Novartis has just started a non branded disease education campaign called “Keep it Pumping.” You can see the television ad on the Novartis web site: www.keepitpumping.com. This Novartis web site discusses the serious condition of heart failure which has only a 50% survival rate after five years from diagnosis.
The ad is very memorable, showing a man sitting in his living room as it fills with water, a metaphor for the rising danger of a heart not pumping well. I have read some physicians are concerned the ad is alarmist. They think the ad will stoke unnecessary fears among patients. Obviously Novartis thinks the serious tone is appropriate.
-Bob Ehrlich
Like all drug companies that do disease education ads, Novartis is running the campaign because it has a new drug to treat heart failure. The drug was approved mid-last year. It is called Entresto, a combination of an old drug, valsartan and a new drug sacubitril. Novartis clinical studies show it is significantly better at reducing mortality versus ACE inhibitor enalapril.
While the ad apparently annoys some doctors, it is certainly memorable. The visual of a flood in a man’s living room while he seems oblivious to it is a good way to show the hidden symptoms and dangers of heart failure. The appropriateness of running an ad that may alarm patients is a legitimate issue. On the other hand, any disease that causes death in 50% of those who have it, is cause for alarm and therefore having an impactful campaign is warranted.
Like all these newer premium priced drugs, the advertisers will face sticker shock from those patients who have problems getting reimbursement or have high co-pays. The recent trend for drug makers has been to advertise drugs regardless of price. They want to create demand as this helps push reluctant payers to cover the drug. Most insurance companies would prefer patients use much cheaper, albeit, less effective old line treatments. DTC for newer drugs is trying to create patient awareness that there are very effective treatments now available. Cost/benefit will be debated by the payers and patient demand has been an important dynamic in pushing payers to cover the newer treatments.
I doubt many Americans who see this ad will suffer undue alarm. Basically, it is designed to get people to be aware that heart failure happens to many of us as we age. The incidence is about 20% over our lifetime. Novartis clearly benefits from encouraging discussions on heart failure because their new drug is premium priced.
I definitely disagree that the ad creates undue fear. Heart failure is not acne, or toe fungus and perhaps a sense of urgency is needed in the creative approach. People who see the ad who might be at risk for heart failure should discuss it with their doctor. Whether he will suggest Entresto or something else is between patient and doctor. Calls for pulling the ad are extreme as there is zero evidence consumers will panic or quake with fear. When I saw it, I paid attention and looked up the web site, not out of fear but out of interest in my health.
Novartis certainly will have to take seriously the opinions of its prescribers and I am sure is tracking physician attitudes. Drug companies should test disease awareness DTC in advance with both consumers and physicians. No ad should be pulled, however, based on a few negative comments. Impactful ads need to be attention getting. Keep It Pumping succeeds and I would keep pumping it out to consumers.
In the book “The Innovator’s Prescription: A Disruptive Solution for Health Care,” Clay Christensen, who developed the theory of disruptive innovation, stated, “There are more than 9,000 billing codes for individual procedures and units of care. But there is not a single billing code… for helping patients stay well.” In the pharmaceutical industry, disruptive innovation improves health by generating ideas that create new drugs at the expense of existing ones. It is an alliance between technological advances and new business models that dramatically changes the performance of the industry. The progressive spectrum of disruptive innovation challenges include lessons from the past showing resistance to change, implications surfacing in the present which emerge from cautious analytics and trailblazing dynamics in the future aligned with patient centricity.
As the above example shows, the advancement of pharmaceutical innovation efforts are most often prevented by established world views, opinions, customs, attitudes, societal values and complex psychological and emotional issues ingrained in the network of relationships that define individuals singly or collectively. In certain situations, innovation challenges are rejected directly because they are seen as threats to the means of support and character of many stakeholders, such as pharmaceutical companies, Federal regulatory institutions and the American Medical Association, that deploy an intangible but forceful influence on decision-making. Resistance to change in pharma emanates from industry incumbents whose jobs rely on sustaining the existing business model and political power. As Upton Sinclair said, “Never expect someone to understand change when their livelihood depends on not understanding it.”
In the future, the drug lifecycle needs to incorporate many facets of patient centricity, including the use of new technologies such as gene- and proteomics, gene therapy, nanotechnology, and Big Data driven predictive analytics. Precision medicine will identify exact patient needs and tailor molecular profiles to create the most beneficial treatment plans for patients on an individual level. New social media tools will allow patients to share information and participate in collaborative discussions with regulators and pharma.
Pharmaceutical marketing is changing. With increased industry spend, new marketing channels, a more informed consumer, and a shifting healthcare landscape, it is clear that marketers need to be smarter than ever with their investment decisions. It is also clear that DTC marketing is no longer just about pumping money into national TV ad buys (though they continue to receive substantial investment). It’s now also about targeted messaging. It’s about digital. It’s about patient engagement. In this environment, it is more complex than ever to understand how to get the right message in front of the right consumer at the right time. Marketers will need to innovate.