Last week’s post “Fake Pharma Advertising” elicited a number of responses from members of the PHARMA-MKTING Online Discussion Group. I include the dialog and further comments here.

James, an interactive ad agency guy, said:

I agree with your perspective on celebrity endorsements. They are definitely problematic when used to promote a specific drug or device.

However, I’m more favorable about their potential value as a condition awareness-raising tool. I think Pfizer’s been smart about this — e.g. Lorraine Bracco (depression), Mary Lou Retton (bladder), etc. All unbranded and designed to motivate a consumer-physician dialogue.

I’m not sure what it says about our society, but people do sit up and take notice when someone they know/like discusses a sensitive condition.

A quick scan on Google suggests they’ve been very effective at drawing attention to themselves and motivating people to speak with their physician.

Here’s a whole page devoted to celebrity medical endorsements –


If anything, I am all about transparency. So I approach celebrity endorsements the same way I approached the ethical use of the Internet for dissemination of health information when I founded the Internet Healthcare Coalition (a non-profit organization which is now disbanded).

Unfortunately, the health site you mention is not very transparent in distinguishing editorial content from paid promotion. The entire Celebrity Speak Out page is suspect in this regard. Has Dr. Donnica received money or services in kind for including all or some of these celebrity endorsements and links on her site?

We don’t know.

All we know is that SpotLight Health and a few pharma brands/companies are sponsors of the site. Spotlight gets paid for managing celebrity endorsements. The Celebrity Speak Out page, however, appears to be Dr. Donnica’s personal and purely editorial picks, not picked by Spotlight or the pharmaceutical sponsors.

This is very similar to the old DrKoop website which was exposed during the infamous “dotcom era” for misleading site visitors into believeing that a list of recommended hospitals was chosen based on merit rather than promotional fees paid to In other words, DrKoop’s list of hospitals, just like Dr. Donnica’s list of celebrities, appeared to be editorial content, not paid promotional content. The expose set in motion a movement to develop a voluntary set of ethical guidelines for health Web sites (see eHealth Code of Ethics).

Alfred, another member of PHARMA-MKTING, emphasized that transparency will help build trust among cynical consumers:

You really nailed some major issues — the new DTC guidelines to me are not the answer to the key question regarding pharma marketing: how do you build trust, or at least, credibility, with a cynical consumer.

Transparency is a marketing or financial services word, it really means nothing to a consumer without some sort of Code that details the communications standards needed to create the sort of materials that educate, qualify, motivate, a patient to the right treatment.

Do you know of such a code that takes the new guidelines and brings them to life? Because right now, ‘education’ in the new DTC world seems to mean having a doctor lecture you for 30 seconds while unbranded materials fly in and out of the frame.

Buzz and Free Speech

Brian, top dog at a branding agency, had this to say about Buzz:

Good observations, John, but I have a feeling you misunderstand the power of ‘Buzz’.

How did Viagra succeed as a product?

Everyone out there think about that question very carefully.

Was it the phenomenal development program that Pfizer invested in to create a marketplace for ED? (How could that be when the drug was developed as a cardiovascular solution provider that had a stunningly unanticipated side effect?)

Could it be the intense PR activity that Pfizer put into newsrooms everywhere when they realised that they had serendipitously uncovered a new big thing?
(No – Pfizer stayed well out of the foreground of press speculation and tasteless humour that emerged with the genesis of Viagra)

Could it be that doctors had been waiting for years for an effective treatment that they could offer to the legions of ageing males queueing through the night for the best treatment for their problem? (As I understand it, ED wasn’t that big until Viagra)

OK, the it must have been the advertising agency. What a success story. We launched Viagra to the world and the world listened and AIDAed and bought it. If there was a Nobel prize for advertising, we should get it. (I’m not even going to comment on that one)

Back to the point. Buzz is the most powerful medium available to this (or any) industry that is entirely outside of any kind of regulation (since Mao Tse Tung, or perhaps Mr Hussein). It’s called ‘free speech’. What made Viagra succeed was simply that it legitimised and enabled conversations between men and men, men and their doctors, men and their wives…. It ignited a forest fire of Word of Mouth, fuelled by the often misinformed, misled and down right dangerous involvement of the press and media, who were immediate in their interest and coverage of this new wonder drug. Pfizer may have had a hand in some of this, but I doubt it. The corporate engine maintained a safe distance from the frenzy of misinformation, and chose a path of dignity, when the product arrived to market. I’m sure Pfizer didn’t really care. They had no idea what they were sitting on. (I’d love to see how they thought they would do with a product going to market on the strength of a useful side effect!)

Word of Mouth – Buzz – The Human Network. It’s entirely out of the control of regulatory bodies or medico-legal approval. It’s further from ‘control’ than where most brand budget is spent, but it’s where brands are truly born. It’s where experiences and success stories are shared – whether water cooler conversation between professionals or supermarket aisle secrets that housewives share like small change on the weekly shopping trip.

Anything that drug companies can do to ignite conversations among and between the tribes that surround any product in any therapeutic area that ad energy and potential to the products commercial gain should be explored.

It’s branding at its purest. I embrace it, endorse it, encourage it, and whenever I see it happening, applaud it.

And there’s nothing (in today’s networked world) that any authority can do to stop people talking.

The branding trick is: How do you ignite the fire?

I doubt that paying someone to endorse a product is really a freedom of speech situation. You are paying people to say what YOU want them to say, not what they are free to say! I think Danny DeVito’s character in the movie The Big Kahuna eloquently summed up the difference between free human conversation and buzz:

It doesn’t matter whether you’re selling Jesus or Buddha or civil rights or ‘How to Make Money in Real Estate With No Money Down.’ That doesn’t make you a human being; it makes you a marketing rep. If you want to talk to somebody honestly, as a human being, ask him about his kids. Find out what his dreams are – just to find out, for no other reason. Because as soon as you lay your hands on a conversation to steer it, it’s not a conversation anymore; it’s a pitch. And you’re not a human being; you’re a marketing rep.

However, the real issue is credibility or loss thereof if and when the financial incentive is revealed. Think of Armstrong Williams, a prominent “black pundit,” who was paid $240,000 to promote No Child Left Behind as part of a $1 million Education Department contract with the Ketchum public relations firm.

Regarding the Viagra buzz: Sometimes idly standing by and doing nothing to curb the buzz can be interpreted as actively “aiding and abetting.” I say “curb” because buzz can get out of hand and result in incomplete or false information. This is not a big problem if you are promoting soda pop, but it can be dangerous for prescription drugs.

It took Pfizer several months after Viagra was launched before it built the web site with approved information about the product. Meanwhile, as as soon as Viagra hit the market, there were plenty of non-Pfizer Viagra Web sites selling Viagra as well as plenty of buzz on online bulletin boards.

And while this situation was going on a few guys were being rushed to emergency rooms because they didn’t know about the interaction between nitrates and Viagra — something not mentioned in all the buzz!