Reviews

Promoting drugs through hairdressers: is nothing sacred?

The HRT (hormone replacement therapy) scare, which began this July with the release of the Women's Health Initiative (WHI) study, could be expected to be a major worry to pharmaceutical companies. After all, HRT accounts for 10% of the sales of a company like Novo Nordisk, for example. Ten per cent of sales, from a company that made a net profit of almost £330 million, is quite a lot to have at stake. These companies have moved swiftly to respond to this business risk in various ways. Nor did they have all their postmenopausal hormone chips on just one drug. Consider, for example, how another of Novo Nordisk's HRT products, a tropical preparation called Vagifem, was ready to step into the breach for women concerned about not losing one of HRT's selling pointsmore comfortable intercourse.

Doctors and journalists responding to the WHI results were swift to let women know about the Vagifem alternative. One doctor recommended it in the Washington Post, and one of the doctors from the WHI study also gave it a positive mention in the New York Times. Although this free publicity was to be expected, the manufacturer of Vagifem had something far more ingenious up its sleevebypassing doctors and journalists to get hairdressers to promote the drug. Yes, hairdressers. By October, a media agency had won a prestigious Australian media award for this innovative concept.

Novo Nordisk had commissioned a media agency, Starcom, to devise a campaign to increase the sales of Vagifem. Discovering that more menopausal women confide in their hairdressers than in their doctors on these matters, they piloted a programme of hairdressers' promotion of the product. In a classic piece of "disease-mongering," a website about painful intercourse was used. Its addresswww.whylovehurts.comwas emblazoned in reverse on capes for women to wear in hairdressing salons, so they could see and memorise the address while they sat in front of the mirror. As well as the jaunty, free capes, the hairdressers got "scripted messages" to use themselves, along with fact sheets to hand out to their customers. Sales of Vagifem spikedand Starcom walked off with the national award in the "best one-off media campaign" for Australia. It must have been cost effective, too: the same campaign also scored a nomination in the "best use of small budget" category.

Hairdressers in Australia are being approached to promote this solution to "why love hurts"with rumours of direct financial incentives, not just free capes. Meanwhile, in North Queensland, they are being recruited in a new health promotion campaign to increase exercise. It is true that many of us sit for much longer in hairdressing salons than in doctors' surgeriesnot to mention visiting more often. However, despite this new discovery of the potential of this captive audience and the person they trust, the chairperson of the Consumers' Health Forum of Australia, Lou McCallum, says: "It is stressing the imagination to think drug companies might want to call hairdressers healthcare providers." In Australia, the code of conduct for pharmaceutical advertising precludes advertising drugs to anyone other than a healthcare professional.

McCallum reports that the Consumers' Health Forum "has had concerns about the application of the code in Australia for some time. We have made complaints in the past which have been rejected on technical grounds, and it seems that the companies are intent on either ignoring the code completely, or testing out the limits of the code's jurisdiction by coming up with as many ideas as they can to move towards direct to consumer advertising." McCallum said that the forum now intends to lodge a complaint about the Vagifem campaign.

Direct to consumer advertising is officially allowed only in the United States and New Zealand. However, it is leaking across the planet, thanks to the internet (both websites and email campaigns) and cross border sales of many glossy US magazines and newspapers. Advertising efforts for drugs are big business now as well, and these campaigns feature prominently in advertising awards around the world: the Vagifem campaign is only one of many award winning drug campaigns. Indeed, a quick scout on the internet could not find any list of awards that did not include a drug company. That is not surprising, given the size of advertising budgets in the pharmaceutical industry. Consider the amount of money spent on promoting the COX 2 inhibitor Vioxx. In 2000, while Nike spent $78.2m on advertising its shoes and Pepsi spent $125m on advertising its drink, the Vioxx advertising budget was a whopping $160m.

We already knew all that; but, advertising via hairdressers? What next? Offers of hints on a little something to help relieve your feelings of anxiety and guilt, the next time you're sitting in a confessional?

Hilda Bastian, former chair. 

Consumers' Health Forum of Australia hilda.bastian{at}flinders.edu.au