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It happened to Prozac. It happened to Claritin. And now it's happening to the "little blue pill" that has worked wonders for the sex lives of millions of Americans. After five years with 96% of the U.S. erectile dysfunction (ED) market to itself, Pfizer's Viagra isn't the only game in town for ED sufferers any more.

In August 2003, GlaxoSmithKline and Bayer's Levitra launched an aggressive campaign. In short spots, the company touts "a new choice," and suggests men "get back in the game" and talk to their doctor. In a longer commercial, a 50-ish man is playing around in the yard, trying to throw a football through a tire swing. His initial throws fail to go through the tire's hole and the ball bounces off the side. But after a voiceover mentions Levitra, the ball goes through repeatedly. Soon the man's younger—we guessed 28-year-old wife—joins him in the yard and they playfully hug.

Levitra is focusing on the estimated 80-90% of sufferers not currently receiving treatment. In addition to DTC ads, GlaxoSmithKline and Bayer also simultaneously launched "Tackling Men's Health," a national education program designed to decrease embarrassment about talking with a doctor about ED treatment options. Tying into their three-year, $18 million sponsorship with the NFL, the makers of Levitra recruited former NFL player and tough-as-nails coach Mike Ditka as spokesman for a promotional tour to NFL markets. Reminiscent of Viagra's initial marketing efforts with Bob Dole, Ditka announces, "I'm not embarrassed by coming out and saying I have ED. If you have a problem, you seek a solution." Other "Tackling Men's Health" campaign components include pseudo-public service announcements, a booklet, and a website round out the effort.

According to published reports, Bayer and GlaxoSmithKline have, as of this writing, invested between $50-$75 million on DTC advertising for Levitra and are clearly succeeding in expanding the category as new prescriptions for Levitra have come less at the expense of Viagra and more from bringing new customers into the market.

More recently, Cialis, nicknamed the "le weekender" because of its promised 36-hours of effectiveness, jumped into the fray with a promised $100 million ad blitz. Rather than play-up restored masculine virility, Cialis plans a different tack. Capitalizing on the greater "window of opportunity" offered by the drug, advertisements encourage sufferers to, "choose the moment," and have a more romantic flavor, according to Eli Lilly & Co. and Icos, the joint-venture makers of Cialis. "When a tender moment turns into the right moment, you'll be ready," promises the Cialis tagline. In addition to the ad campaign, marketing of the third ED-entrant also includes a sponsorship deal with the PGA Tour.

For its part, again as of this writing, Pfizer plans to continue running its "see the doctor" Viagra campaign, commercials with men in different social and professional situations eliciting questions from friends and colleagues who wonder what's different about the guy. As it turns out, each of the men (to the visible relief of their female partners) talked to their doctor and a voice-over mentions Viagra. Pfizer also intends to continue Viagra's relationship with NASCAR driver Mark Martin and Major League Baseball player Rafael Palmeiro. Though Pfizer reportedly does not plan any major shifts in strategy or tactics, which we think is a mistake, the company is prepared to spend more to hold the top spot for Viagra, one of the most widely known consumer brands in the world generating $1.74 billion in sales in 2002.

But that pledge to maintain strategy and spend more begs the questions, how much more does Pfizer need to spend to keep Viagra on top? Moreover, how should the company spend it—on more advertising, new sports sponsorships, web/direct marketing, etc.—to reach consumers and counteract competitive moves by Bayer and GlaxoSmithKline and Lilly and Icos? Is there a best defensive strategy for Viagra—and other pharmaceutical drugs in a similar position—to employ to save and even recapture market share?

The best way we know to answer these questions is to use DRM—Defensive Response Modeling Technology.

How Does DRM Work

DRM is a spin-off of DTC simulated test marketing and represents a complex set of very sophisticated equations that predict real world output (including new and repeat prescriptions) from marketing plan inputs (such as primetime network television target rating points per month) following the introduction of one or more new entries in a market.

A DRM consumer model includes inputs—the campaign media, share of voice; product concept; price, availability (distribution)—and are common to other marketing mix models. Similarly, the outputs are familiar to pharmaceutical marketing executives—brand or campaign awareness, physician contact, physician compliance, pharmacy visit, etc.

What is not so common in a model specifically for the pharmaceutical industry are the inputs of "sufferer need," "category involvement," and "physician innovativeness." These affect brand awareness, physician contact, pharmacy visits, and prescription refills. Data gathered during 20- to 25-minute internet interviews, the length determined by the optional questioning areas with 200 to 400 sufferers and 150-300 physicians who geographically represent the product category, drives the model.

The advantage of DRM is that it permits marketers to experiment with inputs to instantly see their effect on the output. What targeting and positioning strategy, for example, will best counter competitive in-roads? Will more television advertising have a profitable impact on sales? More than direct marketing? Which day-part will have the most effect? How much more? At what cost? It also enables marketers to quantify the specific effects of each element at different levels of investment. What are forecasted sales if we increased each component in the marketing mix by 20%? By 100%? What happens if we decrease it by 10%?

Importantly for a pharmaceutical marketer in Viagra's position, DRM can account for competitive efforts by including factors such as share of voice. Advertisers define share of voice as the advertising percentage individual companies spend in the market. As an example, if all the companies in a product category spend a combined $100 million in advertising in a year, and one of those companies spends $15 million, it has a 15% share of voice. The share of voice tempers the effects of gross rating points (GRPs). The GRPs purchased by a firm with a low share of voice, for instance, would not produce the same level of awareness as the same number of GRPs purchased by a company with a high share of voice.

It's important to remember that the goal of DRM is not to obtain a simple volume forecast. The objective is to provide diagnostic insights that will improve marketing performance in the face of new and increasing competition. Good DRM will tell you not only how you're doing, but what to do differently. Such a system goes beyond forecasting volume potential to providing insights into improving the targeting strategy, positioning message, advertising executions, website, public relations efforts and the media weight and schedule.

DRM in Practice

Now you might be thinking, "This sounds great in theory, but can you give us some examples of companies that have used DRM to address encroaching competitors?" Yes we can.

We worked with the market leader (who will remain nameless for to protect client privacy) in a well-established, very active DTC category. Our client had some indications based on information published by the FDA that the #3 player in the category was planning a new DTC campaign to promote a innovative once-a-day dosage. The market leader was in the midst of planning for the following year and wondered, given an impending competitive campaign, if it should even bother running a DTC ad campaign—would it impact incremental prescriptions at all? If it did continue a DTC campaign, would a branded campaign, where the product message is tied to a specific brand name, or an unbranded one, which tend to discuss a disease or condition and mention that a treatment is available, perform better?

Enter DRM. Using dummied-up ads for the #3 player with the anticipated message and executions for a branded campaign and an unbranded one for the client brand, we used DRM to determine campaign effectiveness, as well as offer other diagnostics such as how the branded and unbranded campaigns performed among different audiences—diagnosed sufferers currently treating the condition, diagnosed sufferers not treating the condition, and undiagnosed sufferers—in a competitive context. Based on feedback from the DRM, the company made the decision to continue DTC advertising, selected the branded campaign, and successfully preserved market share.

In another industry and in an entirely different situation, an international brand came to us concerned that a planned change to a primary ingredient to its food product would generate consumer protest. We used DRM to test three different negative consumer responses to the proposed change and three potential responses the company could use to determine the most effective counter-strategy. Again, based on feedback from the DRM, the brand was able to preserve market share AND protect brand equity by squashing any controversy before it snowballed.

What DRM Can Do for Viagra

So back to Viagra. Using DRM technology, Pfizer could not only forecast what share of the market Viagra is likely to lose to Levitra and to Cialis, but also develop the most effective and efficient defensive marketing plan to save or recapture share based on actual or anticipated spending levels. Obviously, Levitra and Cialis could use simulated test marketing to develop the best offensive strategy as well. If everyone was using these evolving, we would see some of the highest performing marketing plans in the pharmaceutical business—in the world, for that matter—today.

Copernicus works with pharmaceutical companies in a variety of treatment categories. Click here for our recent discoveries about direct-to-consumer campaigns. You can read more about the approaches, thinking, and tools we recommend to pharmaceutical marketers in The Five Habits of Highly Effective Pharmaceutical Marketers.

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