Sanofi-Aventis

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Sanofi-Aventis

174, ave. de France
Paris, F-75013
France
Telephone: 33 1 53774000
Fax: 33 1 53774296
Web site: www.sanofi-aventis.com

SPIRIT OF FREEDOM CAMPAIGN

OVERVIEW

NOTE: Since the initial appearance of this essay in the 1998 edition of Major Marketing Campaigns Annual, Hoechst Marion Roussel became a part of Sanofi-Aventis. The essay continues to refer to the company's former name, as that was the official name of the organization when the campaign was launched.

On August 8, 1997, the United States Food and Drug Administration (FDA) announced new guidelines regulating direct-to-consumer (DTC) advertising of prescription drugs. The following Monday Hoechst Marion Roussel of Kansas City, Missouri, aired a revised version of its "Wheat-surfer" commercial for Allegra, its non-sedating prescription antihistamine. The previous version of the spot mentioned the brand name but not the condition it treated, in compliance with the old FDA rules that prohibited the mention of both the brand and the condition. The new commercial, which was the first television spot to take advantage of the updated rules, complied with the new standards by stating the brand, purpose, and benefits of the drug, while also mentioning possible risks or side effects and indicating a toll-free telephone number and a website for further information about the product.

The commercial itself fused high technology with symbolic imagery suggesting the freedom Allegra offered its users from their allergies. In the commercial a wind-surfer sailed across a sea of wheat, suggesting both the ability to coexist with allergens and the liberty to remain active and have fun during the allergy season. Hoechst's advertising agency, the Medicus Consumer division of DMB&B New York, enlisted the services of Industrial Light & Magic Commercial Productions, the outfit that revolutionized special effects with the Star Wars movies, to create the illusion of windsurfing on dry land. Industrial Light & Magic subsequently produced follow-up commercials depicting a snorkler swimming through a flower field and a skier traversing a meadow. Competitor Claritin used similar imagery—a brightly-colored hot-air balloon that rose high above allergy-producing plants.

Traditionally pharmaceutical companies had targeted physicians with their prescription-drug advertising, since doctors by law controlled the consumption of these medicines. Patients, however, were the final consumers of the products, so in the mid-1980s companies began to target consumers directly, first with print ads and then with television commercials. The FDA's loosening of restrictions was intended to lessen the confusion created by the previous policies, though some critics questioned the wisdom of over-commercializing medicines since the consumer had no direct control over the accessibility of these drugs; doctors remained the gatekeepers.

HISTORICAL CONTEXT

In 1985 Hoechst Marion Roussel introduced Seldane, the first nonsedating antihistamine. Seldane dominated the prescription market almost immediately, forcing antihistamines containing sedatives such as Schering-Plough's CTM and Parke-Davis' Benadryl to be sold over the counter. The prescription antihistamine market expanded markedly as consumers responded to this new remedy that produced significantly less drowsiness. Other pharmaceutical companies developed nonsedating anti-histamines to take advantage of this new market, but none could challenge Seldane's market control. Johnson & Johnson's Hismanal came closest, with sales of more than $200 million in 1992; that same year Seldane's still dominated the market, with sales of more than $500 million.

Also in 1992 researchers discovered that Seldane could be hazardous in certain circumstances. If patients also suffered from liver disease, or if they were also taking a common antibiotic (erythromycin) or antifungal drug (ketaconozole), Seldane could build up in their bodies, possibly causing heart problems such as cardiotoxicity and arrhythmia that could threaten their lives. Although these circumstances were rare, the "black box" warning on the label required by the FDA branded Seldane as dangerous, eroding its control of the market. The subsequent year, Schering-Plough rebounded from its departure from the prescription antihistamine market by introducing Claritin. Claritin was marketed on the strength of its easy, once-a-day dosage and on the weakness of Seldane's perceived dangers. With the addition of Zyrtec from Pfizer, Seldane's control of the prescription antihistamine market dwindled, while Claritin's control increased until it gained dominance of the prescription antihistamine market in 1995.

In August 1996 Hoechst introduced Allegra, a prescription antihistamine that was a metabolite-meaning that it entered the bloodstream pharmacologically active instead of having to be metabolized to be activated. Allegra thus avoided the hazardous problems associated with its parent drug, Seldane. Furthermore, FDA regulations prevented television advertising of Seldane because of its "black box" status, so the advent of Allegra allowed Hoechst to recommence its television advertising. Although it was tempting to market Allegra on the equity created by Seldane, Hoechst realized that the negative publicity surrounding Seldane's hazards damaged the integrity of this equity, so Hoechst set out to create Allegra's own brand identity among the four other non-or low-sedating antihistamines on the prescription market.

TARGET MARKET

The marketing of Allegra represented a challenge to Medicus, as the advertising had to reach two distinct camps: physicians and consumers. Since physicians alone could prescribe medications, they needed to be informed of what Medicus' executive vice president and management director Lorraine Pastore called Allegra's "constellation of benefits": speed of action, power, efficacy, convenience of dosage, and all-around safety. "The diversity of preferences [that doctors mentioned in Medicus' research] led us to a collage presentation," Pastore said. Resembling a Monty Python cartoon, the collage featured 19th medical engravings as part of a six-page print ad that ran in prominent medical journals such as the Journal of the American Medical Association, Diversion, Medical Economics, Postgraduate Medicine, New England Journal of Medicine, American Family Physician, Cortland Forum, and Family Practice News, as well as publications geared toward allergy specialists and internists.

ALLEGRA FREEDOM FORECAST

In order to offer consumers (especially those not currently prescribed Allegra) more information about allergic reactions, Hoechst Marion Roussel set up the Allegra Freedom Forecast via a toll-free number and the Allegra website. The forecasts—devised by the aeroallergen research firm Multidata, Inc., of St. Paul, Minnesota—automatically fed variables such as past pollen records, variations of temperature, humidity, and rainfall, and percent of sunshine into a mathematical formula that predicted allergen counts with 85 percent accuracy in 50 U.S. cities on a daily basis.

Simultaneously (and equally important), Medicus initiated a consumer print campaign in August 1996, featuring stills of the wheat-surfer in such mainstream publications as USA Today, the New York Times, the Washington Post, and weekly and monthly magazines. A television commercial featuring action shots of the wheat-surfer appeared two months later, in October 1996. Television's far-reaching influence was a key to marketing Allegra, with the potential to directly access those who suffered from allergy symptoms, the majority of whom did not seek prescription relief. A 1997 study by the American Pharmaceutical Association and Prevention magazine revealed that almost two-thirds of all consumers had seen DTC advertising, and 60 percent of those saw commercials on television. This exposure prompted almost a third of those who had seen DTC ads to ask their doctors about the advertised prescription products, and 29 percent of that third asked their doctors to write a prescription for the product. Doctors heeded these requests three-quarters of the time. So DTC advertising created a funneling effect whereby vast media exposure prompted a moderate number of inquiries, some of which translated into prescriptions and purchases.

Allegra's marketing targeted not only those who suffered from allergies regularly but also those who experienced allergic reactions sporadically. The revised "Wheat-surfer" spot specifically mentioned seasonal allergic rhinitis (SAR), an allergic reaction triggered by unseasonal changes in the weather or travel to new places that caused chronic flu-like symptoms. Since SAR could strike even those unaccustomed to allergies, and since its symptoms resembled those of a cold or flu, informing consumers of SAR was a means of establishing new markets.

COMPETITION

Schering-Plough's Claritin led the prescription antihistamine market in both revenues and market share. Claritin's North American sales amounted to $1.7 billion dollars in 1997, as compared to second-place Zyrtec's $265 million and third-place Allegra's $214 million. In the United States 67 percent of all antihistamine prescriptions written were for Claritin; Allegra was the second most-prescribed antihistamine, at 16 percent, followed by Zyrtec at 14 percent. Although Allegra was prescribed more often than Zyrtec, Allegra was the lowest-priced prescription antihistamine on the market, thus earning less in revenues. But Hoechst priced Allegra lower to attract customers from Claritin, which cost approximately 18 percent more. Each company spent roughly the same amount in 1997 advertising for these products, according to Competitive Media Reporting: Schering-Plough spent $68.4 million on Claritin, Hoechst spent $64.2 million on Allegra, and Pfizer spent $53.5 million on Zyrtec. Comparing these expenditures to revenues, Claritin was clearly the profit leader.

Claritin's commercials used imagery similar to Allegra's. Claritin's "Blue-Skies Balloon" spot featured a bright-colored, logo-branded hot-air balloon flying above the earth and then depositing its riders on the ground, unaffected by floating allergens. But the spot did not fully comply with the new FDA regulations; the benefits of the antihistamine pill overshadowed the risks and safety information, which were presented faster and in colors that did not distinguish the print from the background. The commercial had been in production when the FDA changed its rules, forcing Power Post Production to revise the spot quickly. An updated version that complied with new FDA regulations broke a few weeks later, in late August 1997.

Claritin ran into trouble earlier when it tried to capitalize on Seldane's hazards. On January 13, 1997, the FDA announced that it was considering banning Seldane because its benefits "no longer outweigh[ed] the risks of potentially fatal cardiac side effects"; Claritin immediately mounted a print campaign that quoted this FDA statement, then added, "Claritin. A safe choice." Hoechst filed a false-advertising lawsuit against Schering-Plough on the grounds that the FDA's announcement was based upon the availability of Allegra as an alternative to Seldane, a fact that the Claritin ad overlooked. The U.S. District Court in Kansas City, Missouri, granted a temporary restraining order blocking the Claritin ad. This had little effect, however, as the ad had already run its course. Hoechst and Schering settled the suit out of court in mid-February 1997, though the terms were not made public.

MARKETING STRATEGY

The strategies Hoechst developed for marketing Seldane's principal active metabolite, fexofenadine HCL, spread wide, extending as far as the choice of name: Allegra. Ads headlined, "Ahhh! Allegra!," followed by a lead-in line reading, "This allergy season, go far ahhhfield." The alliterative invocation of the "a" sound not only echoed the brand name but also reminded the consumer of respiratory relief. The first four letters of the name mirrored the condition it corrected, allergies, but the middle passage of the name also sounded like another important allergy-related term, alleviate. In its logo the swirling "e" was meant to suggest the spirit of freedom.

The "Spirit of Freedom" motto underpinned the entire Allegra campaign. Allegra offered physicians "prescribing freedom" with Allegra's "constellation of benefits"—the fact that Allegra responded to so many different symptoms freed doctors to prescribe Allegra with confidence that it would address their patients' needs and be safe for use. Researchers did testing of the collage ad on the toughest professional audience, New York City doctors, renowned as ad skeptics who did not typify national attitudes. The underlying humor of the collage ads struck a chord with the cynical crowd, and—much to the surprise of the marketing team—the test results from New York City matched the positive feedback from doctors around the country. Defending the seeming irreverence of the Monty Python approach, Hoechst's product manager Jan Creidenberg commented, "It's provocative. We want it that way so that you can't turn the page without looking at it. It will stop M.D.s. Research shows that."

Creidenberg applied a similar spin to the consumer audience for Allegra: "We've done a lot of in-depth research with the consumer on this. We think we've captured allergy sufferers' deepest needs—wanting to be free of the limitations of allergies. We think we've expressed the consumers' spirit of yearning for the freedom to enjoy life to the fullest." The actions of the windsurfer were intended to emphasize this spirit—not only did the windsurfer sail across the wheat, she also did flips and twists, accentuating her freedom. Medicus creative director Jerry Weinstein explained, "We wanted the right body language in the surfer. It's freedom with ability and confidence." Weinstein further explained that the marketing of Allegra attempted to move beyond surface reasons for using this antihistamine and delve into the internal motivations for taking allergy medications—a longing for freedom from the effects of allergies.

This approach was "unexpected," according to Weinstein. Traditionally, noted Medicus creative director Richard Norman, antihistamine advertising relied on "conventional allergy icons—smiling patients, pills, flowers, fields, allergens, clear skies for clear breathing, sunrises for day-long effects." He continued, "We decided we could work against this background to create a strong Allegra brand identity. Allegra is a brand with a mind of its own." Hoechst and Medicus could have marketed Allegra using the usual imagery for antihistamines, or as Seldane's offspring, but neither method would have garnered as much attention as the bold move they made in striking out into unchartered territory to redefine the way antihistamines were advertised and marketed.

OUTCOME

Allegra outpaced most drugs in terms of its research, development, and submission for FDA approval, completing these steps in 2.8 years as compared with the average 14 years it took most drugs to reach the market. But Hoechst needed a product to replace Seldane quickly. When Allegra entered the market alongside Seldane, approximately half of Seldane's consumers switched to Allegra, maintaining company loyalty; at the same time, approximately a third of consumers new to the prescription antihistamine market chose Allegra, according to Hoechst public relations spokesperson Julie Gladman. On December 24, 1997, the FDA approved Allegra-D, which reached pharmacies in January 1998. On February 1, 1998, Hoechst removed Seldane and Seldane-D from the market altogether. The speed with which the two Allegra products replaced the two Seldane products minimized any damage done to public perception by the hazards associated with Seldane and maximized the transfer of market shares from Seldane to Allegra as much as possible.

The efficiency and efficacy of Hoechst's introduction of Allegra was too successful in one sense: since the "Wheat-surfer" spot was the first to take advantage of the relaxed FDA regulations, and since its technological wizardry made it so memorable, it became a lightning rod for criticism of the commercialization of prescription drugs. Two newspaper reporters, Daniel J. Vargas of the San Antonio Express-News and Erik Parens of the Cincinnati Enquirer, wrote articles criticizing FDA regulations of DTC advertising using examples from the "Wheat-surfer" spot. Neither article focused exclusively on prescription antihistamines, so Allegra bore the brunt of criticism for the entire prescription drug market.

Parens' editorial encapsulated others' arguments against DTC advertising, stating that "when advertisers aim their products at patients rather than physicians, they are changing the dynamic of the way drugs are prescribed. They are suggesting that consumers diagnose themselves—and present that diagnosis to their doctor." Diane Seo of the Los Angeles Times quoted doctors' pronouncements that "medicine should not be a commodity" and that the "role of the physician is being displaced by the push of consumerism." There was concern that some patients would fixate on the brand name advertised and remain deaf to doctors' advice that cheaper alternatives existed.

But doctors admitted that DTC advertising sometimes benefited patients, educating them about certain medical conditions and the drugs available to treat them. Hoechst's Julie Gladman pointed out that consumers "still can't get the product on their own," since doctors alone could write prescriptions. The makers of Allegra, according to Gladman, wanted "to increase the dialogue between consumer and doctor." Unlike most advertising, prescription drug advertising had a filter built in between the consumer and the product in the person of the doctor, thus necessitating greater saturation of the market with the brand's message, and even this did not guarantee a return on advertising expenditures.

The most noticeable outcome of the FDA's relaxation of DTC advertising regulations was the predictable increase in advertising spending: the American Association of Advertising Agencies reported a leap in DTC ad spending from $250 million in 1995 to $1 billion in 1997 (Allegra's ad expenditures jumped from $19.9 million in 1996, when it was introduced to the market, to $64.2 million in 1997). In the battle for shares of this $2-billion-a-year market, which promised to grow since the majority of those who suffered from allergic reactions did not seek prescription relief, Allegra continued to spin out new versions of its "Spirit of Freedom" message.