Guest guest Posted June 22, 2004 Report Share Posted June 22, 2004 [i'm glad that places like RedFlagsWeekly.com read links from all over. This article from " Pharmaceutical Executive " , a trade magazine for the pharmaceutical industry, describes the tactics they use to market to doctors. At least they're honest. Perhaps that makes it all the more unsettling. It certainly made my stomach churn. --David] The Art of Advertorial They look like articles, but they work like ads -- and they're crucial in conditioning the market. May 1, 2004 By: Charlene Prounis Pharmaceutical Executive http://www.pharmexec.com/pharmexec/article/articleDetail.jsp?id=99422 & pageID=1 In today's cluttered marketplace, it's not only important to tell your audience about your product, but to get them to anticipate it. There are few better ways to do that than a well-timed, well-placed advertorial. Certainly, a market that's knowledgeable and anticipates a new therapy is more important than ever. With increasing pressures for companies to maximize product lifecycles, advertorials are one way for companies to increase uptake for their therapiesparticularly biologics, which represent vastly new and more complex approaches to disease. " There is every indication that companies are trending more and more toward educational rather than promotional materials, " says Robert Osborn, senior vice-president, magazines, at Dowden Health Media and a past president of the Association of Medical Publications. " The Office of the Inspector General makes it appealing to pharma companies to focus on education. " This article outlines what advertorials are, highlights how companies should use them, and explains how to evaluate the tactic to determine if it is right for the company's brand. By Definition An advertorial is simply an ad that is designed to deliver the experience of reading an article. In the pharma industry, companies use advertorials to convey sound bites of science that educate a target audience of physicians about specific aspects of a disease and its management in new and different ways. Beyond the design, advertorials differ from typical ads in that they are based in education and are scientifically rigorous, often citing clinical studies and information, rather than hard-selling a product. Companies often use advertorials as part of their prelaunch marketing mix, and therefore don't include the product name. But that's not to say that the advertorials aren't brandedquite the contrary. Well-crafted advertorials create the drug's prelaunch messaging, which evolves into its launch messaging, and as such are part of the foundation of the brand. Therefore, companies should take time to consider the visual elements and messages of the advertorial, which in the long term, will help to drive home messages that will eventually be tied into a comprehensive brand promotion. Prime the Market. Within the prelaunch category, companies can use advertorials to achieve several goals. A review of 40 advertorials (that ran from January 1995 to June 2003) obtained from 253 journals under 60 medical titlesincluding general, popular, and specialty journalsrevealed four primary messages that pharma companies aimed to convey when using the medium. Specifically, companies used advertorials to: * show relevance of a new therapeutic agent's mechanism of action by explaining its relationship to the disease process * build awareness of a disease state in anticipation of a new therapeutic class * create an urgency to treat diseases earlier and more aggressively * address the need for new treatment options that improve quality of life for underserved patient populations. Explain the mechanism. Advertorials that fell into this category aimed to establish a new understanding of the etiology or progression of a disease and set forth the premise that new drugs under clinical study would specifically target the proposed pathology. Of the advertorials analyzed, companies used this approach most often, particularly for immunologicals, to explain the new science to physicians. (See " Across Categories. " ) Case in point: the advertorial that Biogen developed two years before launching Amevive (alefacept), which would become the first FDA-approved biologic to treat psoriasis. Because physicians had traditionally managed the disease using standard oral agents, Biogen needed to educate physicians about a new treatment paradigm that would allow them to address the underlying immunologic causes of psoriasisT-cell activation. So the company took out a three-page unbranded advertorial, " Looking Beneath the Surface, " in the Journal of the American Academy of Dermatology, which underscored the need to treat psoriasis at the cellular level, at the cause of the problem, to provide long-lasting remission. That way, when Amevive was approved, physicians understood the benefits of long-term management of the disease. In the therapeutic area of oncology, Genentech ran advertorials highlighting the role of vascular endothelial growth factor (VEGF) . In doing so, the company established an educational platform for the reader in understanding how Avastatin (bevacizumab), which works by inhibiting VEGF, helps fight the disease in patients. Those advertorials were similar to Biogen's in that they had a primary focus on pathogenesis and introduced new therapeutic modalities that use a novel mechanism of action to target and treat the underlying cause of the condition. Companies can also include language in these types of advertorials that represents their commitment to delivering a scientific explanation about disease progression and discovering novel therapeutic options to treat that condition. Alternatively, companies can use corporate branding to express that same idea. Build awareness. Because this approach highlights improvements above and beyond those offered with current treatment options, companies commonly use this type of advertorial to increase the awareness of a condition and present the next generation of therapeutic options. Merck used this tactic in 1995 when it debuted its advertorial in support of soon-to-be launched Fosamax (alendronate) for the treatment of osteoporosis. Indeed, Fosamax represented a major advance in the management of osteoporosis, and Merck used the expanded space advertorials offer to educate physicians about the prevalence, seriousness, and the need for appropriate treatment of the condition. Advertorials that follow this approach can be considered almost " refresher " courses because they give the basic facts about the disease. Roche's " The Art of Influenza Management " advertorial is a classic example with dedicated sections on awareness, recognition, and treatment of influenza. Physicians are offered an entire snapshot of a disease and treatment options, both current and upcoming, in a two-page spread. By increasing disease understanding, these advertorials also lay the path for improved treatment. For example, Lilly ran an advertorial to help physicians build awareness of, and better recognize, the signs of depression. With the headline, " We're not re-inventing it. We're just taking a closer look, " the advertorial intends to redefine the symptoms of depression to include physical as well as emotional symptoms. In doing so, the company is educating physicians about psychosomatic illnesses and, in effect, expanding the market for treatment Create urgency to treat. Companies use this type of advertorial to encourage physicians to treat diseases earlier and more aggressively. In general, they address categories that are underdiagnosed or undertreated by the medical community. The approach is exemplified by Aventis' " Deep Vein Thrombosis: A Major US Health Crisis " advertorial run in 2002 and 2003 for Lovenox (enoxaparin). The advertorial aimed to instill an immediate sense of hurry by including a patient case study that reported a woman's unexpected death from a pulmonary embolism. Another example is the series of advertorials Lilly created that aimed to increase the early identification of sepsis. Within this series, Lilly provided the target audience with information that supported the need for early and appropriate treatment, then explained the cascade of events that may be responsible for the condition. These advertorials also provide the audience with an immediately useable toola table of identifying criteriathat guides the early identification of sepsis. Advertorials within this category also tend to use dramatic and alarming statistical data to emphasize the commonality and burden of the condition, thereby establishing a need for immediate action, such as early diagnosis and initiation of appropriate treatment. For example, Wyeth used a list of startling statistics to convince healthcare professionals, who previously didn't consider obesity a disease, to evaluate and manage the condition appropriately. Improve quality of life. This category encompasses several different types of unmet therapeutic needs. For example, it can be used to increase the awareness of an underserved disease category—disease states that are grossly underdiagnosed, undertreated, or inadequately treated. Or—more commonly—this advertorial approach is used to create a need to treat conditions that negatively affect lifestyle and impact patients' quality of life. This category shares many commonalities with advertorials that create an urgent need to treat. For example, Pharmacia's advertorial for overactive bladder (OAB) demonstrated that despite its high incidence rate—higher than that of Alzheimer's disease—patients, and sometimes even healthcare professionals, do not talk about the condition. That silence only serves to keep the disease stigmatized, undiagnosed, and untreated. The advertorial also went to the next level by saying that when the disease is treated, it is done so with undesirable and poorly tolerated therapies. Through the advertorial, Pharmacia let the healthcare community know that patients should not have to " live with it " or accept overacive bladder as a normal part of aging, but rather to think of it as a condition that can be treated with well-tolerated medications that are " coming soon. " Amgen/Wyeth also created an advertorial that acknowledged the fact that ankylosing spondylitis is inadequately treated and in need of new therapies that can address specific symptoms. Although companies typically use advertorials for pre-launch activities, marketers may decide to run them after launch as well. Novartis, for example, continues to run its Zelnorm (tegasarod) advertorial to educate physicians about the symptoms and severity of the irritable syndrome so that they will increase diagnoses of the disease. Decide, Then Develop There are few hard-and-fast rules for developing advertorials. One rule of thumb, however, is that the more educational and balanced the copy is, the more likely it is to hold the reader's interest and attention. That doesn't mean that marketers should squeeze as much copy as they can onto a pagetoo much text, and the message will be lost. Companies can improve the readability on full-text pages with graphs and pull-quotes. Advertorials are like any other ad, and will only get a fast glance if they fail to pull the reader in. In addition, companies should ensure that they match the colors, typography, and images on advertorials to subsequent communications. That's because, like other prelaunch activities, advertorials are a step along the pathway of product branding. Marketers can determine if an advertorial is worth their investment by asking the following questions. A positive response to one or more indicates that an advertorial may be worthwhile. * Is there a new understanding of the disease process that may lay the foundation for the introduction of more targeted therapies? * Does the company have a new message regarding a specific disease-state pathogenesis? * Do healthcare professionals need to be made more aware of a given disease or treatment option? * Is there currently a lack of appreciation or understanding regarding a given condition? * Are there new efficacy or safety benefits that healthcare professionals need to be made aware of? * Is there a reason to establish a compelling sense of urgency? * Does the product address an underserved need? * Is there a lack of social acceptance about a given condition? Companies should ensure that advertorials follow either the publishers' guidelinesor the guidelines of the American Society of Magazine Editors (ASME)which many major publishers adhere to. Otherwise advertorials may be perceived as editorial, and publishers may refuse to run them. " When an advertorial cannot be distinguished from editorial, companies run the risk of losing the readers' trust, " says Peter Murphy, former division director of advertising sales and marketing for the American Medical Association and now vice-president and general manager, primary care group, for Advanstar Communications. " A publication has two customersthe reader and the advertiser. As publishers we have to maintain the trust with readers because that's what makes them come back to us on a regular basis. If we can deliver the reader, then we can deliver the exposure the advertiser is interested in. " Advertising agencies should already be intimately familiar with the ASME guidelines. However, the most salient points include: Content. Advertorials should be sufficiently distinct from the magazine's editorial material so readers will not confuse editorial pages with sponsored content. Sponsorship declaration. Each text page of a special advertising section must be clearly and conspicuously identified as a message that has been paid for by advertisers, typically by including the word " advertisement, " which should appear near the center of the top of every page containing text, in type at least equal in size and weight to the publication's normal editorial body typeface. Layout. The layout, design, typeface and literary style of advertorials should be distinctly different from the publication's normal layout, design, typefaces, and literary style. Magazine's brand. In general, the publication's name or logo should not appear as any part of the headlines or text of such sections, except in connection with the magazine's own products or services. Placement. Advertising sections should not be placed adjacent to editorial material in a manner that implies editorial endorsement of the advertised product or services. No editorial involvement. The names and titles of editors, editorial staff members, and regular editorial contributors should not appear on, or be associated with, special advertising sections for their own publication, for other publications in their field, or for advertisers in the fields they cover. Nor should edit-orial staff members work on projects prepared by the publisher for one or more advertisers. Editorial review of ad pages. In order for the publication's chief editor to have the opportunity to monitor compliance with these guidelines, material for special advertising sections should be made available to the editor before publication, in ample time for review and to recommend necessary changes. Break Through the Clutter Typically, companies should introduce advertorials to the target audience early in the prelaunch phase, possibly as early as two years before launch. They should run them based on the same principles of other media schedulesdeciding what levels of reach and frequency they want to obtain among physicians and spending appropriately. Pharma companies can view the tactic as part of both educational and market development activities. As such, support through an advertising campaign and medical education efforts can perpetuate the momentum created by the advertorials. " Advertorials allow companies to deal with a complex subject, which is similar to sending a letter to doctors, " says Dowden's Osborn. " However, while we see promotional materials appear in doctors' mailboxes by the jillions, relatively few advertorials are run in journals. If I had a complicated message, putting it in the journal is going to have a high degree of impact because it will be one of the few in the issue. " Because they are only one component of the brand's overall communication plan, it is difficult to determine their discrete and exact impact. For the most part, measurement of advertorial effectiveness falls into the category of attitude and usage changes over time, especially when used as part of the pre-launch marketing mix. Marketers can judge the effectiveness through ad studies or market research. Advertorials are effective at breaking through the clutter because " they are the solution for companies that don't want to undergo the peer-review process, yet still want to promote a message, within a journal or other literature, that their target customer is planning to read, " says Carol Bak, director of journal programs at Lippincott Williams & Wilkens Healthcare. Indeed, the evaluation used for this article shows that companies' use of advertorials has become more pronounced in recent years. " In the 1990s, very few advertorials were run, " says Advanstar's Murphy. " They've just come back into vogue at the end of 2001 and beginning of 2002, and I believe that form of advertising is on the increase. 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