Dinosaurs, Drugs and Politics

One of the most heated debates in the pharmaceutical industry is aping the struggles of a hundred million years ago. The typical titanosaur was about 30 metres long and weighed a lithe 80 tonnes. It was very single-minded (as it had to be because it needed over a tonne of food a day) so it did not pay much attention to anything non-edible. However, when it saw danger – or felt something take a chunk out of it – it swung into action; as it thrashed around in the mangrove swamps, not much of the surrounding vegetation survived but the predator was long gone: it took about five seconds for the first sign of danger to get to the giant dinosaur’s brain. Not much has changed since the heyday of the sauropods in the middle cretaceous period but a conference this April is trying to move evolution along. Industry, patient groups, politicians and experts in branding and communications will gather for what may be a leap into the future on direct-to-consumer (DTC) communication. The pharmaceutical industry, much of which dreams of having the marketing agility of a primitive vertebrate, has found a sales-promotion tool that sometimes works in the United States and New Zealand. DTC advertising has brought in high volumes of sales, at least for a few products in a few sectors and anything that can sell an extra two billion-dollar’s worth of one elderly anti-histamine must be worth pursuing. While some have taken a more evolved approach, a few of the big, international pharmaceutical companies have single-mindedly focussed on getting the American model of direct-to-consumer promotion adopted in Europe. If they can’t get the whole thing adopted, they will take whatever they can get. If you are having trouble imagining a titanosaur, think Donald Rumsfeld dealing with NATO. For parts of the pharma industry, sun started filtering into the swamp eighteen months ago when the European Commission proposed a trial period in which some DTC communication would be allowed in three specified disease areas. This would only be a trial and it would have lots of restrictions but industry was excited. Unfortunately, an enthusiastic titanosaur can be a bit intimidating so the Commission began sounding much more cautious. It did not, it suddenly decided, really mean anything very radical. In fact, it said, some of its proposals were more restrictive than the status quo. Even these watered-down proposals were too much for the European Parliament which has tried to stamp firmly on any change. The Parliament’s opposition comes in part because the industry is not alone in the mangrove swamp. The other 80 tonne monster is the European consumer movement. Like the average sauropod, its central brain is rather over-stretched because its limbs are so spread out but what spare capacity it has is focussed on loathing of multinationals and especially those in the pharmaceutical industry. Anything industry wants, the consumer movement knows instinctively it has to thrash around to stop. Industry seems to like DTC so the consumer movement knows it must be stopped. Most of the organisations representing medical professionals have sided with the consumer groups. Allow the companies a science-based Web page tomorrow and you will have dancing girls giving away free samples of anxiolytics next week. Think Jacques Chirac contemplating a glass of New Zealand white wine with dinner. As the two great beasts face off, one makes a bold aggressive manoeuvre. After an appropriate delay to process the information, the other one swipes at where its target had been fifteen seconds before. As they lurch around, the well-being of patients and the interests of European health systems tend to get thoroughly trampled. Patient groups point out that many people – especially those with chronic diseases – are demanding more information on which to base personal treatment decisions. It cannot be logical that those who know most about medicines, the developers of them, are forbidden to pass on this information. European doctors and hospitals despair as patients arrive with stacks of print-outs from US Web sites – much of the information is simply irrelevant in Europe and the discussions about the prehistoric US insurance system mystify many patients. On-line quacks make fortunes from selling dubious herbal remedies and bootleg pharmaceuticals through Web sites and phone lines which are subject to no effective regulation at all. There is no clear way out of the flattened vegetation. This is where a conference in April comes in. The luxurious golf course at The Belfry (near Birmingham in the UK) should give the right evolutionary hints to the delegates at the Fifth Annual DTC Marketing & Communications Forum organised by Access Events International Ltd. It is far removed from the mangrove swamps. Here, experts from industry, patient groups, management consultancies and the PR industry will try to carve out a European way forward on DTC. Mary Baker, President of the European Federation of Neurological Associations, will present new patient-centred proposals that she and the Federation have prepared along with a small group of leading neurologists and Members of the European Parliament. “We have commented on the proposals of others for too long,” said Baker. “We have to start formulating ideas of our own which put patients at the centre of any reform.” Dr Yves Furet of Schering AG will present an overview of Schering’s approach and a case study on a European DTC programme which has not simply worked but which has generated praise from regulators, professionals and patient groups. “One of the most important parts of DTC is the integration with all other marketing, communication and education tools. It should not be a department apart and should be closely linked to activities with prescribers,” said Furet. Lisa Power, from AIDS charity The Terrence Higgins Trust, and Rodney Elgie, from the umbrella mental health group GAMIAN, will ask whether it really is “such a disaster if companies are allowed to communicate with patients”. The US model may, anyway, be going the way of the dinosaurs according to several of the expert consultants speaking at The Belfry. Boston Consulting’s Philip Evans believes that the next stage of the information revolution will have a profound effect on the marketing of all branded products, pharmaceuticals included. In this data-rich world, claims to be better, quicker or safer will be easy to check; consumers will pick instead the brand which is tied to the most helpful overall experience. This will require a re-think of the industry’s traditional data-based approach to selling. Simon Bryceson, a guru in corporate reputation circles, takes a less optimistic view of evolutionary processes. He believes that the pharmaceutical industry is already far down the road last travelled by the tobacco industry. Rather than becoming dinosaurs, he thinks pharmaceutical companies will become pariahs and that there may be no way to counter the Darwinian trends. For those determined to try to survive, Jenny Hope of the Daily Mail (a UK mid-market tabloid) will give tips on getting noticed by the press and Ed Slaughter, a US market researcher, will look at what the data show has worked in the US DTC model and, maybe more significantly, what has not. Twenty or so other speakers will focus on internal and external planning and techniques. Senior executives from Astra Zeneca, Pharmacia and Roche will give detailed case studies. The sauropods are thought to have been wiped out by an asteroid which hit the Yucatan 60 or 70 million years ago. Delegates to The Belfry meeting are hoping for a different flash of light over the golf course to usher in a new aeon of industry-patient collaboration on communicating about medicines. For further information and to register please contact Samantha Evans on +44 (0) 20 7566 4810, Email: samantha.evans@access-events.com or visit www.dtc.access-events.com . Reference 1. In case anyone has a ten year-old with an encyclopaedic knowledge of dinosaurs who wants to challenge my reporting of the period, I got it from http://www.palaeos.com/Vertebrates/Units/Unit330/330.500.html