Marketing to Professionals: No Sales Force, No Problem

When it comes to direct-mail marketing, tiny envelopes and wordy letters just don't cut it. But for a fraction of the cost of a sales call, you can create an eye-catching mailer that will land on physicians' desks rather than in the circular file.

George Koroneos

The key is to use a dimensional mailer that will stand out from the ton of regular mail that doctors receive every day. This can be anything from a poster tube to a box containing an alarm clock shaped like an egg.

Direct-marketing firm Harte-Hanks recently took advantage of this marketing tactic when King Pharmaceuticals approached the agency to reinvigorate interest in Intal, an inhaled mast-cell stabilizer indicated for allergies, seasonal allergic rhinitis, and bronchial asthma. The 17-year-old brand hadn't been marketed since 1999—the only thing that existed in any form from an aesthetic standpoint was a logo. Worst yet, King had no e-mail lists or customer-relationship management (CRM) information and zero funds for sales force marketing.

According to Julian Parreño, senior vice president of pharmaceutical markets at Harte-Hanks, the product had been a favorite among allergists. However, as new medications were introduced and as the asthma inhaler category widened, doctors stopped prescribing the drug. Many physicians weren't even sure which company manufactured the product.

Harte-Hanks mailed colorful posters to physicians in a campaign designed to boost interest in Kings Intal asthma medication.

The challenge was on, and Harte-Hanks accepted. The agency began up-front studies and phone surveys and established a control group before any marketing activity started. This was done to determine the average physician's propensity to prescribe the drug. Harte-Hanks also surveyed King's existing database of physicians to better target the marketing material. The most coveted audiences were allergists, pulmonologists, pediatricians, and family and general practitioners.

Since there were no e-mail lists for e-detailing, Harte-Hanks felt that mail would be the best route for marketing. Matt Rosenblatt, vice president of creative services at Harte-Hanks, told King, "You're really going to know the viability of the mail tactic because there is no other game in town. There is no sales force, no e-mail address list, no general advertising being done—nothing."

The agency segmented its audience into categories on the basis of impact; doctors who write a lot of scripts in the category of asthma but don't have high brand awareness were hit with the biggest packages and the most mailers. Fewer mailers were sent to doctors who don't prescribe much but who do prescribe a lot of Intal. Finally, the smallest mailers were sent to physicians who consistently prescribed the drug, despite the lack of reminder marketing.

"Physicians are the toughest audience to reach by mail," Rosenblatt says. "Very often, you're dealing with office managers who are tossing promotional packages before they even reach the desired physician. We had to create mailers that felt clinical but that really popped so they'd get past the office manager to the doctor."

Make Mailers Matter

Harte-Hanks had the budget to do four high-end packages: two dimensional and two flat. The first wave of mail came in a large blue tube with Clear the way embossed on the label. The tube held a large poster. According to Rosenblatt, posters work very well as mailers because physicians hang the posters on their waiting-room walls, spurring further patient–healthcare professional dialogue.

"We knew we had to start with dimensional and end with dimensional," says Rosenblatt. He likens the strategy to hearing the specials in a restaurant. "More often that not, you remember the first and last items a waiter reads. This is very similar to how agencies send direct mail. Agencies must support the large-size mailers with flat mail in the middle of a direct-mail campaign, because usually there's a limited budget. You can't make all your mailings dimensional."

The poster illustrated all the triggers, such as trees and storms, that can set off an asthma attack and how Intal can help overcome them. The agency incorporated vibrant colors to evoke air and water and clarity. "The poster really stands out in stark contrast to all the competitive advertisements on a doctor's waiting room wall," Rosenblatt says.

After two smaller, follow-up mailings, which included paperwork redeemable for samples, Harte-Hanks polished off the campaign with an unusual twist. The agency delivered to targeted physicians a brochure attached to a large pillow pack—a puffed envelope for fragile materials. The package included a live bamboo plant that the physician could hang in his or her office. It was labeled—of course—with the Intal inhaler logo. "We don't want physicians to just raise their hand and get samples—we're out for share of mind," Rosenblatt says. "We wanted the Intal Inhaler to be everywhere, even after the package is discarded." The bamboo plant did the trick.

According to Harte-Hanks, as of May 2005, the campaign achieved a 24.4 percent response rate for sample requests from its primary targets: allergists and pulmonologists. Overall, the campaign generated a total response to mailings of 11 percent. The response rate for sample reorders is approximately 34 percent, and it continues to build.

Tactics that Work

Harte-Hanks isn't the only agency considering alternative tactics to market drugs to physicians. Other brand teams are using dimensional packaging and online resources to bolster sales for older drugs and to support sales calls.

"In scenarios where there isn't the budget for a sales force or for high-level bells and whistles marketing, you have to use very aggressive business-to-business direct marketing," explains Chrysanthe Georges, president of Georges Marketing. "Your lead medium can be direct mail, but it has to be high-impact direct mail. The pharmaceutical company must be willing to spend some money to break through the clutter."

Risa Bernstein, co-president of FlashPoint Medica, recommends that agencies bring thought leaders to doctors and prescribers through face-to-face Web casts. New computers from Apple and Sony come standard with pinhole-size cameras that allow doctors and reps to communicate visually while using instant messanging. "These are augmented sales opportunities, where it's not a live salesperson, but you are getting all the benefits of an interactive conversation for way less money than a sales visit," Bernstein says.

Kathy Magnuson, managing director of Brand Pharm, believes that there will soon be fewer sales reps calling on physicians, so finding media that are as effective at conveying the message as the sales force will be important. "But that means that we, as agencies and marketing teams for the brands, must make sure that we are capitalizing on the media and not just sending a bunch of stuff."

The holy grail is getting doctors to tell the drug companies what media they best respond to. Though it may be cheaper than using a sales force, sending direct-mail pieces won't be effective if the physicians don't care. "Targeting the right doctors requires market research, CRM programs, and understanding who your existing customers are to begin with," Magnuson says.

"When you really think about the cost of a sales call being between $150 and $600 a visit—even if you use a conservative figure of $175—it does stimulate companies to think about using other kinds of tactics to market to doctors," Bernstein says. Companies are now looking to cut cost structure out of their sales forces, and there is pressure on the sales reps. Companies are asking their agencies to think about new models for non–sales force marketing.

"What non-personal promotion does best is multiply the impact of the sales call," says Dale Taylor, president of Abelson-Taylor. "In a situation where a drug has a long history and is well established and well liked, the reminder power of direct mail or even journal advertising might be enough to get [a prescription] written."

George Koroneos is associate editor at Pharmaceutical Executive. He can be reached at gkoroneos@advanstar.com