The latest regulatory threat: new taxes and changes to tax laws that could make it far more costly for pharma companies to advertise.

Historically, pharma marketing dollars have predominantly been allocated to campaigns targeting physicians and patients. The latter often feature ads with the now-infamous “Ask your doctor if…” call to action. But spurred on by issues such as prescription drug abuse and the opacity of drug prices, there are growing calls to reign in pharma’s marketing machine, particularly the part of it that speaks to consumers directly.

But are pharma marketers doing it wrong anyway?

Amber Gilbert, the MD at consultancy Cyan Health, believes the answer is yes. In an opinion piece published by, Gilbert notes that “According to the DRG Digital/Manhattan Research Taking the Pulse survey for 2017, only 16% of physicians always prescribe their first-choice drug these
days, while the other 84% usually or always follow formulary guidelines.”

Formularies are created by pharmacy and therapeutics (P&T) committees that are made of experts including doctors, nurses and pharmacists. Payers, such as insurance companies, decide which drugs they will pay for, and how much. They can also decide the order in which drugs become accessible to patients. For example, a low-cost generic drug would likely be preferred over a higher-cost brand name drug that treats the same condition.

One of the reasons physicians have moved from prescribing the drugs they personally prefer to prescribing the drugs that are part of a formulary is that when they prescribe drugs not on a formulary, those prescriptions can be rejected and/or require a sometimes complicated and lengthy authorization
process. For patients who need to address a health issue, the potential for bureaucratic headaches and delays are obviously not very desirable.

Access first

The statistics make it clear: if pharma companies want to sell their drugs, they first and foremost need their drugs to be included on formularies so that patients can have access to them. But by some estimates, access marketing – marketing designed to see that a drug is actually available to patients –
accounts for under 10% of the total budget pharma marketers have to work with. Gilbert likens this to “a clear case of fighting the last war, when physicians had greater control over their prescribing decisions.”

Unfortunately for pharma companies, Gilbert says the dollars that do get allocated to access marketing are often not being spent effectively because marketers are largely repurposing assets from campaigns that speak to the needs of patients and providers when the interests of payers can be quite different.

Her advice:

“It’s time for pharma companies to focus more purposefully on payer-targeted advertising campaigns in which the message, tone, and visuals are explicitly directed at payer needs, mindset, and culture – campaigns that address the value story head on, to the degree that data support and regulation allow. That story can go beyond traditional clinical content to include messaging regarding unmet need, economic burden, impact on population, and cost
of comorbidities, as well as the quality and consistency of available evidence.”

More on pharma and healthcare

The Consumerization of Healthcare – Trends report

Rethinking everything

Prescribing trends do suggest that pharma marketers would be wise to reconsider who they target their campaigns to, but the tarnished image of pharma generally also suggests that pharma marketers should be rethinking everything they do.

This is especially true as the ongoing scandal with opioid drug maker Purdue Pharmaceuticals brings into the open aspects of the industry that pharma companies would probably prefer not be promoted publicly.

In short, pharma marketers don’t just need to communicate to the right people, they need more than ever to be more effective with what they communicate. In some cases, pharma companies will need to consider making broader strategic changes to ensure that they have something to communicate that would be well-received by providers, patients and payers alike.

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