How advertising contributes to appropriate use of medicines Forum on information, promotion, and advertising of medicines in the service of health Caracas, Venezuela - October 2008 David Spangler, CHPA (USA)

How advertising contributes to appropriate use of medicines 1.OTC medicine context 2.Advertising context 3.Information systems 4.OTC advertising illustrations 5.OTC communication systems 6.Closing thoughts

3 1. OTC medicine context Shifting perceptions of who we are serving Passive Patient Proactive Participants

1. OTC medicine context Premise: Interested consumers

1. OTC medicine context Premise: Interested consumers

1. OTC medicine context Premise: Information access exploding Example: Internet is the most widely used resource for health information: - 59% of USA adults use online resources (Source: iCrossing)

1. OTC medicine context Information access exploding

1. OTC medicine context Information access exploding: Internet penetration » From Miniwatts Marketing Group, 2008 (through 8

1. OTC medicine context Information access exploding WebMD has 51.9 million visitors a month 3 out of every 4 women seeking health information

2. Advertising context Low involvement medium PAGB study by Taylor Nelson Research: –2 or fewer messages recalled by consumers (Thailand study similar) University study in Germany on print ads: –Greater the information volume, less specific recall

2. Advertising context Focus on what ads can do: –Attract attention –Offer choices: Reinforce or introduce a product and brand

2. Advertising context Given limitations, heightens importance of brand name Brand (or trademark) as merchant’s “authentic seal; by it he vouches for the goods which bear it; it carries his name for good or ill” Subjective, not objective –Recognition –Trust –Behavioral connections –Relationships

2. Advertising context Brands as powerful, subjective communicator

2. Advertising context Brands are subjective bundles, not a series of instructions Advertising  brands –Not a substitute for labels. Never have been. Never will be.

3. Information systems OTC Labeling –Terms that speak to consumers for their direct use

3. Information systems Labeling Educational materials, including on-line Health professional communications Advertising

Information systems not limited to medicines What messages reach people when and where are blurring lines “Passengers using ANA’s cell phone check-in facilities in Japan and China don't even need to flip open their phones to show their 'boarding cards' when going through security, if their phones have ID chips.”

3. Information systems Shopping experience

4. OTC advertising illustrations Losing one pound Takes four pounds of pressure off your knees Feel better, Tylenol ® Arthritis Pain

4. OTC advertising illustrations Talk shows prove it all the time Crying reduces stress Feel better, Tylenol Extra Strength

4. OTC advertising illustrations

5. OTC communication systems OTC nicotine replacement therapies: + Label + Tapes + Free phone number for advice line + Support group suggestions + Training group leaders + On-line materials + Advertising

5. OTC communications systems Drawing attention to nicotine replacement therapies to help people quit smoking had a dramatic impact –NRT use up 150% 1 st year post-Rx-to- OTC switch (USA) –114,000 to 300,000 new former smokers annually (USA) »Shiffman (1997; 2000)

5. OTC communication systems “The ability to sustain smokers’ interest in quitting with NRT may be attributable, in part, to the intensive advertising and promotional campaigns that have characterized the OTC market in NRT.... Although many promotional activities promote particular products, this marketing and outreach effort also brings smoking cessation messages before the public in unparalleled intensity.” »Shiffman (1997)

5. OTC communication systems Availability and ability to advertise cough cold products drove meaningful results Fewer doctor visits for cough/cold –110,000 per year drop from mid-’70s to late ’80s »Temin (1992) Costs of cough/cold still large Imagine what if...

5. OTC communication systems Educational brochures

5. OTC communication systems Print public service advertising

5. OTC communication systems Web and web-based brochures

5. OTC communication systems Partnerships

5. OTC communication systems Different tools, different roles –General education –Condition, product, or brand awareness Advertising or mass outreach In-store –Label or labeling at time of purchase decision –Label or labeling at time of use decisions -- post-purchase

6. Closing thoughts Timing crucial in choice of communication tool –General v. awareness v. narrowing choice v. time of choice v. time of use –Motivation differs, so retention differs

6. Closing thoughts Ultimate contribution of advertising of medicines –Provide people with choice –Raise awareness of conditions and potential treatment options –Provides guarantees of quality, reliability, consistency –Helps recognition among range of choices Individual is choosing to buy. Individual in control