From: Subject: Rezulin introduction Date: Tue, 22 Feb 2005 10:37:13 -0000 MIME-Version: 1.0 Content-Type: text/html; charset="Windows-1252" Content-Transfer-Encoding: quoted-printable Content-Location: http://www.cpsnet.com/reprints/1997/07/rezulin.htm X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2800.1441 Rezulin introduction

Launch Pad
New advertising=20 Campaigns

Rezulin introduction puts scientific rationale = center stage=20

by William G. Castagnoli

Executive summary:

Facing the creative challenge of introducing new scientific = information=20 while gaining and maintaining interest, the introduction of the diabetic = drug=20 Rezulin used concept and ad testing to find the right balance for = success.=20 Emotion didn't work. Scientific exposition didn't work. A = straightforward=20 demonstration of the drug's action aimed at the physician's frustration = in=20 dealing with the illness was the answer.

When the success of an introductory campaign depends on physicians=20 understanding new, scientific information to appreciate the product's = value, the=20 launch program takes on two tasks. The first is the ever-present = imperative to=20 gain attention; the second is the delivery of that new information in a = readily=20 absorbed, memorable manner.

This was the creative problem faced by Parke-Davis and the Rezulin=20 (troglitazone) team at its agency, Lally McFarland & Pantello. = Rezulin is=20 the first in a class of Type II diabetes drugs and the only oral agent = that=20 works within the cell's nucleus on the DNA to overcome the cell's = resistance to=20 insulin. (Type II diabetics produce insulin, but their cells poorly = respond to=20 the hormone, preventing proper metabolism of glucose.) The challenge = with=20 Rezulin was to strike an effective middle ground - enough flash to gain = interest=20 linked to a clear exposition on Rezulin's unique cellular action and = clinical=20 benefits. With launches for products like Rezulin, the right balance is = not=20 easily achieved. Campaigns can err by stressing arresting copy and = graphics for=20 the sake of visibility and lose out on scientific communications, and, = likewise,=20 undramatic science can be ignored by journal readers.

The only way to engineer the proper mix, given enough lead time, is = through=20 concept and ad testing. Judgmental calls have their place; in fact, = creative=20 experience/judgement is the place to begin in defining the necessary = balance.=20 But when a mega-launch or a potentially mega-drug is on the drawing = boards, both=20 agency and client must rely on a testing process to arrive at the = optimal launch=20 message. Parke-Davis and LMP proceeded accordingly and what was learned = about=20 physicians' attitudes toward diabetes, Rx advertising, and Rezulin's = science=20 shaped the product's launch.

Patients - a turn-off
A pool of concepts and ads = was=20 tested with general practitioners - the major script-generating audience = in=20 diabetes. As was to be expected, one approach emphasized the human side = of=20 diabetes. Accompanying an appealing photograph of a female patient was = the=20 provocative headline, "Her cells are working against her." The concept = was=20 strong on emotional impact and the headline led to an explanation of = Rezulin's=20 cell-site action.

The approach met with a lukewarm response. Physicians did not see the = product=20 as answering a need since they believed they already had the tools and = knew how=20 to deal with the problem of the Type II diabetic. Moreover, the = emotional=20 opening apparently slowed down the idea flow toward Rezulin's mechanism = of=20 action - the product's unique new science.

Secondly, in a finding which has significance for all = patient-oriented=20 pharmaceutical advertising, the up-front patient graphic gave the ad a=20 generic-disease quality. M.D.s remarked that the ad looked like = hypertension or=20 arthritis advertising, or other people-focused messages. "The problem we = ran=20 into," says Howard Weisman, senior director, diabetes management, at=20 Parke-Davis, "was that the typical Type II diabetic patient looks a lot = like=20 every other middle-aged patient the doctor sees - maybe a little = graying,=20 probably overweight." In short, the approach lacked diabetes identity. =

(This "same signal" problem goes beyond patient-oriented Rx = promotion. Don't=20 we all have trouble with the happy-people /quality-of-living-style of TV = commercials which makes messages for beer, fast food, life insurance, = credit=20 cards, snacks, and sportswear, etc. all look alike?)

Another approach in the testing pool emphasized the new science = behind=20 Rezulin. The exposition on the DNA action employed receptor site = graphics in a=20 high-tech manner. This approach proved a negative for the general = practice=20 physicians who, based on the look of the ad, interpreted the message as = intended=20 for the specialist.

The pool also contained experiments with graphic devices and creative = analogies explaining Rezulin's action and therapeutic benefits. Some = simply=20 didn't work, but even for those that scored well, a reading of the = research=20 indicated that the M.D.s found them delaying elements from what they = were most=20 interested in - namely Rezulin's scientific story.

"We came to the conclusion," says Brendan Ward, LM&P's chief = creative=20 officer, "that the Rezulin launch should be dedicated to a = straightforward=20 exposition of Rezulin's science. We needed an attention-getter - a = metaphor -=20 but it had to be understood quickly and lead immediately to the news = about the=20 product." The testing process had led to an understanding of the proper = balance=20 between creative flight and scientific explanation for Rezulin. = Additional=20 creative work then fleshed out the campaign based on the emphasis ratio=20 established by the research.

Research had revealed something else as well. Says Judith Beggs, = R.N., vice=20 president, account supervisor at LM&P, "We found that M.D.s believed = a=20 fundamental defect in Type II diabetes is insulin resistance. To treat = the=20 condition, they increase insulin or approach through other mechanisms. = With=20 Rezulin, they can go right to a root cause."

The launch ad capitalized on physician understanding = of insulin=20 resistance in Type II diabetics. Page = one of the=20 eight-page introductory ad presents the signature graphic of the = campaign - a=20 transparent sphere (representing a cell) containing two smaller spheres = -=20 secured prominently by a lock. The headline, "Locked out of control," = with the=20 subhead, "Cellular insulin resistance is a barrier to glycemic control," = played=20 to M.D. appreciation of insulin resistance. Surrounding the sphere-like = cell are=20 floating molecules of glucose.

Addressing M.D. frustration
On = page = two, the=20 outer sphere has been opened and the glucose molecules are free to move = into the=20 inner workings of the cell. Headline: "Unlock insulin resistance." = Subhead: "A=20 key to glycemic control." Says Parke-Davis' Weisman, "We wanted to = appeal to=20 what physicians felt about diabetes. From the research, we found a level = of=20 frustration in treating the disease. At a point they became blocked in = what they=20 can do and I think the lock symbol says this very well in representing = their=20 feelings. Then, Rezulin is the barrier-breaking agent to help them." =

After this direct, "straightforward" demonstration of Rezulin action = on=20 insulin resistance, page three weighs in with the information M.D.s need = to know=20 on how the resistance barrier has been breeched The Rezulin logo appears = top and=20 bottom and center page. A high science illustration deals with the = receptor site=20 blockage of insulin in the cell membrane and Rezulin's action on the = cell's DNA=20 in the nucleus, allowing insulin transport of glucose into the cell. The = theme=20 of insulin resistance is registered in three subheads - under the logo = top of=20 page: "The first agent that directly reduces insulin resistance through = a unique=20 nuclear mechanism;" mid-page over the illustration: "Works at the = cellular level=20 to treat mechanisms of insulin resistance;" and as tagline at bottom of = page:=20 "Unlocks insulin resistance."

Pages four and five present clinical research on Rezulin. In = describing the=20 research, Marlene Molinoff, group copy supervisor at LM&P, explains, = "The=20 study population consisted of obese Type II diabetes patients who had = been=20 diagnosed for 10 to 11 years and who were inadequately controlled, = despite=20 average daily doses of 70 to 75 units of insulin =85 The results shown = on the=20 left-hand page demonstrate consistent glycemic control over a period of = six=20 months and the results shown on the right-hand page focus on the fact = that=20 Rezulin allows many patients to reduce or eliminate insulin doses while=20 maintaining or improving glycemic control. These are dramatic results=20 considering the patient population tested."

Data is presented in three sizeable bar charts and one pictographic = diagram;=20 findings in summary headlines and chart captions. Pages six and seven = cover side=20 effects ("comparable to placebo") and dosage ("Once daily dosing may = enhance=20 compliance"). At the bottom of page seven are four photos of patients -=20 full-faced, middle-aged to elderly men and women - typical of the kind = of Type=20 II diabetics M.D.s would be treating. Page eight gives a brief summary = with an=20 insert of the graphic from page two.

The introductory unit attracts and intrigues with the graphics of the = locked=20 and then unlocked sphere. This creative device, however, has sufficient=20 scientific overtones to draw the reader into Rezulin's technical message = - the=20 information the advertisement needs to deliver for the brand to be seen = as a=20 therapeutic advance. Copy, beyond comparing insulin resistance to a = "lock"=20 barrier to glucose, is clinical in vocabulary with no writing flourishes = or=20 advertising jargon which could compromise the desired scientific tone. =

A pig and a tortured tree=20
To prepare the way for Rezulin, Parke-Davis and LM&P = conducted=20 a pre-launch campaign to establish a mind-set receptive to the product. = Goals=20 were to dramatize the need for new products and new thinking in diabetes = and=20 diseases associated with it. The first ad which appeared in September, = 1996,=20 carried the headline, "How come the biggest breakthrough in diabetes = happened 75=20 years ago?" with an illustration of a mammoth test tube containing a melancholy = pig -=20 an illusion to a animal source of insulin. Extended text recounted the = history=20 of diabetes - Banting and Best were the discoverers of Type II disease - = and=20 concluded, "A significant gap seems to exist between what we know about = diabetes=20 and how we treat it."

The = second=20 ad, appearing in November, 1996, queried, "Insulin resistance: at = the root=20 of an array of pathologies?" and took up its insidious effects ending = with the=20 question, "Is it possible to specifically treat or even prevent the = insulin=20 resistance associated with Type II diabetes?" This was the question = Rezulin was=20 prepared to answer with its April, 1997, introductory campaign. Art for = this=20 advertisement was designed to gain attention for the message with an=20 expressionistically rendered, leafless tree contorted into a suffering = human=20 shape - limbs and branches as twisted arms and hands and a trunk with = branch=20 sockets and a hollow resembling a howling face. Below ground level, a = root=20 system is visible linking to the headline.

The pre-launch ads - art illustrations, blue/green color scheme - did = not=20 foreshadow the Rezulin launch. Usually, pre-launch campaigns have a = design=20 linkage to the eventual product introduction. Why none here? Brendan = Ward=20 explained, "We wanted thoughtful, serious readership to get the ideas = across and=20 we wanted to avoid a later backlash - a resentment of commercialism - = when we=20 got to our science presentation in the launch. We were trying for an=20 independent, editorial look. Something like an article in The = Atlantic=20 or Harpers."

The campaign is running in a number of journals covering the primary = care=20 audience, including AMA News, JAMA, New England Journal of = Medicine,=20 and American Family Physician; in pharmacy journals - = American=20 Druggist, U.S. Pharmacist, and Drug Topics. Other journal=20 advertising is directed toward endocrinologists, diabetologists, = residents,=20 physician assistants, and nurse practitioners. Overall, 34 journals are = carrying=20 the program.

At Parke-Davis, the Rezulin launch has been directed by Howard = Weisman,=20 senior director, diabetes marketing, and Brion Brandes and Cathleen = Croker,=20 product managers. The Rezulin team at Lally McFarland & Pantello = consists of=20 Brendan Ward, chief creative officer; Marlene S. Molinoff, group = creative=20 director; Judith Beggs, R.N., account group supervisor; Audrey Naverson, = group=20 art director; Mariette Gelfand, senior art director; Tina Duque, copy=20 supervisor; Jessica Agone, account supervisor; Heather Breslow, = assistant=20 account executive; Lisa Ingersoll, media; and Brenda Sheppard, account=20 coordinator.

Parke-Davis reports Rezulin sales are "on target," and feedback from = the=20 field indicates the representatives are getting the time to present = Rezulin's=20 scientific rationale in depth.

William G. Castagnoli is a Medical Marketing & = Media=20 contributing editor.

=A91997 CPS Communications, Inc. All = rights reserved.=20 Site comments? webmaster@cpsnet.com

Return to=20 top