At its best, DTC marketing is making a difference in the lives of patients. Ralph Nader, a powerful political activist who opposes DTC marketing recently attended a conference about them. Succinctly, he said "these ads should be banned." His overarching attitude is that "Greed is infinite for Big Pharma." Something is wrong with this attitude. An executive at the conference stood up and said, "Mr. Nader, I beg to differ." While not all DTC marketing is positive, we've done many very good things. For example...
DTC Marketing Has Changed How Society Understands Depression
Years ago, Eli Lilly developed its "Depression Hurts" campaign. You may not remember, but in those years it was important to educate about depression. Pharma ads often demonstrated that depression was triggered by chemical factors beyond the control of patients. Communication was intended to show that depression is not a personal failing. Few will remember, but the same process was needed to overcome stigma related to alcoholism.
At the DTC Conference, Ralph Nader spoke stridently against patient marketing. In a side conversation, a woman spoke about her brother who suffered from depression. He took his life. She believes that the latest advertising about the condition would have helped her brother.
Even Doctors Were Not Telling This Story
Recognizing a serious problem within the medical community, the National Institute for Mental Health (NIMH) launched an education campaign about the condition in 2003, "Real Men, Real Depression." It was designed to show that even tough guys can experience depression. Among the early ads, Jimmy Brown, a firefighter from New York, talks about how the condition was stealing the joy from his life. Some of the men interviewed for the campaign reflected on the stigma that they experienced. They said that a major barrier to seeking help was social pressures they felt among friends and in the workplace around having psychological problems. In these days, when the reality of depression is accepted by many, we forget those early days when depression was in the shadows. We act as if it always was this way. But it wasn't. In those days, many patients suffered in the dark.
DTC Marketing Changed How We talked About "Impotence"
What is the Definition of "Impotence?"
Not so long ago, erectile dysfunction was commonly referred to as "impotence." And society framed it as a masculine failing. Patients were afraid to talk about it. And doctors also did not bring it up. It was called the "doorknob" topic. If a man ever talked with the doctor about the problem, he might bring it up just as the doctor was walking out of the door. Something like, "Hey doctor, not sure if this means anything, but I've been having difficulty in the bedroom for years. I was embarrassed to talk about it, but could this be a medical condition?"
DTC Marketing Can Alert Patients About Medical Conditions
Yes, erectile dysfunction is a medical condition. And you should not call it "impotence." It is not an "old man" condition. And you should stop calling it "impotence" because it is not your fault. When was the last time you heard this term used? And why do you think that is so? Do you think that society just starting thinking about it in a new way on its own? No, it did not.
Advertising for ED medications like Cialis and Viagra was necessary. And as with depression, it made the lives of many people better. Did Pharma profit from the sales of Cialis and Viagra? Of course they did. But changing the dialogue was necessary to help patients with their lives.
That Was Long Ago, What About Now?
At the same conference this week, I was blown away by a presentation from Mike Mazza, who is an executive at Horizon. They are doing advertising for Krystexxa, which is used to treat gout. Unlike depression or erectile dysfunction, Krystexxa only affects a small percentage of the population (less than 4%). In the past, this discussion would definitely be left to the doctors. However, Horizon realized that patients need a voice. They help patients to understand gout even years before they may use medication to treat it.
Understanding the Patient Journey
Coming from a CPG background, Mike knew that the path to treating gout is often non-linear. Patients who suffer from the condition do not follow the straight sequence that we often think about: going online, searching about symptoms, going to a website, then talking with a doctor. It isn't that easy. Mike's team learned about the patients, and he is creating a program that can truly help them.
It can start in very early days. Patients will begin to experience pain in their joints that they cannot explain. They may wonder about it, but will often not explore it with doctors. And to be honest, the doctor may not want to take it up with them either, asking them to wait. Horizon is helping them to take the next steps.
DTC Marketing Addresses The Patient Journey
Horizon developed a patient program that serves the population. Often years before receiving treatment, Horizon will speak with patients about their symptoms. Mike points out that he puts the patients in control of the conversation. If they search for information about the symptoms, he gives them the option to use a website or to speak with a nurse! You heard that right, Horizon is funding direct CRM that supports patients to answer their questions, even if they may never use Krystexxa. This is the long game. Horizon is speaking to a population that needs help and providing solutions.
So Mr. Nader, should DTC advertising really be banned? I think not. Patient communication informs patients and helps them understand treatment options is having a very positive impact on treatment.