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The American public's trust level in pharmaceutical companies fell 13%, dropping down to 38% in 2018 compared to 2017, accord to Edelman's recently released Edelman Trust Barometer. According to the report, the “pharma industry [is being] blamed for high cost of drugs and aggressive marketing of opioids as addiction reaches epidemic levels”.

Steve Weiss, Senior Vice President at Edelman, writes on Edelman's website that “This makes pharma companies the least-trusted healthcare industry in the U.S., far lower than hospitals/clinics (70% trust), consumer health (56%), biotech/life sciences (55%) and insurance (46%).” One way to combat this, Weiss suggests, is by partnering with advocacy groups. Such partnerships will add to credibility, especially if the advocacy group is a member of the National Health Council, which has a stringent set of accountability and ethical standards.

Weiss also advises to increase transparency – starting with research and drug development to financial / funding situations, all the way through to content development and article authors, editors, and reviewers. Globally speaking, the general public were more trusting of a pharmaceutical company “if it also provided information, tools, and support to help [patients] manage [their] disease.”

Click here to read the full 2018 Edelman Trust Barometer report.

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I was watching HHS Secretary Alex Azar during the White House press briefing unveil an idea we have heard pushed before. That is, DTC advertising should disclose the price of the advertised drug. That sounds fair but is a lot more difficult to implement than any other advertised category.

Most advertised retail prices have relevance to consumers. A car advertised at MSRP will sell for somewhere between 85-100% of that price. That is true for most products that disclose prices. Health care prices are wildly variable depending on the payer. Those prices can vary by as much as 50-75%. I understand the goal of HHS. It is to give consumers an idea about how expensive a drug is before they and their physician make the decisions to use it.

“I doubt a DTC ad is the right place to discuss price.”
-Bob Ehrlich

In my last column on this topic, which was written last July after the American Medical Association recommended that a drug’s price be required in DTC ads, I said prescription drugs are unique in that consumers have no idea what the advertised drug costs based on the ad itself. No other category has ads where its products range from $300 a year to $100,000. Consumers who are interested in an advertised drug may be in for sticker shock and depending on coverage may be paying a high out of pocket cost. Secretary Azar thinks that the consumer deserves to know that price information in advance. The issue is how to do that in the prescription market with its myriad of discounts. What consumers want to know is what they will pay, not what their insurer will pay. Given the numerous payers, all with different formulary coverage and individual discounts, that is hard to communicate.

Clearly drugs can be broadly categorized by cost, so perhaps an ad can say in what pricing category the drug fits. Maybe there are terms HHS can come up with to give consumers an idea in which cost category the drug belongs. Even if they do, consumers care what they pay not the listed retail price. It is possible a $100,000 drug costs them less than the $3000 drug based on reimbursement.

This price disclosure motive seems to be designed to put pressure on drug makers to be embarrassed advertising high priced drugs. That may mean those $100,000 cancer drugs prefer not to advertise if they had to list a high retail price in the ad. My recommendation would be to have ads refer to a link on their website or an HHS website that can discuss price in detail. In a 60 second spot HHS can only expect a super that discloses a list price or a voice over saying what the drug may cost. That would be totally insufficient for consumers and more likely confuse them.

OPDP likely will propose research studies on how best to convey price and we can expect a guidance several years out. I do not agree with the practical value of some of their research studies but this one deserves careful study. I doubt a DTC ad is the right place to discuss price but if it is mandated by FDA then it must be done to help consumers evaluate a drug on the cost/benefit context, and not just to generate public outrage that some drugs are very expensive.

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The FDA recently released “Drugs@FDA Express”, a mobile app that allows users to search for information about FDA-approved brand and generic prescriptions, OTC medications, and biological therapeutic products. The mobile app is a “light” version of the full website, with the app omitting letters and reviews – although the app's homepage states this and includes a link to the website for “the complete version.”

Users of the free app can search by drug name, active ingredient, or application number. They can also view the last seven days of product approvals, as well as links to FDA web pages and FDA help and support (including the agency's glossary, FAQs, and emailing the Division of Drug Information, FDA/CDER).

FDA Commissioner, Scott Gottlieb, MD, stated in the news release announcing the app: “Consumers are embracing digital health technologies to inform everyday decisions. From fitness trackers to mobile applications tracking insulin administration, these digital tools can empower consumers with a wealth of valuable health information. Advancing mobile apps that inform people about their health and medical choices represents a significant public health opportunity and is a high priority for the FDA. The FDA is continuously seeking ways to bring information to consumers in more accessible formats. Today, with the launch of the Drugs@FDA Express mobile app, we're bringing the public important information about drugs in an easy-to-use, mobile format. We hope that by making this important health information more easily accessible we can help empower patients and providers in making their treatment decisions.”

The app is available for both Apple and Android devices.

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Earlier this month, Sen. Claire McCaskill (D-Mo.) introduced a bill to end the advertising cost tax deduction; this is separate from the larger tax cut bill from last December which failed to remove the practice. This latest attempt, Senate Bill 2478 a.k.a. The End Taxpayers Subsidies for Drug Ads Act, is co-sponsored by Sen. Jeanne Shaheen (D-NH).

Much like previous bills similar in nature, industry pushback from both pharma and media companies alike is expected to be significant – largely citing the arguments that removing such an ad deduction for pharma would be discriminatory; it is a threat to the First Amendment; and it would prevent or limit important, valued health information from reaching consumers.

Jim Davidson, Executive Director of The Advertising Coalition, spoke with DTC Perspectives on this matter: “Section 162(a) of the U.S. Tax Code allows any U.S. business to deduct the ‘ordinary and necessary costs' of conducting their business. Those costs include salaries of employees, office rent, business supplies – and yes, the cost of advertising. Rather than ending a taxpayer subsidy for advertising, S. 2478 would impose a tax on advertising for prescription medicines that does not apply to any other business advertising. Previous efforts to tax DTC advertising have been defeated because they threaten the First Amendment protection for commercial speech. The proposed legislation overlooks the information that this advertising provides to consumers who may be unaware of a treatment for rheumatoid arthritis, Crohn’s disease, depression, or Hepatitis C, among other diseases. Even more important, watching an ad may be the motivating factor that prompts someone with a medical condition to see a doctor for treatment.” (Jim will discuss this, as well as other Threats to Pharmaceutical Advertising, in his presentation at the DTC National Conference in Boston, April 18-20.)

“The Coalition [for Healthcare Communication], the 4A’s and our advertising allies will be taking this bill seriously, but it is unlikely that it will be enacted in this session of Congress,” said Coalition for Healthcare Communication Executive Director John Kamp in a news release in response to the bill. “While the provision is likely to garner some Democratic and even a bit of bipartisan support, the Republican-controlled Senate is not expected to hold hearings or set the provision for a vote.” He added: “The Coalition has long opposed such a change in the tax law. Proposing a ban or tax penalty on prescription drug advertising suggests that consumer ignorance should be preferred to consumer information and involvement in healthcare decision making.”

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In the latest Gallup poll, 55% of Americans “worry a great deal” about the availability and affordability of healthcare. The concerns around healthcare top the list, beating out other major concerns such as Crime and violence, Federal spending and the budget deficit, and Availability of guns. A further 23% ranked their concern level at “a fair amount” and another 23% classified themselves under “only a little or not at all.”*

According to Gallup, this is the fifth consecutive year that healthcare availability and affordability tops the list. (The first year that healthcare was asked about was in 2001.) Senior Editor Jeffrey M. Jones, PhD, noted in the article highlighting the results that, “It is the only issue of the 11 Gallup has measured consistently to maintain this level of worry.”

Jones added that after being nearly “equally likely to worry about [healthcare] in between 2014 and 2016, after major provisions of the Affordable Care Act went into effect,” currently “Democrats have typically worried more than Republicans about the issue, including a 72% to 39% difference this year.”

With President Trump and Congress “taking steps to undo key provisions of the law,” Jones predicts that “Americans' anxiety about the healthcare situation should persist. … Democrats' especially high concern about healthcare could make it a mobilizing issue for the party as it seeks to win control of Congress this fall.”

For more information and poll results, click here.

* Results for this Gallup poll are based on telephone interviews conducted March 1-8, 2018, with a random sample of 1,041 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia. For results based on the total sample of national adults, the margin of sampling error is ±4 percentage points at the 95% confidence level.

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Out-of-home advertising company, Brite Media Group, has acquired Mesmerize Marketing, a leader in patient education at the point-of-care. “Gregory Leibert, the founder and Chief Executive Officer of Mesmerize, and Craig Mait, Chief Operating Officer, will join Brite Media in leadership roles and will continue to operate the Mesmerize business along with their existing team,” outlined the news release.

With Mesmerize's “targeted educational materials including wallboards, literature distribution, branded medical essentials, and mobile integration to patients and care givers in waiting rooms, exam rooms, and other high traffic areas of doctors’ offices, dental offices, community-based organizations, AIDS service organizations, and independent pharmacies,” Brite Media now has strong access to the point-of-care space. In return, “[t]he partnership with Brite Media gives Mesmerize Marketing the resources necessary to scale our rapidly growing point-of-care networks,” said Leibert. “Mesmerize will also look to expand our patient education and deliver significant results to our customers, by supplementing our industry-leading static media presence with new static and digital media platforms.”

Michael Ellis, Brite Media’s President and Chief Operating Officer, added that “Mesmerize will perfectly complement Brite’s current media platforms. The combined companies will leverage the strengths, creativity, and human capital of both businesses to continue delivering outstanding results to our customers.” Brite Media had been acquired by The Beekman Group in 2014. Since then, Brite Media “has more than doubled in size through organic growth and acquisitions led by Beekman and management.”

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Andrew Schirmer has taken on the role of Chief Executive Officer with Ogilvy CommonHealth North America, a WPP Health & Wellness company. He returns to his roots, having started his career with the company in 1987. Schirmer was most recently President with McCann Global Health, overseeing the firm's global and public health unit. According to the news release, he was “responsible for leading the work the agency did for UNICEF, the US government, the Bill & Melinda Gates Foundation and private sector organizations, and the groundbreaking ‘Immunity Charm' campaign, which tracks vaccinations on behalf of the Afghanistan Health Ministry, and for which the agency won a Grand Prix at Cannes Lions in 2017.”

Mike Hudnall, CEO of WPP Health & Wellness, stated in the news release: “Andrew exemplifies the values we hold dear: excellence in client partnership, support for our incredible people, and an unbridled passion for making the world a better and healthier place. His professionally diverse background in healthcare marketing, consumer wellness, and public health and policy positions him well to help accelerate OCH’s diversification and growth strategy moving forward. Andrew is a champion of great work and true visionary who will bring a human-centered leadership to OCH’s culture. I have complete confidence that Andrew is the right person to unlock the potential of our people and our business as we move forward.”

Schirmer will report directly to Hudnall and work closely with Marc Weiner, Ogilvy CommonHealth's COO; Darlene Dobry, managing partner; and Terry Cully, managing director in Canada. Schirmer fills the vacant CEO position after Matt Giegerich's departure in spring 2017. Giegerich founded his own company, Lucky 7 Consulting, before becoming CEO with Inception Companies, a leading provider of video production, interactive visual solutions, broadcast and webcast platforms for virtual meetings, and audio/visual support.

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DTC Perspectives, the leading forum for direct-to-consumer (DTC) advertising thought leaders, will honor a dynamic group of pharmaceutical companies and brands at the much-anticipated DTC National Advertising Awards. The awards are part of the 18th Annual DTC National Conference held April 18-20 in Boston.

Sponsored by Health Monitor Network, the 2018 Advertising Awards showcase the best marketing and advertising across 22 categories, including a Voter’s Choice and Chairman’s Award categories. (Industry voting for the Voter’s Choice category will run in March. Stay tuned for details!) Gold, Silver, and Bronze winners will be announced during the Advertising Awards Dinner held on April 19.

“The DTC National is exciting each year for us as a celebration of the creativity and effectiveness of DTC consumer promotion,” says Ken Freirich, President of Health Monitor Network. “As an entrepreneurial company celebrating our 35^th anniversary, developing creative solutions to facilitate patient and HCP dialogue, we are pleased to sponsor the awards and to recognize the many successes in the marketplace.”

[button link=”https://www.dtcperspectives.com/dtcn/2018-ad-awards/”]View the 2018 Finalists[/button]

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Last week the Departments of Health Human Services (HHS), Labor, and Treasury proposed a rule that would “expand the availability of short-term, limited-duration health insurance by allowing consumers to buy plans providing coverage for any period of less than 12 months, rather than the current maximum period of less than three months.” This will not only provide affordable coverage to Americans who may not have been able to afford current premiums and options, or lacked access to choices that properly matched their needs, but it will “increase competition, choice, and access to lower-cost healthcare options for Americans.”

While the purpose of these health plans was for temporary coverage, but due to their affordability, access to such plans “has become increasingly important as premiums have more than doubled between 2013 and 2017 in health plans on the Federal Health Insurance Exchange,” the news release stated. The short-term, limited-duration insurance does not have to comply with federal requirements for individual health insurance coverage.

Health and Human Services Secretary and former Lilly USA president Alex Azar stated: “Americans need more choices in health insurance so they can find coverage that meets their needs. The status quo is failing too many Americans who face skyrocketing costs and fewer and fewer choices. The Trump Administration is taking action so individuals and families have access to quality, affordable healthcare that works for them.”

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In the spring of 2018, Apple plans to premiere AC Wellness, independent medical centers for its employees and dependents offering concierge-like healthcare. As first reported by CNBC yesterday, Apple “quietly published a website, acwellness.com, with more details about its initiative and a careers page listing jobs.” While little information is currently available, AC Wellness’ website boasts that their Network will combine technology, high-quality care, and a unique patient experience to drive engagement and achieve exceptional health outcomes. The website also advertises for career opportunities. Positions to be filled include Health Partner, Physicians, Care Navigator, and Nurses, among others.

This initiative comes shortly after Tim Cook commented about Apple’s ability to make “significant contributions” to health care earlier this month during a shareholders meeting. Cook shared that the tech innovator is in a “great position”, being able to leverage its consumer-friendly approach, as reported by CNBC.

Apple has already been collaborating with the FDA to improve regulations on digital health products. Other coordinators announced last summer as a part of the FDA’s Pre-cert pilot program were Fitbit, Johnson & Johnson, Pear Therapeutics, Phosphorus, Roche, Samsung, Tidepool, and Verily. The work is a part of the Digital Health Innovation Action Plan.

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