To their health: rx companies are trying to figure out the best method for reaching aging boomers

A muscular, blond windsurfer skims the tops of golden wheat fields. A woman with perfect, pink toenails plays footsie with her boyfriend and coyly suggests that he too take off his shoes. And a grandfatherly figure helps a small child learn to ride a bike. All are images used by pharmaceutical manufacturers to sell their drugs in recent direct-to-consumer (DTC) advertising. From control to personal fulfillment, from freedom to fear, many pharmaceutical manufacturers are playing on emotions these days to motivate consumers to ask their doctors about their drugs.

DTC campaigns, which include an extensive use of direct mail and Internet marketing, are booming, increasing from just $25 million spent in 1988 to an estimated $1 billion plus in 1998. Unaccustomed to such heady levels of spending, concerned pharmaceutical executives are trying to figure out the return-on-investment for their expanding DTC expenditures and determine how these millions can best be spent. As they sort through the data, the psychographic profiles of those 40-and-older, it appears, is worth considering for other categories, like financial services and even automobiles, as it is for medical care and prescription drugs.

Many forces impact on the writing of a prescription, including the physician's style of practice, the patient's health insurance coverage and his or her perception of the need for medication. Regardless of the influencers, the starting point remains: who is the potential consumer or patient? Because those 40-and-older clearly account for $8.40 of every $10 of all prescription drugs sold in the United States, they are the overwhelming target for DTC advertising. The lifetime value of a patient suffering from a chronic disease or condition such as adult-onset diabetes or osteoporosis is immense.

Attitudes Drive Health Choices.

Not all diabetics seek control, nor will a purely rational appeal motivate someone with prostate problems to take an advertisement to the doctor. In the long process of making and keeping a pharmaceutical sale, intuition and logic aren't reliable in determining what will motivate consumers. A product positioning may succeed with one segment, but turn off others. And the marketer's own logic is not necessarily shared by consumers who may not even see or appreciate the benefits of a drug.

DTC marketers also have to recognize that consumers with a specific illness or condition don't share the same motivations. There is no "average" diabetic or "average" person with high cholesterol or "average" post-menopausal woman. Markets are always made up of two or more segments with very different motivations. When these are averaged, the resulting positions don't mirror anyone's concerns. DTC efforts will have a better chance of succeeding if they're based on a quantification of what consumers perceive to be important about their health. Attitudes toward health and wellness, health information sources, and compliance are also tough to change. Not only have they been shaped through years of living, they're often at the very heart of a person's perceptions of life itself. It's far easier for DTC advertisers to target receptive consumers in the information sources or media they prefer. This approach includes creating relevant messages targeted at a specific psychographic segment.

Psychographics Integrate DTC

Based on ongoing surveys of the mature market going back to 1989, combined with experience in creating psychographic segmentation strategies, the database we use includes over 15,000 respondents, 50 million pieces of data and nine separate segmentation strategies. Our 1997 study includes 3,000 randomly selected U.S. consumers 40-and-older and is the source for the findings presented here.

The three separate health-related segmentation strategies, discovered by quantitatively assessing a unique set of core values and innermost needs about specific aspects of health and wellness, include:

* Health segments. What does or does not motivate someone to actively take care of their health?

* Health information segments. What motivates someone to seek and use health-related information?

* Health compliance segments. What motivates people to comply with their doctors' instructions and drug regimens?

The health psychographic segmentation includes these categories: Proactives, Faithful Patients, Optimists and Disillusioned (see chart on page 31).

Of the four health segments, Proactives and Faithful Patients dominate pharmaceutical sales to those 40-and-older. Proactives account for 38% of pharmaceutical sales, while Faithful Patients represent 32%. As we have noted in the chart, there are massive differences between the Proactives and Faithful Patients in their motivation to take care of themselves, their use of health information, and their receptivity to media. These stark differences show that it isn't sufficient to target "heavy users," a category that is made up of more than one psychographic segment.

A Marketing and Sales Mesh is Key

The fact that the important Faithful Patients are only slightly receptive or swayed by health-related messages in advertising or mass media makes it imperative that DTC mesh with sales efforts. Faithful Patients are very open to health messages delivered by their doctors. A "pull" strategy is effective with Proactives, heavy consumers of health-oriented media. Achieving the necessary synergy between marketing and sales efforts is easier if a segmentation based on health attitudes in general is used, rather than several segmentations, one on every specific disease. DTC advertising is the first step, creating awareness and laying the groundwork for trial. But to achieve its highest return, DTC should reinforce the actions of the patient's physician; friends and family the pharmacist; and provide a support program whether sponsored by a pharmaceutical company, drug store chain of HMO. And all of these efforts have to unfilled by the same understanding of the patient's motivations toward health.

Select Media and Message by Psychographic Segment

While recent FDA changes have loosened restrictions on pharmaceutical advertising on television, decisions about where to advertise should flow from a knowledge of what media each segment prefers. Since mass advertising conveys the 800-number or Internet address to the consumer that begins the direct cycle, it's important to select media reaching the greatest number of consumers with the disease or condition who are receptive. For example, DTC advertising in Prevention reaches more Disillusioned and Proactives than those in the other health segments. While they are open to information about health, it's important for DTC marketers to note that far more Disillusioned than average are either too poor to pay for a prescription or have no health insurance coverage.

In considering whether to place a DTC advertisement in Business Week or Kiplinger's Personal Finance, we know that Business Week reaches fewer Proactives (34% versus 43%) and more Optimists (22% versus 16%) than Kiplinger's. Though they are an upscale segment, Optimists largely ignore symptoms, avoid taking pharmaceutical drugs and run away from doctors.

Triggering a Contact

Overall, 8% of those 40-and-older have called an 800-number to receive information about a pharmaceutical or prescription drug, or treatment in the past 12 months. The percentage calling such a number is virtually the same for older boomers in their 40s and elders 65-and-older. But there are significant differences by health segment. Few Optimists make such calls, and Disillusioned are only average. The majority of callers to 800-numbers are Proactives and Faithful Patients. Knowing that someone calling an 800-number is either a Proactive or Faithful Patient should lead a pharmaceutical company to respond based on each segment's motivations. To achieve the highest ROI on a DTC campaign, the messages embedded in the materials sent, the frequency and type of contacts, and the design of relationship-building programs should differ significantly by health segment.

Internet Holds Promise

Among those 40-and-older, only 4% have used the Internet in the past 12 months to secure advice or information about health. Among those 40 to 49 the percentage is 6%. Far more Proactives (10%) in this age group are making use of the Internet in this way than are Optimists (2%). To attract Proactives to their sites and keep them coming back, DTC marketers have to provide this segment with substantive and reliable information.

Recognizing Regional Differences

Prioritizing DTC media expenditures on a market-by-market basis increases the likelihood that marketing dollars will be spent most effectively. Regions of the U.S. differ by the incidence of disease. Since the 1960s, for example, scientists have known about the "Stroke Belt" that snakes its way through much of the South and Southeastern U.S. Regions also differ by HMO penetration, styles of practice by physicians, sales force strength and level of activity, and the percentage of the population that's insured. While all these factors must be considered, a psychographic analysis of consumers in each market shows that two of the four health segments, Proactives and Faithful Patients, skew to different states. Greater percentages of Proactives than average can be found in such states as Oregon and Maine. Faithful Patients are disproportionately located in Alabama, Kentucky, and Tennessee. These insights can be tied to both push and pull strategies. In a market dominated by Faithful Patients, it would be best to use a push strategy through physicians. Where Proactives dominate, media can be selected by their preferences .

Optimizing Media Selection

Using Strategic Direction's 40+ database and Simulator [R] software, we have tied together our psychographic health segments with behaviors, demographics, disease categories and media usage to lay out the most targeted and cost-effective media plans. If Simulator is set up to reach Faithful Patients with diabetes, for example, TV Guide comes up as one in a group of selections that provides the greatest efficiency: the highest reach at the lowest cost. With psychographic segments as an integral part of Simulator's optimized media schedule, DTC advertisers can craft messages that will motivate the most profitable health segments.

Crafting Targeted Messages

A message relevant to Faithful Patients would stress listening to their doctors' advice. The idea that they can actually do something about their condition may get the attention of those Faithful Patients who are also Uninvolved Fatalists, a health information segment. Proactives, especially those who are also Internal Health Actives, another health information segment, would be receptive to the concept of taking medication as a way of caring for themselves.

Predicting Trends with Psychographics

It's true the aging of the U.S. population will fuel the sales of pharmaceutical companies, but those increasing market share will use DTC effectively. They will design DTC programs to target specific psychographic segments of this aging population. As we have seen, not all psychographic segments in the 40-and-older population are receptive to DTC. And 70% of pharmaceutical sales to those 40-and-older are made to two very different mindsets: Proactives and Faithful Patients. Basing DTC strategies on consumers' motivations will ensure that pharmaceutical brands are integrated, targeted and refined.

RELATED ARTICLE: PSYCHOGRAPHIC HEALTH SEGMENTS

* Proactives:

--Committed to exercise and believe they are physically fit.

--Very careful to eat a balanced, low-fat diet.

--Believe in getting an annual physical.

--Actively seeks information on how to stay in good health.

* Faithful Patients:

--Aware they should eat well and exercise.

--Do little to take care of their health.

--Rely on doctors and medications.

--Continually try new over-the-counter drugs

--Look to religion in times of poor health

* Optimists:

--Say they almost never get sick.

--Optimistic about staying in good health.

--Don't believe in having a yearly physical.

--Will take medicine only when absolutely necessary.

--Believe they get enough exercise.

* Disillusioned

--Least trusting of doctors; lack faith in medical system.

--Careful to eat balanced diet.

--Feel their health insurance is inadequate.

--Convinced the U.S. needs guaranteed healthcare.

Carol Morgan and Doran Levy of Strategic Directions Group, Minneapolis, are co-authors of "Segmenting the Mature Market." They can be reached at (612) 228-7250 or market@4growth.com.

COPYRIGHT 1998 BPI Communications, Inc.
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