|Deals on pills
Drug companies depend on innovation to find blockbuster
drugs. But when it comes to marketing to consumers, two
pharmaceutical giants are taking cues from well-worn
strategies in other industries.
Last month, Pfizer Inc. announced that Viagra users filling
six prescriptions would be able to get a seventh for free. The
promotion would reward loyal users at a time when Pfizer's
market share is under siege from new competition.
Novartis followed more recently with another unusual offer:
Patients who fail to control their blood-pressure on Novartis'
drugs can get refunds. The company called this its "money-back
These campaigns, along with other free-trial or rebate
offers in recent years, represent the latest shift for an
industry still relatively new to lobbing pitches at consumers
- with come-ons more common in ads touting cellphone plans and
"I think that as [direct-to-consumer] marketing and
pharmaceutical marketing has matured it has started to look at
consumer marketing in general to see what best practices it
can borrow," said Mary Brown, senior vice president and
director of business development at the Quantum Group, a
health-care consumer advertising agency in Parsippany.
Drug companies have long offered free samples of their
brand products through physicians' offices. But offers
appealing directly to consumers - and their wallets - are
likely to resonate more today than in years past: Patients are
paying more for prescription drugs as employers trim benefits
or increase co-payments.
So, AstraZeneca touts a seven-day free trial for its Nexium
drug for acid reflux disease. Aventis advertises on its Web
site 40 percent off out-of-pocket costs for its Allegra
allergy pill, up to $15. Women seeking Johnson & Johnson's
Ortho Evra birth-control patch can get $5 off for their next
Novartis' money-back guarantee for its drugs Diovan HCT and
Lotrel ties in with a patient-enrollment program called "Take
Action for Healthy Blood Pressure." Nearly 60 million
Americans are estimated to have high blood pressure, but only
about 30 percent are adequately controlling it, and health
advocates call it a "silent killer."
Novartis will launch a massive TV and magazine ad campaign
that addresses blood pressure goals and the consequences of
not managing the condition, without mention of the company's
products. Other promotions in the program include a coupon for
a home blood-pressure monitor and 30-day free trial of
But the attention-grabber is the money-back opportunity.
Patients can recoup up to four months of out-of-pocket costs
if their doctors certify they failed to meet blood-pressure
goals after taking the highest doses of Diovan or Lotrel.
Novartis sold $777 million worth of Lotrel last year, all in
the United States, and $2.4 billion worth of Diovan, making it
the company's top-seller.
The money-back concept stemmed from 3,000 interviews
Novartis conducted with patients and physicians, in an effort
to understand the challenges in controlling blood pressure,
said Bob Laverty, a company spokesman.
"The goal is to get them in to see their physicians and
talk to their physicians about the program," Laverty said.
At least one other company has a similar offer. For its
cholesterol-lowering drug Zocor, Merck & Co. has had a
money-back guarantee, marketed to physicians through the
company's sales force but not advertised, Merck spokesman Tony
Any program that can motivate patients to bring their blood
pressure under control would be welcome in principle, said Dr.
Muhamed Saric, an assistant professor of medicine in the
cardiovascular diseases division at the University of Medicine
and Dentistry of New Jersey. But Saric said a doctor's first
option should be to prescribe less-expensive, older
blood-pressure medicines, citing a landmark federal study that
supported their effectiveness.
"I wouldn't be surprised if the Novartis program in the end
brings about a measurable improvement in the blood-pressure
control of Americans,"
Saric said. "But what strings are
Meanwhile, Pfizer's "Value Card for Viagra" program comes
as the little blue pill is encountering two new competitors,
Cialis and Levitra, in a category Viagra owned for years.
Eligible men are those who pay full sticker price for
Viagra or have only partial coverage; pills obtained with a
co-payment don't count toward the Value Card. Viagra retails
for about $10 a pill.
John Colaizzi, dean of the Ernest Mario School of Pharmacy
at Rutgers University, said he would be less comfortable with
the "buy six, get one free offer" if it were applied to other
drugs beyond "lifestyle" medications. He said the temptation
to get a free prescription might improperly induce patients to
stay on a medicine that either is failing to work or causing
adverse side effects.
"Some of these medications, you have to be clear that the
continued use of it ... is done in a responsible way,"
The wrinkles from Pfizer and Novartis are the latest
experiments in the drug industry, which has promoted
prescription drugs much more feverishly to consumers over the
past five years.
Part of the trend stems from a 1997 decision by the Food
and Drug Administration to clarify its consumer-advertising
policy - a move credited with helping to grease the wheels for
a slew of TV and magazine advertising to the public. At the
same time, consumers have sought greater control over their
health care decisions.
That latter trend, Colaizzi said, means that consumer
advertising of medicines, while controversial, is likely here
"My sense is, it's kind of inevitable because you are
dealing with consumers who are, year after year, more
sophisticated in these matters, who year after year are a lot
more interested in their health," Colaizzi said. "The best
thing we can do is see how can we deal with [advertising]