Healthy Skepticism Library item: 14971

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Silverstein B.
The Big Three in ED: Pharma Brands Get in the Mood
brandchannel.com 2009 Jan 26
http://www.brandchannel.com/start1.asp?fa_id=461

Full text:

Levitra and Cialis currently use lookalike imagery of mature men and women in romantic interludes. Cialis is somewhat more compelling since it focuses on specific vignettes. For example, a couple is getting amorous just as their daughter arrives from college to interrupt their private moment. While the images are visually similar, Cialis does promote the fact that it is the only ED drug that lasts for 36 hours. Levitra, on the other hand, draws a connection between ED and high cholesterol or diabetes.

Viagra has achieved differentiation from its rivals by using a song, “Viva Viagra,” in its current advertising. One of the Viagra ads depicts a musical group of mature men singing the song and having a good time, presumably before they go home to their ladies. In fact, Viagra has come under fire from critics who say the “Viva Viagra” theme, a takeoff on “Viva Las Vegas,” encourages partying.

Viagra, now ten years old, was the first ED brand on the market. It was originally promoted by the likes of politician Bob Dole and baseball star Rafael Palmeiro. But ED as a brand segment really began its promotional life during the 2004 Super Bowl, that uniquely American test of testosterone. Levitra and Cialis were introduced via two television ads each. Ironically, this was the same Super Bowl during which the infamous Janet Jackson “wardrobe malfunction” occurred. (If you were living on another planet at the time, one of Jackson’s breasts was exposed, supposedly by accident, during the halftime show.)

Despite the fact that they were promoting a new pharmaceutical category, the Levitra and Cialis Super Bowl ads were understated if not downright vague. Levitra used football great Mike Ditka to urge men to “take the Levitra challenge.” The ad never said what the challenge was, or what Levitra was for. The Cialis ad showed a man and a woman looking out over a moonlit beach. Strangely, each of them is seen lying in a separate bathtub. A voice-over said “Cialis is here. Are you ready?” As with Levitra, there was no mention of the condition Cialis treated in the first ad. A second Cialis ad did reference that the product treated erectile dysfunction. By the way, Cialis still uses the two-bathtub imagery at the end of its current ads.

Promotionally, these ads were not very effective on their own. The intent was to drive interested consumers to the appropriate website. But the real issue is not the effectiveness of the advertising, or lack of it-rather, it’s the underlying challenge: how do you truly distinguish one ED brand from the other? Cialis works longer, but all three drug brands treat the same condition. And all three drugs have essentially the same side effects and risks, which must be stated in the advertising.

This represents a larger, more fundamental question: should prescription drug brands such as these be advertised directly to consumers in the first place?

Only the United States and New Zealand currently permit “DTC” (direct to consumer) advertising of prescription drugs. In the US, the practice began in 1996 and has grown since into an advertising business worth more than US$ 4 billion. Over 70 prescription drug brands have been promoted directly to the consumer.

According to Advertising Age (“Ten Years Later: Direct To Consumer Drug Advertising,” October 1, 2006), it was a 1996 TV ad for allergy medicine Claritin that started modern day DTC advertising. In order to avoid lengthy disclaimers, the Claritin ad did not mention what the product was for, causing the FDA to relax earlier guidelines for television drug ads. Now, reported the Advertising Age article, “Instead of including the ‘brief summary’ that took up a full page in magazine ads and would take too long to explain in a TV spot, pharmaceutical companies could direct viewers to a magazine ad, an 800 number or a website.”
That was the start of a drug-advertising deluge that has yet to abate. DTC advertising has not proceeded without controversy, however. In January 2008, a US congressional committee began an investigation into the use of celebrities in drug advertising. In June 2008, pharmaceutical companies agreed to wait six months before promoting newly approved drugs, but that is less than the two-year waiting period requested by Congress.

One concern about prescription drug advertising is that it can create consumer demand, sometimes artificially, for a particular brand. The consumer-patient approaches the doctor and asks for that specific drug. The doctor may or may not agree the patient’s condition warrants the use of that drug, but the doctor is put in a potentially uncomfortable position. In the case of the three ED brands, men may have the condition the drugs are designed to treat, but they are not medically qualified to determine which of the three brands is best for them.

Nevertheless, DTC advertising appears to benefit the sale of drug brands. According to a 2007 study in the New England Journal of Medicine, “evidence suggests that direct-to-consumer advertising of prescription drugs increases pharmaceutical sales and both helps to avert underuse of medicines and leads to potential overuse.”

Barring governmental intervention, if drug companies continue to utilize DTC advertising, they will have to find ways to make their brands distinctive, if not memorable. That presents them with a number of challenges:

Pharmaceutical brand names are vague and often meaningless. They do little to distinguish one brand from another. Consider such popular drug brand names as Celebrex (arthritis), Lunesta (sleep aid) and Vytorin (cholesterol). What do these names say about what the drugs accomplish?

Drug advertising is, for the most part, dull and unexciting. It is a category that could use new, more effective ways of breaking through.

Regulatory restrictions, no matter how lax, will continue to make it difficult to advertise drugs without including a list of side effects. Sometimes the recital of the list itself creates an unintentionally foreboding or even humorous aspect to a drug ad.
This brings us back to the Big Three in ED. Today, it’s a real horse race. Viagra is unable to maintain its dominance with two competing brands in the marketplace. While the Levitra and Cialis brand names are less meaningful than Viagra, Cialis has managed to distinguish itself because of its claim of 36-hour effectiveness. This attribute has vaulted Cialis into category leadership. According to Lilly, the manufacturer of Cialis, worldwide sales increased 25 percent in 2007 to over US$ 1.2 billion.
Lilly recently launched a European television campaign to get around DTC advertising restrictions outside the United States. In the United Kingdom, Lilly is running TV ads centered on the theme “40over40,” which promotes the fact that ED supposedly affects 40 percent of men over the age of 40. As required by law, the ad and an accompanying website never mention Cialis. But the brand’s two distinctive colors, orange and green, are prominently used in the ad and on the website.

While pharmaceutical companies struggle with the effectiveness of DTC advertising, the Big Three in ED will likely continue to battle for brand dominance. Erectile dysfunction must be too large a category for drug makers to ignore.