Sugar the pill

Getting a foot in the door of a doctor’s surgery is no easy job for a drugs company sales rep. Promoting the message to hospital practitioners can be just as hard.

While many of the UK’s 36,000 GPs are now fundholders – in effect functioning as small businesses – modern doctors have little time to fly off for briefings in the Caribbean, or to be wined and dined by expense-accounted reps. The strict rules covering the promotion of pharmaceuticals mean entertaining by drugs companies has been pared to the bone, and many doctors may not be susceptible to such blandishments anyway.

Even the value of the gifts which companies can give to doctors as “aides-memoires” is limited to &£5. Under Government rules on how much profit drugs companies can make from the National Health Service, companies can offset some marketing and promotional expenses against their maximum allowed profits, but this is strictly limited to seven per cent of sales.

One place where drugs companies can capture doctors’ attention is at medical conferences or symposia. Companies spend large amounts on sponsoring these events and setting up exhibition stands promoting their company and the drugs it produces.

Second opinions

Doctors often attend a handful of conferences on specialist therapeutic areas each year and GPs are expected to make regular visits to their local hospitals for updates on the latest research on existing and new drugs, as part of a requirement to keep their knowledge and skills up to date. But, as Peter Stevens of Intercontinental Medical Statistics points out, the proportion of doctors attending conferences is limited. He says: “They can’t all go, or there would be no one left to look after the patients.”

This makes targeting those doctors who do attend conferences all the more important, and companies are always on the look out for fresh ways of constructing their stands and capturing a few minutes of a doctor’s time. Alison Buchanan, director of programmes for pharmaceutical marketing agency 4D Communications, says most conference activity is about general profile-raising rather than promoting specific brands. But standard exhibition stands are giving way to more off-beat methods of attracting the medics’ attention.

She says: “Things that interact on different levels can be good. Computer games were seen as state of the art, but these days they are not ‘different’ enough. Other companies have tried games such as mini-golf – anything that engages. Doctors are looking for some light relief from the academic sessions.”

The rules laid down by the Association of the British Pharmaceutical Industry covering the sponsorship of doctors’ meetings and hospitality provided by drugs companies state that the meeting must have clear educational content, and the hospitality associated with the meeting must be “secondary to the nature of the meeting, must be appropriate and not out of proportion to the occasion”.

Exhibition production companies have assumed an important role in marketing pharmaceuticals to doctors. Creativity is critical when working within the tight guidelines on the promotion of drugs. But conferences are just one element of a marketing strategy that also includes advertising in medical journals, direct marketing and of course personal visits from sales reps.

Reps are the key to selling drugs. It is they who are closest to the doctors and often take the credit – or the blame – if prescriptions of a drug in their area increase or decline. Personal relationships between doctor and rep may be of prime importance, but enhancing the reputation of a pharmaceutical company and its drugs is a long-term operation which requires gentle persuasion and subtle brand-building.

Mechanism of action

Grey Healthcare European managing director Peter Carr says it is hard to tell which component of marketing actually determines whether doctors prescribe one drug or another, but that having a presence at a conference is crucial to general perceptions of a company and its brands: “For a company to be seen as credible and ethical, there’s a real need for doctors to see that company or product at meetings. It may not register consciously in a doctor’s mind, but the doctor may feel that, if a company is spending money on a drug, it must have a future,” he says.

He adds that the positive thing about exhibition sponsorship is that doctors are aware that many exhibitions would not take place if it were not for the funds supplied by the drugs companies. Doctors may be sceptical of pharmaceutical marketing, but exhibition sponsorship enables drug companies to present themselves as contributors to general health education.

Carr also warns companies against going to extremes with their stands – making them like a Las Vegas casino, or having them too cheap “can do more damage than not being there”.

Patient confidentiality

One company that claims it has constructed an exhibition stand that makes a real impression is Japanese drugs giant Takeda, which took a stand at a meeting of the European Association for the Study of Diabetes in Glasgow. The meeting was attended by about 10,000 doctors. Rather than setting up a conventional stand to promote its Actof diabetes drug, Takeda built a four-metre, plain white wall around three-quarters of its 212 sq m exhibition area, making the stand accessible only through a discreet front entrance. The company says doctors had to make a conscious decision to visit the stand. The only visible clues they had to the stand’s content were signs stating that the area was devoted to the history of diabetes. On entering, they were confronted by an Egyptian pyramid.

The exhibition area contained several “themed” rooms with tour guides, video clips, sound effects and artefacts representing various stages of the history. The company’s presence itself was barely visible. Visitors were invited to enter a simple competition, answering questions to win various small prizes. The answers could only be found by walking around the whole exhibition. By the end of day one, 35 per cent of the conference delegates had entered the competition. By the end of the conference this figure had reached 105 per cent, as many visitors returned for a second look. Delegates queued for up to 45 minutes to visit the exhibition.

According to Alison King, managing director of On Screen Productions, which produced the exhibition: “Doctors are very difficult to sell to as they are quite cynical. They walk a narrow line between being sold to and putting patients’ interests first. They try to cut through the hype as they have a lot of marketing directed at them.”

King says regulations dictate that much pharmaceutical marketing is non-promotional and so it focuses more on education – such as showing the history of diabetes – which is something is not found in other markets.

Symposia on defined therapeutic areas are the Holy Grail for pharmaceutical marketers, according to Bates Healthworld managing director Gill Adams. She says such educational meetings are where doctors really learn about the relative performances of different drugs: “Whereas in a promotion a medical rep goes in to see a doctor and says: ‘Our drug is great,’ medical education is more about getting reputable doctors to explain why one drug is better than another. It is like reading about a car in a newspaper’s motoring section.”

Side effects

At a four-day conference there may be speakers from lots of clinical areas talking about research on different drugs, and this is probably the strongest way of communicating a drug’s benefits, says Adams. There are also satellite symposia – breakaway meetings about the latest developments in more specialised areas – and these will more often be sponsored by a company than a particular drug brand.

Doctors have to be persuaded that a particular drug is the most effective and has the least harmful side-effects. But one pharmaceuticals insider quips that marketers should avoid words ending in “-est” – they should not say a drug is the best, the strongest or the cheapest. It is hard to prove that one drug is more effective than another, but proving sweeping claims like “the best” is even harder, because much may depend on the target patients and many other variables.

In reality, marketing pharmaceuticals is similar to other forms of marketing, and faces a similar product parity crisis. With so many products offering similar standards, the challenge is to get doctors to prescribe one drug rather than another when there are only slight differences between them. But few other areas of marketing are so tightly controlled, nor do they have such a well-informed and educated constituency. Not all drugs companies follow the route of sponsoring medical conferences, but for those that do, a clear vision of what makes doctors tick in those odd moments between academic lectures is essential.

International Confex 2002

International Confex will take place from February 19 to February 21 at Earls Court in London, with more than 1,300 exhibitors from more than 70 countries.

Now in its 20th year, Confex is split into four industry sectors:

UK venues and destinations

Overseas venues and destinations

Corporate hospitality

Support services.

Exhibitors include national tourist offices, hotels, venues, special event organisers, display specialists, catering companies and convention bureaux.

A programme of seminar sessions provides practical advice on all aspects of conferences, incentive travel, corporate hospitality and events. There is also a series of workshop sessions, subdivided into five further categories:

Sales and marketing

Event management

Technology

Personal development

Best practice in business.

In addition, discussion boards have been provided to carry on debates or ask questions. Speakers from the seminars will be taking part in these discussions.