Branding

Branding is still a tricky issue for many in the pharma industry. But it doesn’t have to be, say industry experts Neil W. Matheson, CEO of AXIS Healthcare Communications LLC, Sue Miller, a Partner at The Cementworks, and Lorraine Pastore, President of Brand Pharm.

“Medical-ese’ can be very intimidating and off-putting. We try to use very clear, simple language”
-Sue Miller, The Cementworks

NGP. Pharmaceutical companies are not foreign to branding, for years doctors have been receiving free samples as well as free pens, notepads and folders bearing the name of their corresponding drug. How do you make the leap from advertising to doctors to advertising to patients?

LP. Core marketing principles should remain the same whether communicating to a physician or a patient. The key differences are regulatory limitations, the media, the complexity of the story and the language employed, and finally, the call to action. As long as these are kept in mind, it’s really not a leap at all.

NM. The pharmaceutical market place is changing dramatically. The drivers of this rapid change are the aging baby boomer population, the demand from this generation for more information and involvement in their own healthcare decisions, the perceived high price of medicines, and the public perception of the industry. In response to all of these market drivers, the pharmaceutical industry has to develop brands that physicians, patients, and consumers equate with value. The brand has to deliver the promise of better care, improved quality of life, and a significant advantage over present agents.

The core principles of creating a successful brand are the same for physicians, patients, and consumers. A patient has to form a relationship with the brand so they must be able to relate to the brand and its personality. The actual brand name and the graphic icons used to depict the brand are an integral part of the brand relationship-building process but brand loyalty is more than a fancy logo. Iconic brands are ones that people remember because they relate to everything the brand stands for – they trust the brand and acknowledge the value it delivers.

There are already great examples of iconic brands in the pharmaceutical world. It is interesting that these brands have become iconic because they have been so successful at building relationships with patients and consumers. Nexium (the “Purple Pill”) and Viagra are both examples of iconic pharmaceutical brands.

SM. Here in the US, direct-to-consumer (DTC) advertising has become a widely used vehicle for pharmaceutical promotion. That’s not to say that its not controversial even to this day – in fact there are constant rumblings from Congress that they may “look at” this practice again and perhaps put more restrictions in place.

DTC advertising has evolved significantly over the past 8 years or so. Many large consumer advertising agencies have jumped into the fray, lured by the substantial media budgets that support large brands such as Claritin (prior to its conversion to OTC), Celebrex, Viagra, Crestor, etc. Obviously the messages to consumers are different than those directed at healthcare professionals. Most, if not all, of the steps taken to develop a communication plan for physicians are applied to consumers, i.e. positioning and messaging research, a competitive analysis, determination of strategic imperatives, evaluation of the most effective and efficient vehicles for dissemination, etc.

We will customise the types of research we do to gain meaningful patient insights and understand the emotional connections that patients have with their condition and its treatment.

Once we have settled on the positioning and key messages that must be conveyed, we carefully craft the language. We strive for a 5th-8th grade reading level when developing copy for patients. “Medical-ese” can be very intimidating and off-putting. We try to use very clear, simple language – not to understate safety concerns, but rather to help make sure that we are not scaring or confusing patients unnecessarily. The “fair balance” that is required by FDA regulation can act as a real “sales prevention” block at times.

The media spending necessary to break through to a patient audience is substantially larger than the budgets to place ads in medical journals. Return on investment is very difficult to assess. As a result, print and television based DTC campaigns are limited to brands that require a mass audience. Categories such as hypertension, lipids, arthritis, allergies, etc come to mind. However, the internet makes it possible for even smaller, more niche brands to affordably reach their desired audience. Once you’ve captured a “surfer’s” attention and gotten them to a branded or unbranded site, you have the opportunity to provide meaningful information, and perhaps even capture a name into a database to be able to continue a dialogue over time.

Although I have not seen the statistics to back this up, I believe that over the next few years, investment in internet-based strategies will begin to overtake investment in traditional print and television.

NGP. Brand building is very important as it drives customer loyalty. How do you start that brand building process?

NM. The fundamental building blocks of brand building are determining the brand personality and the way in which you want customers to relate to your brand. Once this disciplined process has been completed and a brand identity agreed, the outputs must be driven to reflect that identity and personality at all times. Many companies compromise the brand personality and identity resulting in confused customers that are left wondering what the brand stands for.

The most successful pharmaceutical brands have been built on a “big idea” that becomes the foundation of the brand strategy and drives all tactics to all target audience. As previously mentioned one of the best examples of a very successful big idea is the “Purple Pill” concept used by Nexium to extend the lifecycle of the first proton pump inhibitor – Prilosec.

In fact, Prilosec was also marketed on the back of a big idea – instead of calling the drug a proton pump inhibitor they described it as an acid pump inhibitor and went about reclassifying diseases as acid-related (acid-related reflux instead of GERD). Once the big idea is in place it drives the communications messages. Selection of appropriate media (including online and digital media) is then the key to successful tactical execution.

SM. Given our name, The Cementworks, it’s not surprising that we use an architectural/construction model to describe our brand building process. The analogy works very nicely because we believe that great brands aren’t born, they’re built. We constantly remind our clients that when you’re building a house, you can’t put the wallpaper up before you’ve built the walls.

We start with a “site survey”. What does the competitive landscape look like? Is this a crowded category, such as hypertension, which we would liken to New York City or an undeveloped market like erectile dysfunction was 10 years ago – which we would liken to an unspoiled island perhaps. Are we building the first building? The tallest building? A modest structure that will be dwarfed in some other brands shadow?

Next we assess the “environmental impact” – here the twist is to figure out how we create the greatest impact within our environment. During this phase we identify the strategic imperative for success, we conduct a needs/gap analysis to see how we can differentiate our brand and address an unmet need in the market (hopefully). We search for the best “coupling” of the rational benefits that the brand delivers to the emotional needs of our customers (yes, even physicians have emotional needs!). We develop positioning and the message platform.

Finally, we draft the “brand blueprint”. At this stage we crystallise the “softer” side of the brand: its promise and its personality, even the colour palate that we’ll use. We begin developing concepts for the logo and icon – which become the brand signature. And we develop the overall campaign to launch the brand.

Once research has helped us refine the concepts, we go into full “construction” mode. Illustration or photography is commissioned, the materials that will be disseminated to various audiences are written, designed, reviewed by medical and regulatory personnel, and finally printed.

What has been conceptual up until this point is not “real” – we have the printed materials, the premium items, the videos, the booths, the ads, etc. This we call the “brand opening”. As exciting as this stage is, it doesn’t stop there, however. Because a brand, like a building, requires upkeep and maintenance – sometimes even a new addition is added along the way. Like a landmark building, it can draw people for years to come.

LP. At Brand Pharm we have a proprietary brand building process called BrandStock. This process is steeped in alternative research approaches. The first step is understanding the customers, the construct of the market, the competition and the clinical milieu in the context of our brand and its various scenarios as well as those of current and future competitive brands. And that’s just the first step!

Our core vision is alternative thinking. By combining our right brain and left brain thinkers behind tactical development, we come at strategic and creative solutions in a different way, a way that ensures the promotional materials we developed not only get noticed in journals, but also are positively seen by the most important medium in our business of all, client sales forces.

NGP. A patent can often run out just a few years into the commercial life of a product, how do you make sure that a product will continue to have a monopoly on its market?

SM. Boy, that’s the multi-billion dollar question. If I had that answer I would be able to retire tomorrow!

As you know, pharmaceutical companies have armies of lawyers who do nothing but protect, defend, and develop strategies to extend the patents on big brands. The introduction of a generic competitor will erode market share by 50 percent virtually overnight. New formulations, new indications, new combination therapies, and OTC switch strategies are regularly employed. In the US, companies are granted six months additional patent life if they conduct paediatric trials. Virtually all companies now take advantage of that strategy.

Despite the lawyers’ best efforts, only a few products that I’m aware of have been able to maintain substantial market share once the patent has expired. These include Premarin, Synthroid, and Dilantin. The secret to their success seems to lie more in the manufacturing complexity than marketing genius, however. Brands that rely on delivery systems such as insulin, growth hormones, asthma inhalers, etc, have the added advantage of developing a superior device to maintain share. This has been very effective in some categories.

Recently, some manufacturers have been successful in educating physicians and patients about the wide variance in pharmacokinetics that can be seen with generics – particularly if different brands of generics are utilised in refill situations. Pancreatic enzyme replacement therapies and antiseizure medications are two examples that come to mind. They have even been successful enlisting patient advocacy groups to help lobby to prevent mandatory pharmacy switches.

If anything, I suspect this will become even a greater concern for pharmaceutical companies as legislative bodies, at least in the US, are talking about shortening patents – not lengthening them – in the near future.

NM. David Wood, one of the best in the pharmaceutical “branding” business once said that he believed a strong brand would carry a drug beyond its patent expiry and through its generic life. The price would have to be reduced to compete with other generic entries but a strong brand would survive on the brand loyalty it had generated prior to patent expiry. In order to realise this opportunity the industry has to start looking at its products beyond patent expiry (presently though of as the end of the product lifecycle rather than a transition point) and develop lifecycle plans that include a post-patent brand strategy.

LP. Perhaps this is a question better suited for attorneys than marketers. Seriously though, there is little a marketer can do once a product goes off patent other than the appropriate pricing strategies. Another way of thinking about this is to drive the brand to peak sales as soon as possible after it is launched. This entails starting the branding process early in the life of a product, as early as phase 2, to establish personality, a lexicon and awareness prior to launch.

NGP. Do you believe that it is possible to build a brand within a specific pharmaceutical area and then use this brand name to branch into other niches within the pharmaceutical industry? If so how would you go about this and which industries would you branch into?

LP. In consumer marketing, line extensions are used to stretch promotional dollars and extend profits associated with the base brand. Line extensions grow share of retail shelf space, offer options for various consumer segmented needs not be served by the base brand, and help increase the brand’s SOR (share of requirement). There are also watch outs – the main one being the risk of sullying the base brand, if the extension has quality issues, fails to perform or is not positioned consistently with the base brand. For example, it would be unwise to offer a value-priced line extension to a luxury brand.

If we apply these principles to our business, there are opportunities for extending brands. For example, in dermatology, equipment such as lasers could be branded to coincide with topical treatments that are often used after such procedures. In the cardiovascular space, similarly, imaging equipment could be co-branded with any of the procedural agents used.

SM. I have only seen this strategy work after a prescription medication has been switched to OTC status – J&J was able to expand their Monistat franchise with line extensions – some were even different molecules. I am also thinking of the ConvaTec division of BMS which has two divisions, ostomy and wound care. They have utilised this strategy to extend brand equity to line extensions.

My gut tells me that the strategy would work better in the device arena than in the pharmaceutical arena, however, unless we’re talking about fixed dose combination products where two compounds are combined. Even here, though, most companies opt to sell the new combination as a new entity and in fact work hard to make customers see the value beyond convenience.

NM. The obvious example of this is a brand such as Prilosec that built a loyal following with physicians as well as patients and then took the brand into the over-the-counter are and leveraged the equity of the brand in the consumer market place. Nexium has the brand loyalty to do the same thing, as has Viagra.

I don’t see a pharmaceutical brand ever being used in another area outside of pharmaceuticals. However, if you are thinking of an agency brand then that is different. There are many examples of agency brands that are huge across several industries – just look at Saatchi.

Neil W. Matheson is CEO of AXIS Healthcare Communications LLC. Neil joined the pharmaceutical industry in 1983 as a sales representative for Ciba Geigy New Zealand Limited where he was involved in the launch of Voltaren, the world’s largest selling NSAID. Neil held senior management positions with Adis International and OCC North America, Inc. before teaming up with Larry Lesser to establish ApotheCom Associates LLC in September 1999. ApotheCom experienced rapid growth and is now a member of AXIS Healthcare Communications LLC. AXIS provides a full spectrum of healthcare communications services to the pharmaceutical, biotechnology, and medical device industries through its strategic consulting, medical communications, medical education, healthcare advertising, and sales training agencies.

Lorraine Pastore has been involved in pharmaceutical communications for many years, with brand experience ranging from lifestyle to high science products. A self-proclaimed science ‘geek’, her wealth of knowledge spans pre-marketing conditioning, launch – over 15 launches, 9 global – DTC marketing, Rx-to-OTC switching, and shepherding brands through their lifecycles. Lorraine joined Medicus NY in 1991 and has been an integral part of the Publicis Healthcare Communications Group ever since. She is currently President of Brand Pharm – the agency of alternative thinking.