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This article by Barbara Fox was published in U.S. 1 Newspaper on June 24, 1998, all rights reserved.
New Twist in Drug Marketing
With many brands targeting each disease, today's drug marketplace is getting to be as crowded as the cereal marketplace. So though pharmaceutical firms may be more cost conscious, their advertising budgets remain healthy. When their original "pioneer" drugs are in danger of being replaced on the shelves of the managed care organizations (MCOs) by newer brands or cheaper generics, the big pharmas are fighting back.
They say, in effect, "If you won't put our drug on formulary (the list of approved prescriptions) we will go direct to the consumers to motivate them to complain to the MCOs." Then they stage "direct to consumer" (DTC) campaigns on television and in glossy magazines.
"A growing number of patients have signaled that they want to be empowered, to play a more active role in determining the treatment choice," says Jeff Trewhitt, spokesman for Washington-based Pharmaceutical Research & Manufacturers of America. "DTC advertising is marketing, but it is also a form of education."
These DTC campaigns were experimental from 1992 to 1994, and lots of mistakes were made. But when the big spending started -- $400 million in 1995, $600 million in 1996, a projected $1 billion in 1998 -- the big pharmas realized they could not afford to mount expensive campaigns for each and every one of their products, and that they needed to commission careful market research to choose which ones to promote, and how.
"The more money you spend the more you need to spend to find what works," says John Kamp of the American Association of Advertising Agencies. He notes that the industry's research and marketing techniques got considerably more sophisticated last year. Also last year the FDA relaxed its rules on broadcast advertising so firms can now choose to advertise on television.
In such a fast-moving environment big firms are even more ready to farm out the work than they were in previous years, and a new trio of healthcare marketing and/or market research firms stands ready. Charlotte Sibley's Isis Research and Jane Donohue's Consumer Health Sciences are at Research Park, while Karen Hyver and Harriet Kozak have moved NOP Healthcare Advanced Consulting Group to 1 Palmer Square. All three firms stand ready to help pharmaceutical firms pick their battles, fight to bring products to the attention of the consumer, and use marketing to "get to yes."
Unlike 15 years ago, a lot of the really strategic thinking is being done on the agency side," says Charlotte Sibley, who opened the U.S. office of Isis Research at Research Park in March. Because of re-engineering, she says, senior level marketing executives at pharmaceutical firms spend most of their time on day-to-day tactical work, "putting out fires," which leaves little time for strategic planning: "Under the tyranny of the urgent, what's important doesn't get attention until it becomes urgent," says Sibley.
Charlotte Sibley speaks from the experience of 10 years at Bristol-Myers Squibb, where she was head of marketing research and competitive intelligence for the United States Pharmaceutical Group. Labeling the reason for leaving her post as "differences in philosophy," Sibley says "it gave me the opportunity to do something that takes advantage of my skills and capabilities in a more entrepreneurial way, the opportunity to put my ideals and principles in practice on how to do research and how to use research."
Market research should be done for the right reasons:
Sibley was hired in 1987 by Jan Leschly, then CEO of Bristol-Myers Squibb, to be head of the worldwide business research and information group. When she left in September, 1997, Colin Maitland hired her to open the United States office of his 25-year-old firm.
Maitland knew Sibley from having done work for Bristol-Myers Squibb and from her having been president of the professional association, the Pharmaceutical Business Intelligence and Research Group. "Colin said he had been looking for almost three years for a president of the Americas and as soon as I was available he approached me," she says.
"The legacy of Isis is positioning and advertising research," says Sibley. In the 1970s Maitland was known for innovating eye-tracking technology in the advertising industry, so the firm started as Eyescan, but it changed its name to coincide with the name of the second string rowing team at Cambridge.
"It is one of the few truly integrated global healthcare firms, in the sense we have our own internally owned and operated fieldwork agency," says Sibley. Fieldwork International, based in London, does telephone interviewing in more than 30 countries around the world, including the United States. "It gives us control of management and costs."
Isis has more than 110 research executives worldwide. "We have major offices in Asia, not just `a man and a dog' as the British would say," notes Sibley. Regional headquarters is in Hong Kong, plus there are offices in Beijing and those opening in Shanghai, Manila, and Kuala Lampur. Europe has offices in Italy and France with one planned for Spain. Because her office has responsibility for Canada, Mexico, and South America, she is president of ISIS Americas.
John Brandberg from Buschman Jackson-Cross represented her in leasing just under 2,000 square feet at Research Park. A colleague -- Jane Donohue of Consumer Health Sciences LLC -- helped point her to that space.
"It was the opportunity to build a team," says Sibley. "I do it very well and I love doing it. It re-energizes me." With the help of Bill Williams, of Cranbury-based Cardinal Management, she hired four vice presidents, and she notes how unusual it is for a start-up business to start out with so many top-level positions: Gerarda Collins, senior vice president of business development, was with Migliara/Kaplan. Louise Kier Zaretta, vice president, also came from Migliara/Kaplan. Dan Fitzgerald, vice president of operations, had headed up the panels for medical audits for IMF, the audit corporation for pharmaceutical market share. Don Marshall, vice president, came from Novartis and Bayer. Her staff also includes George Philip, who came from Prudential, and Adrienne Richter, formerly in competitive intelligence with Bristol-Myers Squibb, and office manager Debbie Hartman.
"It feels great," says Sibley, "from the initial details of finding the office space and arranging for telephones, it's been very exciting and a lot more fun than I would have believed."
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Hyver & Kozak
The days of hit or miss development are gone," says Harriet Kozak. "Every dollar has to be spent more wisely, both in R&D development and in marketing research. Pharmaceutical companies don't have the luxury of redundant studies."
Harriet Kozak and Karen Hyver opened a business unit of NOP Healthcare Advanced Consulting Group at Carnegie Executive Center and have moved it to 1 Palmer Square. As vice president of business development, Hyver heads the domestic team, and Kozak heads up the global team, working with multinational firms. The office is a subsidiary of Market Measures, based in Livingston, but it is also part of a conglomerate based in the United Kingdom, United News & Media, which is traded on the London Stock Exchange.
Their firm collaborates with clients to provide and customize market-validated solutions. "One client might need to know where a product is positioned in the minds of physicians, another might want help making the switch from a prescription drug to an over-the-counter drug," says Kozak. "An advertising agency might need market research for qualitative assessment, concept testing, or message testing. A biotech firm might want advice on what indications it should look for in its clinical trial plan."
To answer these questions and more, NOP Healthcare provides data collection, data modeling, and forecasting on a consulting basis. "Consulting" is the key word for NOP Healthcare Advanced Consulting Group, which put the word in its name deliberately.
Combining research with consulting is really not such a new idea, counters the general manager of a competitive firm, Migliara/Kaplan. "Helping clients carry through with consulting -- we have been doing that for the 20 years we have been in business," says Sheryl Olitzky, general manager of Migilara/Kaplan's 50-person Princeton office on College Road. Founded 20 years ago, it also has offices in Maryland and London.
But as Olitzky points out, the healthcare industry is just catching up with the packaged goods industry in its use of top consultants to help shape unusual programs that will sell more prescriptions more quickly. And the industry itself is growing, even faster than the telecommunications and information technology areas. So there is plenty of work to go around.
"When the pharmaceutical industry was rich, it didn't second guess itself on putting out broad programs, but now it is cost-conscious," says Kozak, "and what we provide is market validation to say that a particular endeavor or business situation can be simulated in the market. It's one thing to do research in an ivory tower setting, but we provide the research to be actionable, so more meaningful decisions can be made."
Kozak points out that, overall, the firm has been doing international research for over 35 years, "and that combined with our industry perspective provides a unique benefit. We have also done a lot of research with clients. We put everything into the perspective of where client needs are evolving to."
The conglomerate, United News and Media, has 19,000 employees in 21 countries. Its United States-based holdings include a public relations firm (PR Newswire), a convention organizer (Miller Freeman), a stock photo firm (Visual Communication Group, VCG), a real estate magazine (Harmon Homes), and a magazine readership research firm (MAI).
As part of MAI, the NOP Information Group is one of the dozen or so largest market research businesses in the world, says Hyver. Market Measures is one of 15 companies that do research in such sectors as media, automotive, business-to-business, consumer products, and healthcare. The Palmer Square office of NOP Healthcare Advanced Consulting Group was created last year and is Market Measures' newest unit.
Hyver majored in medical technology at Louisiana State, has a doctor's degree in physical-analytical chemistry from the University of Mississippi, and did post-doc work in pharmacology and experimental therapeutics at Johns Hopkins' medical school. She worked as a chemist and as product development manager at Hewlett-Packard, was business development manager at Baxter Healthcare, and most recently had been an account executive with Migliara/Kaplan Associates, where she conducted more than 100 custom market research studies among healthcare professionals, patients, and payers.
Kozak earned bachelor's and master's degrees in business administration (concentrating on marketing and finance) from Temple and Philadelphia College of Textiles and Science. Her 16 years in the pharmaceutical industry includes Johnson & Johnson and Bristol-Myers Squibb, where she most recently was director of strategic and scientific evaluation. As vice president of the global division she offers "market-validated consultancy" to multi-national pharmaceutical clients based in the U.S.
Pharmaceutical efforts to enhance the bottom line have brought consumer polling to the fore, says Jane A. Donohue, who has started a new kind of hybrid healthcare information company. "What is different now is an awareness of the importance of the consumer."
Donohue left Janssen Pharmaceutica to found a healthcare information firm, Consumer Health Sciences LLC, to do both outcomes and marketing research. It aims to fill a gap in information on what drives patients to seek medical advice and what happens to them when they leave the doctors' offices. All of its surveys include questions on quality of life reported by both patients and caregivers.
"The whole advent of direct-to-consumer advertising is a clear recognition of how patients can make decisions," says Donohue. "Though people think they have fewer choices under managed care, paradoxically they are forced to make more healthcare decisions than they did before."
The MCOs want to influence their clients to engage in healthier behavior, and pharmaceutical firms want to influence consumers to ask for a particular drug. Both benefit when they understand the consumer.
"It was quite clear that there weren't very good data sources on what the patient was doing," says Donohue. "We are collecting patient information. We try to be the voice of the healthcare consumer focusing specifically on patient issues, and we sell information on syndicated databases. Our analysis is completely quantitative."
She and her two sisters grew up in Chicago, where her father was a marketing executive at Readers Digest. She majored in psychology at St. Lawrence, Class of '74, and then earned a Ph.D. in social research from Bryn Mawr. Her most recent position at Johnson & Johnson was director of outcomes research at Janssen Pharmaceutica, and she founded this firm 18 months ago.
Her product line includes a General Health Audit with more than 15,000 respondents age 18 and over, which she says profiles the health of the nation in a large sample size. That database contains both attitudes and behaviors and resource utilization (frequency of seeing the doctor). It also includes unusual questions such as use of over-the-counter and alternative medicines.
She has also developed disease specific, longitudinal studies for depression, schizophrenia, Alzheimer's, and diabetes. More than 4,000 people are enrolled in a depression study that is updated every six months. A schizophrenia study contains data on 800 patients and more than 1,300 caregivers and contains what she terms "incredibly robust information that assesses satisfaction with care." The Alzheimer's study involves 3,200 caregivers, and the diabetes study has more than 3,000 respondents.
"Every one of our studies has a medical advisory board for clinical oversight and analyses," says Donohue. Her 14-person firm has researchers with master's and doctor's degrees who design the questionnaires. The firm also scans, processes, and analyzes the data in-house. Though the studies are sold to pharmaceutical and managed care companies, the firm owns the data and will be publishing the results in medical journals.
"In the Alzheimer's study we have quantitatively documented that the time from when a caregiver notices the first signs and symptoms to the actual receipt of the diagnosis is about 3 years. So it's the first three years in which the Alzheimer's patients have an opportunity to put their life together before the disease progresses. When they are misdiagnosed, the opportunities to provide better care are missed. There are new Alzheimer's disease management drugs, and they have the potential of being most beneficial at the early onset of disease.
"I would argue that patients have the right to know so they can get their lives together. I would want the choice," says Donohue. This study was recently presented at the American Association of Neurologists, to better train practitioners and the public as to the early signs of Alzheimer's disease.
The General Health Audit had an overwhelming response rate of more than 50 percent. Of 30,000 surveys mailed, 15,000 responded. "We get unbelievable letters and phone calls thanking us," says Donohue. "People are desperate to be heard."
Though the firm is self-funded, CoreStates has furnished an SBA line of credit. Mike Briehler of Buschman Jackson-Cross represented her in contracting space at Research Park. Ken Field of Field & Higgins is the accountant, and Barbara Spalding is the benefits consultant.
"I just took a huge risk," says Donohue, who left Janssen when she was 43-years old. "At times it felt as if I had jumped out the window, but the ground didn't come up as fast as I thought it would," says Donahue. "We have been phenomenally successful -- last year we were profitable."
"I think what we are providing is a very important service. We are enhancing the public health of a nation, and the nice thing is it can be a win/win situation, it can be a good business. I'm happy I can be in the forefront. I am not aware of a competitor right now. It is indeed exciting."
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