Continuing my study of PR (Public Relations) as a “stealth” pharma marketing tool, I read the book “The Fall of Advertising & The Rise of PR” by Al and Laura Ries — the same people who wrote the “22 Immutable Laws of Branding,” which I mentioned in a previous post (see “Immutable Laws of DTC Domain Naming“).

PR: Advertising by Other Means
Actually, this was the second time I read the book. After the first reading I felt that the Ries’s had a valid point — that PR, not advertising, builds brands — but that this was not true of pharmaceutical brands. Mostly, I thought PR was not a form of marketing. In other words, I bought the notion that:

advertising = marketing

The Ries’s attempt to wedge PR into that equation and put it ahead of advertising as in

PR, followed by advertising = marketing

In fact, the Ries’s go so far as to say that “Advertising is a continuation of public relations by other means…”

However, not until I did my own analysis of the importance of PR as a pharmaceutical marketing tool (see “Marketing Disguised as PR” and “PR Marketing: Mystery Wrapped in a Riddle“) did I realize that not only is PR an important tool wielded by pharmaceutical marketers, but, unlike advertising, PR is not subject to much regulatory scrutiny nor are there any industry guidelines for the ethical use of PR by drug marketers.

The Chantix Case Study
But do pharmaceutical marketers follow the Ries’ advice and build their brands with PR followed by advertising? After my second read of the their book, I have to say “Yes.”

To illustrate this, let’s look at Chantix, a newly-approved drug for smoking cessation, brought to the market by Pfizer.

Chantix was approved just this last May and the traditional forms of pharmaceutical consumer marketing (ie, advertising) — direct-to-consumer (DTC) print and TV ads, web sites, etc. — have not yet begun.

The product web site ( is not yet “fully operational” and mostly is focused on collecting names and email addresses of visitors wishing to receive future information (I signed on for the full PR treatment, but have not yet received any confirmation message). The majority of the information on the Web site (other than the required package insert) is PR material such as a link to the Pfizer Press Release and the FDA Press Release.

When the Ries’s speak of PR, they are not talking about press releases. They are talking about getting the story of your brand presented by a credible third party — and the most credible third party source of information is the media, especially print media and especially the Wall Street Journal.

Today the Chantix public relations campaign begins in earnest with the publication of a news story in the Wall Street Journal (“Pfizer Drug Appears to Help Smokers Quit” – subscription required). From an advertiser’s point of view, the article could have been more “positive,” but from a PR point of view, it is a knockout. For one thing, the article appears “above the fold” on the front page of the Personal Journal section.

The importance of an article like this in the WSJ is not its direct influence on public opinion, but it’s influence on other media. The story will be picked up by other publications and rewritten in dozens of papers across the country. The PR has done its job according to the Ries’s: It has reached “somebody who counts” — the WSJ.

Pro PR
Not all pharma PR, however, is focused on the “lay public.” The most important pharma PR is focused on the healthcare “professional public.” This form of pharma marketing is so important, it is given a special name in pharmaceutical companies: “professional relations.” So, we can still call it PR. To distinguish it from the lay version of PR, let’s call it “Pro PR.”

Some forms of Pro PR, such as continuing medical education, are being taken out of the hands of marketers and therefore are in danger of being marginalized. For more on this, see the June 2006 issue of Pharma Marketing News (FREE ACCESS for a limited time) and, in particular, the article “Trends in Commercial Support of CME.”

By far the most important form of Pro PR is the placement of favorable research articles in medical journals like the Journal of the American Medical Association (JAMA), which is to the medical public what the WSJ is to the lay public. If you get an article published in JAMA, not only will it get to “somebody who counts” in the medical world — such as key opinion leaders who influence ordinary doctors — but it will get to somebody who counts in the lay world (editors of print media like the WSJ and TV news anchors).

In fact, today’s WSJ article on Chantix features research results published in JAMA and other medical journals. Of course, it’s not all positive news, which makes it even more credible. Most of the negative stuff, thank God, appears towards the end of the article where it has less of an effect on the mind. PR’s goal of planting a new idea in the mind — that Chantix is a NEW and different and more effective smoking cessation product — has survived unscathed by the negative vibes that appear later in the article.

The Chantix case illustrates one other important facet of Pro PR — the use of key opinion leader physicians in the employ of pharma companies to spread the word. As the WSJ points out, the majority of the authors of the three studies it cites either have done “consulting work or received honoraria or research grants from Pfizer and other drug companies, or are Pfizer employees or shareholders.”

That’s quite a gamut of drug company interest by these authors. Obviously, Pfizer has worked hard and paid good money to employ medical researchers to get these studies published. This is a major focus of Pro PR — Publish or Perish!

Now that the “new idea” has been planted in the minds of the professional and the lay public, the groundwork has been laid for traditional advertising — “cheerleading” as the Ries’s would say — to take over. This happens when the drug is officially “launched” and made available for sale.