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Ehrlich on Creative

The Rx Available Without A Traditional Prescription

July 2, 2020 0
The opium overdose antidote Narcan (naloxone) is a very interesting DTC case. Naloxone is widely used by EMTs and first responders to counteract opioid overdoses. States have recently made Narcan from ADAPT Pharma available to the general public to use on those in the home who overdosed. Narcan is a branded nasal spray version of naloxone.

The interesting development is this is a prescription drug that most states (42) make available from the pharmacist without requiring a doctor to write a script. The new television campaign is an Rx DTC campaign explaining why Narcan should be stocked in households where opioid painkillers are used.

The ad is a :60 second spot that looks like a typical Rx DTC ad. We see a scene with a teenager who injured himself playing sports and is now on an opioid pain killer. The theme is for parents to be ready to deal with an accidental overdose. I assume that Narcan is also widely used to help opioid drug abusers. This ad only deals with prescribed pain use, not illegal drug use, but the idea is the same. Narcan can save a life by reversing the effect of an opioid which has depressed the breathing or induced unresponsive deep sleep in affected individuals.

This is a very serious drug and risks and side effects are discussed just like all DTC Ads. Narcan is running digital ads as well. These ads state that 40% of opioid overdoses are prescription based used for legitimate purposes. The goal of the ad is for every opioid using household to keep Narcan handy. Prescription opioid use is a hot topic in every state because of addiction and abuse. Lawsuits against opioid makers has resulted in large judgements because of over marketing. About 25% of adults have used a prescription opioid in the last two years. According to the CDC, 168 million prescriptions were written in 2018.

Narcan is highly effective and can quickly reverse the effects of opioid overdose. Much like EpiPen, Narcan is something many households should have ready in emergencies. The ad says opioid overdose can happen at any time. The premise is that parents can reduce their anxiety by knowing Narcan is in the house. As a nasal spray, Narcan is easier to administer than an emergency injection, which many people might be reluctant to use.

There is obviously a big market for Narcan given the widespread use of opioids for pain. The DTC effort likely makes financial sense given the sales potential of stocking opioid containing households with an emergency antidote. Like most people, I thought of Narcan as something EMTs and first responders carried rather than a drug we all could keep ready in the household. This DTC campaign, which was developed with help from FCB NYC, hopes to change that.
Bob Ehrlich, Chairman
DTC Perspectives, Inc.
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To The Point-Ubrelvy

June 24, 2020 0

I like ads that are clear and get to the point. Ubrelvy, a new migraine drug from Allergan, now part of AbbVie, does clarity well. In what I would call a near OTC ad, Ubrelvy intro only took 45 seconds to tell its story. It is positioned as “The Anytime Anywhere Medicine”. That is an OTC like slogan. 


I had to watch this television ad several times to make sure it is a prescription drug. Fortunately for Ubrelvy, the side effects and risks are few and that allows for the 45-second time frame compared to 60 seconds or longer for most DTC. Ubrelvy also has a new 30-second ad and to do that, they cut the section about discussing the drug with your health care provider or using telemedicine as an option. From a messaging perspective, the 30-second ad delivers the selling points just as well as the 45-second spot.


Creatively, Ubrelvy uses a print ad like headline approach with on-screen graphics of the selling messages over scenes of migraine sufferers shown at different times of the day. It is shot in black and white with some color in the supers. The key selling point is ease of use as it is one pill that can stop migraines within two hours. 


There is no consumer print yet which is interesting given this headline approach adapts well to print. The digital approach is clear and concise as the website mirrors television. The website has more information on price support and disease education. It also can connect the patient directly to a telemedicine provider and get a prescription. There is a fee for that service that goes to the telemedicine service.


The consumer media plan is basically 98% spent on television with the rest digital. The new 30-second spot extends the efficiency compared to most DTC ads in the category which are 60 seconds. Ubrelvy is the perfect broadcast brand as the fair balance section needed only eight seconds compared to 25-30 for most brands. Ubrelvy has focused on a memorable slogan and has an easy to understand benefit. Many DTC brands are more complex and require more detailed explanation. Ubrelvy has the benefit of a category well established in consumer expectations for a treatment; that expectation is quick relief in an easy to use form. Simple, clear, and concise was Ubrelvy’s goal and that was accomplished in this campaign.

Bob Ehrlich
Chairman
DTC Perspectives, Inc.

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Taking on Supplements-Vascepa

June 18, 2020 0

It is interesting when you contrast the regulations for benefit claims for prescription drugs and OTC supplements. We all know the unproven health claims made for most supplement brands. They often have a tiny super on screen that says these claims have not been evaluated by FDA. Contrast that with prescription drugs which are regulated where every word is parsed over by regulators.


It is rare a prescription drug takes on the supplement industry directly. Vascepa is a drug that treats high triglycerides. Many OTC fish oils make claims about heart health. Amarin, the maker of Vascepa, offers a highly purified fish oil that did clinical studies on triglyceride reduction. In their latest Vascepa campaign, they are aggressively taking on the fish oil supplements for effectiveness.


The first campaign in 2018 did not compare Vascepa to competitive OTC supplements. The launch ad just introduced Vascepa and referenced that there are unapproved competing supplements. Vascepa must have seen data that showed consumers and payers needed more convincing that a prescription is needed instead of an OTC. Hence the latest Vascepa campaign talks the negative effects of some OTC fish oils that can raise bad cholesterol. It is a good strategy to show that OTC fish oil may actually be harmful to heart health if bad cholesterol increases.


Vascepa is contrasting its capsule by showing the purity of its drug as evidenced by the clear liquid vs. the yellowish fish oil. Amarin references its extensive R&D and clinical studies to contrast with fish oil supplements unapproved by FDA for triglyceride reduction. The patients are shown in a super modern looking clinic discussing Vascepa with their doctor. This is done to add emphasis to the cutting-edge science of Vascepa.


The regular price of Vascepa is not mentioned in the ads. This is a potential issue with consumers once they get a prescription and go to the drug store to fill it. Vascepa is expensive versus OTC alternatives. The retail cost is about $2.50 a pill versus $.05-.20 per pill for most OTC products. Insurers are likely reluctant to cover Vascepa fully given the hundreds of cheap OTC alternatives. The DTC ad probably helps Amarin get formulary coverage as insurers know patients and doctors will be requesting reimbursement. They do have a price support deal for new customers.


The latest DTC campaign is designed to basically say that when it comes to reducing triglycerides, go with a brand you can trust, one that has been researched fully, and had claims validated by FDA. This is a very interesting case study of how to take on OTC supplements which compete across many Rx categories.

Bob Ehrlich
Chairman
DTC Perspectives, Inc.

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Bob Ehrlich

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Embarrassing Conditions? Endo talks Peyronie’s Disease

June 10, 2020 0

One of the benefits of DTC advertising is making it easier to talk to the doctor about conditions patients may find embarrassing. Viagra was a pioneer in talking about erectile dysfunction (ED). This created an opportunity for many men to deal with what was often a condition not treated. Since ED could be indicative of blood vessel blockage, what was embarrassing could also create a discussion that saved a life.


Some other examples of conditions patients are often reluctant to discuss are toenail fungus, urinary incontinence, low testosterone, and depression. DTC has been very helpful in making those conditions easier for patients to raise with their health care provider.


One of the potentially hard to discuss diseases is treated by a drug from Endo Pharmaceuticals. The disease is called Peyronie’s Disease (PD) which is a bend in the penis when erect. Endo, which makes a treatment called Xiaflex, has been running a non-branded campaign since 2016 starting with print and digital. The firstTV campaign started in 2018 and was designed to introduce the idea of abnormal curvature. Using the “curved below the belt” line was a way to discuss the penis and erections without mentioning those terms in the ad. The ad told men that there are thousands like them who have abnormal curvature.


In the second 2018 campaign Endo got more bold. They explicitly mentioned erection curvature and from then on, added more facts that directly addressed the possible causes. The first-year campaign used fairly standard visuals of men lookingconcerned while the voice over addressed the condition. In recent executions, Endo became creative visually with representations of a bent penis. Using fruit and vegetables we see cucumbers, carrots, and bananas standing in for the penis.


Endo has a very good explanation about the causes of PD on its website. Xiaflex as a treatment option is explained as an injectable that can break up the plaque which forms from an injury to the area. In fact, we learn on the site there are millions of men who have this disease. The degree of curvature is used as an assessment tool on the site to determine whether treatment is needed.


Interestingly, we also see Xiaflex used for another common condition called Dupuytren’s Contracture which is a rigid bend in the finger joint. Endo has a separate campaign on air for this condition. This is clearly something patients may be less reluctant to discuss with physicians.


Critics of DTC Ads should recognize that educating patients about hard to discuss conditions is one of the unheralded benefits of DTC. I am sure discussing a bent penis is not something men would generally find easy. Having an educational campaign that says it is common and treatable makes many men more likely to discuss it with physicians. The fact that Endo has been running a PD TV campaign for over two years indicates they are seeing increased PD related urology visits. It is not easy to do a DTC campaign on sexually related conditions and Endo has done that well across multimedia platforms.

Bob Ehrlich,
Chairman
DTC Perspectives, Inc.

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Bob Ehrlich

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Cosentyx Lasts

June 3, 2020 0
It is great to have a campaign that lasts. Too many advertisers change their ad executions too quickly. Consumers benefit by seeing a good campaign kept on air. It takes a long time to establish brand recall and keeping continuity of a campaign helps with brand and ad awareness.

Cosentyx, from Novartis, is one of my favorites as an enduring campaign for psoriasis. It is not the only one. Humira also has done a good job over the years. Cosentyx is particularly good at finding a memorable theme. They found a few words to headline their integrated media message. “See Me” and “Watch Me” are four words that convey the essence of their message over the last four years.

It is very easy for DTC brands to want to advertise all their benefits and over complicate the message. Consumers want the bottom-line benefit in language they can understand and remember. Cosentyx found the emotional cue so important in good advertising. In the initial ad back in 2016, Cosentyx showed real sufferers who felt they were judged by their disease and visible symptoms. They wanted people to see them and not their disease.

This “See Me” was therefore born as an enduring psoriasis campaign. Cyndi Lauper was added to the mix of real sufferers which was an interesting celebrity use. Usually a celebrity gets their own ad but, in this case, Cosentyx added Cyndi to the mix of regular folks.

Cosentyx has stuck with the “See Me” message in all media formats. It is successfully adopted in print, digital, and video. Cyndi Lauper is still integrated into the mix of real patients four years later. She is not the star of the ads, just a memorable celebrity who is one of many sufferers profiled. 

Cosentyx figured out that psoriasis makes sufferers feel more than physical problems. The condition creates an emotional separation as patients feel other people see the disease, not the person behind it. This is a brilliant insight that makes the ads so effective. I do not expect this idea will ever become old and Cosentyx can run with the “See Me” and “Watch Me” for years longer.

The latest psoriatic arthritis ads use “Watch Me” as the main tag. They show real patients who have had enduring relief and are saying watch me control this disease. The takeaway is that Cosentyx has been around long enough to be a trusted drug that works. I applaud Novartis and their agency Hill Holliday Health for creating a campaign that is enduring and unique.
Bob Ehrlich
Chairman
DTC Perspectives, Inc.
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Bob Ehrlich

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Rinvoq A New Approach

May 28, 2020 0
Rinvoq, a new drug for Rheumatoid Arthritis (RA), is on my creative radar this week. The AbbVie drug has an interesting 60 second spot that debuted earlier this year. There are several elements that I think are done quite well. First, the benefits are well explained with a voice over and supers for emphasis. Second, there is a clear demo of how RA attacks the body. Third, and I think most unique for DTC, is how the fair balance is introduced. 

Fair balance is often presented as a quick voice over and supers that sometimes is confusing because it is integrated with the benefit discussion. In Rinvoq, there is a clear transition between the benefits and fair balance. At exactly the 30 second mark a new voice over announcer takes over. The benefit section has a female announcer and the fair balance is voiced by a male voice. I am not sure this has been done before but clearly the consumer is helped by such a distinct transition in voice overs.

Research has shown that fair balance is actually seen positively by consumers. Therefore, why not do what Rinvoq does by clearly presenting the risks and side effects instead of trying to hurry through them as many ads do? Consumers deserve to hear the balance in the same tone and manner as benefits. It gives them reassurance that the drug maker is not trying to confuse them or minimize the risks.

I also like the logo of a swirl that is part of the brand name super. Having some logo to aid brand recall is important. It can give consumers an alternate way to describe the band to physicians. It also can connect the brand identification in print and digital media. Memorable devices used in the past, like the Prilosec Purple Pill and the walking bladder from Myrbetriq, exemplify the idea of alternate brand identification.

Rinvoq shows an ad can add unique elements while still using a fairly standard DTC approach. This vignette approach is done in most DTC ads because the drug industry is heavily constrained by FDA regulations and by nature formulaic. Here we have scenes of a female photographer on safari and a female renovating a house with a sledgehammer. These are probably not what most RA sufferers do,but Rinvoq is trying to show strenuous activities are possible after taking Rinvoq to control RA.

So I guess you can say a meat and potatoes creative approach can still be unique when you add in interesting visual and voice elements. In this case, Rinvoq has created an excellent ad by adding in interesting elements throughout including the oft neglected fair balance portion.
Bob Ehrlich
Chairman
DTC Perspectives, Inc.
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Bob Ehrlich

Ehrlich on Creative

A Time For Hope Through Science

May 20, 2020 0
Dear DTC Colleague,

The first campaign I have chosen to discuss is corporate. Normally I will focus on brand or disease information campaigns. In this case and at this time, however, it is highly appropriate to discuss the new Pfizer spot on research for COVID-19 which first aired April 15. The campaign is a powerful statement on what research scientists at Pfizer and other private and public institutions are doing to battle COVID-19.

The 60 second campaign is themed around the phrase “Science Will Win.” The creative device here is showing vignettes of scientists conducting research. An authoritative announcer narrates the reassuring story that society has faced disease and pandemics in the past and won and will again. What is very interesting is the term Coronavirus or COVID-19 is never said. The ad starts with scenes of people with masks and empty store shelves. We don’t really need to hear the disease name as it is obvious to all of us what the ad is referencing.

“With Science Will Win, we sought to create hope by reinforcing our commitment to scientific collaboration and our pledge to use our resources to battle against and ultimately end the pandemic,” Pfizer's Dana Gandsman, Senior Director, Reputation Communications told DTC Perspectives.

Why is this ad good? At a time when the Pharma industry is facing so much criticism over the price of drugs, it is inspiring to hear that the drug makers are likely to give us hope for an eventual return to normalcy. The role of drug makers as heroic saviors of mankind may have seemed disingenuous to many Americans in the past. When PhRMA ran its excellent industry campaign a few years ago promoting its research it was probably seen cynically by many critics. Industry has argued that clinical research will suffer under price controls. That argument was difficult to make successfully as politicians and consumer advocates constantly criticized drug company pricing and profits.

The new Pfizer ad is coming at a time when industry probably does have the admiration and support of most Americans. Pfizer does not try to explicitly promote its own company in this ad. In fact the only company mention is in the super at the end of the ad. Pfizer has been in the news for its COVID-19 vaccine development with a German partner and the possibility of a vaccine available by year end.

Drug makers have a huge opportunity to drastically change their image. Gilead just donated all of its existing Remdesivir doses, the first drug proven to treat COVID-19. I am sure a vaccine will be priced very favorably and will not be a huge financial win for the drug industry. Will Bernie Sanders still hate us? Yes, but hearing him still talk about drug company profiteers seems odd and out of touch. The lesson from COVID-19 is we need the power and, yes, profitability of private industry to keep us safe.

Pfizer and Grey, who is the agency behind this ad, deserve credit for producing an ad that gives accolades to every research scientist at all of the companies working on cures. This is not a time for self-promotion as we are truly all in this together. Will ads like these change the feeling about drug companies? I expect that if one of these companies produces an affordable vaccine or cure within a year the image will improve dramatically. Will consumers get back to complaining about high drug prices? They will, but drug companies will build up a lot of goodwill if normalcy returns because their investment in science won over the virus.
Bob Ehrlich,
Chairman
DTC Perspectives, Inc.

Bob Ehrlich

DTC-In-Perspective by Bob Ehrlich

DTC in Perspective: Importing Canadian Drugs?

August 2, 2019 0
The Trump administration wants to allow Canadian drugs to be imported to give consumers lower prices. This is also supported by almost every Congressional Democrat and many Republicans. It sounds great to allow American consumers to buy cheaper drugs from Canada and is already happening somewhat through online Canadian pharmacies. Consumers can generally save 30-50% and in some cases by a lot more.
So why is this tactic going to fail? First, drug makers do not want to sell to Canadian distributors just to have those lower priced drugs come back to the United States. They happily will sell what Canadian consumers need but will not allow much more than that to be sold into Canada. Drug companies know some Americans buy Canadian drugs but that is a relatively small amount. Once that reimportation gets to be a big business drug companies will restrict what Canadians can buy.

Bob Ehrlich
“The American people will demand a price solution…”
-Bob Ehrlich

Second, the Canadian government has already said they have experienced drug shortages and will not allow Canada to become an exporter of drugs if their own citizens face problems filling prescriptions. Drug makers will not allow their golden goose US market to be destroyed by a Canadian end run. Drug makers always have the option of not selling a drug in Canada if the approved price is too low. That could deprive Canadians of getting access which is not a good scenario.
Unfortunately for drug makers it looks like there will be some system of price indexing or outright price controls in the future. There is no strong support from either party for drug makers charging US consumers more than other developed countries. While Republicans are more friendly to drug makers, they cannot convince their constituents that it is fair to pay significantly more than the French, Canadians or Germans. While they know innovation is funded by US profits, that is a hard sell for voters having trouble affording rising health care costs.
What is the solution? Drug companies must self regulate their desire to raise prices beyond inflation. Any increase beyond that is difficult to defend. American consumers need to get a tangible benefit paying a premium price. That could be faster access to new drugs, and more price support during the introductory period to prove the value of the premium drug. While the industry’s ad campaign explaining the wonders of drug research is good, I am afraid it is insufficient to assuage concerns that Americans pay too much.
The best solution is to have one developed market price for a drug with Canadians and Europeans paying more and Americans paying less. Why would other governments agree to that? There would have to be some benefit in allowing drug companies higher prices in price-controlled markets. That could be through trade concessions in other categories. Any fair price system would take a massive negotiating effort between the drug industry and multi government regulators. Perhaps over time an index system could work as long as the drug industry could make substantially the same returns.
Another solution is to extend patent expirations in exchange for lower prices. Also, any system that speeds approval can be leveraged against high drug prices. What needs to be done is a pragmatic approach that balances need for innovation with lower prices. Saying that drug companies are greedy will not get to a workable long-term drug strategy. American consumers will not benefit if mandating lower prices leads to a cut in vital research.
What I do predict is the drug price issue cannot be successfully fought much longer by lobbyists. That can no longer be the main strategy of drug makers. The American people will demand a price solution as this ire is being stoked in every political debate. Unfortunately, the proposed solutions will not be favorable to drug maker profits. One of the ways to mitigate profit impact is to increase demand. DTC could be a beneficiary of that demand-based strategy. If drug prices are forced down, I would expect drug companies to increase marketing budgets to grow their user base and retain those users.
After so many years of drug prices debates, 2020 looks like the time action will be a reality. Of course, the extent of price action depends on who gets elected. The Sanders/Harris/Warren plan is highly punitive for drug makers while Biden and other moderates will go softer. Trump is not far from moderate Dems on his plans so drug makers will get hurt whoever wins in 2020.

Bob Ehrlich

DTC-In-Perspective by Bob Ehrlich

DTC in Perspective: Chantix Goes Slow Turkey

February 22, 2019 0

I have been in the DTC business a long time. After seeing the excellent Ray Liotta ad I might have predicted the next version would use Joe Pesci or Robert De Niro. Chantix instead cast a wild turkey as its star. Who says DTC can’t be creative?

Bob Ehrlich
“Chantix breaks out with the creative…”
-Bob Ehrlich

In what will be a very memorable spot Chantix takes the “cold turkey” expression literally by casting a turkey to represent a person who quits smoking with Chantix. The story line is that Chantix allows you to gradually quit smoking by decreasing the urge and thus you don’t need to go cold turkey but go slow turkey as the spot is named. In a world where much of the DTC Ads have become boilerplate style, Chantix breaks out with the creative device here. Sometimes using a character to represent a brand is risky. It works well when we get an Aflac Duck. The question a brand and agency must wrestle with is will using a character diminish the serious nature of an Rx drug.

For DTC we have had a number of such character representations. Digger for Lamisil, the walking bladder for Myrbetriq, a dancing stomach for Prevacid are some DTC examples. The risk is that patients who suffer from disease may not like seeing their problem in character terms. Some diseases are clearly inappropriate for creating such treatments. I doubt cancer ads would contain a singing Lung.

For Chantix I love the use of the turkey. After seeing so many testimonial ads in DTC, it was certainly attention getting to see a turkey sitting by the pool dumping its ashtray. The ad was so different from Ray Liotta that I had to go back and make sure I was seeing correctly. Yes, that was Chantix.

Sometimes an attention getting character might have stopping power but dwarf the message. In this case the Chantix story still came through well and the creative just replaced a human with the turkey in situations like lounging by the pool or mowing the lawn. I give Pfizer a lot of credit for approving a story board so different from the traditional user testimonial. Ray Liotta was very effective but so is the turkey. The agency should be applauded for recommending it as it is not always easy to bring something so different like this to the client.

My concern is that Ray may want to whack the turkey for taking over as spokesperson. A Goodfella hates rivals. I do not know how long this turkey creative can last. After all there is no saying like cold squirrel or cold cow. I am afraid the pool out potential may be limited but that depends on the acting range of the turkey. That said if the turkey is meant to get potential Chantix users to get engaged this ad will do that very effectively.

Bob Ehrlich

DTC-In-Perspective by Bob Ehrlich

DTC in Perspective: The Assault on Drug Makers Widens

January 18, 2019 0
Drug companies are under renewed attack. There is yet another new bill in the Senate to end the tax deductibility of DTC ads. The latest is from Elizabeth Warren, who will use drug companies as a campaign talking point about corporate greed. The bill would end all forms of tax benefits for any media type.
We also see the House scheduling hearings on how drug companies price their drugs. We can expect harsh treatment of drug CEOs who will be called to Washington to be attacked by Congress in public televised hearings. Another idea floating in Congress and HHS is to peg US drug prices to Europe. Congress will say that this is a fair way to set US prices as Americans should pay no more than the Germans.

Bob Ehrlich
“DTC could be a sacrificial offering to the critics…”
-Bob Ehrlich

According to a study by Deloitte, all this vitriol is happening as R&D return on investment is down to a paltry 1.9% last year. So critics want drug companies to develop drugs to fight disease with price controls and crappy returns on their R&D investments. Drug companies are in a no-win situation. The critics say drug makers make too much money and are raising prices too fast based on inflation. Yet the data shows they are having trouble recovering R&D investment. Critics want drug companies to improve health outcomes but want to prevent drug companies from free market pricing.
Drug makers are an appealing political target for both parties. Some of the criticism is valid. Drug makers have taken prices up too far too fast. A little prudence is called for if drug makers want to prevent the political hammer from dropping. On the other hand, their dilemma is how to fund that R&D while still providing decent returns to investors. Europe and Canada are getting a free ride off of American consumers. No one expects the average Parisian to volunteer to pay more. Riots in Paris over fuel costs show no chance Europe will help out on drug price support.
So here we are. What is the solution to this mismatch in drug prices? Clearly drug companies are risking draconian measures from Congress. As Dems turn left you can bet they will attack drug companies more vigorously and might even get Republicans and Trump to agree. Nothing will happen quickly but this time may be different. I am afraid it is entirely possible that DTC could be a sacrificial offering to the critics who vastly overestimate the power of DTC ads to create demand. DTC works but is not the driving force in building brands. That advertising, however, is the public face of the drug companies and critics blame DTC for raising demand for premium priced drugs. They think that keeping the information from consumers will keep prices down.
Congress and HHS will try to cajole drug makers to slow down increases. They have already decided to mandate list price be part of consumer ads. Next may be ending the tax deduction for advertising. After that price controls are a real possibility. The Democratic candidates for the 2020 Presidential election will all have a plan to nationalize health care and they will all include price controls in that platform. With Trump as anti-industry as they are we can expect violent agreement that drug makers will be targeted.
So to my colleagues in DTC advertising, buckle up and expect new regulations geared at making DTC harder to execute. I do not expect a ban, but FDA and Congress will be looking for ways to make all our professional lives more difficult.

Bob Ehrlich

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