1. PHARMA
Ranking the digital competence of
pharmaceutical brands
MAY 2010
Prepared By: Industry Partner:
A THINK TANK
for PRESTIGE BRANDS
PHD Media
© L2 2010

2. I. INTRODUCTION .......................................... 3
II. METHODOLOGY .......................................... 4
III. RESULTS the rankings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
IV. DISCOVERIES ............................................ 9
V. FINDINGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
VI. OBSERVATIONS by disease state . . . . . . . . . . . . . . . . . . . . . . . . 25
ASTHMA & ALLERGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
CARDIOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
GASTROINTESTINAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
NEUROLOGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
PSYCHIATRY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
RHEUMATOLOGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
UROLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
WOMEN’S HEALTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
VII. TEAM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
© L2 2010 2

3. INTRODUCTION
The Killer App tion with highly trafficked health portals, and forays onto
Facebook and YouTube put brands like Gardasil and
The killer online app isn’t porn or social media, but med-
Viagra at the top of our ranking. However, the industry
ical advice. Arguably, no medium has so much influence
as a whole disappoints, as most brands offer obsolete
over so much spending—one sixth of the nation’s GDP .
technology, anemic site content, lack of search optimiza-
In 2009, the number of Americans seeking pharmaceuti-
tion, and scant social media programs. In sum, there are
cal information online reached 102 million1. Pharmaceu-
millions of unregulated conversations taking place online
tical companies continue to search for a voice that can
regarding prescription drugs, but the voice of the phar-
rise above the digital cacophony. Although the emerg-
maceutical companies is largely absent.
ing direct-to-consumer relationship on the web allows
for robust patient discovery and education, the online
Our thesis is that digital aptitude will be a defining compe-
efforts have experienced fits and starts because the
tence that separates winners from losers in a medium too
ambiguous regulatory environment leaves pharmaceuti-
powerful to ignore. Key to managing and developing apti-
cal brands paralyzed.
tude is an actionable metric. This study quantifies the U.S.
digital competence of 51 pharmaceutical brands across
The Innovator's Dilemma
eight disease states and ranks them by their Digital IQ™.
The Food and Drug Administration’s Division of Drug Our aim is to provide a robust tool to diagnose a brand's
Marketing, Advertising, and Communications (DDMAC) digital strengths and weaknesses relative to its peers to
has expanded under the Obama Administration. As achieve greater return on incremental investment.
digital accelerates in new directions—mobile, geo-
targeting, and healthcare information technology—the As in each L2 study, we brought in experts from aca-
uncertainty surrounding regulation threatens to ham- demia and industry to provide color and commentary
string pharmaceutical companies and shift power to on our findings. We were fortunate in this study to have
third-party portals and content sites. Brand managers insight from Peter Golder, professor of marketing at Dart-
are faced with a decision: take an aggressive approach mouth's Tuck School of Business on innovation, Scott
and face possible regulatory wrath, or wait and lose Hagedorn, U.S. CEO of PHD Media, on media trends in
ground to more innovative, risk-tolerant peers who are the industry, and Kristen Goelz of Flashlight interactive
garnering skills, fans, and followers. When it comes to on web site messaging.
marketing and regulation, it may be heads the digital
media win and tails digital wins again.
Despite the uncertain regulatory environment, some
Scott Galloway
companies are innovating online and building a founda-
Clinical Associate Professor, NYU Stern
tion for digital growth in anticipation of an unshackling.
Founder, L2 (LuxuryLab)
Robust branded sites, visibility in search, collabora-
1
Manhattan Research
© L2 2010 INTRODUCTION 3

4. METHODOLOGY
PLATFORM - 40%
Site Effectiveness: Reinforcement of core brand • BRAND TRANSLATION
associations and values through aesthetics and • Aesthetics and Messaging
interactivity. Also includes technology incorporation, • Interactivity
navigation, consumer funnels, relevant content, and • SITE ELEMENTS
customer service. • Technology Integration
• User Interface
• Customer Service
• Content: Disease Education, Conversion,
Community Content
OFF-PLATFORM MESSAGING - 25%
Digital Marketing Efforts: Online advertising on and • PORTAL AND OTHER ONLINE ADVERTISING
off consumer healthcare portals, mobile compatibility, • MOBILE
email marketing, and other messaging. • EMAIL MARKETING
SEARCH ENGINE OPTIMIZATION (SEO) - 20%
Visibility: Organic and paid search visibility on • TRAFFIC
popular search engines. • KEYWORDS
• WEB AUTHORITY
• SEARCH ARCHITECTURE
SOCIAL MEDIA - 15%
Social Media Presence: Following, content, and influ- • FACEBOOK
ence on major social media platforms, and buzz on • TWITTER
blogs and other web 2.0 forums. • YOUTUBE
• USER-GENERATED CONTENT
© L2 2010 METHODOLOGY 4

5. RESULTS
The Digital IQ Index ranks brands according to their digital
competence, with each falling into one of five categories:
140+ GENIUS
Digital competence is a point of competitive differentiation for these brands. Their sites are
search optimized, aesthetically engaging, functional, interactive, and offer clear calls to
action. These brands are highly visible advertisers on consumer health portals and
elsewhere online and experiment on the edge of the network with social media content.
110-139 GIFTED
Sites are crawlable, brand enhancing, and include calls to action. Brands typically advertise
on health portals, are highly visible on top search engines, and offer email marketing.
90-109 AVERAGE
Brand sites are functional yet predictable. Innovation efforts are uninspired and lack
ambition. Boilerplate marketing online and in email.
70-89 CHALLENGED
These brands offer little content online. Bare-bones sites provide only basic drug information.
Engagement is limited to web property, and digital campaigns are an afterthought.
<70 FEEBLE
Brands have largely ignored the digital phenomenon. Sites lack basic functionality and
navigability, and brands disregard digital marketing initiatives.
© L2 2010 RESULTS: the rankings 5

6. PHARMACEUTICAL BRANDS RANKED BY DIGITAL IQ SCORE
Rank Brand Parent Disease State IQ Label Comments
1 VIAGRA Pfizer Urology 149 Genius Site tech and interactivity are industry standouts; brand
leverages iconic name in search and online buzz
2 NEXIUM AstraZeneca Gastrointestinal 143 Genius This social media maven offers best-in-class lifestyle
support tools, including online access to dieticians
3 CHANTIX Pfizer Neurology 140 Genius Connects digitally with consumers both on and off site with
(Smoking Cessation) email, short messaging service, and a dominant presence on
health portals
4 ORTHO TRI- Ortho-McNeil Women’s Health 137 Gifted Top in the competitive Women’s Health category; brand
CYCLEN LO Janssen (Birth Control) boasts interactive tools and desktop reminders
5 CRESTOR AstraZeneca Cardiology 135 Gifted Strong onsite tech integration and activity on portals and
blogs elevates top brand in disappointing cardio category
6 GARDASIL Merck Women’s Health 131 Gifted Rallies community online with pioneering Facebook
(Infectious Disease) page and strength in search
6 YAZ Bayer Women’s Health 131 Gifted YAZXpress site offers interactive community content;
(Birth Control) brand also connects with users in mobile and email
8 SYMBICORT AstraZeneca Asthma & Allergy 130 Gifted Interactive video journey customizes site for best-in-
category user experience
8 NUVARING Merck Women’s Health 130 Gifted Brand boasts innovative web advertising and strength
(Birth Control) in search
10 LUNESTA Sepracor Neurology 126 Gifted A YouTube channel coupled with strong off-platform
(Insomnia) efforts keeps brand awake online.
11 SEROQUEL AstraZeneca Psychiatry 124 Gifted Site provides strong educational content and
community information
12 LIPITOR Pfizer Cardiology 121 Gifted Site branding and online advertising form the pulse of
this brand’s digital efforts
12 LEVITRA Novartis Urology 121 Gifted Humorous multichannel In Bed video campaign
generates online buzz
14 SEASONIQUE Teva Women’s Health 120 Gifted Brand understands how to integrate digital content and
(through Duramed) (Birth Control) user behavior
15 AMBIEN CR Sanofi-Aventis Neurology 118 Gifted Site highlight is a downloadable tool that tracks and
(Insomnia) analyzes sleep patterns
16 CYMBALTA Eli Lilly Psychiatry 113 Gifted Strong visibility on WebMD portal
17 ORENCIA Bristol-Myers Squibb Rheumatology 111 Gifted Strong presence on health portals
17 ABILIFY Bristol-Myers Squibb Psychiatry 111 Gifted Impressive site funneling and substantial traffic raise
brand’s profile
19 KAPIDEX Takeda Gastrointestinal 110 Gifted Strong branding and video content differentiate site
20 SYNVISC Genzyme Rheumatology 107 Average Search architecture and informative videos are brand
strengths
© L2 2010 RESULTS: the rankings 6

7. Rank Brand Parent Disease State IQ Label Comments
21 ADVAIR GlaxoSmithKline Asthma & Allergy 106 Average Asthma.com unbranded site incorporates education
and technology
22 SINGULAIR Merck Asthma & Allergy 105 Average Site aesthetics, disease education and flash features
are strengths; some presence on health portals
23 ZETIA Merck Cardiology 104 Average Presence on health portals and brand translation on site
give IQ a boost
24 PLAN B Teva Women’s Health 102 Average Site offers eligibility calculator and find-a-pharmacist
(through Duramed) (Birth Control) feature
24 SPIRIVA Pfizer and Asthma & Allergy 102 Average Multichannel disease awareness campaign tests the
Boehringer Ingelheim waters on Twitter
26 VYTORIN Merck Cardiology 101 Average Strong site disease education and presence on top
portals, but crippled by poor visibility
27 CIALIS Eli Lilly Urology 100 Average Although SEO is strong, customer relationship
management program that directs users to PO Box
shows digital failings
27 CELEBREX Pfizer Rheumatology 100 Average Status quo online advertising keeps this brand average
29 ACIPHEX Elsai and Ortho- Gastrointestinal 98 Average Playful animation on site and strong keyword visibility
McNeil Janssen
30 RITUXAN Biogen and Rheumatology 94 Average Site incorporates elegant flash features, but efforts in
Genentech search and online advertising get lost in the crowd
31 HUMIRA Abbott Rheumatology 93 Average MyHumira site for current brand users offers support for
patients
32 ANDROGEL Solvay Urology 92 Average The Low Testosterone Lowdown sponsored content on
WebMD has minimal visibility
32 ENBREL Amgen and Wyeth Rheumatology 92 Average Customer service standout offers find-a-doctor feature
and toll-free phone access to nurses
32 MIRENA Bayer Women’s Health 92 Average Trails strong Birth Control peers; interactive site
(Birth Control) elements are absent
32 PLAVIX Bristol-Myers Squibb Cardiology 92 Average Portal ads keep this brand in the middle of the pack
and Sanofi-Aventis
36 LOVAZA GlaxoSmithKline Cardiology 87 Challenged A strong site is brand’s only notable effort
37 AVODART GlaxoSmithKline Urology 86 Challenged Leverages GSK customer service features
37 NASONEX Schering-Plough Asthma & Allergy 86 Challenged Although “Don’t Blow It” game on Facebook
disappoints, it scores points for social media effort
39 VERAMYST GlaxoSmithKline Asthma & Allergy 85 Challenged Allergyrewards email marketing program offers savings
and tips
40 LYRICA Pfizer Rheumatology 84 Challenged Strong presence on WebMD, but site is poorly
organized to reach users interested in newly
approved Rheumatology indication
© L2 2010 RESULTS: the rankings 7

8. Rank Brand Parent Disease State IQ Label Description
41 OMNARIS Sepracor Asthma & Allergy 82 Challenged Robust SEO
42 FLOMAX Astellas Pharma and Urology 71 Challenged Bare bones, text-heavy site with dated technology and
Boehringer Ingelheim no call-to-action
42 PRISTIQ Pfizer Psychiatry 71 Challenged A New Day patient support program has email
marketing component; site is repurposed TV branding
44 LESCOL XL Novartis Cardiology 65 Feeble Obsolete site features newspaper-style cartoons
45 TRILIPIX Abbott Cardiology 63 Feeble Anemic site content, but ad presence includes spots
on Hulu
46 CADUET Pfizer Cardiology 62 Feeble PDF downloads abound on this brand’s dated site
47 NIASPAN Abbott Cardiology 61 Feeble Brand fails to be brought to life on site and limited web
advertising
48 PATANASE Alcon Asthma & Allergy 60 Feeble Worst in search; find-a-doctor feature is strongest
element of site
49 TOPROL-XL AstraZeneca Cardiology 59 Feeble Mention on AstraZeneca’a YouTube channel is this brand’s
lone social media effort
50 PULMICORT AstraZeneca Asthma & Allergy 52 Feeble Brand does little digitally beyond light display advertising
51 ASTEPRO Meda Asthma & Allergy 42 Feeble Miserable web site and absence from other digital media
© L2 2010 RESULTS: the rankings 8

9. DISCOVERIES
The Tipping Point PETER
Consumer appetite for digital health content is voracious and grow- GOLDER
ing: the number of Americans accessing health information online is Tuck School of
up 159% from 20041. Health portals including WebMD, Everyday Health, Business at
Dartmouth
and About.com Health attract millions of unique visitors. In addition, traffic to
branded pharmaceutical sites increased 82% last year, suggesting brands “Companies must
have a legitimate role in the online conversation. Disparity in the quality of the move beyond a DTC mentality and
digital content produced by pharmaceutical brands leads discriminating con- adopt a DFC mentality (i.e., direct
sumers to vote with their browsers. While brands categorized as Genius or from company). Instead of companies
Gifted experienced average traffic growth of 175% from March 2009 to March pushing information to customers,
2010, 40% of the brands in the study realized negative traffic growth. customers will pull information from
the company. An even better approach
is DFC + P2P, direct from company
Anti-Social Pharma plus peer-to-peer redistribution.”
Despite hearings in November 2009, the FDA has remained silent
about social media marketing regulation, restraining movement to
platforms such as YouTube, Facebook, and Twitter. Although 80% of
parent companies are starting to dip their toes into social media, only 19% of SCOTT
pharmaceutical brands maintain a presence on at least one site. Parent com-
HAGEDORN
PHD Media
pany efforts lack sophistication, offering little more than glorified PR content
and one-sided conversations. As a result, they have attracted few followers.
Bright spots include Johnson & Johnson’s YouTube channel, viewed more “We often get
than 1.6 million times, and Merck’s Gardasil human papillomavirus (HPV) asked if social activation should play
awareness Facebook page, with more than 100,000 fans. Patient demand for a role in brand efforts. Our advice
online networking opportunities has been validated by the emergence and is that it isn’t a matter of ‘if’, it’s a
growth of condition-specific patient networking sites such as PatientsLikeMe, matter of ‘when’. It comes down to
which doubled subscribers from December 2008 to December 2009, Juvena- mapping the brand introduction time-
tion, and Bayer’s MS-Gateway. line and knowing when to use social
and when not to in order to increase
impact while also mitigating risk.”
1
Manhattan Research
© L2 2010 DISCOVERIES 9

10. Learn by Doing Deserted Islands (Visibility)
Brands with a higher Digital IQ demonstrate more After the FDA submitted warning letters regarding
risk tolerance when approaching digital marketing. paid search to more than 40 pharmaceutical brands
Based on an assessment of regulatory compliance on in April 2009, most suspended search engine mar-
branded sites, brands ranked Average and below err keting. Although paid search has rebounded, and 70%
on the side of caution regarding FDA Web guidelines of brands currently purchase search terms, many brand-
while brands ranked Genius and Gifted employ broader ed sites are not optimized for organic search. As a result,
interpretations. Genius and Gifted brands have greater site visibility on major search engines for upper-funnel
social media penetration: 37% are present on at least disease-relevant terms lags that of such popular health
one platform, compared with 9% for Average and below portals as WebMD, Yahoo! Health, and HealthCentral.
brands. High IQ brands also returned to search marketing
faster than their laggard peers: 89% of Gifted and above
brands participate in paid search versus 59% of
Average and below brands.
SOCIAL MEDIA PENETRATION Brands
Brands vs. Parent Companies Parent Companies
YouTube
Facebook
Twitter
0% 10% 20% 30% 40% 50% 60% 70%
HEALTH PORTAL AND BRANDED-SITE TRAFFIC Health Portals
Monthly Unique Visitors to Health Portals and Branded Sites Branded Sites
20,000
18,000
Monthly Unique Visitors (thousands)
16,000
14,000
March 2010
12,000
10,000
8,000
6,000
4,000
2,000
D LTH H ES H E E NG AL M CIA RA FY A
BM EA ALT AD ALT AL
AG LIN RO TR XIU EN VIT ILI GR
WE YH ! HE GR Y HE RE LTH ST EN NE OR LE AB VIA
DA OO H LIT HE
A
LIV
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Y H ALT A ALT
ER YA HE QU HE
EV
© L2 2010 DISCOVERIES 10

11. Innovation Silos SCOTT PETER
The average dispersion in brand- HAGEDORN GOLDER
level Digital IQ among pharma- PHD Media Tuck School
of Business at
ceutical companies with more
Dartmouth
than one product in the study is
40 points. This large spread high- “Pharma is one “The results of
lights a silo mentality—digital com- of the few remaining categories with the Digital IQ studies present
petence within large companies sits this level of disparity around ide- companies with the triple threat of
isolated, with minimal shared learn- ation. It is hard for vertical teams innovation. First, with incremental
ing among brands. Although some structured around specific brands to innovation, companies can upgrade
companies leverage small econo- share best practices with other brand each of their own web sites to match
mies of scale (e.g., AstraZeneca teams. It is up to the agencies that internal best practices. Second,
sites are sometimes templated, and touch multiple brands to step up and through radical innovation, com-
GlaxoSmithKline sites offer universal help replicate innovative best practices panies can adopt and improve upon
customer service tools), digital efforts across the client brand verticals.” industrywide best practices. Third,
appear largely uncoordinated. The for truly breakthrough innovations,
lone exception is in social media, companies can look to unrelated in-
which is primarily deployed at the dustries for inspiration in developing
parent company level with little completely new approaches to digital
brand-level integration. communication.”
DIGITAL IQ DISPERSION
Range of Brand Digital IQ Scores and Average Digital Score by Parent Company
Viagra
GENIUS
Nexium
Chantix
140
Crestor
Gardasil Yaz
Symbicor t NuvaRing Lunesta
GIFTED Lipitor Seroquel
Ambien CR
Cymbalta
114
112
110
Singulair Advair
107 106
104 Zetia 104 105
AVERAGE Vytorin
Celebrex Cialis
Humira
90
91
Lovaza Plavix * Mirena
Avodar t
Lyrica Veramyst
CHALLENGED Omnaris
72
70
Pristiq
Trilipix
Toprol-XL
FEEBLE Caduet Niaspan
Pulmicor t
IZE
R
EC
A
RC
K INE TT CO
R LY NT
IS YE
R
PF EN ME KL BO RA LIL VE BA
Z TH AB P ELI A
T RA MI SE FI-
AS OS NO
AX SA
GL
* in par tnership with Bristol-Myers Squibb
© L2 2010 DISCOVERIES 11

12. Younger “Age of Onset” SCOTT
Brands Lead HAGEDORN
As one would expect, brands that market to younger consumers have PHD Media
higher Digital IQs. In an attempt to reach a generation raised on Google
and Facebook, brand marketers in categories such as Birth Control, HPV and
“We’ve seen the
Psychiatry have worked to understand how to design informative and interac-
internet emerge as the medium all
tive web sites, incorporate community content and technology, attract users
segments of the population say they
to branded sites, and test social media. Yet, this is a case of not seeing the
could not live without. There is clear-
forest from the trees as the vast majority of prescription drugs are consumed
ly an opportunity for pharma brands
by older adults who are increasingly online— in the five-year period from 2004
marketing to a senior population to
to 2009 Internet usage increased by 55% to 17.5 million users2 for seniors.
increase their web presence.”
Furthermore, the fastest growing cohort on Facebook is boomer-age women.
2
Nielsen
DIGITAL IQ AND AGE OF ONSET
Average Digital IQ Score and Age of Disease Onset by Disease State Category
HPV Human Papillomavirus
GENIUS BCL Birth Control
140 PSY Psychiatry
HPV ASM Asthma & Allergy
GIFTED RHM Rheumatology
BCL
GST URL Urology
110
GST Gastrointestinal
PSY URL
AVERAGE CDV Cardiovascular
RHM
90
ASM CDV
CHALLENGED
70
FEEBLE
0 0 0 0
E2 E4 E6 E8
AG AG AG AG
© L2 2010 DISCOVERIES 12

13. Patent Cycle’s Impact AVERAGE TIME TO PATENT EXPIRY
Brands categorized as Genius
12
and Gifted have an average of
1.7 more years before patent 10
expiry than brands categorized
Average and below, suggesting 8
digital marketing is correlated
YEARS
6
with the patent cycle.
4
Pharma brands typically invest
heavily in online disease education 2
and awareness efforts before FDA
0
approval. Drugs also invest early
Genius Gifted Average Challenged Feeble
in the patent cycle, one year after
FDA approval, as they are building DIGITAL IQ
awareness for the brand. Brands
new to the market have higher Digi-
tal IQs, suggesting a greater digital
investment and focus.
© L2 2010 DISCOVERIES 13

14. FINDINGS
Platform
Branded sites inform consumers and encourage patient compliance at different PETER
stages of the disease cycle. Sites for drugs with multiple indications face the ad- GOLDER
ditional challenge of tailoring content to different conditions. Because of the variety Tuck School of
Business at
of patient audiences, clearly directing users and prospects to appropriate informa- Dartmouth
tion is the hallmark of a strong site. Among branded sites, Symbicort and Abilify's
“Quantitative
are among the best at funneling visitors by condition and stage of diagnosis.
measures are most useful for bench-
Although all sites offer basic drug information, the best include disease educa- marking and upgrading sites on
tion, like Crestor’s scientific videos, and community content, like Nexium’s site established performance criteria.
with patient success-story videos and lifestyle tools. The biggest divergence Qualitative insights are most use-
among pharmaceutical sites is in the use of technology to amplify content. ful for generating and introducing
Although strong sites offer videos and interactive features with anatomic im- entirely new performance criteria.”
ages, doctor interviews, and patient testimonials, 55% fail to incorporate flash
elements, popular for adding animation and interactivity to web content and a
barometer of web sophistication, beyond the home page. QUICK STATS
Every site aims to influence visitors to act through one or a combination of Branded Sites:
symptom assessment surveys, doctor discussion guides, coupons for a new or
• 85% offer a Doctor Discussion
continuing prescription, and tools to encourage compliance with a prescription. guide
Many of these tools are PDF documents, which in many cases is not the best
• 62% offer little or no community
way to leverage the speed and convenience of the digital medium. Exceptions content
include Spiriva and Synvisc, which offer to send assessment results via email. • 57% offer savings for first-time
CALLS TO ACTION ON BRANDED SITES prescriptions
• 47% have an unbranded site,
60%
typically devoted to disease
50% education
40% • 45% offer a compliance tool,
Frequency
such as email, text reminders, or
30%
a downloadable PDF calendar
20% • 42% offer savings for current users
10% • 26% have no access to customer
service
0%
Visit Doctor New Rx Rx Savings Compliance
Call to Action Message
© L2 2010 FINDINGS 14

15. Forty-five percent of sites offer savings
to current users, effectively diminishing
the profitability of those sales, although
there may be gains in market share
when the drug is in a head-to-head
battle with a major competitor.
The creation of unbranded education-
oriented sites is a popular technique
to market drugs before approval
by the FDA. Once a drug is FDA-
approved, the use of unbranded sites
declines. Still, 47% of brands in the
study maintain a microsite to comple-
ment their branded site’s disease
education content.
Comparatively, the unbranded site
www.symbicort.com
typically generates significantly fewer
unique visitors than a branded site,
even when offering better disease
education information and technology
integration. For example, Advair.com
has more than 16 times as many
visitors as its arguably superior un-
branded counterpart, Asthma.com.
Low traffic combined with the danger
www.viagra.com
of competitive brands benefiting from www.viagra.com
other’s unbranded efforts, calls into
question their longer-term value.
www.abilify.com
© L2 2010 FINDINGS 15

16. Search Engine Optimization
Search engines are the primary tool pharmaceutical paid search advertising is primarily limited to two types of ads:
consumers use to seek health infor- brand-reminder and help-seeking. Brand-reminder ads incorporate a brand’s
mation online, and search remains a name and are restricted from explaining drug treatment uses and benefits;
digital priority for most pharmaceuti- help-seeking ads tout the uses and benefits of a drug, but do not mention
cal brands1. Brands strive for search its name. Brands in the study strongly favor brand-reminder ads, particularly
engine visibility, not only for consum- for patients further along the disease cycle using more specific, lower-funnel
ers seeking specific drug information, terms, and also because consumers may perceive help-seeking ads as con-
but also for those learning about a fusing and potentially misleading. In November 2009, Google proposed two
condition. Generating awareness new types of ads: product-claim ads, which would link to a product site and
among upper-funnel consumers explain drug benefits, and black-box ads, both of which link to full text black-
helps brands acquire diagnosed box warnings. Yaz is the lone brand in the study to use black-box ads.
but untreated patients. Research
has found that consumers who visit
a brand’s site are three times more
Brand-Reminder Ad {
likely to request a drug by name2,
and 44% of physicians prescribe
Help-Seeking Ad {
a requested drug3. Weak search
engine optimization by pharmaceuti-
Black-Box Ad {
cal brands allows health portals to
dominate in organic search visibility
for every disease state. RELATIVE TRAFFIC OF TOP BRANDED SITES
In 2008, more than 30% of pharma-
ceutical search engine traffic was
directed from paid ads4. Because of
March 2010
space limitations and FDA regulation,
1
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2
Manhattan Research
3
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QUICK STATS
BRANDS BY DISEASE STATE ON PAID SEARCH
SEO:
• 70% of brands engage in paid 100%
search on Google or Bing 80%
March 2010
• 62% of brands engage in branded 60%
paid search on Google or Bing
40%
• Google Page Rank average for
branded pharmaceutical 20%
sites is 4.75 0%
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GA
AS
© L2 2010 FINDINGS 16

17. Off-Platform Messaging
In 2009 pharmaceutical industry online advertising spend was up 31% SCOTT
year-on-year, to $117 million, while consumer ad spending overall remained HAGEDORN
virtually flat5. Digital spending represents about 4% of total DTC budgets. As PHD Media
online advertising becomes a larger part of pharmaceutical marketing bud-
gets, brands are looking for innovative ways to reach consumers, however,
most efforts remain focused on boilerplate ad offerings on highly trafficked “In addition to
consumer health portals, like WebMD or Quality Health. shifting ad dollars, marketers are
re-examining their overall market-
Fifty-eight percent of brands in the study advertise on WebMD, Everyday ing investments. We see a shifting of
Health, or About.com Health and 60% of these brands advertise on more than dollars to platforms that offer deeper
one of the portals. Branded presence on portal sites ranges from traditional engagement with consumers. We be-
display advertising to sponsored editorial content and diagnostic tools. The lieve this is driven in part by the richer
most effective advertising is highly visible on primary pages about a specific experiences that digital media offers.”
condition on the most popular sites. This coveted space sells out quickly,
often relegating competing brands to less desirable pages. Notable advertis-
ing initiatives beyond the portals are Cardiology drug Trilipix’s ads on video
platform Hulu, HPV drug Gardasil on the CW TV Network’s site, and allergy
QUICK STATS
brands' display advertising on AccuWeather and Weather.com. Portal Collaboration:
• 58% of brands advertised on
5 WebMD, Everyday Health or
Medical, Marketing & Media
About.com Health in February 2010
• 42% of brands had a noticeable
presence on WebMD
• 47% of brands had a noticeable
presence on Everyday Health
• 13% of brands had a noticeable
presence on About.com Health
• All Psychiatry and Rheumatology
brands were visible on top health
portals
www.webmd.com
www.qualityhealth.com
© L2 2010 FINDINGS 17

18. Email QUICK STATS
Email is a low-cost way to engage patients and ensure they stay current on
Email:
their drug regimen. More than 80% of brands offered opt-in email from the
• 72% of email programs
branded site, although less than 60% of these brands corresponded in a six-
contain a clear call to action
week period. Often a brand email effort is touted as a support program and is
to prompt doctor discussion or
complemented by an offline effort, including direct mail. prescription fills.
The number one reason consumers opt in to email programs is to receive • 70% of branded programs
coupons6, and 30% of email programs specifically offered savings. The personalize emails.
purpose and content of email campaigns ranged from calls to action (75%) • All Cardiology brands have email
to branded-drug-specific information: (75%), disease education (50%) and marketing programs.
community content (30%). • All Neurology brands have email
marketing programs with clear
In the best cases, emails were customized and personalized like Pristiq’s A
calls to action.
New Day support messages. Some brands, including Ortho Tri-Cyclen Lo,
Yaz, Humira, and Lovaza, offer patient reminder emails to support compli-
ance.
6
Epsilon
Lescol XL email
Humira email Pristiq email
© L2 2010 FINDINGS 18

19. Mobile
Pharmaceutical branded mobile
NOTABLE DISEASE MANAGEMENT APPS
activity is scant with the exception
of SMS reminder alerts sent by 15% MOBILE Disease Customer
APPLICATION State Rating Comments
of brands. Third-party companies
Enhanced $5.99 version allows
are also offering reminder and
users to log, track, and analyze
compliance apps, including the Chronic Pain Tracker Rheumatology 3/5 pain and download data into
PDF for healthcare provider
“Pill Phone” and “PillBoxer.”
discussion
None of the brands in the study $4.99 app allows users to
have applications available in iTunes, iHeart-Pulse Reader Cardiovascular 5/5 monitor and track their pulse
over time
however many iPhone apps exist for
both general and specific disease $0.99 app offers customizable
PureSleep AmbiScience Insomnia 3.5/5 audio programs to promote
management purposes. Notable in sleep
the general category is WebMD’s
$0.99 app provides tools to
app, “WebMD Mobile,” which pro- Live Happy Psychiatry 3/5 track mood and exercises to
vides information about symptoms, promote happiness
drugs, and first aid. Apps are com- Free app tracks number of
Smoking
mon for disease state management Quitter 3/5 smoke-free days and cost
Cessation savings
for conditions such as smoking ces-
sation, insomnia, allergies, rheuma- $0.99 app reminds users to
Pink Reminder Women’s Health 3/5
tology, and cardiovascular disease. take medication
QUICK STATS
Mobile:
• Merck and Sanofi-Aventis are the
only pharmaceutical parent com-
panies with iPhone apps. No
brands have iPhone apps
i-Heart Pulse
Reader App
ThePill.com App
Livehappy.com App
© L2 2010 FINDINGS 19

20. SELECTED HEALTH PORTALS
Unique
Monthly Advertising
Visitors Brands
PORTAL Description (millions) Key Advertising Tools include
Educational content, expert commentary, medical reviews, 17.4 • Banner ads Chantix
community services, and health management tools. Cymbalta
• Sponsored editorial
Content includes information about conditions, a drug Enbrel
• Sponsored “health checks”
database, healthy living advice, and news. NuvaRing
• Technology superior to other
Message boards and newsletters serve as a precursor to Viagra
sites
its upcoming Health Exchange community site.
Educational health content for more than 100 health 6.4 • Banner ads with flash and video Abilify
categories ranges from information about common health • Sponsored editorial Chantix
conditions to interactive symptom checkers to nutritional
• Custom email campaigns Lipitor
and exercise tips.
Orencia
Community section incorporates 2.0 tools, including blogs,
Plavix
personal profiles, and photos, to promote interaction
among site visitors. Seroquel
Viagra
Vytorin
Content organized by condition centers with information No • Banner ads Cymbalta
on the condition, symptoms, treatment options, and data • Video ads Kapidex
support resources.
Seasonique
The site also features healthcare news, videos, interactive Zetia
symptom checkers, and community content in the form of
health newsletters and such social media tools as blogs,
chat rooms, and forums.
Offers news, videos, tips, drug guides, and interactive 6.3 • Banner ads Cialis
health tools across a number of disease-specific • Video ads Lunesta
categories.
NuvaRing
Social media tools are integrated to promote community, Pristiq
and offer condition-specific groups, message boards, and
expert advice blogs.
Editorial content and videos often courtesy of third-party
health content providers.
Provides educational health content across more than 45 2.9 • Banner ads with flash Cymbalta
disease categories, with information on causes, symp- • Video ads Kapidex
toms, and treatments.
• Sponsorship of health centers Vytorin
The portal offers videos, news, expert advice, drug guides, • Sponsored editorial
and interactive tools, including symptom checkers and
quizzes. 2.0 tools include blogs and support groups.
Features informative health and fitness content, interac- 2.8 • Banner ads with flash Chantix
tive tools, resources, expert advice, videos, specialized • Video features Enbrel
reports, and community content across more than 50
Lipitor
disease centers.
Lyrica
Disease centers include content in line with that of other
NuvaRing
portals, such as news, information on symptoms, and treat-
ment options. Partners with third-party content providers. Pristiq
Viagra
© L2 2010 FINDINGS 20

21. Social Networking company channels (Ambien and QUICK STATS
Only 19% of pharmaceutical brands Toprol-XL). Videos range from offer-
Social Media:
are on at least one major social ing specific information about a drug,
media platform: Facebook, You- its benefits and side effects, to playful • 48% of parent companies have
a presence on Facebook
Tube, or Twitter. Standouts Gardasil content about a disease state, as in
• 28% of branded sites have
and Nexium maintain pages with the case of Levitra’s InBed videos
Facebook as a top-5 referral site
rich media content and have at- featuring a cartoon couple dealing
• Facebook is a top-5 referral site
tracted thousands of fans despite with erectile dysfunction.
for all Women’s Health brands
prohibiting wall postings to avoid
On the flip side, parent company • 60% of parent companies have
adverse-event reporting. On Twitter,
social media adoption tops 80%. a presence on Twitter, with an
the Purple Pill listens to custom- average growth in followers of
The disparity in participation be-
ers and direct messages an 800 31% from February to March
tween parent company and brands
number in response to tweets about 2010
highlights the effect of the current
the drug. The only other brand ac- • 36% of parent companies have
regulatory limbo concerning social
tive on Twitter is Spiriva, with five a presence on YouTube
media. However, most company
Twitter handles, four from celebrity • According to Manhattan
efforts are little more than PR or
spokespeople, conversing about the Research, almost 50% of con-
human resources tools. Johnson & sumers seeking health informa-
Drive4COPD campaign.
Johnson is a notable exception; the tion watched health videos online
Eighteen percent of brands have a company maintains an engaging in 2009
presence on YouTube ranging from presence on all three major plat-
dedicated YouTube channels (Yaz forms. Its YouTube channel features
and Lunesta) to videos on parent monials to educational pieces. The
videos ranging from patient testi-
corporate Twitter account retweets
and converses with users, while the
Gardasil Facebook company’s Facebook page features
wall postings of varied and interest-
ing content.
Some companies are experimenting
with sponsored communities tailored
to patients of specific disease
states. Bayer’s MS-Gateway forum
for multiple sclerosis boasts more
than 12,000 members and 200,000
posts. Other interesting efforts
include Novo Nordisk’s Voices of
Diabetes community and Novartis’s
CML Earth, an elegantly designed
platform for leukemia patients.
As social media platforms experi-
ence double- and triple-digit user
growth, the pharmaceutical industry
is missing a key opportunity to con-
nect with consumers. According to
Yaz YouTube Manhattan Research, more than 80
million Americans use social media
for health-related issues. Brands often
© L2 2010 FINDINGS 21

22. cite regulations about adverse-event
reporting as the reason for their hesi-
tation to embrace social media. Yet, a
November 2009 Nielsen study found
that only one in 500 online postings,
or 0.2%, incorporate the criteria re-
quired for adverse-event reporting.
Third-party patient communities are
proliferating, like PatientsLikeMe,
with over 50,000 members, but they
seldom offer brand advertising. Con-
sumer health portals are also moving
into the social networking space. In
March 2010, WebMD announced the
launch of Health Exchange, a new Johnson & Johnson
health social networking platform, to YouTube channel and
Facebook page
grab share from already entrenched
third-party social media communi-
ties. Well-known destination sites
are also strong on Twitter, Facebook,
and YouTube: LIVESTRONG’s CEO
tweets, retweets, and direct mes-
sages with some 1 million followers,
and Mayo Clinic’s YouTube channel
has generated more than 1.7 million
views.
Patientslikeme.com
© L2 2010 FINDINGS 22

23. TOP PARENT COMPANY TWITTER EFFORTS
Total
Follower Tweets Tweet Re-
Company Twitter Followers Growth* ** Growth* tweets? Comments
Pfizer pfizer_news 5,146 14.1% 99 11.2% N Mostly PR, some pharmaceutical news and links to
blogs and social media news
Novartis Novartis 4,652 ND 150 4.2% N Information about the company, products, links to
other social media and technology. Company also
appears to own protected handle Novartis Trials
GlaxoSmithKline GSKUS 3,426 ND 254 13.9% Y Links to GSK blog posts, news, other links; glaxo-
smithkline also appears to be occupied by com-
pany, but no tweets
Johnson & JNJComm 3,201 ND 744 7.2% Y Highly personalized content; retweets and
Johnson converses; provides color on industry and more
general news
Roche Roche.com 3,193 ND 661 7.1% Y Conversations and news about company
Genentech genentechnews 2,754 6.6% 81 11.0% N PR news, information, links; brand also occupies
genentech handle but no tweets
Amgen Amgen 2,124 8.4% 101 4.1% N Corporate PR and financial news
Sanofi-Aventis Durbaniak 1,677 ND 1,484 ND Y Vice president for innovation tweets about
pharmaceutical social media
AstraZeneca AstraZeneca 1,287 17.4% 107 16.% Y PR information, including comments from CEO
Sanofi-Aventis sanofiaventisTV 924 6.3% 132 6.5% N French-language handle
Bristol-Myers bmsnews 785 31.5% 4 ND N Mostly business news. First tweet March 1, 2010
Squibb
Merck merckcareers1 669 8.6% 1,056 10.0% N Posts job openings. Company also appears to
occupy Merck handle but account is protected
Bayer BayerHealthCare 556 143.9% 48 ND N German and English bilingual account tweets news
AstraZeneca AstraZenecaJobs 481 12.4% 888 13.6% N Tweets about available jobs
Genzyme genzymecorp 397 26.0% 0 0.0% N No content; unsure if official
Pfizer RayKerins 362 ND 31 3.3% Y Retweets Pfizer content and other pharmaceutical
posts. Updates about FDA approvals and other
industry news
Lilly Eli Lilly 205 9.6% 0 0.0% N No content; unsure if official
Novartis NVSOncoCareers 128 ND 58 141.7% N Links to job postings
Amgen AmgenFoundation 61 103.3% 2 NA N First tweet late February about Amgen’s
foundation and philanthropic efforts
Galaderma galaderma 38 18.8% 0 0.0% N No content; unsure if official
* February-March 2010 ** As of March 2010
© L2 2010 FINDINGS 23