Precise operation

Direct marketing has moved on greatly since the days when it basically meant a dear doctor letter. In today's crowded and busy marketplace, it takes a lot more imagination than that just to get your materials further than the receptionist's 'special filing place', in that round metal thing under the desk.

Customers are bombarded with magazine advertising, mailings, and sales visits. They are drowning in information. There is also more competition between medicines in the same class and it's harder to make your offering stand out.

Of course, the good old dear doctor letter is probably now inappropriate because the people you need to target today and tomorrow might also include nurses, pharmacists or managers. You may even need to communicate with patients, and these different groups will respond to different media, be it direct mail, journal inserts, emails or text messages.

Yet, there are opportunities on offer too. New methods make it easier to analyse information about customers and to initiate a two-way dialogue with them through direct marketing. It is more important - but also easier - these days to determine whether your direct marketing is providing good value for money.

Return on investment
You start to question the sense of bulk mailing or contacting every physician in the country or every physician in Europe - that has become a waste of time, says Mark Kroes, general manager for e-marketing solutions at Dendrite Europe. The company supplies a range of direct marketing services to the pharma industry, including CRM software, market intelligence and strategic advice.

There used to be so much money in the industry, but nowadays when money is a bit more scarce... people are monitoring the success of anything they do with direct marketing much more closely. Their budgets are smaller and they have to achieve more with less, he adds.

A decent response rate to a piece of business-to-business direct mail in the pharmaceutical/health arena, according to the latest 2006 data from the Direct Mail Information Service, is around 6.7 per cent. This compares relatively well with 7.3 per cent for FMCG campaigns, while a charity-based mailing elicits on average a response rate of nearly 21 per cent.

The good news is that results from direct marketing are easily measurable. This is one of its real strengths, says Mike Gale, marketing director at Precision Direct Marketing, a full-service direct marketing agency. Whatever method you choose, he says, you can test direct marketing at very little cost.

You can also do a small trial run before committing a lot of money to a particular direct marketing activity, he adds. This is routine in sectors like FMCG but less common in the pharma industry. I love to see people testing, Gale says. If you have a hypothesis but you're not really sure about it... do some testing and find out. For example, you could pilot two different mailings and ask the sales reps to evaluate the response in the field.

Many people look at the cost per item - the origination cost - but when they do this they are missing the point, he notes. The important answer is the cost of your desired result. It's not cost per item, it's cost per customer response, or per customer acquired, he says. Converting a GP to your product has huge rewards over time, so you shouldn't be looking at it in terms of cost of production for a mailing pack.

Everyone's measuring the bang for the buck, agrees Steven Bauer, managing director of DXS UK, a company that accesses clinicians through added-value clinical software. What's not measurable generally doesn't get budget approval.

Financial pressures also mean that the audience focus is getting tighter all the time. If you're going to spend wisely, you need to target your audience precisely. Just to make things interesting, you have to do this at a time when the points of influence are multiplying.

Who are you talking to?
In the past, direct marketing was aimed mostly at physicians, but the audience is expanding rapidly, says Kroes. Nowadays, it could be any player in the field that is in any way a decision maker to get your drug prescribed. So it could be an insurer, a payer committee or a government.

In fact, some of your most influential customers might fill both a management and a clinical role. A consultant might be on the local drugs and therapeutics committee, and a GP could also be their PCO's medical adviser. Yet, these valuable customers can be the most difficult to identify.

The challenge for the industry is that many of these influential organisations are virtual, says Derek Monaghan, business development manager at Binleys, a company best known for its database of NHS contacts. It's not always easy to find out who the local influencers are and where they actually work most of the time. It might say `GP' on the nameplate, but that person might have an array of different management functions not only within the practice and practice-based commissioning cluster, but also in the PCT, Monaghan says.

Suppliers like Binleys can offer a lot more than a mailing list, he purports. You can ask for their advice on the best way to approach different customers. For example, once they've been identified, PCO customers might merit extra attention, such as invitations to a seminar or a visit from a `super rep'.

Other clinicians are important customers now, too. Nurses and pharmacists have an increasing influence over prescribing decisions and, in the UK, their own prescribing powers are now significant. This trend is prompting direct marketing suppliers to come up with new products. For example, whereas DXS UK has focused on GPs in the past, the company has recently launched a product specifically for pharmacists.

The industry is also taking a closer look at each of these professional groups and then dissecting each one with fine tweezers.

Dendrite's Kroes notes: Direct marketing has now become targeted marketing, which is not really novel because we have always targeted, but now we have gathered much more information about the customer. The company draws on an expansive database, containing CRM data from more than 30,000 sales reps working across Europe, to help clients understand their audience. It also questions hundreds of physicians about their interests, prescribing decisions, preferences, and their roles as patient group advisers, speakers and researchers.

This type of information can be cross-matched with demographic data, which provides a picture of the doctor's patients, to yield a detailed customer profile, the firm explains.

Whoever you need to talk to, the marketplace is busier than ever and it is difficult to make your voice heard over all the noise. Once you have identified the decision makers, how do you send a message that will capture their interest, and get that message across in the most effective way?

E-marketing
One of the sexiest new possibilities is the use of `e-channels' - a term used to talk about any number of digital communication methods, such as email, websites, computer software or text messages.

E-channels were popular a few years ago but suffered a decline after people got their fingers burnt, says Bauer at DXS UK. Too much was promised and some marketers went away with their tails between their legs when the internet failed to deliver. Things have gone full circle again and we've seen e-marketing channels coming back into the mainstream with more realistic objectives, he adds.

DXS provides software that is compatible with the customer's existing clinical system, either in the GP surgery or the pharmacy, a hassle-free trait and a crucial advantage when using e-channels, the firm notes. The package offers clinicians patient information, a listing of patient support groups, research and professional development materials, and information about medicines, all of which pops up on the screen at the point of prescription.

Content is provided largely by independent publishers and organisations like NICE, but pharmaceutical companies can also add material if they `own' a therapy area in the system.

E-channels have their limitations, however. Email has been successful in other industries because it's cheap and provides a quick response, says Charles Russell, managing director of RMS Research and Marketing Services. Yet, in healthcare, it is still a limited medium. Getting email addresses for individual customers is probably the biggest limitation, and many customers opt out, saying they don't want to receive industry emails. It's not always possible to use it, says Russell.

He adds, though, that if you are able to use email, you need to think about the content and presentation very carefully. You have to use a different approach. It's got to be very fast. People have to see exactly what they're going to get. It's a very instant decision.

Style and lan
Even if you are limited to tried and trusted approaches, such as basic direct mail, there is still room for innovation. Because of the serious nature of the products and strict regulatory requirements, the pharmaceutical industry has taken a conservative approach to communications with its customers; but there is room for more creativity, even humour.

It is important to think about the people at the other end of this communication, says Precision Direct Marketing's Gale, who is currently planning a cartoon-based campaign. If you think about them as human beings, as well as professionals, there are ways to be professional in the way you communicate but do it with a bit of style and ?lan and without boring them to death. The materials should also include a specific call to action and lead communications to another stage, he advises.

Any direct marketing materials, such as mailing or emails, should be integrated with the look and feel of the brand and the campaign, notes Gale, and this is most likely to happen if you start thinking about direct marketing at the very start of your campaign.

Good timing
Indeed, a common warning from direct marketing experts is not to leave it until the last minute, tacking these activities on to the end of the campaign. To get the best results, you should consider carefully the role of direct marketing at the very outset. Success is all in the planning, and the earlier the better.

You look at what you're trying to achieve, the messages that you're trying to get across, how you're trying to change the way the audience thinks or feels, and come up with some return on investment proxies, a determination of what success looks like, says Gale.

No media operates in isolation, Bauer adds. We are one final reminder at the point of prescription to remind a GP to prescribe a particular brand. But there's a whole lot of work that's been done before that point, with traditional media and rep activity that has built a theme and personality for the brand. Pharma companies have an opportunity to solidify those key benefits or features at that last moment of the decision-making process.

Frequency is another thing to consider, Kroes points out. Once you have analysed your audience thoroughly, you might decide that it is best to target a particular group repeatedly, rather than send one big mailing to everyone. It might be better to ditch plans for a blanket mailing to 100,000 doctors, and instead opt for a series of five mailings to 20,000 carefully selected customers.

Whatever approach you prefer to take, direct marketing suppliers are keen to offer pharma the benefits of their experience as well as the contacts in their databases.

Kroes says that direct marketing companies can offer valuable knowledge and experience when it comes to making strategic decisions. It's not just about collecting the information; it's also helping the customer decide how to use it.

The Author
Colleen Shannon is a freelance healthcare journalist. For some general information on direct marketing, visit www.dma.org.uk