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DTC-In-Perspective by Bob Ehrlich

Harnessing the Power of Artificial Intelligence

January 14, 2025 0

I’ve been pondering what the revolution in artificial intelligence (AI) truly means for DTC marketing. Can my aging brain grasp how AI works? Does it mean DTC advertising could be developed without engaging real patients, or even without agencies crafting the ads? Could we one day see virtual pharma marketers? Imagine our annual Top DTC Marketers list featuring artificial entities — what a surreal awards dinner that would be!

After speaking with experts, it’s clear that AI offers DTC marketers a vast ocean of opportunities. The potential benefits span the entire spectrum, from concept testing to producing polished ads. Faster copy development, reduced costs, and more options to present to real patients could redefine the process. Envision a world where virtual focus groups test ad concepts in mere seconds. Every target group could evaluate countless concepts, with AI instantly refining them until the ideal message emerges.

AI offers DTC marketers a vast ocean of opportunities, from faster concept testing to personalized ad creation.

Imagine media teams using AI to virtually identify the optimal omnichannel mix, tailored to every patient target group. The current array of media choices is already overwhelming. AI could enable us to explore every option at a micro level, creating unparalleled precision.

We’ve already seen digital advertising move in this direction. However, DTC remains television-centric, with about 60% of spending focused there. Most consumers are exposed to just a few ad executions per brand. AI could change that dramatically, enabling instant variations that adapt to the viewer. Those three standard ads could become 300, each optimized for the audience in real-time.

Of course, significant challenges lie ahead. The steep learning curve of adopting AI will inevitably slow its widespread use. Internal legal and regulatory reviews remain essential. The OPDP may also struggle to oversee a world of hundreds of promotional variations.

The advice from AI experts is clear: experiment with the tools available now. Adoption will take time, but starting small is the first step for pharma marketers. Ultimately, AI is a tool for human marketers to create more personalized and effective ads. My hope is that AI will lead to more creative, distinctive ads that cut through the clutter of DTC advertising.

Every pharma marketer should challenge themselves, their agencies, and their research partners to integrate AI into their processes. Start small, experiment, and see where AI can lead you. The journey will undoubtedly be challenging, but the potential rewards make it a path worth exploring.

Bob Ehrlich

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DTC-In-Perspective by Bob Ehrlich

Jardiance and The Turtles

January 8, 2025 0


Media courtesy of Vivvix

 

Can a drug commercial shock me? I have been watching them, analyzing them, and critiquing them for almost 30 years. Jardiance is well known in the ad world for its musical- and dance-themed diabetes ads. Love them or hate them, they are different and effective.

In announcing a newer indication for Chronic Kidney Disease (CKD), Jardiance has gone about as far away from its use of musical format. It used animated CGI turtles playing soccer. It is very basic in its messaging. The main turtle says Jardiance can slow the progression of CKD and reduce the risk of kidney failure. Obviously, turtles know how to slow things down as the lead turtle tells us.

Was I shocked when I saw the turtle ad? Yes, but shock is not necessarily a bad thing in advertising.

I have no issue with the ad itself. It is different, easily understandable, and likable. The question is can or should a brand so dramatically change its creative approach without risking confusing its audience? The advertised CKD indication is different, but does that merit a 180-degree shift in creative?

Could Jardiance have just added the new indication to its current campaign with a super or voiceover? I assume they wanted a separate campaign because the CKD indication is not only targeted at people with diabetes. It is also hard to create a second song dedicated to CKD. That said, I still wonder if the brand image might be affected by such a drastic shift in creative approach.

As one who has argued that too many DTC ads are formulaic, I applaud the use of new approaches. The fact that the new Jardiance ad is so different from the musical version does make for some interesting discussion. There are many multi-indication brands in the DTC world. I have yet to see a brand that has veered so far away from its current creative approach as Jardiance when adding new indications. That is not a criticism because they obviously have research showing the ad works. Was I shocked when I saw the turtle ad? Yes, but shock is not necessarily a bad thing in advertising. On the Golden Globes, the turtles ad certainly broke through the heavy DTC ad clutter. We shall see if this ad is just a brief announcement campaign. But if getting noticed was the goal, it worked.

 

Bob Ehrlich

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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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Unveiling the Agenda for the 25th Annual DTC National Conference in Boston!

December 17, 2024 0

The 25th Annual DTC National Conference is your gateway to discovering the cutting-edge strategies redefining direct-to-consumer (DTC) marketing in pharma. Set to take place April 2025 at the Westin Copley Place in Boston, this milestone event promises to bring together the brightest minds and trailblazing leaders in the industry. Join us as we tackle the most pressing challenges, reveal actionable solutions, and set the course for the future of patient engagement.

This is your opportunity to gain powerful insights, network with key decision-makers, and stay ahead of the curve in a rapidly evolving landscape. Secure your spot today!

Here’s a Sneak Peek at the Powerful Sessions You Won’t Want to Miss:

1. State of the Industry: Insights & Trends Shaping the Future

Kick off the conference with a comprehensive overview of today’s most critical DTC marketing trends, challenges, and innovations – setting the stage for what’s next in pharma marketing.

2. Market Landscape Analysis: Shifts, Influences & Emerging Drivers

Deep dive into the data! Explore DTC spending trends across media types, disease states, and brand categories, while uncovering the key forces shaping consumer engagement and behavior.

3. Mastering Drug Launches & ROI: Strategies for Success

Learn how to maximize the impact of your drug launches with innovative digital tools, patient-centered strategies, and robust ROI frameworks to deliver measurable results.

4. Opportunities vs. Risks: Navigating Today’s Complex Landscape

Discover how to identify growth opportunities while mitigating risks in an increasingly competitive and complex DTC environment. Stay ahead of key challenges and unlock your brand’s full potential.

5. What’s New from OPDP? Insights You Need to Know

Led by a former FDA Director, this session will provide the latest research, updates, and guidance from the Office of Prescription Drug Promotion (OPDP) and their direct implications for DTC campaigns.

6. Case Study: Innovating Patient Activation Through Omnichannel

Learn from real-world examples of how leading brands are revolutionizing patient engagement through seamless, omnichannel strategies that activate, empower, and retain audiences.

7. Case Study: Leveraging Macro & Micro Influencers to Boost Impact

Explore how influencer marketing—both macro and micro—can amplify your reach, elevate brand credibility, and foster trust with patients, creating meaningful connections.

8. AI in DTC: Transforming Strategies & Driving Success

Discover how AI-powered tools are transforming DTC campaigns, from streamlining FDA reviews to enhancing consumer engagement. Learn how to outperform competitors and drive efficiency through technology.

9. Interactive Roundtables: Personalizing DTC to Meet Patients Where They Are

Engage in dynamic, collaborative discussions with industry experts and peers, sharing strategies for delivering personalized, patient-first DTC campaigns that resonate.

10. Specialized Breakout Tracks: Delve Deeper Into What Matters Most

Customize your conference experience with focused breakout sessions tailored to the most pressing topics, emerging trends, and specialized challenges in DTC marketing.

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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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