The per unit strength of medical journal advertising has never been more impressive than it is today

At various times over recent years we've heard criticisms of medical journal advertising as a declining tool in medical marketing. Direct to consumer television and print advertising, web-based information services, detailing and other avenues have supposedly taken much of the luster off of journal advertising, leading to reduced campaign budgets, media cancellations and publishing woes.

But where is the hard evidence supporting the rationale for these phenomena?

In the late 1960s and throughout the 1970s ample evidence could be found, testifying to the fact that medical journal advertising was a mixed bag...though a gradually improving mixed bag. Had medical journal advertising gotten no better, the moves away from the medium might have made sense on the grounds that creative talent to make medical journal advertising better just couldn't be found.

But lo and behold a measurable quality surge has been underway, to some extent in the 1980s and now (through the 1990s and into this century) at an accelerating rate.

So, strange as it may seem, investments in medical journal advertising have been shrinking at the same time that per ad quality is reaching its highest level of effectiveness ever!

The quality to which we're referring is not based on "gut feel" or anything like that. It's based on measurable, statistically defensible test results, giving us access to an ample fund of supporting evidence. So let's take a look at what we've learned over these past 38 years:

We've been testing medical journal advertising since 1968, when it was admittedly horrible...black and white ads featuring worried, constipated-appearing patients, full-color illustrations of blood and guts, line-drawing cartoons that weren't funny, technical terminology that was truly mind-numbing. It was generally awful stuff and, not surprisingly, it tested poorly (the initial norms that we generated were nothing to write home about, surpassed on the downside by only a few dreary advertising categories like life insurance, stock brokers, consumer stomach remedies and pain killers).

Comparatively little medical advertising research was being done back in the 1960s, and what there was was more likely to be qualitative (i.e. focus groups) or in the form of the post-test ad readership studies funded by publishers. Systematic, quantitative, norm-based research was being done in other industries and in many categories of consumer product advertising, but early in the decade it wasn't readily available within the pharmaceutical industry.

But unlike today, budgets for medical journal advertising were growing in the 1960s, so with that growth came increasing demands for accountability -- how do we know that this is a good campaign? are these the strongest ads that we have available? are our communications objectives being met?

October, 1968 marked the initiation of our Norm-based advertising pre-tests in the pharmaceutical industry. Within a few months we'd built up Norms for prescription drug advertising overall as well as for launch ads promoting new products (see Table One).

TABLE ONE -- OUR FIRST PRESCRIPTION DRUG & NEW Rx DRUG LAUNCH AD NORMS -- Palshaw Ad Test results from late 1968/early 1969

(NOTE: Each Norm is based on the first 15 ads studied in the category,
overall Rx Drug or New Rx Drug Launch ads)

TABLE ONE COMMENTARY: While it’s perhaps no surprise that the initial Norm for Rx Drug Launch Ads significantly outperformed the initial overall Norm for prescription drug ads, that latter overall Norm showed numerous areas of weakness. And it has not since been as low as was revealed here…every slice of the overall Norm taken in subsequent years has surpassed the initial Norm.

At the time these data were being gathered, medical journal advertising and detailing by the sales force were the primary communications tools used by pharmaceutical marketers to get the word out regarding their prescription products (interestingly, those two channels of communication are still considered as being paramount by the physicians we survey...in spite of the passage of time and the entry of and buildup by so many other communications channels).

As noted in the Table One chart's Commentary, the initial Norms were not impressive, falling well below most of the other industry areas and product categories with which we were experienced.

Looking at the ads themselves suggested that creativity in the late 1960s was about a generation behind other industries, and for reasons not solely related to the skill levels of the available creative talent. Client conservatism (an unwillingness to run advertising that was in any way "out there"), the committee-driven and oversight nature of the approval process and the less-than-generous compensation offered to creative talent all played into the situation. For whatever reasons, there was ample room for improvement.

Gaining an audience…the most critical factor

Generating more immediate interest in reading a medical journal ad was of course the primary challenge. After all, if the ad doesn't pull in a good-sized chunk of the target audience it doesn't matter how good and persuasive the body copy may be, because the audience will never get to it.

In examining the next chart and those that follow, it should be stressed that our experience, however substantial, is limited to those advertisers who have chosen to pre-test their advertising with us over the years, and to the competitive advertising chosen by our clients to round out each study. For all we know, some advertisers may have never tested their creative product or otherwise been included in our studies. We can't comment on what they're doing.

Table Two ("Changes in the Palshaw Ad Test Norm for Reading Interest") illustrates changes in our Norms for initial Reading Interest, which were nothing much to begin with but which have gradually improved. The charts are based on slices of data that each typically cover about two years of testing, and some slices of data are clearly superior to others. The trend is what's rewarding, however, as it's gradually moving up... documenting a consistently improving creative effort that's become notably more successful in generating an audience (see Table Two).

TABLE TWO -- Changes in the Palshaw Ad Test Norm for Reading Interest...
all Rx Drug Ads & New Rx Drug Launch Ads 1968 through 2006

(NOTE: The initial norms were based on the first tests producing enough data to establish Norms; subsequent results for the overall Prescription Drug Ad Norm are each typically based on 135-150 ads each...and for the New Prescription Drug Launch Ad Norm, 20-30 ads in each grouping)

TABLE TWO COMMENTARY: OVERALL Rx DRUG AD NORM: In the late '60s and throughout the 1970s the average level of Reading Interest earned by prescription drug ads being studied under the Palshaw Ad Test ranged from a low of 42% (the initial Norm) to percentages in the mid 50s. Since then, each normative grouping of 135-150 ads has tended to reach percentage levels in the 60s (most recently at an average level of 64%, still significantly lower than Rx launch ads, but closing the gap).
NEW Rx DRUG LAUNCH ADS: Early on we typically found launch ads for New Rx Drugs scoring about 20 percentage points higher than the overall Rx Drug Ad Norm. That gap is narrowing, even as launch ad results improve.

Having demonstrated an ability to learn from their research and to measurably improve journal advertising effectiveness in garnering an audience, medical advertising agencies and their pharmaceutical marketer clients were also responding to the need to convey their key arguments in the most important, newsworthy and persuasive manner possible.

Most of the remaining charts in this article will deal with that challenge and how it's been met over the years.

Let's begin with the level of Prescribing Importance that physicians are willing to assign to the claims being made in medical journal ads (see Table Three).

TABLE THREE -- Changes in the Palshaw Ad Test Norm for Idea Importance
...all Rx Drug Ads & New Rx Drug Launch Ads 1968 through 2006

(NOTE: The initial norms were based on the first tests producing enough data to establish Norms; subsequent results for the overall Prescription Drug Ad Norm are typically based on 135-150 ads each...and for the New Prescription Drug Ad Norm, 20-30 ads in each grouping)

TABLE THREE COMMENTARY:
OVERALL Rx DRUG AD NORM: With the exception of the initial 15-ad Prescription Drug Idea Importance Norm of 66%, average results through the 1970s and 1980s were typically found at a percentage level in the mid to high 70s. The last six normative groupings, however, could all be found at 80% or better…attaining a high of 89% in the most recent analysis (an exceptional performance documenting on-target idea communication).
NEW Rx DRUG LAUNCH ADS: As was the case overall, earlier results were substantially less successful than those in more recent groupings…the 2nd-half being no worse than 87%, and four times being over 90% (finishing up with a new high of 95%).

It is especially noteworthy that the last slice of Normative data (covering essentially 2005 and 2006 test results) attained the highest results shown to date -- 89% Idea Importance for the overall Prescription Drug Advertising Norm and 95% for the New Rx Drug Launch Advertising Norm. Those are exceptional results, and while it may be a fluke that they occurred most recently, and within the same timeframe, it nonetheless suggests that agency creative teams are currently producing medical journal advertising of maximum effectiveness.

Doesn't that make it seem odd that advertisers are continuing to cut back on their use of that medium? Does it mean that great advertising isn't good enough? Or is it that the siren call of other promotional channels, particularly direct-to-consumer advertising and web-based promotions, is so alluring and powerful that it's absorbing available budgets at an ever-increasing rate? I'd submit that we're still awaiting hard evidence that these alternative channels are more cost-effective than advertising in medical journals.

One thing that we can definitely attribute to communications channels other than medical journal advertising is the fact that "news" regarding new prescription drugs is finding its way to the physician marketplace through a broader variety of avenues than ever. Just take a look at Table Four ("Changes in the Palshaw Ad Test Norm for News Value") for evidence of the recent decline in the ability of New Rx Drug Launch advertising in telling physicians about a new drug for the first time (see Table Four).

TABLE FOUR -- Changes in the Palshaw Ad Test Norm for News Value
...all Rx Drug Ads & New Rx Drug Launch Ads 1968 through 2006

(NOTE: The initial norms were based on the first tests producing enough data to establish Norms; subsequent results for the overall Prescription Drug Ad Norm are typically based on 135-150 ads each...and for the New Prescription Drug Ad Norm, 20-30 ads in each grouping)

TABLE FOUR COMMENTARY:
OVERALL Rx DRUG AD NORM: After an initially weak 15% Norm established back in 1968, the News Value of Prescription Drug advertising averaged in the low to mid 20s throughout the 1970s and 1980s, and – in the last 4 groupings of data (for the late 1990s and from 2000 onward) – scored at a News Value level of 33% or higher.
NEW Rx DRUG LAUNCH ADS: The proliferation of multiple communications channels in addition to medical journal advertising has in large part negated the trend toward higher scores in recent groupings, though the highest score yet attained for a grouping – 72% in group 17 – is certainly recent.

While the overall Prescription Drug Advertising Norm reveals continuing progress by journal advertisers in getting across "new" information...the last four Normative data slices averaging 33% or more in News Value (reaching a high point of 38% most recently)...the New Rx Drug Launch Advertising Norm had a major hiccup in the most recent data, falling from average News Value of 72% down to 54%.

As the news of new products keeps occurring, one can only assume that other channels of communication (BLOGS and other web content come to mind immediately) are spreading the word on new products more rapidly and diminishing the newsworthy impact of ads or articles in medical journals.

CONVERTING AN INTERESTED AUDIENCE INTO A PERSUADED AUDIENCE – WHERE IDEA CONTENT MUST DO ITS JOB

We'd noted earlier how critically important it is for medical journal advertising to perform well in generating substantial initial Reading Interest. But of almost equal importance is the ability of those ads that succeed in generating high Reading Interest to also score well in generating high levels of Prescribing Interest...ultimately persuading physicians to lean in the direction of a positive action.

No measure of Prescribing Interest can predict with certainty how many prescriptions will be written as a result of exposure to a journal ad, a sales call, a patient question, a BLOG or anything else. There are simply too many variables at work to be that predictive. But common sense would suggest that medical journal ads which score significantly high in generating a High Prescribing Interest score are indeed more desirable than ads that don't.

Most importantly, the significantly high-scoring ads on Prescribing Interest measures, which can be found to have relied less on past brand familiarity for their support and more on the successful "conversion" of one or two main ideas into frequent expressions of Prescribing Interest, are the ads "most likely to succeed" overall.

In any event, when we examined all those slices of Normative data on the Prescribing Interest measure, we found still another instance of the most positive results being the most recent ones. In fact, a new high of 43% High Prescribing Interest for all prescription drug advertising and a new high of 59% for New Rx Drug Launch advertising occurred when we took the most recent Normative data slice (covering 2005 and 2006).

The chart labelled Table Five provides all of the Prescribing Interest Normative data
slices (see Table Five).

TABLE FIVE -- Changes in the Palshaw Ad Test Norm for Prescribing Interest
...all Rx Drug Ads & New Rx Drug Launch Ads 1968 through 2006

(NOTE: The initial norms were based on the first tests producing enough data to establish Norms; subsequent results for the overall Prescription Drug Ad Norm are typically based on 135-150 ads each...and for the New Prescription Drug Ad Norm, 20-30 ads in each grouping)

TABLE FIVE COMMENTARY:
OVERALL Rx DRUG AD NORM: After a weak beginning (initially just 51%, and with results through the 1970s and 1980s at percentage levels in the 60s and 70s), overall (Any) Prescribing Interest vaulted past the 80% level in the last 5 groupings. In the case of High Prescribing Interest, the last 5 groupings again illustrated a breakthrough, with percentages in the high 30s and (most recently) 43%.
NEW Rx DRUG LAUNCH ADS: 4 of the last 5 groupings revealed High Prescribing Interest levels over 50%, with a new high of 59% established most recently; Any Prescribing Interest finished quite strong as well, with 3 out of the last 5 groupings scoring over 90% (the most recent -- 95% -- tied a previous high).

We made the point earlier that our data are based on those clients whose advertising we've tested over the years, along with the competitive ads they've chosen to include. So it's proper to reiterate the fact that while our data are broadly based, they are certainly not all encompassing.

But having said that, the fact remains that results on this critical Prescribing Interest measure, whether the overall Norm for Prescription Drug Advertising or the New Rx Drug Launch Advertising Norm, have recently been the best they've ever been. It's fair, therefore, to state that a great deal of learning has taken place.

Finally, let's put the numbers aside for a moment and remind ourselves of the trends we've witnessed (see Table Six).

TABLE SIX -- Palshaw Ad Test Norms for Prescription Drugs...1968 through 2006

(NOTE: The initial norm was based on the first 15 ads tested; subsequent results are typically based on slices of 135-150 ads each)

TABLE SIX COMMENTARY: This chart, which reveals the score values in each slice of data extracted from the overall Prescription Drug Advertising Norm, perhaps best illustrates what we've been able to document regarding the per unit growth in the efficiency of medical journal advertising. When we started testing it, it wasn't very good. 38 years later, it has become very good indeed.

There can't be much of a question about it. Medical journal advertising has been getting better and better...more imaginative, more innovative, more creative and more on target in its content.

So why is the use of the medium not growing?