Trends in Pharmaceutical Advertising W I L L I A M T. STRAUSS
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Ciba Pharmaceutical Products, Inc., Summit, N. J.
The character of pharmaceutical advertising has undergone marked changes with the emphasis now being placed on service to the medical profession. Industry is also exhibiting aware ness to public opinion with many companies adopting or ex panding public relations. These trends are illustrated primar ily in terms of advertising.
In an age i n which the commercial singing or otherwise has become a symbol of advertising, the character of ethical pharmaceutical advertising seems indeed p a r a doxical. The word " c o m m e r c i a l " applies strictly to consumer advertising and con notes a message from the advertiser to note the advantages of a product. This is a relatively simple approach to the problem of selling and apparently an effective one i n the consumer field. It is, however, an approach that is taboo i n ethical pharmaceutical advertising for several good reasons. F o r one thing, television, radio, and other consumer media suitable for this k i n d of promotion are usually out of bounds to the advertiser of ethical pharmaceuticals. Obviously, the latter must limit his advertising to professional people—the doctors who w i l l prescribe his product, the medical students who are potential prescribers of his product, or the druggist who w i l l dispense his product. In most instances, these groups resent being approached through anything but ethical media. F u r t h e r more, the exaggerated, repetitious claims of the advertising "commercial" are not favorably received by a well-informed and discriminating professional audience. E t h i c a l pharmaceuticals must be promoted i n the language of science. A precise and often complex language is distinguished by reservation rather than exaggera tion and cannot be effectively translated into consumer advertising jargon. There is another important difference between the consumer advertiser and the advertiser of pharmaceuticals. The consumer advertiser is almost exclusively concerned w i t h promoting either his products or premiums which help to sell his products. The pharmaceutical advertiser, although equally concerned w i t h selling his product, has found i t advantageous to operate beyond the level of pure product promotion. On a second level he performs a v i t a l function—that of providing service. Services by Pharmaceutical Advertiser
Services performed by the pharmaceutical advertiser consist mainly i n keeping the doctor informed of current medical developments, telling h i m how to use pharma ceutical products and, i n general, helping h i m to practice medicine. The prescrib ing of modern pharmaceuticals and the practice of modern medicine require a broad background of information and entail extremely complicated techniques. If the advertiser's product is to be integrated into the pattern of modern medical practice, and i f the good w i l l of the prescribing customers is to be obtained, the pharmaceutical advertiser must perform services for the doctor. I n so doing, he serves his own cause. Of course, a l l services offered by the pharmaceutical advertiser do not meet the criteria. I n a highly competitive business, good w i l l is vastly important. A n d a l most any means of obtaining i t — w i t h i n the limits of ethical practice—is considered cricket. Under certain circumstances, good w i l l may be had by catering to the doctor's cultural interests, or other interests outside the field of medicine. 83
A Key to PHARMACEUTICAL AND MEDICINAL CHEMISTRY LITERATURE Advances in Chemistry; American Chemical Society: Washington, DC, 1956.
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Scientific Publications
Of the services performed by the pharmaceutical advertiser, perhaps the most outstanding is i n the field of scientific publications. Almost every major pharma ceutical house publishes a magazine or "external house o r g a n " which is mailed regularly to doctors, medical students, and others—usually without charge. These magazines cover a wide range of subject matter of general or special interest to practicing, researching, or teaching physicians, and are distinguished i n several instances by elaborate and unusual application of art. A recent issue of the Lederle Bulletin, published by Lederle Laboratories, dem onstrates the character of this type of service. A n article entitled "Medico-Economic F r o n t i e r s : Population Movements" presents a detailed account of mass migrations which have occurred i n this century and outlines medical measures undertaken to safeguard the health of the migrants. This same issue carries, among other things, a lengthy article on recent advances i n ophthalmology and a series of detailed, f u l l y colored illustrations of the female reproductive organs. Product promotion is not evident i n either of these features, although several other articles refer, directly or indirectly, to Lederle products and advertisements of the company's products ap pearing i n the issue. In another publication, Scope, published by the Upjohn Co., an article en titled " T e l l i n g Lines—Some Notes on G r a p h s " appears i n a recent issue. This article deals w i t h the history and development of various types of graphs and their role i n modern scientific procedures. A s w i t h the Lederle Bulletin this issue of Scope carries advertising, but the emphasis is on material offered p r i m a r i l y as a service. Abbott Laboratories' What's New is perhaps the best known service of this company to the medical profession. The emphasis is definitely on art, even to an accompanying text by a well-known a r t critic. Subject matter of What's New sometimes ranges f a r afield of medicine, an indication that Abbott relies heavily on cultural appeal as a means of cultivating good w i l l . One issue of What's New, for instance, carried short stories by E m i l y Kimbrough and J . F r a n k Dobie, poems by Christopher F r y and the late J a n Struther, an original painting by Rouault, and the score for an original song composed by H a r o l d Rome! Newest of the pharmaceutical industry's house organs, and i n some ways the most unusual, is Spectrum published by Pfizer. This publication is issued biweekly and is incorporated into the advertising pages of the Journal of the American Medical Association. P i c k i n g an issue at random, the following subjects were found to be discussed : Current Emphasis on Eclampsia Swimmer's Itch How about the Southwest for A s t h m a Motion picture films, such as those offered by Davis and Geek, Squibb, a n d Wyeth, have become established i n the pharmaceutical industry's promotional pro gram. These films are teaching aids covering diagnostic procedures, surgical tech niques, and methods of treatment. The education of the patient is a service not neglected by the pharmaceutical industry. Brochures, pamphlets, and other printed material are made available through the medical profession. Examples of these i n clude a handbook for diabetics offered by Squibb and dietary instruction sheets pre pared by Meade Johnson. Somewhat more elaborate general presentations, summarizing certain phases of the practice of medicine, have been distributed to physicians. These are offered gratis or at cost. Examples include the well-known DeReMedtca of L i l l y and The Merck Manual. A t Ciba the accent on service is perhaps even more pronounced than elsewhere in the pharmaceutical industry. Looming large among Ciba services is the Clinical Symposia, a magazine distributed six times a year, without charge, to a compre hensive list of doctors, medical students, and others interested i n medicine. Clinical Symposia was inaugurated i n the spring of 1948 w i t h its objective, i n the words of its editor, J . H a r o l d W a l t o n : "to present comprehensive, authoritative articles on subjects of general medical interest, i n a simple and concise style—free from the esoteric terminology of the specialist." I n mid-1949, a policy was inaugurated A Key to PHARMACEUTICAL AND MEDICINAL CHEMISTRY LITERATURE Advances in Chemistry; American Chemical Society: Washington, DC, 1956.
STRAUSS—TRENDS
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under which Clinical Symposia would accept only articles signed by recognized med ical authorities. This policy has been followed strictly. A curious and striking fact is that, even though no fees are paid for articles, a wealth of material is almost always submitted for publication.
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Selection of Articles
Subject matter for the Clinical Symposia is chosen with two broad considera tions i n m i n d ; first, does the subject lend itself to i l l u s t r a t i o n ; second, is the sub ject of wide interest to the medical profession? The second consideration springs f r o m the nature of the reading audience which is made up of 90% or more of gen eral practitioners or specialists i n fields other than that concerned i n any particular article. The first consideration is guided by the trade-mark of Clinical Symposia— the illustrations of F r a n k Netter, who has gained recognition as one of the world's foremost medical illustrators. H i s range of talents has been expressed i n a variety of subjects, such as hemorrhagic problems i n infants and children, diseases of the uterus, pathology of the mouth and jaws, disorders of the hip, and others. H e com bines the a r t i s t r y and craftsmanship of the illustrator w i t h the scientific insight of the trained physician. Two bound volumes of Netter's work, " T h e Ciba Collection of Medical I l l u s t r a t i o n s " and "Nervous System," contain drawings reproduced i n elaborate color plates. The accompanying text is written by experts i n various fields of medicine on com mission from Ciba. Both of these books are distributed free to medical school libraries, and can be purchased by individual doctors or students at cost. These i l lustrations of Netter have also been reproduced on 35-mm. Kodachrome slides. Sets of these slides, containing a l l of the work of these two books, are sent without charge to a l l medical schools, and are also available—singly or i n sets—to individual doctors at cost. Illustrative
Material
These illustrations of Netter have also been reproduced on 35-mm. Kodachrome slides. Sets of these slides, containing a l l of the work of these two books, are sent without charge to a l l medical schools, and are also available—singly or i n sets— to individual doctors at cost. Ciba, as others i n the pharmaceutical industry, considers product literature a n indispensable service. F o r every product i n the Ciba line, a detailed booklet o r pamphlet provides a l l pertinent information on clinical experience w i t h the drug, chemical and pharmacologic properties, experimental evidence, indications and con traindications, dosage, and precautions. A review of the general field of therapy is often included. When a new product is introduced, literature is p a r t i c u l a r l y i m portant. I n this case the pharmaceutical advertiser is certainly the best source of information on the product and his responsibility is to convince the doctor of the value of the product. A l l possible dangers from using this product, necessary pre cautionary measures, and other factors which may circumscribe its clinical applica tion, must also be pointed out. The ethical standards of any pharmaceutical house are certainly put to the test i n its product literature. Product literature is obviously a service that helps the doctor practice medicine— assuming that the product i n question is good medicine. A t Ciba, the A d v e r t i s i n g Division makes available such things as a slide rule for determining hormone dosage, a slide rule for converting apothecary to metric system (and vice versa), record forms for patients undergoing sulfonamide therapy, and a series of maps showing geographical and seasonal patterns of allergy. The advertising staff also helps to prepare scientific exhibits which are shown at various conventions. Exhibits
In these technical exhibits, Ciba has gone beyond a strict concept of product promotion and into the realm of service—for example, a n exhibit on hypertension shown at the last A . M . A . meeting and scheduled for showings at future conventions. This exhibit was created by George K r a j i a n , a n A u s t r a l i a n designer who is rapidly becoming famous for his original and highly complex work i n A c r i l a c (a substance similar to Plexiglas). A series of superimposed acrilac sheets—intricately carved, stained, and synchronized with light and sound—has been prepared to demonstrate A Key to PHARMACEUTICAL AND MEDICINAL CHEMISTRY LITERATURE Advances in Chemistry; American Chemical Society: Washington, DC, 1956.
A D V A N C E S IN
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the basic phenomena of normal blood pressure and hypertension and the application of Ciba's three hypotensive drugs—Apresoline, Regitine, and Esomid. The result was a graphic, 15-minute course on the nature of hypertension and the effect of the newer drugs i n this condition. Another very important part of this company's program of service is Cibascope— a publication directed to a l l retail and hospital pharmacists and to a l l wholesale and chain drug stores four times a year. Besides information on various Ciba spe cialties, it features articles having to do w i t h manufacturing or research activities of the pharmaceutical industry, the history of pharmacy, and other aspects of the pro fession. One issue carried a picture story describing medica! and pharmacy facilities aboard the S.S. United States. In another issue, a story dealt w i t h medical installations on United States N a v y submarines. Favorable response to Cibascope has come from as f a r as Okinawa and Honolulu. Another Ciba service appealing to interests other than medicine is the "Guide to New Y o r k C i t y " — a 60-page book prepared originally for the A . M . A . conven tion. This book has now been reprinted and is available for future medical meet ings in New Y o r k . A m o n g other things, points of interest in New Y o r k , shopping, transportation and hotel facilities, and restaurants are covered. A newcomer to the list of Ciba service is Ciba Reports—a newsletter devoted to highlights of important scientific meetings. A t all of these meetings, correspondents cover the news, b r i n g i n g physicians up to the minute on developments which might not be reported in other media. Reports from current medical literature are also included in this publication when appropriate. Sample headlines give an idea of the variety of its coverage: One in F o r t y Pediatric Patients M a y Be Epileptic Alcoholics L i k e Guns Autosuggestibility Called Important Factor i n Heart Disease New Approach to Care of Infant S k i n Unique Cases of Pelvic Cancer Reported The character of the services which the pharmaceutical advertiser offers to the medical profession is well represented by Ciba Reports. A n d this type of service is more and more i n evidence as the pharmaceutical industry moves forward. The individual practicing physician now depends on the pharmaceutical advertiser for new information, for background material, and even for cultural stimulation. Hackneyed though the phrase may seem, pharmaceutical advertising serves the cause of medicine. RECEIVED
S e p t e m b e r 13,
1954.
A Key to PHARMACEUTICAL AND MEDICINAL CHEMISTRY LITERATURE Advances in Chemistry; American Chemical Society: Washington, DC, 1956.
