Admittedly, for a few drugs, consumer-style branding coupled with direct-to-consumer (DTC) advertising -- "ask your doctor to prescribe you X" -- has been lucrative in the US. But the vast majority of prescription products gets no public promotion. Physicians make the decisions, and they remain the primary target for most drug marketing.

"We look very carefully at how we can identify the critical differences between possible trial designs and what payors ideally want,” Johnson continues. “Where possible we will alter phase III and IIIb trial designs to better meet the expectations of the payor and will work with brand teams to develop positioning and brand essence from the payors' perspective. Clearly the way we describe clinical measures and the visible impact of the product in terms the payor will understand is a key focus for us."

Johnson admits that sometimes branding is more a question of getting the right information in front of payors. "The needs of the payor are very simple and very clear -- they want to understand product impact and value from their perspective. This means they need to understand which patients should receive the product and which ones should not; what the added medical benefit in these particular patients is; what the financial or business implications are. In some countries there may be an interest in health economics (cost-effectiveness) and most payors in socialized healthcare systems want to understand the political consequences of the decision they make."

Many aspects of the brand that excite payors thus cannot be communicated in a promotional sense, says Johnson. "Payors accept this and do not expect to see the same information that is communicated to prescribers or consumers. Their information needs are more pragmatic, more forecast-based and more forward-looking than those of registration authorities."

The problem with concentrating on payors, according Rob Dhoble, a health care marketing specialist and executive vice president at DAS Global, a division of Omnicom group, is that many take a narrow definition of health care costs. "Pharmaceutical firms have gone to great lengths to validate the cost-effectiveness of their medications to payors as part of the branding process… these "pharmacoeconomic" arguments are quite sophisticated in their monetization of the value of new medicine and include savings in earlier departure from hospital, decreased disability from the afflictions (or prevention) of disease, improved longevity, survival and wellness versus existing traditional medicines.”

However, he asserts, “The problem is that most of these payors actually don't care about the longer term beneficial impact of these medicines to patients or to society in general. They care about stretching their expenditures for all drugs in a given current period to the maximum degree."

Coe argues that companies should therefore think more about their corporate brands. "For some payors it may be better to promote the corporate brand rather than the product brand, for instance in the US where you want a bulk formulary deal. Corporate branding may also be appropriate for a company with expertise in a therapeutic area or franchise."

Pfizer, for example, probably has six to eight major brands in the cardio sector, but they are all unrelated. Perhaps a Pfizer cardio franchise brand might encourage administrators to view these brands as a group, and to buy them accordingly.

"The corporate brand has a real role to play in terms of reputation, in terms of commitment to R&D, and in terms of quality assurance and availability," says David Wood, CEO of Interbrand Wood. "One should remember that probably all their physician members and many of their patient members are familiar with the major drug companies; many of them will own stock in the company, for instance, so the opportunity to have the corporate brand do some serious work here clearly exists."

Yet even as companies choose to push their corporate brands among payors, they should never neglect their core audience: the physicians. "Contact with payors is not a brand issue but a distribution issue," argues Leigh Featherstone of Healthworld's Global Business Group. "If launching a new brand of beer, you would build the positioning with people who were going to use it, but it's no good unless you can persuade the top five supermarkets to stock it. Contact with payors is about getting doctors and patients access; the job of the brand is to drive demand."

So while drug manufacturers must not ignore the payors, the visions, missions and essences of their branding teams should always put physicians first.    

[9-Jun-2003]