Messaging Makeover

The US has the largest advertising industry in the world by a considerable margin. China, next in line, spends about one-third the amount the US does. According to Zenith Media, the US is expecting to spend a total of $320 billion on advertising in 2022, and of that total spend, about $200 billion will likely be attributed to digital media.

Digital media has more than doubled in terms of spending since 2017 and has accelerated swiftly since the onset of the pandemic in March 2020.¹ This isn’t a surprise, as the past couple years of pandemic-induced physical isolation have shifted gazes and attention from the real world to screens and devices, including smartphones, tablets, computers, and streaming TV. It’s said that it takes an average of 66 days for a new behavior to become automatic,² and everyone—from children to grandparents—have certainly had the time to form new media habits. Advertisers now have a vast audience primed for relevant digital communication. In addition to this captive audience, advertisers have troves of data and insights available to them before, during, and after campaigns.

The pharma industry seems to be following a similar theme. As of 2020, the US owned nearly half (45.9%) of the total pharma advertising market share worldwide, with China (8%) and Japan (6.8%) being the next two highest in terms of share. When looking at these statistics, it’s important to note that the US is one of two nations worldwide (New Zealand being the other) that permits direct-to-consumer (DTC) advertising, which significantly increases spending. The rest of the world focuses on unbranded campaigns to indirectly impact consumers.

While the majority of industries within the US took a large hit during the length of the pandemic, pharma notably increased its ad spend over the past two years. A lot of this can be attributed to the need to reach several stakeholders in new and creative ways, but there’s also an undeniable focus on health that the pandemic has enhanced dramatically.

Opportunity is knocking for pharma, and companies are looking to capitalize. According to Statista, only the retail industry spends more money on advertising than pharma, at 26% and 18.8%, respectively. Historically, pharma has been largely invested in traditional avenues such as linear TV and print. Though digital has always been in its collective mind, the recent deep dive into the medium is now becoming an unavoidable reality.

Audience awareness and embracing digital

Healthcare has moved to the center of public consciousness over the past 10 years, firmly establishing itself as a growing influence on nearly all aspects of daily life. There is a huge amount of investment, primarily driven by the exponential growth of biotech and its focus on cancer and autoimmune diseases. Constant innovation and a heavy flow of new products and treatments are being developed, which is crowding the markets.

It is a formidable challenge for manufacturers to raise awareness to all the stakeholders involved, which are aplenty: healthcare professionals (HCPs); patients and caregivers; insurance companies and other payers; patient advocacy groups; hospital systems; influencers; KOLs and digital opinion leaders; etc. The goal is to make all these stakeholders aware of the diseases and treatments available, educate them, help remove any stigma associated with the diseases, and ultimately push for more positive outcomes via accessible treatments. The sheer number of targets is expanding, especially considering how specialized the pharma industry is.

HCPs are overburdened and do not have the time that they used to have. Most HCPs now prefer a hybrid of physical/in-person encounters and digital. In addition, the prevalence of the empowered patient has made pharma take notice. The days of simply accepting what your physician tells you as gospel are over. Patients gather their own intelligence on the internet and make decisions way before they step into an HCP’s office—whether physical or virtual. In fact, Google often leads them to an HCP’s office. In 2020, Google received 1 billion health-related searches per day—and that was pre-pandemic.³ Empowered patients are ultimately better patients because they are ready to have a conversation with their HCPs, they have less hesitance, and they take their medication throughout their entire journey. Better adherence leads to better outcomes, which is better for brands.

As a result, marketers have changed their channel mix during the pandemic, moving to digital channels, including social. While the traditional avenues of linear TV, print, radio, and mail certainly have their place (some more than others), digital advertising is quickly becoming a main focus of the pharma industry.

Linear TV losing share to digital channels

A successful pharma marketing campaign addresses its entire audience. While there is certainly still room for more broad-stroke marketing via linear TV and other traditional HCP-targeted advertising (print, radio, e.g.) created to support pharma’s historically greatest asset, the sales force, things have changed dramatically over the past two years.

Since the dawn of pharma commercials on linear TV in the late 1990s, pharma has invested heavily in the channel, relying on upfronts as well as dayparting—the segmentation of broadcast day by hours that helps define the demographics that are tuned into certain programming. While this approach used to be the gold standard, today there are many more targeted options available and many fewer eyes on linear TV.

Today, people commonly stream directly from the internet or via connected TV, such as Roku. New formats are available in these media channels, and more importantly, longer formats that maximize storytelling, better suiting the ads offered up by pharma, which include a significant amount of fair balance as the ads come to close. In addition, new content suppliers are springing up all the time. HBO Max, Paramount+, Discovery+, and Peacock all launched in 2020–2021. Most importantly, there are more advanced data analytics provided in real time, which allows marketers to make informed decisions about ad spend and react to trends as consumers interact with the content.

Brand strategy and media planning

Pharm Exec reached out to Amanda Powers Han, chief marketing officer at Greater Than One, to get an expert opinion on the more granular aspects of a pharma brand planning approach as it stands today. Once pharma’s field force got grounded at the onset of the COVID pandemic, non-personal promotions (NPPs) became vital.

“If you think about the past two years, the access that the sales teams have had in terms of personal detailing has been really spotty and, in some cases, non-existent,” says Powers Han. “So there was and is an increased reliance on non-personal programs that could reach that target list of physicians, and then provide that valuable physician-level engagement data back.”

In October 2021, Pharm Exec detailed how frequency of interactions with HCPs was dropping off a cliff—sales teams were barely able to interact with HCPs during the pandemic. A rep might secure one interaction, but the chances of getting another were cut in half, and in half again, etc. When it comes to NPP, HCPs appreciate personalized and relevant content, so it’s imperative that all of the communications are intelligent. The goal is to win another meeting, whether physical or virtual, or a plain old phone call, and have NPP and personal, human interactions feed off one another to establish good relationships.

“The engagement data we get back, based on the physicians who have either opened an email or engaged with a program, or clicked on something very specific in terms of the content we’ve been serving them, is intelligence that is fed back to the broader commercial organization to be used in more creative ways as well,” says Powers Han. Results of an NPP engagement creates data that provides a more targeted way for a salesperson to go back and have a more engaging human-to-human conversation with that physician based on what the marketer knows interests that particular physician. It’s essentially a way to connect the dots and create a hyper-specific and customized content strategy from one physician to the next.

Another avenue that Powers Han utilizes is engaging HCPs at the point of care or prescribing via electronic medical records (EMR) media. Companies can incorporate advertising as the physician is sitting down with the patient and using the EMR system to record specific interactions, and influence that prescription brand choice as the physician and patient dialogue is taking place.

“It’s great, because with far fewer patients going into the office, the more traditional forms of point-of-care advertising were not always a smart option, because the physician and the patient weren’t necessarily sitting down in the same room having the conversation in the more traditional doctor’s office.” This approach is successful because it takes advantage of being in the right place at the right time, as well as being personalized and relevant.

Search engine marketing remains key

While not as shiny as other paid media forms, search engine marketing (SEM) has always performed well and is successful for a few different reasons. The No. 1 reason is that it provides a solution when the HCP or the patient/caregiver is searching for a specific solution. In other words, it’s always personalized and relevant. “In terms of channel mix, paid search is one of the consistent components in our media planning and buying,” says Powers Han. “When you think about the reliance on awareness-based advertising and building awareness and interest in the brand vs. where we can intercept and perhaps help that physician where they need something specific, search marketing is a workhorse for us.”

As stated earlier, Google received 1 billion health-related searches per day pre-pandemic, about 7% of all Google searches. And according to PranifyRX, when comparing digital channels, more pharma advertisers by far bought Google SEM than any other social, display, or programmatic network in the second half of 2020—and it wouldn’t be too speculative to say that the trend continued throughout 2021 and will continue into 2022. While it’s always great to include some “sizzle” when it comes to exciting opportunities and media programs, impact and results are paramount.

Other ways to hyper-focus a campaign

A media buy, in most cases, incorporates a mix of direct and programmatic placements to achieve credibility in terms of environment but provides an efficiency play that comes with programmatic. And while companies can and should target based on demographics, they can get much more precise. Powers Han details a few additional approaches that can hyper-focus a campaign:

Targeting HCPs by specialty. On Medscape, companies can filter by cardiologists, for example.

Targeting audiences programmatically. Instead of thinking about a specific website such as Medscape, companies can utilize a programmatic or data partner to reach all of the cardiologists who have prescribed a product for hypertension, and then deploy ads across a thousand or more websites—but only to those specific physicians.

Developing contextual ads. Contextual ads allow companies to surround specific content, such as hypertension, with ads that are directly related to a certain condition.

Behavioral targeting. This focuses on the sites that certain HCPs have visited. For example, if they visited a brand site for a certain drug, retargeting that group personalizes a communication, because the interest was there.

The growth of social media

While it has always been in the background, Powers Han says social media has grown exponentially recently, especially for healthcare clients. “Companies are finally getting more comfortable with how we can engage patients and caregivers on social in a way that is authentic and not quite as disruptive or jarring, more so on the unbranded vs. branded when it comes to paid social advertising, and more in terms of developing disease-state communities,” she says.

HCPs are on the same page as well—the vast majority are on social media, especially in the past two years. A survey of 4,000 physicians that’s nearly a decade old conducted by QuantiaMD stated 90% of physicians were using social media, 65% professionally. More recently, a 2021 study indicated that 91.1% of HCPs use social media during the workday.⁴

What’s great about paid social is that it’s all about the targeting strategy. The more sophisticated the targeting strategy, the more optimized and impactful the advertising can be, both in terms of what the client is trying to achieve and from the patient/caregiver perspective—they’re viewing ideas, content, and offers that are relevant to them.

To offer an idea of the level of targeting that can take place, Powers Han provides an example: “We successfully targeted caregivers of children who have plaque psoriasis, a very rare condition, by partnering with a third-party data source that has a relationship with Facebook and could identify them. Data will always be a topic of discussion, but when done in a sensitive and thoughtful way, the content that we’re serving the audience is most relevant, and it resonates with them.”

According to Statista, between July and November 2020, the healthcare and pharmaceutical industries in the US spent $198.3 million on Facebook advertising, with Instagram not too far behind at $151.5 million in ad investments. Other platforms are pushing, and they’re all relevant for one reason or another, whether it’s targeting ability, demographics, or length and type of advertising available. Even the most conservative of clients should investigate the channel and platforms within. The audience is there, and it’s looking and listening for information and conversations about conditions, symptoms, stigma, health, illness, etc.

The top three social platforms used for influencer marketing in the US in 2021, according to eMarketer, were Instagram (67.9%); Facebook (52%); and TikTok (42%), which has really accelerated. The prevalence of influencers in health mirrors the greater market. They are big business in health, acting as advocates for a brand or condition, and can have significant impact. That said, the rules are changing as the medium continues
to develop, and pharma marketers should always stay current
and compliant.

Other digital channels experiencing a boom

In addition to social media, there are a number of other digital approaches experiencing an increase in attention by pharma:

Telemedicine. As a result of the pandemic and an explosive turn toward telemedicine, point-of-care advertising in magazines or kiosks in physician offices has experienced a tremendous downturn. Companies like Populus Media now sell ad opportunities within the telemedicine platforms delivering the virtual office experience. The only challenge is that the technology is so new that it hasn’t quite scaled yet.

Video and podcasts. There’s also been a surge in video and podcast advertising. Video brings an ad to life and allows for more story development and often more emotional connection. Podcasts have been a great medium to advertise because of the demographic data available to marketers, as well as the ability to choose a program with relevant content.

Out-of-Home (OOH) Advertising. Another impactful channel to add to a media mix is OOH advertising, with its place-based media (billboards, kiosks, urban panels, etc.) found on city streets, across transit systems, and in airports, malls, and even doctors’ offices, often in digital forms. This medium reaches valuable, diverse audiences in America’s top cities and provides data-driven solutions for advertisers to reach those audiences. Starting in 2016, OOH exponentially picked up steam for healthcare marketers, largely due to the fact that digital enhancements eased any previous apprehension they harbored about utilizing the channel. And while the entire OOH industry declined in revenue in 2020, the decline in pharma and healthcare wasn’t as steep as other verticals.

According to Ross Krentzman, vice president of sales at Intersection, an experience-driven OOH media and technology company, pharma is increasingly investing in OOH. “Coming off the heels of recent advances in data and technology in OOH—including audience targeting to reach the right audience at the right time, automation for campaign execution, and solutions to measure business outcomes—we’re seeing a huge increase in digital OOH media buying by pharma brands across the board.”

He says OOH now has the ability to hyper-target based on audience demographics and location. Dayparting, days of the week, geo-targeting, and point-of-sale radius targeting are some of these more detailed methods. Brands often like to plan their OOH ad campaigns around medical events or place their ads near hospitals, which is cost-effective and can reach an elusive audience, since OOH cannot be blocked, skipped, or missed. Pharma brands, especially OTC brands, are also looking to be close to points of purchase, such as a Walgreens or CVS.

In addition to advanced targeting and seasonality, there have been massive improvements in measurement and in data. “Pharma companies can measure the effectiveness of their ads in the same way they do in digital,” says Krentzman. “For example, we can measure ‘script lift,’ an attribution study strategy that connects advertising audiences to pharmaceutical outcomes.” Having high-quality data attached to the entire ad journey continues to transform OOH and elevate its perception in the eyes of marketers.

Coordinated messaging and authenticity

Ad spend opportunities and trends are numerous for pharma marketers, and those mentioned here are just part of the story going forward. There is so much left to flesh out, including the complex worlds of influencer marketing and mobile. The growth and advancement of artificial intelligence for marketer intelligence is another incredibly important innovation, while the traditional channel of email marketing is being enhanced by embracing personalization and relevancy.

What’s certain in this ever-changing area is that with all of the stakeholders involved, with all of the complexity that exists in the industry, and with all of the hesitance to embrace new ways to target diverse audiences, marketers should employ an omnichannel strategy that coordinates brand messaging across online and offline channels. With the pandemic-forced mass migration to devices, digital should be embraced wholeheartedly. An omnichannel strategy is at its best when it provides clear and consistent communication throughout its targets’ journey, and it employs a continuous stream of high-quality data that provides flexibility and the ability to pivot at will. Finally, companies need to remember that their audience is human. Human insight and empathy, as well as authenticity and transparency, should always be essential to the pharma industry.

Fran Pollaro is Pharm Exec's Senior Editor. He can be reached at
fpollaro@mjhlifesciences.com.

References

1. https://www.forbes.com/sites/bradadgate/2021/12/08/agencies-agree-2021-was-a-record-year-for-ad-spending-with-more-growth-expected-in-2022/?sh=22df95397bc6
2. https://www.healthline.com/health/how-long-does-it-take-to-form-a-habit#takeaway
3. https://www.telegraph.co.uk/technology/2019/03/10/google-sifting-one-billion-health-questions-day/
4. https://www.cureus.com/articles/61722-a-study-to-see-the-effect-of-social-media-usage-among-healthcare-providers