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In the days of old

Put prescribing information on a medical advert? Certainly not old chap, it's just not cricket, as James Leeming discovered when he travelled back in time...

Times were, a hundred years ago, that when you fell ill - and you would - the road to recovery comprised a hasty snout through the newspaper, spy an advert from a company that sold healing powder, and then a brisk perambulation down to the local druggist to buy `some medicine'. The NHS was still 50 years away, but no matter because, a thruppence lighter in your trouser pocket, the purchased `treatment' would be administered and you could relax and either recover and continue working, or spend an unpleasant few days having a horrible and pain-filled death, which more than likely involved boils.

Yet somehow, life was simpler. Got a headache? See an advert in a magazine for some universal `head ointment', rub the cream in just above the nose area and your aunt's brother is called Robert. Whether it worked was probably down to your state of mind.

In this section is a selection of typical advertising for pharmaceutical products that span the 20th Century. Notable by their particular blend of vagueness in the benefit/risk story, and a distinct lack of regulation in the copywriting department, it is, however, plain to see that many of the key qualities of the work are still reflected in some of today's top-drawer promotional material.

Put succinctly, the brand name dominates, there is an easily recalled and straightforward slogan, a quick mention of the company that makes the product, and the whole thing is based on a meaningful format - in shape and style, and by using an appropriate picture of something or someone.

It's easy to snigger at the straightforwardness of some of the early attempts to persuade people to part with their hard-earned groats in the name of better health, yet it can be argued that many of these experimental efforts don't so much sully the bloodline of modern marketing as set a relevant precedent.

Watson's Nubolic Soap (1904)If only today's marketers were permitted to inculcate such fantastical claims through their campaigns, similar to Watson's Nubolic Soap (1904), which can 'banish all disease', or Dr Robert's Ointment (1905) which, when mixed with Dr Robert's Alterative Pills, will 'cure the most obstinate of wounds, skin diseases and scorbutic eruptions'.

The ointment was a particular wonder, as not only would it treat 'ulcers, eczema and cracked hands', but indeed also 'inflamed eyes, burns, cuts, scalds, pimples' plus, of course, any manner of tricky 'carbuncles'.

A small pot was bought for 1/1 (one Shilling, one and a half pence). The key point to note about these old adverts is that they played directly to people's fears, wants, needs and hopes. Whether intended to enlighten physicians or patients themselves, the ads were designed to reach places in the mind that led to useful emotion-driven action, and hence, sales.

This most basic of concepts is what today's advertisers will claim remains their uncomplicated goal. But has something been forgotten? Look at a typical piece of modern medical advertising, maybe on the television for over-the-counter drugs or nestled centre-spread in a physician- read journal for ethical products, and what do you see? A well- researched, well-executed piece of creative work that skilfully delivers the brand name and benefits directly to your eyes.

Now imagine that you are a GP. How does this advert make you feel? Does it evoke personal sentiment? Is it dextrous enough to squeeze through the cat-flap into your personal mind-lounge, where your picky and distracted brain sits awaiting stimulation and entertainment?

Let's say it does break into your cerebral kitchen and starts cooking up something that smells appetising. Will you do anything about it, or simply appreciate it as another product plug, which appears exactly as you were expecting it to, and return, unmoved, about your business?

Doctors are bored. I don't think advertising works any more for doctors because they're bored by it and they know what's coming, says Tracey Brader, healthcare consultant at the Institute of Practitioners in Advertising (IPA).

There must be something in it for the reader that makes them feel like they want to be part of the club that buys that brand, and somewhere along the way we've forgotten that you need to engage people in order to sell to them, or communicate with them. I can't remember the last time I saw an ad that had a really intelligent headline in our sector.

Brader is quick to add that there is a lot of worthy advertising around in the pharmaceutical arena, yet she feels that there isn't enough of a reward for the doctor - don't forget that (s)he's a human being! - in much of it. It's not because it's dumbed-down, because people invest more brain power now than they ever did before, but it is a bit commoditised - just another piece of paper within the journal and not really something to look out for. What we've forgotten is that there is an intervening variable between the brand and the patient that needs to be engaged and feel that it was worthwhile taking the time to absorb the information in the ad.


She comes up with an analogy: When advertising a brand of nappies to mothers, the pivotal persuasion is not based on the amount of water they absorb, but on making the mother feel good about the fact that she's being the best mum she can be by buying that product - it gives her a reward in the process. We're forgetting to make the doctors feel good about what they're doing.

In the 1970s and '80s, she notes, advertisers appreciated more overtly that doctors were not merely things to be sold at - a notion that might be argued is relatively rare these days. [Modern] advertising lacks the ability to really talk to them, and say, you're the kind of doctor that uses this brand and that says something about you.

Mike Lane, managing director of advertising agency Lane, Earl & Cox (which came up with the memorable mid-90s `Everyday Losec ads'), points to the mid 1970s as a time when healthcare advertising really took off. Pharmaceutical advertising used to be very dull, and much like trade advertising; ie, simple copy stating that 'we'd like to inform the profession that drug X is now available'.

It's only really been since the mid-70s that advertising has looked anything like it does now, because that's when some in the industry started to use consumer-style marketing, including photos, colour and ideas in the ad. He adds: It's still evolving but what we're finding now is that possibly advertising isn't in the place it was in the 1970s because there are so many other conflicting things going on.

Creative director, Phil Cox, adds that today's environment is markedly different. There aren't that many products being advertised now as money is being shifted into other budgets, and there are a number of issues responsible for its current state.   Lane notes: It is evolving and I think there's a great deal more sophistication that goes into it. We're using all sorts of consumer techniques that hadn't been heard of in the mid-70s.

Careful now

Ask a managing director of a successful contemporary healthcare advertising practice whether they feel as if they've been strapped into a 'marketing straightjacket' by today's competitive and overly cautious environment, and the retorts vary from poignant and heart-rending disclosures, such as the emotion has gone, to the unpublishable (we'd need several astute bleep boxes).

Certainly, it seems that the role of research has morphed from a tool that attempted to quantify the risks being taken in a piece of advertising, into something of a paternalistic health and safety official - research has highlighted a risk, so we'd better not take it.

You could say, by way of analogy, that the days of a live elephant being led into BBC 1's Blue Peter studio and promptly defecating upon the floor, causing one presenter to slip over in a most unsavoury manner, before then standing on the producer's foot, resulting in his stifling a string of expletives that would turn your grandmother's hair brown again, are gone. Even with tears of laughter streaming from the memories, people still don't take those sorts of risks in today's culture.

The balance of power

Brader complains that the relative shortage of good brands to work on, and the nervousness of the pharmaceutical companies to be anything but conservative in these post-Vioxx days of lawsuits and Health Select Committee probes, has led advertising agencies to become slavish and subservient to research.

In fact, some might go as far as to say that research pervades today's medical advertising efforts like Sybil Fawlty going through Basil's pockets. Thorough to the point of obsession?

Healthcare advertising is the most over-researched area that exists in marketing, and so everything is dumbed-down and a good deal of the work you actually see is not what the agencies would originally have put up to the client, says Lane.

There are some great campaigns generated, but because everyone is trying to protect themselves, it all goes into research and you get some pretty rubbishy things coming out of the other end - but stuff that tests well.

Brader believes it to be the result of a 'collusion'. The balance of power has changed. If you ask a doctor 'what makes a good ad?' they will always compare it with something they like that's already out there. Yet, the role of the creative agency is to do something different and fresh, and hence research should be about what might work.

Phil Cox adds that the risks of being stung, in one way or another, in the modern industry can act as detractors to creative licence. People are not quite as courageous today. You should be using research for illumination - not for it to make a marketing decision for you.

It seems clear, from speaking to both sides, that the client wants to do something that, internally, will not be seen as bucking the trend, and the agency wants to hold on to the business because it is such a competitive environment.

There is, therefore, an unspoken collusion to do things safely, based around 'I did the research and it showed that... ' so advertising becomes very insular, Brader observes.


Times change

It seems clear then that research and the way it's used has evolved, but just not to everyone's taste. Still, the practice of pharmaceutical advertising has come a long way since the winter of 1904, when the influenza virus feared for its future as people rushed to buy a bottle of Mother Seigel's Syrup (pictured above).

The multi-million pound combination vaccines available today are all well and good, but they're feeble compared to this rather unique concoction, marketed by Mather and Crowther Ltd (of New Bridge Street in Ludgate Circus) which not only revived people who had suffered flu 'for four years', but crucially also kept their blood 'pure' of the effects of London's fog. Impressed?

The advert reads as though this is the type of product a bottle of which the wife should always keep stowed in the medicines cabinet, for days when her husband's upper lip needs stiffening.

What was actually in the syrup? Who cares - as long as it purports to keep you in fine fettle, then it must surely be taken! By stark contrast, today, we're reticent to buy even a tomato unless it can be proven that it was allowed to grow unmolested by inorganic fertilisers and provided throughout its tenure with a free-range, organic field in which to soak up the sun's natural radiance.

Times change and, while the key driver behind advertising remains largely unadulterated - to generate more sales - the way in which drug ads are composed and perceived will always reflect the nature of society, in terms of the industry, at any particular point in time.

In a line up of 20 adverts, two from each decade of the last Century, how easy would it be, using the style and content of each, to match them with their date of creation?

Looking at the relatively more recent efforts, during the 1970s for example, the style of advertising centred on being very literal. If you had a drug that could be used as a bridging therapy, then a simple image of a bridge would do nicely. If your drug had all of the boxes ticked in terms of its objectives, then some ticked boxes would suffice; a paediatric medicine, a child in pain... and so on.

Yet, this was good. As the beleaguered Reginald Perrin cast off his Y-fronts and made a bolt for it across the beach, driven to beyond breaking point by the banality of his world - as well as the unyielding `hippo' - this approach to medical advertising was actually fruitful.

Animal Instinct

Moving into the 1980s, a raft of new advertising agencies was formed, and the idea of the `metaphoric animal' rampaged through the journals.

We had lions, horses, labradors, big sheepdogs, unicorns - everything had an animal stuck on the brand, Brader recalls. It seems that if your drug was fast acting, then a leopard was the perfect descriptor. For targeted therapies, fish with long noses, or a hovering eagle would befit. Controlled-release? - a crawling snail. But it was well-cool, man. Seriously, no sweat. These were good visual metaphors that struck a chord with pharmacos seeking to plant seeds deep into doctors' memories, which were already teeming with new 1980s big brand names.

Then we moved on to people riding bicycles in the 1990s, to represent the idea of improved `quality of life', says Brader. The bicycle, as well as being a hugely underrated mode of transport in big cities - you always get a seat after all - seemed to form a good foundation on which to base ads for conditions of the elderly. On one side of the ad there was a sad, lonely looking woman with a threadbare carpet, taken in Sepia effect, and on the other half of the page we had the same woman, sporting professional-standard make up and looking great wearing a colourful dress, cycling with a handsome suitor through what appeared to be a stunning area of French countryside.


I want to ride my bicycle

The bicycle is still used in advertising now. It remains a symbol of freedom, clear direction and enhanced capability. It is also often routed in a room in people's minds that is reserved for pleasurable memories - riding bikes as a child (your very first taste of independence) or spinning through the countryside, warmed by the sunshine on your back, sniffing the sweet scents of the flower fields either side as you glide to the pub for Sunday lunch.

Cox concurs that advertising can indeed be dated by the changes in art direction and the general visual approach to the subject, but adds that the tightening up of regulations over the years has also
clearly shaped the content of adverts.

He recalls: At one stage we didn't even have to include prescribing information, and you weren't even required to put a generic name in! No PI? Peculiar now, but quite the norm back then. Still, it seems tame when you consider that the 1903 advert for 'Whiteway's Cyder' promoted the old English drink as 'Far more wholesome than malt liquors or cheap wines' and `specially suitable for women and children' - and this 'recommended by the medical profession'!

Yet, there's certainly longevity to the campaign - anyone for a quick `medicinal' one after a tough day at work? See, still good.

The Rowan Atkinson effect

Henceforth then, as this fleeting glance at our advertising history draws to a close, two key questions remain unanswered: 'what is today's genre?' and `what role will Mr Bean play in the future of the sector?'

It's dancing - which has replaced old couples on tandems, IPA's Brader observes. Apparently now when osteoporotic patients get to 63, they take up jiving, or doing funky things in the garden - and Parkinson's patients go tangoing.

As for the next move in advertising: I think we are facing a choice now, and one option for the industry is to pursue the `global' ad, she notes. The British have a very iconic approach to advertising, which is different from the American stance. In order to find something that has universal appeal, advertising has to become more like Mr Bean - universally accepted, and something that no-one can really object to.

So there we have it. It is now possible to say with confidence that pharma advertising has evolved noticeably from the turn of the century, when medicine for your head could also treat the problem with your feet, and maybe even save you from the poisonous London air.

The research undertaken for this article has revealed one certainty, however: if advertising for healthcare products is to progress and move with the times, then it's down to the Rowan Atkinson model of universal appeal to see it through; and who would argue with that.

The Author
James Leeming is a healthcare journalist who admits to having enjoyed the 1980s to excess. Pharmaceutical Marketing would also like to thank the History of Advertising Trust Archive ( for its great efforts to preserve Britain's advertising heritage

2nd September 2008


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