Robert Jarvik, the Baby and the Bathwater

This will be the last, last word on the fate of Dr. Robert Jarvik. We have two parting thoughts. First, Jarvik’s departure was appropriate. Second, we have to be careful not to throw the baby out, as they say, with the bathwater.

Babybath
The blogosphere has been full of commentary on the situation. Here, and here, and here. We have written two previous posts about the situation as well, because it will have an enormous impact on pharma marketing.  Essentially, Jarvik, who was paid over a million dollars to be a spokesperson for Pfizer’s Lipitor, turned out to have several strikes against him.

  • He wasn’t a cardiologist.
  • He didn’t actually scull, although he was depicted as doing so in one commercial.
  • He didn’t begin taking Lipitor until he was retained by Pfizer.

As we previously pointed out, the really troubling thing about all this was that in presenting himself as an example of what Lipitor could do for cardiac patients, Jarvik was misrepresenting the drug, and the outcomes it could reasonably be expected to deliver. Thus, his departure was probably a good thing.

However, big public controversies often have a way of getting used for agendas far above and beyond what they actually justify.  In the case of the Lipitor mess, noises are being made in Washington about restricting the use, or content, of DTC advertising for pharmaceuticals. Hopefully, this movement, if it becomes a reality, will not also be used to limit communication with existing patients, which is what we do. The Jarvik ads are all about patient acquisition. Relationship marketing, what we do, is a completely different animal.

At the risk of sounding a little redundant, the Jarvik ads were intended to get patients to go into their doctor’s office, and inquire about the use of Lipitor to lower their cholesterol levels, which is what statins do. Studies have shown that DTC marketing, at least in the case of antidepressants, makes it markedly more likely physicians will prescribe, and patients will therefore take, the advertised drug.

As relationship marketers, our role is different. We work to make sure that patients are as educated as possible about the drugs they’re taking, and that when a physician tells a patient to take a drug, that the patient keeps taking it. We communicate directly with patients, so technically, we’re in the DTC space just like Jarvik. However, there’s one overwhelming difference.

The Lipitor ads were all about helping the patient influence the doctor. We’re all about assisting in helping the doctor influence the patient. Simple as that. Let’s hope it’s simple to Barack, Hilary or John, too.

Limits on DTC TV are Inevitable and Welcome

I was reading a post by Bob Erhlich’s DTC Perspectives about DTC scenario planning given the coming change in the White House. Bob casts percentages around for different possible outcomes — he always make a good argument. I am glad he used the scenario planning approach. it is safe way to encourage the forward-looking debate that needs to happen on this subject. 

But let me build on it. and cast my stone: DTC TV WILL change. It is inevitable. And maybe that is a good thing. Like any 11-year-old, it could be time for DTC to grow up.

The facts? DTC has helped millions of people deal with conditions and have a greater possibility of living healthier lives. This is often overlooked, but it’s very real. Thanks to DTC, an enormous number of people have gotten themselves into their doctors’ offices for conversations that might now have happened otherwise.

Yet, the spending levels of some brands have raised more than a few eyebrows, as has their direct tie to sales. This looks mighty suspicious in the face of the very ugly reality that for all this acquisition effort, once patients have been acquired, they’re basically ignored. — oh, those nasty dipping compliance curves! That is just plain old bad PR. In a politically charged environment, it makes DTC TV just look obscene.

Remote One scenario could be that DTC TV becomes only unbranded patient education? I think this could be a very real possibility. Helping create a better-informed, better-educated and more prepared patient aids them in understanding why thy should stay on a treatment, not just try it. And in the Age of Consumerism (check out to P&G, http://site.vocalpoint.com/guest/index.html, or any number of sources that show how companies are ceding control of their brands to consumers for their loyalty), the patient wants better control of their purchases and decisions — perhaps health most of all. And loyalty = compliance = sales. And oh yeah, it’s good PR.

Here’s another scenario: DTC TV becomes all about acquisition — but not to trial. No, I am talking about acquiring patients to enroll in programs that make it easy for them to stay on the treatment they are taking. In the mass market world, we call that loyalty acquisition; and in a competitive environment, acquiring the names and profile’s of your customers is both golden AND responsible for pharma and biotech companies.

Here’s my last one for today: the industry and http://www.phrma.org/ take a unified lobby approach. What would be the best scenario? Focus on the healing part of the marketing equation and take on the lousy compliance rates once and for all. Develop a national campaign to keep people taking the medications that are proven to make their lives better.

How to do it? Create a single Adherence Institute that all the pharma and biotech companies contribute to. Brand marketers still do the acquisition, but after 3 months, they hand over the patient file to the Adherence Institute and they handle the patient from there. And no, we would not use Montel for the ads. Let’s get Oprah.

There is much more that needs to be debated on this topic, but I sincerely hope that by casting out a few more scenarios, pharma brand marketers and my agency brethren see that the anxiety can be turned to opportunity.

The Missing Art of Storytelling…

A creative director, Rich Coppola, and I were talking the other day about the ascendence of using video on the Web. He knew the challenges of the medium firsthand — the biggest being creating a smooth combination of technology and an honest feeling human experience. He has the creds to speak to the subject well (www.mypostitsecret.com, www.callawaygolftv.com amongst others).

Eventually, the conversation turned to the need for more authenticity, humanity, and emotion in pharmaceutical advertising. He was in tune with this, but with a twist.

The Art of Storytelling, he told me. Honest emotion. Someone sharing their experience. Many non-pharma brands are starting to tap into this, from Aleve to Kleenex to Hellman’s Mayonaise. Brand managers are beginning to realize that the 20/80 rule does apply in pharma — your hardcore loyalists, the 20% or so of your population who are really wedded to your brnad,  are perhaps your most vocal, and therefore valuable, asset.

Doctor
But while they may be true believers in your brand, they have surely come to define that loyalty in very personal terms. In other words, you no longer define the brand for them.  They define it for themselves.

How do you use this? How do let it not use you? As always, it is all about recruiting and filters.

Rich had encountered filters even n the non-pharma world, but it all worked out well. He cited a recent site we did for Best Foods.  The site was about mayonaise, a product as old as time, but reinvented by including contributions from people sharing this warm spot in their lives. Simple customer-submitted videos put youtube squarely in the space of condiments. He also pointed me at another client site, this one for The Goodlife Recipe pet foods, as an example of ways to use owners’ pride in their pets to tell their story.

More seriously, these and other sites are spotting up. People are telling stories, sharing pieces of their lives. Anyone can see how this would translate to pharma/biotech –which is so in need of emotional honesty. I mean, this industry saves lives and alleviates terrible suffering — it should get the credit! The storytelling approach is the natural avenue to let your best customers say their part.

What stories would your patients tell? I bet they’re telling others.

Rich wants to tell the story of that patient.

DTC is not Monolithic, so why treat it like a one-trick pony?

Note: aafter reading Bob Erhlich’s latest post on defending DTC…well, I had to respond (http://dtcperspectives.com/blog/)

Dear Bob,

You usually take a fairly wise approach to these issues, but in this post you really toss the softball to irresponsible pharma marketers — as in having a BODY DOUBLE for Dr Jarvik doing the rowing. That is plain and simple false and misleading and unnecessary since Lipitor is a great drug and Dr Jarvik does a fine job without the deception. Pharmalot has even create a poll asking readers to judge whether Dr Jarvik should be dumped as spokesperson (http://www.pharmalot.com/).

DTC is not monolithic — there are as many truly helpful and ethical commercials as there are ones that create these false Gods of Health (I think of Flomax and their incessant use of phallic symbols, kayaks, fishing poles, etc.)

DTC is about how you do it, not about doing it at all. We need DTC, but with a higher degree of education and patient engagement, versus patient "push"…one example: why not have a 60 second commercial that is only a tease to drive them online for more information. Why not create educational curriculum for patients to help them understand what is happening to their bodies overall, not just this pinpoint condition and treatment. Or DTC that focuses on compliance for the mega-brands with a supportive program offered to the viewer…

DTC is needed, but with a much higher level of patient engagement and servicing their needs rather than just herding them into the doctor’s office.

Alfred

Dr. Robert Jarvik’s problem: It’s the agency, stupid

In a recent post, we wrote about the risks in using celebrities for advertising. Our pharmaceutical poster boy was Dr. Robert Jarvik, who has spent the last couple of years starring in DTC ads for Pfizer’s Lipitor, one of the biggest drugs in the world. Well,it looks more and more like the problem wasn’t Jarvik, but Pfizer’s agency.

Dr. Jarvik found himself on the front page of the New York Times today. The article says that in addition to not being a practicing physician, which we already discussed, Jarvik also does not row. As in sculling. Which would be neither here nor there, except that in the ad, he is shown vigorously rowing a one-man shell across a pristine mountain lake. Turns out it was a body double, not Jarvik. The Wall Street Journal’s Health blog also weighed in on the story.

Does this matter? According to a post in today’s DrugWonks blog, no. As Peter Pitts sees it, physicians still are in charge of who gets prescribed what, and DTC advertising gets people into doctors’ offices to ask important questions about their health. So, given that perspective, the fact that Jarvik doesn’t row doesn’t matter.

We disagree. Remember Celebrex?

In January, 2005, the FDA ordered Celebex’s maker — guess who? Pfizer — to immediately halt several DTC ads. One of them was a television commercial featuring a woman playing the guitar, and telling the audience that now that she was taking Celebrex, "she played the long version" of the song. The FDA said that this ad made unsubstantiated claims about the drug’s effectivness.

This is reasonable. If you have a serious case of rheumatoid arthritis, you are not going to have the strength or dexterity to fret a guitar, no matter how much Celebrex you take. The commercial is depicting something the drug cannot deliver.

And you could say the same thing about Jarvik sculling. Why? Because sculling is hard. It takes about 20% more calories than  jogging, which  Jarvik also  did in the ad. It  takes tremendous strength in your back, legs and shoulders. It’s very hard on the joints,  particularly the back.  Serious rowers, such as the kind who would scull across the aforementioned pristine alpine lake, take a real physical beating. And depicting Jarvik doing this, at age 61, is just plain misleading. It’s very unlikely that someone his age, with a cardiac condition requiring Lipitor, will be able to do that.

Stockxpertcom_id689668_size1This Is Not Robert Jarvik.

And the real pity of it is that this little indiscretion was completely unnecessary. The other ads in the campaign were great. The ad in question was great, with the exception of the sculling scenes. Lipitor is a blockbuster drug for a reason — it really is a breakthrough. It’s been extensively studied, and it really works.

But for some reason, someone at Prizer’s agency felt the need to go one step too far. This isn’t the first time that advertising has, perhaps, taken some creative license. But this was done in pharma, and the rules here are different.

Our entire industry, and the relationship that make it work, are based on trust. The patient has no idea, really, what’s in that pill or injection or device. It’s not like an airline, where the customer can judge for himself whether or not the commercial depicting a quiet, happy, spotless set of passengers racing through the cloudless sky is accurate (hint: it’s not) and then become a repeat customer or not. The patient has to trust that her physician, and pharma companies, are not fudging anything. She has to, if she’s going to allow herself to be treated.

So, while we think the entire debate about whether or not it matters that Jarvik wasn’t a practicing physician is basically piffle, we think this debate is important. The ad depicted something the drug couldn’t really do, and that is not okay. And, again, even worse, it was unnecessary.

Service is the Most Ignored Form of Efficacy

Dear Pharma and Biotech Brand Marketers,

As we look at 2008, I have a new thought for all us to consider.

The subject is Efficacy. We need to re-define it in patient terms. As of today, for most of our industry marketers, Efficacy = Satisfaction. But that is wrong; the form of satisfaction from a drug working for a patient is only the first dimension of what Efficacy SHOULD mean.

We all need to consider the next level of Efficacy: servicing the patient.

Most pharma and biotech marketing folks grew up inside of the industry — this gives them a wealth of knowledge and unequalled understanding of the medications they market and the complexity of the multiple channels they need to serve, from managed care to professional to patient.

But what many miss, is that patients (as consumers) are used to and are coming to expect more and more: if I buy your product, you will service me like a customer.

So, once a patient is on your medication, you should do everything possible to get them to raise their hand and engage with you, and to do so, to truly scale patient-programs, we need to stop thinking by channel but instead by need.

People need support in nearly all decisions they make — none more so than related to health. And a brochure, a Web site and a direct mail piece that comes six weeks after you ask for information, just is not looking at what patients need — what HUMANS need — in the right way.

GSK has done a good job in understanding that you need to make yourself accessible to answer patients questions and provide that service — you see a face and a phone nmuber on all their Web sites.

What happens when your drug if fifth to market, or a blockbuster threatened by generic switching — what can you do? Service the patient, make it easy for them to build some trust and do not be afraid to answer their questions. After all, with an average of 4-8 minutes a visit, the doctor no longer provides the answers people need.

So, can an industry that acts like scienctists and manufacturers become experts at Service?