Have you ever seen the Seinfeld episode where Elaine’s friend has an ugly baby? Everyone is repulsed except the proud and smitten parents. Some brand managers are just like that;  they can’t see that their brand isn’t cute enough to be on TV.

When exploring whether DTC advertising is right for a brand, you have to see beyond the market opportunity and ask, and answer the the hard question, is my brand attractive enough to entice a customer in 60 seconds or is a “get to know you” brand? Frankly, if your brand is a “get to know you” brand then DTC advertising can force you to  expose the brand’s weaknesses without giving you an adequate opportunity to put its superficial flaws into context.

All Pharma brands have side effects and managing the communications of those side effects is one of the most important aspects of protecting your brand, especially to the public. Two cases in point are Xenical® and Viagra.

Example 1: Xenical­ – Huge opportunity with weight loss. Who doesn’t need to shed a few pounds? But are you willing to risk a humiliating and potentially career-threatening bout of “explosive diarrhea”? I think not.

Xenical is a “get to know you” brand and DTC advertising for Xenical was a crippling mistake and probably not necessary. The market research sized the market for weight loss products at $6 billion in the US – a potentially  huge windfall for Roche if Xenical® succeeded. Unfortunately, the mandated fair-balance was not very consumer-friendly and made it an easy target for Leno, Letterman, and Saturday Night Live. Years in prelaunch mode must have desensitized the marketing team to the impact of required warnings for Xenical, which should have been carefully considered before investing in DTC advertising.

Fast-forward to today’s Web-connected world. If Xenical launched with a non-branded DTC campaign coupled with extensive PR, targeted grassroots events, comprehensive physician education, and offered a weight-loss support group to ensure compliance, that would have been a successful approach.Today, through one-to-one marketing, each consumer can be qualified as a potential candidate, receive education on the pro’s and con’s of the Xenical, and get tips on how to manage the side effects to ensure success and avoid humiliation. Through customer selection, education, and constructive patient and physician dialogue, the benefits of Xenical could be put in the proper context.

Last year, GSK launch a low-dose Xenical by the name of Alli. Marketing expenditures were an impressive $150 million in the first six months. The campaign theme? Isn’t it time for a little honest talk about weight loss? Still, the product attracts a lot of criticism for understating its side-effect risks. Although 4 million have reportedly tried Alli, those in the know say that its commercial performance has been disappointing. Maybe a prescription medicine that shouldn’t be promoted DTC shouldn’t go OTC?

Example 2: Viagra – big brand, big dollars, small ads. I worked on Viagra personally and it was a great lesson on what works and what doesn’t. Marketing Viagra was unlike anything else in my experience.

Top-of-mind for every Pfizer marketer and agency member were two questions; will this improve the perception of the Viagra brand and what effect will it have on the credibility of the Pfizer organization? With all its overnight success, Viagra was a meticulously managed brand internally and externally. Perception was king.

The Viagra team excelled at managing perceptions. And despite the fact that every late-night talk show host used Viagra as a punch line in their opening monologue, the Viagra image was never tarnished.

Pfizer knew that combined with the general stigma of ED, the side effects of Viagra might keep a majority of potential customers from trying the little blue pill. The Viagra team very successfully used all DTC advertising channels like no one had before. Brilliantly, Pfizer used a 5-pronged DTC strategy: unbranded and branded DTC, events, sponsorships, and spokespeople. All of this was directed at removing barriers to discussion and building Viagra into a mainstream brand.

To achieve this, the Viagra team leveraged and carefully nurtured its number one asset – brand awareness. The drug’s novelty and newsworthiness put Viagra on the world stage and raised its awareness to a level that rivaled Coca-Cola. In a market research study, Viagra had 97% awareness globally and Coca-Cola had 99%. Viagra didn’t need to tell anyone what is was indicated for … it just needed to remind people it was available and acceptable.

Pfizer had a three-step DTC plan: De-Stigmatize, Define and Demand.

Step 1: De-stigmatize. Everyone remembers Bob Dole as Viagra spokesperson. The fact is, he wasn’t. He was a spokesperson for Pfizer Men’s Health, but from the onset, Pfizer and Viagra became synominous, so we exploited that. We used the credibility of Bob Dole to legitimize ED as a real and serious medical condition, unbranded. This was important groundwork for the rest of Pfizer’s DTC plan.

Step 2: Define. To help broaden the definition of ED and create demand for Viagra, Pfizer used a combination of educational events and brand assets to power the brand. NASCAR was a great success on the track and off. Supremely masculine, NASCAR helped solidify Viagra’s acceptance as a mainstream brand on the track. In the pits, the Pfizer Men’s’ Health trailer screened, educated and helped redefine ED as a condition commonly associated with high blood pressure, diabetes, smoking, etc. Simultaneously, Pfizer launched its non-branded “Faces of ED” campaign that helped broaden the target audience and further destigmatize ED, moving away from the Bob Dole heritage and moving towards an everyman’s problem.

Step 3: Demand. The luxury of being the only marketed drug for ED afforded Pfizer a great deal of flexibility. Importantly, they recognized it and took advantage.

Getting a man to seek treatment required great care and tact. We couldn’t understate the problem of ED, but we had to preserve the man’s masculine self esteem. Successfully, Viagra brand stood for confidence, virility, and life. Anything that countered that would jeopardize the preceding efforts. That’s why Pfizer strategically used 15-second reminder advertising to enhance its awareness and build appeal while minimizing the negative perception of such side-effects as hypotension, visual disturbances, and erections lasting four hours or longer. That discussion would be handled where it should be, in the doctor’s office.

The Viagra brand had sex appeal and Pfizer knew it. It is the definition of a “love at first site” brand.

As I mentioned earlier, DTC is evolving and for better or worse, many of the tactics employed by Pfizer would not stand the scrutiny of FDA’s current guidance. Nevertheless, brand managers must realize that their side-effect profile may be a serious liability in DTC advertising. Instead, the use of digital DTC advertising, mobile, for example, can help consumers engage in a dialogue with a brand, become better educated, and have a productive discussion with their healthcare professional. In today’s healthcare environment, with the increase of biologics and the increase of government scrutiny, I believe there will be more “get to know you brands” than “love at first site” brands. I believe, these brands will need to use broadcast DTC sparingly and online DTC intensely.