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"SALES DRIVERS" - MM&M November, 2003 by C. Marshall Paul Marshall McLuhan believed that "The medium is the message." His thesis was that "each medium, independent of the content it mediates, has its own intrinsic effects which are its unique message." Eighteen years of testing suggest that it's really the medium and the message that are important. Successful promotion combines the impact of communicating a compelling message with the required repetition of exposure in the appropriate medium/media. One without the other can be problematic. Supporting this idea is the fact that considerable evidence exists that demonstrates the importance of detailing in supplementing the marketing effort with the ability to communicate a motivating message. Our research at ACNielsen HCI indicates that campaign exposure alone does not necessarily correlate to increased sales. What the research does show is that monthly detailing can increase correct product/message association nearly four-fold compared with no detailing effort at all (see chart, page 44). The basis of the promotion effort, however, is the message. The data shows that communication of a message does correlate to increased scripts. Further research also suggests that if the message is relevant, believable and unique, then the degree of correlation increases. As companies utilize appropriate promotional channels, a greater portion of physicians are exposed to the message, and with increased exposure comes an increase in new prescriptions. Determining the correct medium in which to expose a message is an art and fine-tuning the correct balance of media is even more difficult. Post-testing campaigns have now shed considerable light on the topic and we find that the degree of message complexity determines the types of media to utilize as a communication vehicle. Within this context, media selection is a function of reach, frequency, cost per exposure, exposure time and the relative value of an exposure for selected media. Message importance Delivering a compelling message is essential to long-term success. Examples abound in the consumer world as well as with physicians where the pure power of promotion can stimulate initial success. If the product fails to match its claims, success is short-lived. Daypro was a good example of this. The campaign claimed efficacy and tolerability in an NSAID. This was what the physician wanted, but as an older NSAID, Daypro, had tolerability issues. Campaign believability was below norms and as a result the campaign was changed. Typically, it is relatively easy to communicate a unique message that is both believable and relevant. Messages such as "The only once-a-day..." or "The only product indicated for X..." attract attention and are memorable. In situations like this it is possible to communicate with a reasonably low budget. Conversely, it is very difficult to communicate a generic message such as "safe and effective," which could apply to any number of products in a variety of classes. In this situation, even a strong budget cannot achieve significant message penetration and promotion, in general, can become very inefficient. The problem, of course, is that there are a far greater number of product promotions that fall into this latter category. The trick is to find a unique way of communicating a generic position. Roche accomplished this when it used the message "Mean, lean and clean" to promote a safe and effective message for its antibiotic Rocephin. Message recall broke all ACNielsen HCI antibiotic awareness norms. 
Detailing drives the message There is significant evidence available today demonstrating the importance of detailing in complementing the power of the marketing effort with the capability to communicate a message that motivates action. The chart on page 44 provides an example where monthly detailing increased correct product/message association nearly four times over those not detailed and those called on quarterly increased this association by almost three times. Active use of a sales aid dramatically accelerates the communication process. Our research showed that when a physician remembers being detailed with the sales aid, he/she will be more than twice as likely to make the correct message/ product association. Therefore, if association of the message is 40 percent without sales aid usage, this association can move to 80 percent among those exposed to the sales aid. The program is that sales aids are infrequently used for a host of legitimate and illegitimate reasons. When the message is effective, use of the sales aid will help drive market share. Indeed, in one example we studied, the share-point change moved from .6 to 1.5 among those physicians called on quarterly with the sales aid. Further evidence is provided among those seen monthly where use of the sales aid is correlated with increased share point change (1.2 to 2.7). Again, causality can be confirmed when trending this research. The value of detailing Detailing is the most powerful form of promotion because it combines the ability to make and deliver a compelling message with the pure power and presence of personal interaction with the physician. Detailing drives both the believability and relevance of the message. In one study, the message relevance and believability totaled 79 and 77 percent, respectively, among those physicians detailed (see chart). Because response modelists have found that ever increasing levels of detailing lead to higher sales, the industry has increased the number of sales representatives from 38,000 in 1996 to 90,000 this year. Since the resulting number of calls has not increased proportionately, the ROI from detailing has steadily declined over the years. ACNielsen HCI research confirms that proper use of print promotion can significantly increase the impact of detailing at a fraction of detailing's cost, thus improving ROI. In a review of 63 studies in which advertising increased detailing's ROI, it was found that the average ROI for detailing alone was $2.20 for every $1.00 of promotion. This improves to $3.14/$1.00, an increase of 43 percent when print promotion is added to the marketing mix. Our eighteen years of promotion testing supports the premise that it's "the medium and the message" with the following observations:
In summary, there is an enormous opportunity for the industry to dramatically increase its marketing efficiency. Marshall McLuhan also said, "I may be wrong, but I am never in doubt." C. Marshall Paul is president of ACNielsen HCI About ACNielsen HCI Based in Princeton, NJ, ACNielsen HCI is a national pharmaceutical promotion research organization and a recognized leader in physician and consumer promotion planning, measurement and analysis. Since 1982, ACNielsen HCI's strategic promotion planning and evaluation expertise has powered sales, profitability and competitive advantage for pharmaceutical companies through the application of its unique blend of integrated quantitative and qualitative research. Leveraging the insight, knowledge and deep normative data gathered through analysis of more than 6,400 promotional campaigns, ACNielsen HCI provides research solutions addressing critical marketing and sales issues. The company has strong and deep norms in most therapeutic areas.
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