• by Christine Bittar , April 18, 2006

Consumers are increasingly aware that they must be proactive when it comes to their health. And there is some evidence that they actually are becoming advocates for their own healthcare. At the very least, it's clear that they're conducting more of their own research online. For example, 45.7 million Americans went online for information on pharmaceuticals in 2004, versus 24.4 million in 2002, according to a Manhattan Research study cited in eMarketer's July 2005 pharmaceutical marketing online report.

In fact, the Internet ranked as the second most trusted source of health advice after doctors, according to a year-end study conducted by Nielsen/NetRatings and interactive pharmaceutical agency Medical Broadcasting Company (MBC). It makes sense, then, that drug companies have stepped up online media and marketing efforts, and several have pushed the envelope on cutting-edge strategies.

Nearly two years ago, pharmaceutical companies spent just 1 to 3 percent of their marketing budgets online. Now some of the bigger players are spending anywhere from 10 to 15 percent, according to Matt McNally, vice president of media services for MBC. McNally says the agency expects that percentage to hit between 20 and 30 percent within 18 months. At Avenue A/Razorfish, Brad Aronson, executive vice president, says that more than half of the agency's 30 pharmaceutical brand clients doubled online budgets for 2006, in some cases increasing already substantial online budgets from $5 to $9 million, $1.7 to $7 million, and $7.5 to $12 million.

Search marketing has been a key element of drug marketers' online strategies, with most of the larger players using keyword search from early on, says Larry Mickelberg, senior vice president of marketing at MBC. For example, a search for the phrase "migraine treatment" yields Pfizer's Relpax and Johnson & Johnson/Ortho-McNeil's Topamax Web sites as the No. 1 and No. 2 results, respectively. At the same time, GlaxoSmithKline's Rx migraine drug Imitrex takes the top two spots on Google's right-hand column results: the first for savings vouchers, the second for potential volunteers in an Imitrex clinical trial. The search term "headache help" yields another Topamax site, MigraineSolutions.com, as the first sponsored link.

Yahoo's search engine yields similar results. But, despite what appear to be extensive results, Aronson says pharmaceutical marketers are still missing opportunities by not including enough search terms. In some cases, online consumers are engaged with un-branded disease sites, says McNally. But what makes search complicated, he explains, is that where a given drug turns up can depend not only on the marketers' budget but also on where the drug is in its life cycle -- how close or far off it is from patent expiration.

Drug marketers are now using TV advertising more often to drive consumers to their Web sites. For example, Schering-Plough and GlaxoSmithKline traded an overtly sexual Levitra TV and print campaign for an unbranded, educational online and TV campaign by RTCRM, Washington, D.C., which drives traffic to Mensfacts.com. Visitors are only linked to a Levitra-branded section when they access a downloadable "Doctor Discussion Guide," while the new TV campaign and Mens-facts.com home page address erectile dysfunction by tying it to diabetes, high blood pressure, and cholesterol levels. The home page also offers visitors an information kit with a free-trail coupon, opening the door for more direct mail and e-mail marketing. A Schering-Plough representative says the site has received more than 2 million visitors between its launch on Dec. 26, 2005 and Mar. 9.

MBC's Mickelberg says Wyeth and AstraZeneca have been among the most progressive drug companies, using online marketing and incorporating streaming video on their sites within the last year. "For a long time, pharma limited online to things like banner ads," says Mickelberg. "A 30- or 60-second TV spot can raise awareness, but video engages consumers for a longer time and multiple visits so you can form an emotional connection."

That doesn't just mean slapping a TV spot online; it means producing original content, such as work created by MBC, which in January was acquired by Digitas for more than $30 million. For Wyeth's antidepressant Effexor XR, Mytimetotalk.com uses video narration and vignettes to support an interactive Web page designed for patients already taking Effexor.

The narration features a psychiatrist addressing drug treatment, potential side effects, duration of treatment, and other topics. The site also has a section called "Coping Techniques," with videos showing individuals in typical life situations -- a guilty mom, an apprehensive office worker, and a man turned down for a date -- and offering tips on avoiding potentially harmful thinking patterns. Downloadable worksheets are also available as an aid. "We're really doing what a cognitive behavior therapist would do," Mickelberg says.

Another Wyeth site, Talkingtoyourdoctor.com, uses actress Cheryl Ladd as the voice and face of menopause. The site, which indirectly supports Wyeth's menopause drugs Premarin and Prempro, shows the lovely, trim, and youthful-looking Ladd speaking directly to site visitors. "Menopause can be a confusing time for women," she says. "When it began for me, I didn't know what was happening." The site also features an e-card option with a choice of image and greeting.

Using the opposite approach from its ubiquitous "Purple Pill" campaigns for Prilosec and Nexium, AstraZeneca's Getbcfacts.com is an unbranded informational site about breast cancer. While AZ markets breast cancer medications, the site doesn't mention brand names, instead referencing hormonal drug therapy generically, alongside such medical options as chemotherapy, surgery, and radiation.

Beyond bolstering brand recognition, it behooves drug makers to keep patients on their medications. Pharmaceutical executives say that within three months of receiving a prescription, 50 to 70 percent of patients either take themselves off of their medications or don't take them as directed. "Drug companies can help patients succeed on medications, and [our clients] are starting to move to patient compliance [via the Web]," says Aronson.

For example, Teva Pharmaceutical's Mswatch.com, designed for its multiple sclerosis drug Copaxone, lets patients talk directly to nurses via e-mail about their condition -- a potentially valuable benefit, given the complications of living with ms. Aronson says it could be useful for pharma marketers to offer online nurses to general medical and health Web sites like WebMD.

Outside of direct-to-consumer marketing, drug companies are using e-mail messages and e-detailing to interact with physicians. Doctors who participate in e-mail messaging with drug reps tend, on average, to stay online for more than five minutes -- nearly double the time a sales rep typically gets from a doctor during an in-person visit, says Aronson.