Go on, it’s good for you

THE television advertisement shows a tanned young man skiing effortlessly through a meadow of flowers and grass. Despite the clouds of pollen all about, he doesn’t even wrinkle his nose. That is because he takes Allegra, Hoechst Marion Roussel’s anti-allergy medicine.

Welcome to the drug as consumer product. As a campaign for a branded prescription drug, this commercial is ground-breaking. With images from Industrial Light & Magic, the special-effects wizards behind films such as “Star Wars”, it shows a good-looking, healthy young man enjoying himself. Contrast that with the wheezing, grimacing individuals on television spots for cough syrups and headache pills. Like Pfizer’s Viagra for impotence and Merck’s Propecia for balding men, Allegra belongs to a new class of “lifestyle” drugs: treatments which might make you happier, but which you could well live without. Such drugs are being sold with the sort of marketing normally reserved for Coca-Cola.

Until last year, it was virtually impossible in America to advertise named prescription pharmaceuticals on television. An advertisement could name a drug, but could not link the name to a disease unless it read out all the tedious information the manufacturer supplies with the drug itself—which, on average, would take seven minutes of air time. In most of the rest of the world, even naming a drug in an advertisement is banned, though that is likely to change. Britain’s Glaxo Wellcome recently talked of such advertising coming to Europe, and America’s Schering-Plough believes Australia, South Africa and Latin America are all likely to deregulate within the next few years.

The American experience gives a taste of things to come. Since the Food and Drug Administration ( FDA ) relaxed its guidelines on television advertising in August 1997, spending on direct-to-consumer advertising of pills and potions has taken off. Spending in America on ads for prescription drugs, estimated at more than $1 billion this year, now exceeds that on beer advertising. Spending on television alone reached $171m in the first four months of 1998 (see ).

However, the real marketing gold mine lies in the data about patients that drug companies are collecting from calls to toll-free numbers and visits to websites. The drug firms’ push into consumerland comes at an opportune time. According to Jane Parker, of Grey Healthcare, part of Grey Advertising, it coincides with the ageing of the Baby Boom generation, who now want information and choice. Jed Beitler, head of Sudler & Hennessey, the health-care arm of Young & Rubicam, says that growth in over-the-counter medicine has helped to teach people to diagnose and treat their ailments on their own.

The spread of HIV had a role too, by diminishing the reverence for doctors. Through their own networks, patients started learning about treatments more rapidly than their doctors did. The Internet has also opened up the closed world of medicine, though not always for the best (see ). People are particularly likely to take the initiative and demand lifestyle drugs such as Viagra and Propecia, says Matt Giegerich, of the Quantum group, part of Britain’s WPP . Those who believe that doctors do not keep up with medical developments are also using the web to pester scientists directly. Oliver Bogler, who runs a brain-tumour laboratory at Virginia Commonwealth University, regularly receives e-mails from patients and their relatives.

This does not yet add up to proof that patients benefit from advertising. Indeed, there are worries. Doctors and HMO s point to the dangers of patients treating themselves and of doctors coming under pressure to over-prescribe. Also, drug companies tend to promote the most expensive new remedies when a cheaper generic might often do just as well.

Healthy for whom

Some drug companies are even altering clinical trials in order to be able to make marketing claims that will appeal to consumers—for instance, that a drug is delivered in a convenient form, or eliminates an irritating side-effect (though this might count as a real improvement). That Claritin does not cause drowsiness is one reason it can charge HMO s around $1.90 a pill compared with a few cents for generics, which do. Clifford Wong, a director of Kaiser Permanente, an HMO , asks whether that difference is really worth so much extra cost. He argues that direct advertising restricts choice and “is not the best way to educate consumers”.

There is something to this. But drug companies are unlikely to advertise without any regard to patients’ well-being. They know that their advertising must win over not only consumers but also the FDA , doctors and the HMO s. One way of doing so is to point out how much money can be saved when drug firms encourage patients to keep to a medical regime.

A glimpse of the future is disease management through advertising. Acuity Health Group, a two-week-old division of Omnicom, will offer to design individual regimes to encourage patients of its clients to take their medicine, directed in the first place at chronic conditions such as osteoporosis and diabetes.