DTC/DTP: What About The Doctor?

A Prevention magazine survey, conducted by Princeton Survey Research Associates last year, concluded that direct-to-consumer prescription drug advertisements “positively affect patient compliance with prescribed drug therapies.” The survey showed that physicians usually are willing to provide patients with the requested prescription, with 80 percent of survey responders saying their doctors honored their request.

What the survey does not delve into is the attitude of most physicians to the patients' initiative regarding the pre-selection of their medications. We also are not clear on how physicians will react in the long run to the proliferation of DTC/DTP initiatives, which are predicted to expand in 1999 and beyond.

At the 1998 American Medical Association annual meeting in Chicago, AMA delegates approved a resolution urging the Federal Drug Administration to conduct a survey of practicing physicians to assess the effects of direct advertising of prescription drugs on physicians' practices and patient care. The DTC ad resolution also calls on the FDA to perform an economic analysis “to explore the potential for increased cost to the healthcare system that could result from a demand-based rather than need-based pharmaceutical market.” The delegates' decision to proceed with the original resolution indicates the degree of concern among physicians regarding the effects of DTC advertising.

Sidney Taurel, past chairman of PhRMA, believes one way to deal with this issue is for drug makers to formally and publicly state corporate standards for DTC advertising. Mr. Taurel's company, Eli Lilly, finalized corporate DTC standards in 1998, which was developed in consultation with physician and patient groups. “We have pledged to educate physicians and other healthcare professionals about Lilly medications before advertising them to the public,” said Taurel. “In addition, we will inform key constituencies prior to a launch of a campaign.”

A significant number of industry advertising experts believe that consumer campaigns must work in tandem with professional programs in order to achieve optimum results. “We've learned that we could drive a lot of people to physicians with good advertising, but if the physician does not want to write the prescription, or is more inclined to write someone else's product, we're wasting the client's money,” said James Sandino, president of Lowe Direct.

Below are several techniques that can be effectively implemented to ensure that health professionals and sales representatives participate in the development of DTC/DTP programs and become advocates of these communications vehicles.

* Use physicians in the program development phase to ensure that there is fair balance in all advertising and that the featured drug is positioned as part of the answer, and not as a miracle cure.

* Use physician, MCO and pharmacy focus groups to fine-tune the message strategy and creative execution. Relevant graphics and understandable copy are critical elements.

* Mail photo boards of television spots and copies of print ads (be sure to include “major statements”) to target physicians and key MCOs prior to the start of the campaign. Inclusion of one-to-one back-end materials also would help.

* Survey physicians on an ongoing basis to gauge their reactions and those of their patients. Obtain relevant information, which can be used to continuously improve the campaign and to ensure that it offers perceived value in the minds of both patients and physicians. Maintain a database of responses for use in development of future programs.

* Work with key medical societies to ensure they're given the opportunity to provide pre- and post-campaign input.

* Preview rough cuts of TV spots with product advisory boards and with physicians attending key medical meetings. The exhibit could be a great venue and can act as a traffic builder at the booth.

* Involve sales representatives (pre and post campaign) and ensure that they're clear on the strategy and campaign rationale and how it will help them individually. Help them see it as a tool and not as a threat.

* Design special sales reps materials, which would include key elements of the campaign. Reps can use these materials to initiate dialogue with doctors (private practice and MCO's) and pharmacists or to address key objections that might come up during sales calls.

* Test “adequate provision” follow-up materials with doctors and patients to ensure that they're well balanced, understandable and relevant.

* Test “major statements” with consumers and doctors. This will help to ensure that physicians are prepared to deal with the information and will help companies craft statements that will be perceived as nonthreatening.

DTC/DTP advertising is a precarious tactic, which carries the potential risk of estranging the industry's strongest ally, the prescribing physician, and if controversial, the ads can provide unwanted ammunition to its harshest critics. All of these initiatives should be crafted with the goal of enhancing rather than jeopardizing the physician/patient relationship. Without the Rx there is no sale and no opportunity to improve the quality of life of patients who might be ideal candidates for specific therapies.

Julian M. Parreño is senior vice president of pharmaceuticals at Harte-Hanks Direct Marketing, Shawnee, KS.

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