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DTC-In-Perspective by Bob Ehrlich

DTC Advertising and the Clutter Trap: A Call for Creativity

January 7, 2025 0

I have been a close observer of DTC advertising for about 28 years. One of the issues I have is that most DTC television ads still have a similar look. You all know the type of ad that starts with some actor patients saying they have condition X, so they asked their doctor about drug Y and then are feeling better. Then they show the fair balance scenes of active patients on the beach, hiking, playing with the grandkids. These vignette ads still seem to dominate the DTC landscape.

DTC advertisers only have about 28-30 seconds in a :60 second ad to make the selling case. It is hard to get all the information in about brand name, condition, and benefits. I assume that every drug company has a rigorous process to get consumer qualitative and quantitative feedback. Since all these pharma companies are data driven, I also must conclude that every ad aired has met some reasonable internal action standard for success. In other words, every DTC ad aired must be “good” by standard research testing methodology.

That being the case, why are so many DTC ads lacking breakthrough creativity? I have asked this question to many pharma marketers and agency people. Many agree that, aside from their own ad, this creative sameness is a problem. The reality is that most of the ads I analyze are too similar. They may test well pre-air but when on air, with so many other DTC ads in the same time block, they have challenges breaking out of the clutter. Of course we do not want creativity for its own sake. We also need consumers to remember the key selling point so they are interested enough to follow up with their doctor.

Kevin Clancy, a noted marketing guru and author, said at one of the early DTC National Conferences that an ad that tests in the top 20% is twice as effective per dollar spent than an average ad. That makes creativity a valuable goal.

Here are 5 reasons most ads fail creatively to break through:

  1. Most drug ads are trying to be straight forward and logical in their advertising. Drug companies are pretty conservative and problem / solution information rich ads are in their comfort zone.
  2. These ads may in fact test well in a research setting because they are logical. Consumers will understand them and repeat back the benefits.
  3. The internal legal and regulatory folks also appreciate the clarity of the standard ad.
  4. FDA’s OPDP may pre-clear a standard format ad faster, because they have seen hundreds just like it and are less concerned about consumer distraction.
  5. The standard ad is easier to sell up the management chain just because of the logical nature of people running drug companies.

Challenge yourselves and your agencies to do better. I know we are not selling perfume and creativity is harder to execute in drug ads. Be careful when interpreting research data that says your ad tests well with consumers. Make sure your test includes competitive category ads and other DTC ads to simulate clutter. Have a goal to excel on the creative score. There are creative DTC ads out there that also get their logical selling points across. Many cookie-cutter standard ads are still successful in ROI measures because of the level of spending. However, demand that your marketing team and ad agencies strive to get that 2X in spending effectiveness. There is no reason for being average.

Bob Ehrlich

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DTC-In-Perspective by Bob Ehrlich

Weight Loss DTC Will Boom: GLP-1 Drugs Reshape the Market

December 10, 2024 0

The obesity drug market potential is staggering. America is overweight. I am overweight. My friends are overweight. Willpower is obviously not the solution because most of us cannot sustain it. We need to get by with a little help. About 40% of adults in America are obese according to the CDC. Thankfully, we have two currently approved drugs in the GLP-1 category. Wegovy and Zepbound from Novo Nordisk and Lilly, respectively, currently lead the category. Others will follow.

There has never been a category so suitable for DTC advertising. High incidence, easy understanding of the condition, and fast action to see results are the hallmarks of a no brainer DTC drug. A JP Morgan analyst predicted the GLP-1 obesity market will grow to $71 billion by 2032. There are about 110 million Americans who could benefit from using obesity drugs. Currently only about 6% are using them according to the Kaiser Family Foundation.

Wegovy has been blasting its availability over the past year. We have all seen the great march of people down the street DTC ad. The power of “we”. Lilly’s Zepbound started DTC advertising mid-November. Supply issues made advertising unnecessary until capacity issues were resolved. Production has been recently expanded according to Lilly.

Lilly has set up its direct distribution system to consumers to offer that alternative to regular channels of retail pharmacies. They are ready to promote demand growth.

You can count on several new competitors in the next few years as the great gold rush for this market is making drug makers salivate. Lilly and Novo Nordisk know their premium priced drugs will be facing lower priced entries. The window for maximizing sales at premium prices is short. Insurers will be gradually increasing coverage because the added benefits of these drugs are exciting. At current prices, insurers are not rushing to cover them.

The weight loss category from GLP-1 drugs is set to become a massive DTC advertising spender, reshaping how America addresses obesity and its related health challenges.

Research studies are showing a litany of health outcomes beyond weight loss such as reducing blood sugar, blood pressure, heart disease, addictive behaviors, and potentially dementia. It is just a matter of time before they are covered because of the potential reduction in costs of treating heart disease, diabetes, and dementia.

The pressure will be on drug makers to make these drugs more affordable to the average American. Hearings in Congress were recently held with the Novo Nordisk CEO to pressure the company to lower prices on Ozempic and Wegovy, which run about $1,200 a month for self-pay. Discount cards are available, so the real consumer price is about $600 a month unless covered by insurance.

DTC ads will help keep demand high and new competitors will eventually drive down price. Expanding capacity will allow both Lilly and Novo Nordisk to reduce price and make it up on volume. After all, better to have more customers on these drugs for years at affordable prices than have them start and stop due to cost.

Once we see new competitors, we will see DTC ads evolve to highlight brand advantages. Those might be based on price, form of dose as in pill or injection, frequency needed, side effects, efficacy of weight loss, or other collateral health benefits. The weight loss category from GLP-1 drugs is going to be a massive DTC spender for years to come.

Bob Ehrlich

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DTC-In-Perspective by Bob Ehrlich

Revolutionizing Pharma: The Rise of Direct to Consumer Pharmaceutical Drugs

December 3, 2024 0

One of the current trends in DTC marketing is the availability of some branded drugs shipped directly from the manufacturer. Some pharmaceutical companies are starting to cut the wholesalers and retailers out of the purchase cycle. While still in its infancy, the direct to consumer operations have enormous implications for how consumers will get their drugs in the future. Eli Lilly and Pfizer are the first to offer this service.

The direct sales of drugs to consumers have been in place for nearly a decade from non-pharmaceutical companies. Hims started in 2017, and there are now many non-pharmaceutical companies diagnosing, prescribing, and shipping to consumers. Drug companies have decided to enter direct sales in the past few years.

Why are drug companies now getting into the direct sales business? There are several good reasons for this new approach. First, drug makers are now seeing a huge growth in direct sales companies offering compounded versions of their drugs. These are cheaper and, in categories like weight loss, have lots of appeal to consumers. Second, cutting out the middlemen gives drug companies better ability to lower drug prices. Third, there are enormous marketing advantages to knowing your customers and tracking their purchases over time. Fourth, drug companies are concerned about counterfeit drugs through reimportation which is a real problem for consumers ordering from the internet. Fifth, consumers like the convenience of getting diagnoses and prescriptions without having to see their doctor in person.

“Cutting out the middlemen gives drug companies better ability to lower drug prices, know their customers, and combat counterfeit medications – reshaping how consumers access healthcare”

I would expect that drug companies will greatly expand their direct to consumer programs and use traditional DTC advertising to make consumers aware of their purchase options. The direct business will not replace retail drug stores or drug wholesalers for most drugs. Most of the growth will come from lifestyle categories like weight loss, sexual dysfunction, sleep disorders, migraine, anxiety, and depression. Any category where an online survey and virtual healthcare can diagnose a consumer condition is an opportunity for direct sales.

There are legitimate ethical and policy implications to expanding direct pharmaceutical distribution. The non-pharmaceutical direct business makes it easy to get prescription meds through an online survey or telemedicine that inappropriate prescribing is possible. I expect pharmaceutical companies will have better controls in place to make sure a prescription is justified. After all, these big pharma companies have a lot more to lose in public reputation and through regulatory, public policy, and legal actions.

The Amazoning of America has certainly shown that consumers love the convenience of shopping from home. Getting a diagnoses, prescription, and delivery online is becoming accepted for many drug categories. Drug companies see the potential and expect major growth in this channel.

Bob Ehrlich

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DTC-In-Perspective by Bob Ehrlich

Trump and Pharma

November 12, 2024 0

The election of Donald Trump is having pharmaceutical companies evaluate how things may change in terms of legislation and regulation. Trump is not yet clear on his moves regarding pharma. In his first term, he criticized the drug companies for pricing higher in the U.S. than other developed countries. Republicans in Congress have generally not allowed punitive legislation on price controls. They understand the negative impact price controls would have on R&D. Trump wants lower prices and that is publicly popular.  Acting on PBMs would be one option. Another would be allowing and promoting reimportation of drugs.

The DTC Industry should be nervous about Robert Kennedy Jr. being given a large role in healthcare policy. He said on 11/4 that he wanted to get Trump back in D.C. so they can “ban pharmaceutical advertising on TV.”  Scary comment. Kennedy is known for anti-vaccine sentiment and the desire to get corporate influence reduced. He is anxious to focus on prevention of disease which he feels is neglected in budgetary decisions. Kennedy thinks DTC advertisers exert influence on editorial coverage. Anyone who has watched news coverage knows the drug industry has not historically been favorably covered.

I doubt Trump will act on DTC advertising. He did not in his first term and a Republican Congress will recognize the free speech rights to advertise. I do expect Trump to speed up the regulatory drug approval process and that should be a net positive for innovation. In fact, expansion of drug use and DTC ads promoting such should help in the disease prevention goal of Kennedy.

Will FDA be asked by Kennedy and Trump to make DTC harder to execute? It is already harder with the latest OPDP rule recently implemented. Can it be made so restrictive that DTC ads are impractical? That is certainly a possibility, but the drug, media, and advertising agency lobby is strong and persuasive. Usually, the pro advertising forces have prevailed. Republicans have historically been pro-advertising, and I expect Trump not to act even if Kennedy proposes a ban.

Uncertainty is never helpful in DTC planning and the anti-DTC proponents will make a lot of noise. I remain confident, however, that no actions will be taken to ban or further restrict DTC.

Bob Ehrlich

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DTC-In-Perspective by Bob Ehrlich

Bernie Sanders Hearing on Drug Prices

November 6, 2024 0

On September 24, Novo Nordisk CEO Lars Jørgensen testified before the Senate which I watched on C-SPAN. He was asked to appear to discuss the reasons for high prices for GLP-1 diabetes drug Ozempic and its weight loss sister drug Wegovy. The savaging of drug company pricing policies is an ongoing cause for Sen. Sanders.

Bernie pointed out in his opening statement that US prices for Ozempic and Wegovy are multiples of their price in Germany, the UK, Canada, and other European countries. With his usual outrage, Bernie demanded answers from big pharma. Mr. Jørgensen had a few reasons for higher prices, most important that the list prices are high because Pharmacy Benefit Managers (PBMs) want drugs with high list prices. This is because rebates to them are a percent of list price. According to Mr. Jørgensen, Novo only gets 26% of the list price, the rest going to PBMs.

He also said that insurance companies set the net price consumers pay, not drug companies. Bernie then said that even with PBM rebates US prices are still too high. There was no definitive answer given by Mr. Jørgensen on the reasons for the difference between US and European pricing. What was clear was neither Republicans nor Democrats were satisfied they got their answers. Senators seemed frustrated with the complex nature of drug pricing and want legislative action on how PBMs get compensated.

The reality is that US drug prices are higher because the drug makers face price controls in most other countries. Prices would be lower if PBMs were cut out of the loop but still be higher than Canada or Europe. The US consumer partially subsidizes R&D for the world. That is unfair, of course, but reality. If Bernie got his wish and drug companies charged the European price, we would have less R&D. Mr. Jørgensen pointed out Novo Nordisk is spending $30 billion on increasing manufacturing capacity and $4.2 billion on Diabetes R&D last year. He said their annual R&D budget was more than the National Institutes of Health spent. If US drug prices historically matched Europe, it is likely we would not have Ozempic or Wegovy available today.

Innovative drugs like Wegovy will come down in price as production is ramped up and competitors enter the market. The obesity market is huge and Wegovy and Lilly’s Mounjaro will grow exponentially if price comes down significantly. Their makers know this and once they have enough production capacity, they will cut prices and vastly expand usage. Their large DTC spending shows how much they think they can grow the market.

As the GLPs increasingly show health benefits beyond diabetes and obesity, such as for cardiovascular and kidney disease, it is imperative that prices are low enough to get mass use covered by insurers and affordable for direct pay patients. Our collective health may depend on a significant cut in prices.

Bob Ehrlich

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DTC-In-Perspective by Bob Ehrlich

The Implications of the Ubrelvy Letter from OPDP

October 22, 2024 0

On 8/29/24, AbbVie received a notice from FDA’s OPDP that their Serena Williams DTC television ad violated the FD&C Act. The reasons cited are for overstating the benefits of Ubrelvy. The untitled letter illustrates the difficulties pharmaceutical companies face in presenting benefit information that satisfies FDA requirements.

Ubrelvy tried to meet FDA requirements and do it in a :30 second ad. For drug ads, this is very hard to do given most drug ads need :60 and :90 seconds because of complex benefit claims and fair balance. AbbVie has used Serena Williams as a migraine relief spokesperson for several years. She has been an excellent example of a celebrity endorser. Serena has the migraine condition and the ads are presented in a unique creative style.

What happened in this case that OPDP called the ad violative? In sum, OPDP said the stated benefit of providing one dose rapid relief was not consistent with clinical data. That data showed only a minority of users got relief that quickly. The television ad claimed in a large super, “Ubrelvy Quickly Eliminates Migraine Pain”. Serena’s audio says, “One dose works fast to eliminate migraine pain.”

OPDP also had concerns that Serena, as a celebrity, further added to the potential for consumers to believe the one dose rapid relief claim was true for all users of Ubrelvy. OPDP cites several studies supporting the idea celebrities add to claim believability.

OPDP acknowledges that the ad had a small qualifying super saying “some people had pain freedom within 2 hours.” That small super was insufficient in balancing the ad’s stated claims of rapid relief. OPDP says the speed of relief and one dose claims are misleading because they do not work for everyone.

The Ubrelvy case is important because it illustrates the difficulty drug makers have distilling complicated clinical results into concise advertising claims. Ubrelvy and almost all other prescription drugs provide benefits for some but not all users. Trying to get to that one compelling benefit in DTC ads is difficult given that clinical data is mixed in patient outcomes. Drug claims need to have significant enough disclaimers on efficacy to clearly communicate the extent of the benefit.

In this case, OPDP felt Ubrelvy did not present the proven clinical benefits clearly enough. I should point out the Serena ad in question is not vastly different from the other Ubrelvy ads run from 2022. The earliest ads from 2020-2021 were less declarative, however, in the claim using the word “can” help relieve migraines.

I am not sure if OPDP questioned prior ads or had discussions with Ubrelvy during the pre-clearance process. There is a redacted paragraph in the letter that indicated previous OPDP concerns about Ubrelvy ads. This was when Allergan owned the brand before being acquired by AbbVie. Most drug ads are pre-cleared at least for the first campaign used. Sometimes new versions are not pre-cleared if similar enough to earlier ads.

AbbVie has been asked to stop running the ad and it will be interesting to see their response to OPDP. Usually if the pharmaceutical company stops running the ad, the FDA will not take further action requiring corrective advertising.

 

 

 

Bob Ehrlich

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DTC Role in Covid Vaccine Success

December 9, 2020 0

This column is not about a DTC advertising campaign that already exists. Instead, it is about what should happen after the Covid-19 vaccine is approved. Unfortunately, too many Americans are skeptical of a vaccine. 

Trump clearly showed that he was not medically accurate in many of his Covid related treatment statements. His vaccine program was doubted by some for being an election booster if it could be fast tracked and approved before the election. His Democrat opponents cast doubt on any vaccine developed under his watch. Several states said they would independently review vaccine data even after the FDA approved it.

Now that Pfizer and Moderna have announced the phenomenal results, the hard work begins after approval in terms of timely distribution and getting enough Americans to take it. DTC must play a role in convincing Americans the vaccine is the solution to this worldwide nightmare. 

The conundrum is how much should a drug maker spend on DTC when they can sell all they make. Should the front runners Pfizer and Moderna run DTC even though they don’t need to create demand? The answer is yes. This is a case where all drug makers of vaccine have an ethical responsibility to make Americans want to get this vaccine as soon as it is available to them. We know that vaccine makers have done a good job creating ads for their other vaccines. The DTC goal is reassurance that the vaccine is safe and will end the pandemic.

It will be interesting to see the creative on Covid vaccines. The challenges are to first ensure that safety concerns are dealt with as safety data is only over a short period. We don’t want Americans to hold back and let their friends and neighbors go first. The second challenge is the two shots needed. Drug makers are going to have to convince us to get shots a month apart. Third, is the concern that the shot may only last months not years. 

Of course, we can expect that drug makers will see massive government investment in consumer outreach. Federal and state health departments will spend to get the message out. Employers will be adding their own efforts to get employees vaccinated. So, my estimate is we will see over $100 million invested in vaccine DTC. Money should not be a limitation given the Covid pandemic has cost this country hundreds of billions in economic losses. We can hope government will be setting aggressive targets to raise the percent of those vaccinated. Experts think we need at least 70% of the population vaccinated to nearly eradicate Covid. 

Particularly important is convincing African-Americans to take the vaccine. According to Pew Research only 42% said they are definitely or probably going to get vaccinated. The number among the total population is 60%, and among Hispanics it is 63%. All these are under the estimated 70% it will take to get herd immunity. DTC is one of the fastest ways to get Americans convinced the vaccine is necessary. All constituencies, public and private, need to invest in a major DTC effort and accelerate adoption.

Bob Ehrlich,
Chairman
DTC Perspectives, Inc.

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Bob Ehrlich

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Abbott Promotes Its Technology

October 29, 2020 0

A very interesting campaign from Abbott has launched that promotes its wearable technology to monitor symptoms of heart disease and blood glucose levels. These are not disease education ads in the traditional sense. Nor are they the common corporate ads promoting their laboratory research. This campaign is more of a plug for technologies that Abbott developed to change how diseases are monitored.

The theme of the television campaign is that you don’t wait for life, you live it. The idea is that new technologies to monitor disease allow people to go on with the moments of life. The glucose monitoring execution shows children playing with their siblings and mom. After about 20 seconds, we see one child wearing a glucose monitor device on her arm. Then the announcer identifies the Abbott glucose monitor which he says is always on so you don’t wait for life, you live it. 

In the second ad from this campaign, we see a man coming home to a dog apparently newly adopted, and then we see him later in scenes with his new dog. In this case, Abbott is promoting a small implantable heart monitoring device. Like with the glucose monitor ad, the announcer says the heart monitor technology allows you to live life.
The purpose of these ads is not to sell the technology to patients but to promote Abbott as a corporate leader in diagnostic technology. We have all heard about Abbott being active in developing the 15 minute Covid test. These spots seem to be designed to show Abbott is a leader across many disease states in diagnostic technology.

The campaign is an interesting take on corporate ads. We see consumers shown benefiting from the technology by making it easier to live life to its fullest. Abbott’s goal appears to be raising its consumer and investor profile as an innovative diagnostic company.
Abbott is also running print ads with the headline “Life. To the Fullest.” These are running in business publications like Forbes, Bloomberg, and Fortune, which discuss the rapid Covid test as well as the glucose monitor in a separate ad seen in The Economist. 
Covid has raised the profile of Abbott through its widely publicized rapid test and the company also wanted to promote its other innovations to investors and influencers. The campaign is well done as it is visually interesting in both television and print. At a time where diagnostics is taking an important role for most Americans, the Abbott campaign is well-timed and highly relevant.

Bob Ehrlich
Chairman
DTC Perspectives, Inc.

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Bob Ehrlich

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GSK Shingrix- Straight Talk

October 9, 2020 0
The new GSK campaign for its shingles vaccine is very interesting. They have coalesced their message around a very simple statement: “Shingles Doesn’t Care.” They are telling consumers that you can do everything right health wise and still get shingles. 

They are using a multimedia campaign which is well integrated in terms of creative approach. The 60-second tv ad is vignette style with consumers in different scenes saying they take various healthy actions through diet, exercise, and being outdoors. The authoritative voice over says each time that shingles doesn’t care. You can do everything right, but shingles is lurking and as you age the immune system is less effective keeping shingles from appearing.

The ad claims that Shingrix is over 90% effective. What is great about this ad is the clarity of the claims. Basically, shingles will affect 1 in 3 people. Your healthy lifestyle does not matter. Shingrix works well to prevent outbreaks. 

The print campaign is also very memorable. Each execution shows a full page visual of a person 50+ in a healthy situation with a small headline saying what they are doing to keep healthy. Underneath in the center of the visual is the “Shingles Doesn’t Care” headline. 

There is a digital component of the campaign as well with varying reminders to ask your doctor about Shingrix. The website is well integrated in look and feel of the media campaign. There is easy to understand additional information on shingles and Shingrix.

The GSK Shingrix campaign meets all the criteria for very successful DTC ROI. They have a large potential target, a simple solution to a frightening disease, and easy to understand advertising with motivating action steps. The spending to date, according to MediaRadar is about $10 million.
Bob Ehrlich,
Chairman
DTC Perspectives, Inc.
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Bob Ehrlich

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