other laws against deceptive practices."

One particular new technology involves Flash cookies -- cookies programmed using Adobe's Flash. Researchers have found that some Flash cookies were being used to re-create regular browser cookies that users had deleted. "Adobe and the Network Advertising Initiative, an industry group, condemn the practice of using Flash cookies to re-spawn deleted cookies," said the WSJ.

All this prompts me to ask if tracking cookies are being used by pharmaceutical marketers? Please take a few minutes to respond to my Use of Online Behavioral Tracking by Pharma Marketers Survey, which asks the following questions:

• Have you ever used behavioral targeting in an online advertising campaign?
• Should the pharmaceutical industry adopt similar self-regulatory principles that were established by media and marketing trade associations to protect consumer privacy when employing behavioral targeting.
• Should pharma marketers use behavioral targeting at all?
• If they do use it, when is it appropriate?

After you complete the survey, you will be able to see an up-to-date summary of results. AND be able to download the Pharma Marketing News article "Use of Behavioral Targeting by Pharma Marketers."

"Congress and regulators also are looking more closely at online tracking," notes the WSJ article. "Two bills have been introduced in the House of Representatives that would restrict the practice. The Federal Trade Commission is expected to issue new privacy guidelines by the end of the year and is considering a do-not-track registry, similar to the do-not-call list for telemarketing, that would allow consumers to opt out of behavioral targeting."

Pharma Email Spam: Three Degrees of Separation for Merck, Pfizer, and Genentech

Pharma Email Spam: Three Degrees of Separation for Merck, Pfizer, and Genentech

Soon after I posted a blog entry and tweeted about cholesterol-lowering drugs (see here), I "coincidentally" received the following e-mail message (click for an enlarged, readable view):

I do not remember opting in to receive email from Insyst Media -- the company that sent me this email. But, who knows, it may be one of those "third-party partners" of a website where I signed up to learn more about cholesterol.

So, naturally, I clicked on the "GET THE FACTS" button and was delivered to this intriguing Web page (click on image for an enlarged, more readable view):

Again,I don't recall opting in to any list maintained by  SearchNext, which is the company that seems responsible for this page. But being really curious where all this was leading, I obey and click on the button as indicated and end up on this page (click on image for an enlarged, more readable view):

Needless to say, I also never opted in to receive ads from FreshDeals.com --the entity that maintains this page. But I suspected that I was getting close to the sources who paid for all these companies to deliver ads to me. So I click on each ad on this page and discover that the top three links lead to pharmaceutical drug.com sites. One leads to Vytorin (Merck), another to Lipitor (Pfizer), and the third takes me to Zetia (also Merck). The last link goes to a Genentech non-branded site.

Following the Money Trail
I'm not interested in tracking down ALL these entities. I did, however, learn that SearchNext is a "pay-per-click advertiser marketplace [that] makes it easy to expand your already successful Google campaigns. Simply send us a dump of your AdWords campaigns and we will target your best converting keywords, geos and demos with our proprietary targeting and user qualification platform to turn users searching for your products into sales."

This "marketplace" conveniently puts 3 degrees of separation between the spam email I received and the pharmaceutical advertiser:

Pharmaco --- Fresh Deals --- SearchNext --- Insyst Media -- ME

I wonder if Merck, Pfizer, and Genentech realize that their Adword campaign is paying for spam e-mail? With 40% of pharma's online advertising budget allocated to search marketing, I can't imagine them NOT knowing!

DTC Marketing Mix: Radio & Outdoor Ad Spend Soars, Internet Not So Much.

DTC Marketing Mix: Radio & Outdoor Ad Spend Soars, Internet Not So Much.

As reported by Nielsen Monitor Plus and reported in the June, 2010, issue of DTC Perspectives, direct-to-consumer (DTC) advertising spend by the pharma industry increased by nearly 2% in 2009 versus 2008 (see trend chart below).

 As reported by DTC Perspectives, radio and outdoor "see largest increases in 2009 DTC promotion" (112% and 55%, respectively), whereas Internet spending (display ads only) saw a 31% increase. About 2.6% (a meager $117 MM) of pharma's DTC ad spend budget in 2009 was devoted to Internet display ads (4.4% if you include search advertising, which is estimated to be about 40% of the total Internet spend). The following chart compares the 2009 mix with the 2008 mix.

Not much of a change.

Nobody Knows You're a Fake Patient on the Internet!

Nobody Knows You're a Fake Patient on the Internet!

Last night I had the honor of hosting the #socpharm "Tweetchat" session, standing in for Eileen O'Brien (@EileenObrien; Siren Interactive) who is the founder and regular host of that Twitter discussion stream.

One issue discussed in last night's session was Sara Baker, a "fake" patient created by MedSeek, a health IT company (see Lori Moore's comment to this post).

"Meet Sara Baker," says MedSeek on its website. "ePatients like Sara Baker are the future of eHealth. She uses the Internet to stay connected with friends, check her bank balance and make purchases. She is Web-savvy and expects her healthcare provider to be, too. She has growing expectations of her healthcare providers for 2011 and beyond. And she will be the driving force behind your healthcare organization's ePatient revenue center." [emphasis added]

MedSeek even created a Facebook page/personna (eSaraBaker) for Sara where she posts things like "Just found out my hospital is adding a new online feature starting June 1: Now I’ll be able to log in one time to manage everybody’s appointments, prescriptions, etc. Me, Alex, Brad and Jake… all in one place. How great is that?"

Phil Baumann (@PhilBaumann) first called attention to this marketing ploy that "promises to deliver revenues to healthcare organizations wishing to market to so-called ePatients." Baumann coined the term "fPatient" to distinguish the likes of Sara from real ePatients (see "fPatient – Ethics and Mediocrity in Healthcare Marketing").

The #socpharm discussion of Sara Baker lead to a discussion of the use of "fake" patients on drug.com websites, something I have written about many times here on Pharma Marketing Blog. See, for example, "Alice, 35, is Not a Real Ambien CR Patient." After I wrote that piece, sanofi-aventis added the disclaimer "Not a real patient" to the animation on the site. Since then, however, they have moved away from images of "fPatients" to roosters. Oh well.

The trend today, however, is to solicit and portray real patient stories. See, for example, "Barb" on the Novartis Reclast site. She's featured in a "Dramatic Health Production" video in the "Real Reclast Stories" section of the website (here).

Although Barb is real, there are other "patients" featured on the website who may not be real. Take "Rhoda" for example. There's a written profile of Rhoda, but I can't find her in the "Real Stories" section. Is she real or fake? I can't say for sure one way or the other.

Obviously, actors are used in direct-to-consumer (DTC) Rx drug ads all the time. Sometimes, we are lead to believe that actors playing doctors in TV ads are real doctors or actually rowing when they are not (see "Jarvik: A Modern DTC Tragedy"). On TV we also see actors portraying patients. Sometimes they even speak and say how the drug helped them. Most often, however, these "patients" don't really say anything. They certainly are not identified by name and age as is the case with "Rhoda" and other questionable "patients" on drug.com websites.

Is it ethical for pharma marketers to employ "fpatients?" Is it even necessay? asks Baumann: "Is the deployment of fake profiles in Healthcare Marketing even necessary? Marketing not only has to be effective, it also has to be respectable. Why create a fake social object when so much more social capital can be built by simply being honest and truthful and direct? Why not take advantage of direct interaction and feedback?"

We might have to wait until hell freezes over before pharma marketers are "honest and truthful and direct" let alone before they "take advantage of direct interaction and feedback." Like the Reclast marketers, however, pharma marketers will go on location to videotape a real patient and create a well-crafted, edited video profile that they can feature on their websites and on YouTube for extra-added search engine benefit. You can't get that kind of ROI from "truthful, direct, honest interaction."

Is Your Brand a Digital Genius or a Feeble-Minded Idiot?

Is Your Brand a Digital Genius or a Feeble-Minded Idiot?

When it comes to digital IQ, some brands are geniuses and some are feeble-minded idiots, according to the "L2 Digital IQ Index" for pharmaceutical brands, a first-of-its kind measurement of the digital competence of 51 pharma brands across eight therapeutic categories.

The index was created by think tank L2 in partnership with media agency PHD Network. They evaluated pharmaceutical brands’ digital presence across four criteria: Platform (40 percent, including site effectiveness and brand translation); Off-Platform Messaging (25 percent, covering digital marketing efforts such as online and mobile advertising); Search Engine Optimization (20 percent, based on visibility on top search engines); and Social Media (15 percent, defined by presence on popular 2.0 platforms). Each brand was scored against more than one hundred qualitative and quantitative data points, and assigned a Digital IQ ranking of Genius, Gifted, Average, Challenged or Feeble (see press release).

The top ten brands on the index are (ta da!):

1. Viagra (Pfizer)
2. Nexium (AstraZeneca)
3. Chantix (Pfizer)
4. Ortho Tri-Cyclen Lo (Ortho-McNeil Janssen)
5. Crestor (AstraZeneca)
6. Tie between Gardasil (Merck) and Yaz (Bayer)
7. Tie between Symbicort (AstraZeneca) and NuvaRing (Merck)
8. Lunesta (Sepracor)

What's interesting is that although AstraZeneca emerged as the industry’s digital powerhouse with four brands in the top ten -- Nexium, Crestor, Symbicort and NuvaRing -- it is somewhat of a "digital idiot savant." Two other AZ drugs -- Tropol-XL and Pulmicort -- have a digital IQ in the feeble-minded idiot zone. This digital IQ disparity among brands within the same company seems standard within the drug industry (see chart below).

Pfizer's Viagra and Chantix are digital geniuses whereas Pristiq and Caduet are feeble-minded digital idiots!

How can that be?

The simplest answer is "brand silos." In an interview yesterday, L2 founder and NYU marketing professor Scott Galloway told me that drug companies are "highly siloed by brand. There's almost no sharing of best practices or competencies within the organization." I hope he's just talking about digital marketing! Which is bad enough.

The longer the bar in the chart above, the more "digitally siloed" is the company. AstraZeneca, it appears is not merely a digital powerhouse, it is also a siloed house!

The iPad as a Pharma Marketing Platform

The iPad as a Pharma Marketing Platform

"DTC marketers can't afford the luxury of waiting to see how many people purchase an iPad they have to start experimenting with app development and marketing NOW," says Rich Meyer over at World of DTC Marketing Blog.

The best example of an iPad DTC app Meyer could think of, however, was a cookbook for people with diabetes. As if the world needed a new diabetes cookbook!

I have an iPad and am enjoying it. I have even used it when cooking -- propped up on my kitchen counter next to the chicken parts. But I used the browser to find a recipe for BBQ ribs -- there were hundreds to choose from. I don't need an app for that. I assume the Internet is also full of recipes suitable for people with diabetes.

But Rich was probably thinking of something more useful. Something like Sanofi-Aventis's GoMeals app developed for the iPhone/iPod.

MM&M noted that "Sanofi-Aventis [S-A] is promoting it through outreach to diabetes bloggers as well as tactical advertising, such as banners on diabetes sites, and to the patient community through third-party orgs. As of [December 2009] it was the seventh-most-popular app in the free health and fitness section of Apple's iTunes Store."

I downloaded GoMeals for my iPod and used it to find restaurants in my area. You can compare the nutritional value of different restaurant menus and keep track of your own meals. It's very useful for all of us, not just for people who have diabetes. BTW, I  "forgot" to use the GoMeals app to calculate the nutritional value of my BBQ ribs.

When I used GoMeals on my iPad to find restaurants in my area, it crashed. At first I thought it was because my iPad was not GPS-equipped, but "Mic" said that iPad does have GPS (see comments) -- and he's right! Google Earth knows where I am! At least within 100 yards of where I am. Anyway, S-A needs to fix this problem and develop an iPad version. But is it worth the effort?

The GoMeals app has absolutely no marketing ROI for S-A. It may only be one part of an overall marketing plan to position S-A as a player in the diabetes area. Dennis Urbaniak, S-A's new VP of U.S. Diabetes, was previously Vice President of Innovation and New Customer Channels. No doubt Urbaniak was involved in developing the GoMeals app. BTW, listen to my Pharma Marketing Talk interview of Urbaniak: "What Sanofi-Aventis Learned from Its FaceBook Experience & What the Experts Recommend It Do Now."

Geoff McCleary, a mobile and tablet computing expert and vice president of strategy for imc2 health & wellness, suggested these consumer-oriented apps for the iPad that pharma marketers should develop:

• Weekly/monthly health eMagazine for disease state information
• 3D, touch interactive MOAs for disease or treatment education
• Branded support program materials delivered weekly or daily
• Social media-based content for brands or disease groups

How much disease state information can a monthly eMagazine publish and how would an iPad app be better than opening your email and a browser? We don't need an app for that. Same with branded support programs and social media-based content.

How about a "3D, touch interactive" MOA animation for Viagra or YAZ? Now those are pharma apps I'd like to see on my iPad!

You can find McCleary's white paper, "Considering the Apple iPad™ for Pharma Marketing," which has other ideas for apps -- including physician-oriented apps -- here.

P.S. The real marketing value of iPad is iAds, just announced by Apple's Steve Jobs (see "Apple Unveils iAd, iPhone 4.0"). iAds are "in-app" ads served up while you are using a "free" app like GoMeals, which does not have any advertising. Personally, I believe in-app ads are annoying, but if the app is valuable, I will put up with them. For pharma, the hard part will be coming up with truly useful apps.