Branding Disease

IT'S difficult to turn on the television these days without getting an earful on medical conditions that were unheard of just a few years ago. Diseases that were once obscure at best, such as "Restless Legs Syndrome" (RLS) nd BPH (benign prostatic hyperplasia, or enlarged prostate), now have become as commonly known as heartburn and eczema. So what's going on? Have researchers uncovered a whole new world of diseases—or are the names just new?

The answer to both questions is yes. The phenomenon described above is known as disease branding, and it has become an increasingly important and frequently used strategy for pharma marketers who are looking to differentiate their products while also building new understanding about diseases among patients and physicians.

WHY BRAND A DISEASE?

Disease branding has grown in popularity largely because it builds customer awareness and makes the complexities of medical conditions easier to understand.

While detractors have criticized the practice as empty profiteering, in truth, disease branding provides many legitimate benefits for both pharmaceutical companies and their customers. These benefits can include:

• New understanding of diseases that have been around for many years

• Awareness of little-known conditions

• A more positive (or a less negative) perception

of a disease.

SEEING OLD DISEASES IN NEW WAYS

To understand how disease branding can drive new understanding of existing conditions, consider "anxiety" as a brand.

While the condition encompassed a broad range of patients and symptoms in the late 20th century, anxiety as a stand-alone brand fails to spell out the vastly different aspects of the condition as we know it today and, in turn, fails to guide physicians and patients in the selection of the most specific, effective therapy.

Over the years, medical researchers have come to acknowledge that all anxiety is not alike. People who suffer from acute, debilitating attacks (panic disorder) benefit from a different therapeutic approach than those who worry about every little detail (obsessive-compulsive disorder). By branding diseases more specifically, patients and healthcare professionals—as well as society in general— are united in how they understand and approach such pathology, thereby transforming confusion, frustration, and stigma into awareness, satisfaction, and better self-esteem.

Disease branding can also create new understanding of the seriousness or legitimacy of certain conditions. For example, the term heartburn was coined decades ago by antacid brands, and suggests that the mechanism of action in the treatment of indigestion is acid neutralization, which is exactly what antacids do. However, researchers discovered in the 1980s that chronic heartburn could be further described as a malfunction of the esophageal sphincter—a more serious disorder that can

lead to the erosion of gastrointestinal tissue over time. Glaxo and its drug Zantac worked to rebrand chronic heartburn as a more insidious medical concern, coining the term GERD (gastroesophageal reflux disease).

Branding GERD not only shifted the public's perception about the dangers of chronic acid reflux, it also put Zantac in the spotlight as the best overall solution. Acid blockade (which is what Zantac and other H2 antagonists do), rather than acid neutralization, implies that the problem should be stopped at the root of the condition, not after it manifests itself and does damage.

Years later, proton pump inhibitors were able to take better advantage of this disease brand because they blocked acid even further up the acid-cascade cycle.

BRINGING OBSCURE CONDITIONS TO LIGHT

Disease branding can provide similar benefits for conditions that have never been widely recognized. The most notorious example of late, Restless Legs Syndrome, is a bona fide neurological disorder that has been acknowledged by the medical community since the late 19th century.

Until recently, RLS was virtually unknown by patients and was under the radar for most healthcare providers who didn't have an effective means to treat it. The approval of GSK's Requip in 1997 and the subsequent launch of a disease-awareness campaign for RLS in 2005 gave an identity to the tormenting affliction. Patients who had suffered with RLS for years celebrated the acknowledgement, thinking, "I'm not crazy after all." And physicians celebrated, too, realizing, "Hey, I can help." The result is that thousands of untreated patients went to their physicians and are now experiencing relief.

ELIMINATING STIGMAS

Disease branding is also an effective way to drive the market to a different way of thinking about a condition that is socially stigmatized. As an example, consider how Pfizer's Detrol transformed the archaic and demeaning idea of "incontinence" into the more positively accepted "overactive bladder."

By definition, "continence" is about self-control; and therefore anyone who is incontinent lacks control. By rebranding the condition as overactive bladder—a slight physical malfunction rather than an emotional shortcoming—Pfizer was able to eliminate many of the negative connotations that previously made patients embarrassed to admit they had the condition.

As overactive bladder became a more commonly known disease, patients felt more comfortable self-identifying and seeking help, and physicians were better equipped to provide a medically therapeutic answer along with the usual behavioral guidance (e.g. drink less, avoid going to places where toilets are scarce, etc.).

Lilly also effectively eliminated a stigma when it developed a disease-awareness campaign for an emotional condition surrounding menstruation—PMDD (premenstrual dysphoric disorder)—in conjunction with the promotion of its antidepressant Sarafem (or Prozac). The condition that used to be called "wild mood swings" and trivialized as a necessary evil that women should just "get over," is actually a disorder that is hormonally mediated and, more importantly, treatable. The condition brand, PMDD, is aptly reflective of the situation it seeks to address. It has a medical ring to it, emphasizing the fact that it is, indeed, worthy of serious consideration. Yet, it is also easily and discreetly summed up in its acronym so that patients can feel as comfortable in discussing it as healthcare professionals are.

The brand PMDD—like all good disease/condition brands—acts as a password between the two audiences, empowering both parties to take action and facilitating diagnosis and treatment.

HOW TO LAUNCH A SUCCESSFUL DISEASE-BRANDING CAMPAIGN

When considering a disease-branding initiative, pharma companies should first consider whether it is even right for the product. While it can be an extremely effective marketing strategy, it doesn't work for all drugs.

Biotech and pharma companies should develop clear protocols for disease-branding initiatives as well as criteria for when such initiatives should be launched. Three questions that can help:

• Does the product impact a disease or condition in a new way?

• Are there stigmas/social concerns about the condition that can hinder customer self-identification and the patient–physician dialogue?

• Does your product have significant benefits for a little-known condition?

Once the brand team has determined that disease branding is an appropriate approach, the next step is to conduct customer-insight research to gain a baseline understanding of consumer and professional beliefs and behaviors. In addition, an audit of the scientific literature is critical to assess existing terminology, trends, and historical attempts to rewrite the condition.

The marketing team should then enlist the help of key opinion leaders in the field to generate scientific concepts that capture a more enlightened perspective of the given condition. Best practices advise that this activity take place in a one-day workshop for several reasons. Aside from the obvious efficiencies of blocking out the calendars of key marketing and medical professionals, the workshop venue allows each of the participants to hear and respond to what others are thinking, brainstorming ideas in greater number and clarity.

More importantly, the workshop builds consensus around a few powerful concepts. This is critical because the ultimate goal of a successful disease-branding program is that the brand should transcend the marketing campaign and be adopted and sustained by the patient and physician community. For the brand to take root and flourish on its own, it must have the unified support of the very group of medical thought leaders who will be instrumental in speaking about it in lectures and writing about it in the medical press.

When executed effectively, disease branding can serve the needs of the patient, the physician, and the pharmaceutical company. However, to be successful, the initiative is dependent on good customer-insight research—a strong strategy that balances the needs of customers with the proven benefits of a specific medical therapy. The best campaigns produce a brand name that unifies patients and healthcare professionals around a condition that is real, worthy of discussion with a physician, and most importantly, able to be managed effectively for a better outcome.

Vince Parry is president of Y Brand, an inVentiv Health company. He can be reached at vparry@ybrand.com