1. Milnacipran
More than Just a Pain Medicine
October 8, 2008
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2. Agenda
Welcome and Introductions Paul Klein and Team
A Look at Our Agency Paul, Rich Roth, and Phil Silvestri
Milnacipran
Our Strategy Kate Persky, Kate Gill
Creative Ideas Kurt Nossan, Yvonne DeSanti
Strategies and Tactics Maureen Russell, Sue Maserjian
Approach to Measurement Kate Gill
Discussion Group
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3. Our Strategic Process
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4. Creative Business Idea Approach
Research and Other
Insight Feeds
Market Momentum: Consumer Category Brand
Consumer
CBI Focus: Creative Business Idea
Brand Category
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5. What We Did to Prepare
Review of Milnacipran On-line Review: Review of Secondary Resources Conducted Qualitative Adcept &
Briefing Documents Monitored Chat Rooms, Analyzed Imagery Research: In-Depth
FMS Websites & Support Programs Interviews/Focus Groups
Competitive Audit: Review of Category Interviews with
Communications and Competitive Brands KOL Rheumatologist Dr. John Nitsche
and Psychiatrist Dr. Lydia Fazzio
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6. Consumer
Brand Category
The Consumer
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7. Consumer
It’s About Physical Pain…
Brand Category
_ “Even like brushing my teeth sometimes, pain in
my hand from holding the toothbrush.”
_ “I cannot read a hardcover book; it’s too heavy to
hold.”
_ “It affects everything you do. Combing your hair
becomes a chore when your arms feel like lead
and they’re burning.”
_ “A feather feels like a 10-ton truck.”
_ “It feels like this tiny tourniquet is turning all the
time.”
_ “It’s like having the flu; everything aches.”
_ “It’s definitely about more than pain.”
Source: Euro RSCG Tonic Qualitative Research, 9/08
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8. Consumer
There Are Other Physical Symptoms
Brand Category
_ “It’s like nobody’s home. You ask me questions
and I can’t even grab words.”
_ “I couldn’t get my brain focused.”
_ “If I just water the plants and take the dogs out,
I’m exhausted.”
_ “It’s psychological, depression’s involved, lack of
sleep…can’t work as much.”
_ “You feel like you’re in a fog…not functioning
properly. You’re doing what you have to do but
you’re not fully there.”
MY BODY CALLS THE SHOTS
Source: Euro RSCG Tonic Qualitative Research, 9/08
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9. Consumer
It Changes the Way I Live My Life
Brand Category
_ Universally, the most difficult part of the day is
getting out of bed in the morning, when sufferers
feel stiff, even “paralyzed”
_ Most have some type of “barometer” to evaluate the
kind of day they’re going to have
_ “I’m having a good fibro day or a bad fibro day”
_ Movement is important but the body doesn’t always
cooperate
_ Managing the disease requires ongoing negotiation
with their body…plus a pharmacopoeia of drugs and
alternative treatments
_ A positive attitude and proactivity help somewhat
_ The constant grind wears them down
_ “It’s like being punished, pummeled, being in the ring
every day”
Source: Euro RSCG Tonic Qualitative Research, 9/08
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10. Consumer
It’s an Emotional Struggle, Too
Brand Category
The doctors said
“I feel all alone and
“you’re crazy, you’re
kind of trapped ”
losing your mind”
“Keeping it secret
“It’s all the time, like
makes my life
Chinese torture”
smoother”
“When they tell you
“There’s a lot of fury
you’re crazy, it
and a lot of rage”
infuriates you”
“You start to wonder if they
“Everyone with FMS
could be right; you start to
is pretty pissed off”
question yourself”
Source: Euro RSCG Tonic Qualitative Research, 9/08
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11. Consumer
I Have No Support
Brand Category
_ Sufferers feel discounted and misunderstood…
even by medical community
_ Can take years to be diagnosed correctly
_ Often told “it’s all in your head”; feel
anger/frustration—at docs, friends, family who are
skeptical or don’t understand
_ The invisibility of the disease leads to secrecy
Source: Euro RSCG Tonic Qualitative Research, 9/08
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12. focus group video

13. Consumer
It’s a Vicious Cycle
Brand Category
_ Different symptoms exacerbate and reinforce one another with emotional
consequences, leading to the need for medication plus support
Anger Frustration
Cognitive Problems Self-doubt
Exhaustion
Fatigue
Physical Pain
FMS
Sleep Disorders
Self-blame
Punished Depression/Anxiety
Stress Misunderstood
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14. Consumer
The Consumer
Brand Category
Trapped in the
multi-dimensional vise
of fibromyalgia
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15. Consumer
Brand Category
The Category
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16. Consumer
An Emerging, Yet Unformed Category
Brand Category
_ Significant potential as category projected to grow
substantially
_ Influx of new medications and an upsurge in
diagnosis rates
_ Lack of disease awareness and understanding
among general population and medical community
_ No one owns the FMS relationship—PCP,
rheumatologist, psychiatrist, osteopath, yogi—
nor the brand
_ Opportunity to shape the conversation, as the
dialogue is just beginning
Source: DataMonitor 2007
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17. Consumer
Lyrica: Legitimizing FMS
Brand Category
_ Beginning to shape the fibromyalgia space
_ Communications live in the solution
_ Captures a real consumer insight with
“the unique pain of fibromyalgia” yet fails
to fully leverage the power of this idea
_ Focuses on the functional improvement
and the reduction of pain the drug
delivers, but doesn’t capitalize on the
emotional aspect of the condition
_ Positions itself as the fibromyalgia
medication not indicated for depression
_ Branded and unbranded communications
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18. Consumer
Cymbalta: Entrenched in Depression, Stepping into FMS
Brand Category
_ Recognizes the mind/body connection with “Depression hurts, Cymbalta can
help” campaign — in the depression category
_ Depression heritage may limit Cymbalta’s potential to leverage FMS indication
_ FMS DTC to date online only, and professional print
_ Anticipate Lilly to capitalize on existing relationships with HCP’s to promote the
FMS indication
_ Prasugrel didn’t get approved; may free up money to allocate to Cymbalta
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19. Consumer
The Category
Brand Category
Efforts are just beginning to
validate the condition, but no
one owns the FMS relationship
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20. Consumer
Brand Category
The Brand
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21. Consumer
Strong Functional Advantage
Creates Meaningful Benefits
Brand Category
Ultimate Benefit Feel less trapped/more positive
Treat FMS symptoms
Functional Benefit
more successfully
A more
Functional Advantage complete treatment
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22. Consumer
But Huge Need Gap Remains with FMS
Brand Category
_ Doctor/patient face-to-face time is as brief as six minutes
(Source: medscape.com)
_ 72% of doctors interrupt the patient’s opening statement
after an average of 23 seconds (Source: A. Suchman, Journal of American
Medical Association)
_ Doctors remain key source of information, but access to
them is limited — HCPs can’t fill the gap
_ “With FMS, if you just throw medication at them, and don’t
give them the benefit of the time and counseling they need, I
don’t think their treatment will be optimal” (Source: Interview with
John Nitsche, MD, September 2008)
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23. Consumer
Getting a Prescription Is Just the Beginning
Brand Category
_ 75% still seek information via talk, online, ads*
Actions taken
after filling
Read the product information that came with the medicine 87%
Ask your pharmacist questions about the medicine 41%
Talk with a friend/family member who is taking the same/ 33%
similar medicine
Find yourself stopping to read/watch an advertisement for the medicine 29%
Look online for:
Information about the medical condition 38%
Information about the medicine 34%
Recontact your doctor to ask more questions:
About the condition or illness 25%
About the medicine 21%
* % who say they filled the prescription, when a doctor prescribes a medicine they have never taken before
Does not include read the product info that came with the medicine they saw or heard advertised
Source: Prevention magazine 2007 DTC Study
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24. Consumer
Information Overload, but Little
Understanding of What to Believe
Brand Category
_ The search for chronic pain relief drives sufferers to
seek the latest information and to be open to new
medications/treatments
_ Seeking information can be overwhelming
_ Google search: over 9MM results for fibromyalgia in .14
seconds
_ Media contradictions lead to patient confusion and
become barriers to treatment/prevention
_ Even Dr. Frederick Wolfe, who first defined the diagnostic
guidelines for FMS, now does not consider it a disease
(Source: The New York Times, “Drug Approved. Is Disease Real?” January 2008)
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25. Consumer
Sufferers Need a Guide or Advocate to
Help Them Navigate
Brand Category
_ The increasing complexities of medical care make it
harder for patients to understand their condition and
treatment options
_ “Getting reliable information is a source of
comfort and empowerment…patients are even
attending disease advocacy group meetings to
hear about the latest research and meet other
patients.” –Ken Schueler, Patient Advocate
They need someone to partner with them in managing
their FMS—physically, mentally, and emotionally
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26. Consumer
The Milnacipran Brand
Can Address These Needs
Brand Category
Giving sufferers greater control over the
physical, mental, and emotional impact of FMS
Body Is in Control Feeling of Personal Control
Empower
Endless The Brand Meaningful
Struggle Management
Empathize
Multi-dimensional Vise Reduced Symptoms,
More Support
Turning a vicious cycle into a virtuous cycle
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27. Consumer
The Milnacipran Brand Can Redefine
the Relationship
Brand Category
_ Milnacipran needs to become the:
_ More complete treatment that goes beyond pain—to
treat the total fibromyalgia syndrome
_ Ally: embracing the whole person—physical, mental, and
emotional
_ Advocate: giving sufferers a voice and changing the
conversation about FMS: patient to doctor, patient to
family, patient to peers
_ Partner: delivering a true personalized support
program, with on-going dialogue and feedback
Insulating the brand from competitive encroachment
now – and in the future
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28. Consumer
Extending the Strategy via a Personalized Support
Program Makes for a Stronger Emotional Connection
Brand Category
Ultimate Emotional Benefit Feel less trapped/more positive
Elevated Brand Benefit Better control of your
condition
Treat FMS symptoms more
Functional Benefit Treat FMS symptoms
successfully and manage
more successfully condition more successfully
A more complete A more complete
Functional Advantage treatment treatment/support
Source: Adcept Focus Groups
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29. Consumer
Brand
Brand Category
Address the whole person in
a whole new way
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30. The Creative Business Idea
Consumer
Trapped in the
multi-dimensional
vise
of FMS
Finally, a reason
to be optimistic
Beginning to
Address the
legitimize condition,
whole person in a but no one owns the
whole new way FMS relationship
Brand Category
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31. Milnacipran Creative Brief
What is the challenge?
To drive diagnosed sufferers to ask their doctor about Milnacipran and connect with sufferers on a more meaningful level, by
demonstrating a keen understanding of the condition and their physical and emotional plight
Who are we talking to?
Sufferers who have been diagnosed with fibromyalgia (primarily women ages 20–60) and are open to new treatment options to
enhance their quality of life.
What is their mindset?
Fibromyalgia is about more than just pain. It can include symptoms such as sleep disorders, fatigue, morning stiffness, anxiety,
and cognitive problems—symptoms that can reinforce and exacerbate one another. It’s a vicious cycle and wears on sufferers
physically, mentally, and emotionally, as they learn how to live with and manage the disease. Added to this daily grind is the
frustration they feel as a result of often being misunderstood by their family and friends, and misdiagnosed and mistreated by
the medical community. The disease becomes their secret—you can’t see it, and others are skeptical about it. Those who
manage the disease best try to maintain a positive attitude and are more proactive about their condition.
The Idea
Finally, there’s a reason for fibromyalgia sufferers to be optimistic.
Reasons to Believe
_New milnacipran does more than just treat pain: It’s a more complete treatment for the total fibromyalgia syndrome
_It’s proven to help you function better in your day-to-day life
_Milnacipran offers a true, comprehensive support program for the fibromyalgia patient
How should the brand speak?
With conviction, understanding, and optimism.
Media
Lead with print and deliver 360° idea.
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32. Creative
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90. Strategies and Tactics
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91. Moving to a Better Model for DTC
Transaction Model: Mass Awareness
Info Click to
search websites
Mass Ask doctor Compliance
Awareness for drug
Peer-to-peer
Read articles
Relationship Model: Creating Better Patients
Targeted Ask Dr
Engagement Foster Refer to doctor for drug Loyalty
understanding Discuss
condition Compliance
Self- with doctor Persistency Advocacy
assessment
Start two-way
Discuss drug
conversation
with doctor
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92. Strategic Imperatives
FROM TO
Mass awareness Targeted engagement
Empower with information Empower with understanding
Drive to physician Start a conversation
Ask for drug by name Discuss condition and drug
with doctor
Do not upset doctors Help doctors
Contrived messaging Relevance and richness of
meaning
Acquisition Acquisition and real relationships
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93. How We Get There
Brand and agency collaboration: Obs/Strats, alignment
Consumer Deep Dive – identify gaps, research, gain insights
Develop branded campaign
Unbranded campaign to educate and build database
Launch unbranded support program
Branded campaign launch: NEW 6 mos.
Launch branded support program
Convert unbranded to branded
Professional Marketing
FDA
DDMAC DDMAC
Approval
Submission Response
Q4 ’08 Dec ’09
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94. Approach to Measurement
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95. Measurement, Optimization, and ROI
_Euro RSCG is known for creating integrated marketing
communications that “move needles”
_Approach
_ ETHOS: We deliver “applied creativity”; if it doesn’t work, it wasn’t
creative. And we monitor all the indicators through the purchase
funnel—from copy-testing through lead generation, and on to
profitable share growth
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96. Measurement, Optimization, and ROI
_ GLOBAL ANALYTICS CAPABILITIES: Our Global Director of Marketing
Science serves as lead on the group that manages Tracking studies, DR
analytics, medical marketing research, author support statistics services
_ All of our below-the-line projects have built-in tracking and measurement
_ For larger projects, we can draw on the resources of Euro RSCG offices globally
_ FLEXIBLE PARTNERING: We can provide turnkey services across the
marketing measurement cycle. Or we can work to integrate information
streams from your databases and those of third-party vendors
_ A NETWORK BEHIND US: When customized analytics are required, we
have access to our network for specialized analyses
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97. Thank you
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