How to reach consumers in a market where DTC is not allowed Received (in revised form): 9th August, 2007 Chang Dae Ham is an advertising doctoral student in the University of Missouri at Columbia. He fi nished his masters degree at the University of Florida. He worked in advertising business as an account executive in South Korea for ten years. Jong Woo Jun is a full time lecturer at the School of Communications, Dankook University, Seoul, South Korea. He earned his PhD degree in the Department of Advertising at the University of Florida. Previous to his study, he worked in the advertising business. He has worked for LGAd and Crayfi sh in South Korea. He received a BA and an MA, both in mass communication from the Hankuk University of Foreign Studies, Seoul, South Korea. His research interests include international branding and event marketing. Hyung-Seok Lee is a doctoral student in Department of Advertising, College of Journalism and Communications, University of Florida. His research focusses on brand personality, intercultural communication and health communication. Keywords South Korean pharmaceutical market , erection dysfunction drug , and BTL marketing communication Abstract This study explores the characteristics of the rapidly changing South Korean (S. Korea) pharmaceutical market, specifi cally focussing on the erectile dysfunction drug market. The S. Korean drug market is in the middle of a signifi cant transition stemming from a Free Trade Agreement (FTA) with the United States, as well as the separation of dispensary services from Korean medical practices. Due to strict restrictions on DTC (direct-to-consumer) marketing in S. Korea, the role of BTL (below-the-line) marketing has received a considerable amount of attention from both researchers and industry marketers. Little is, however, known about its real-world application to a fast-moving market such as one fi nds in S. Korea. Thus, the understanding of how BTL can be applied to a specifi c market would be meaningful for the elaboration and implementation of marketing action. The fi ndings show that the most useful and most frequently used marketing communication tools for erectile dysfunction drug marketing in S. Korea were academic symposia and public relations (PR) events. While their primary marketing target was doctors and pharmacists, marketers also use various BTL marketing tools to communicate with consumers. By using press releases about their activities, they effectively convey their brand information to a general target audience. Finally, the implications of BTL marketing for researchers and practitioners are discussed. Journal of Medical Marketing (2008) 8, 159 – 168. doi: 10.1057/palgrave.jmm.5050123 Jong Woo Jun Department of Advertising INTRODUCTION
College of Journalism and Communications
In general, the pharmaceutical industry is
said to be one of the higher value-added
different depending on the region of the
businesses in the world. Annual global sales
world where the products are offered. For
Fax: + 1 352 846 5117 e-mail: [email protected]
2008 Palgrave Macmillan Ltd 1745-7904 $30.00 Vol. 8,2159–168Journal of Medical Marketing
Reportedly, S. Korea signed FTA contracts
agreement with the United States. 6 Since
year. In contrast, developing markets such
as Asia, Latin America and Eastern Europe
faced with a serious situation. For instance,
excluding the Japanese market, represents
only 8 per cent of the global market, it is
competitive against these global giants is
one of the fastest growing pharmaceutical
to strengthen R & D capacity as well as
marketing power. 7 It is diffi cult, however,
pharmaceutical market share will represent
2.3 per cent of the global market share by
experienced what can be described best as
2006. This will be one of the fastest global
separated pharmaceutical dispensing from
growth rates. Primarily due to a growing
medical practices. The core change of this
elderly population as well as an increase in
policy was to classify all drugs into either
S. Korean pharmaceutical market will be one
of the markets with suffi cient potential to
purchasing ETC drugs without a doctor ’ s
prescription. In addition, marketing activity
companies. 4 Given the rapid growth rate
pharmaceutical market, it is meaningful to
prohibits any type of direct-to-consumer
the S. Korean market, it is important to
pharmaceutical marketers have effectively
domestically in accordance with the Free
countries. 5 When two countries agree to
strategies under these signifi cant changes
and strict restrictions. Specifi cally, this
Journal of Medical MarketingVol. 8,2159–168 2008 Palgrave Macmillan Ltd 1745-7904 $30.00 How to reach consumers in a market where DTC is not allowed
study focussed on how effectively erectile
meters, and in other locations ’ ; and
‘ product placement in movies ’ (p. 40).
examples of BTL marketing such as ‘ direct
mail ’ , ‘ creative sales promotions ’ and ‘ access
chosen for the current study because they
innovations ’ such as product placement,
also because they are generally one of the
done via websites, banner advertising, web
promotion tools used in today ’ s rapidly
current study explores the effectiveness of
erectile dysfunction drug marketing in S.
transmitted through personal home pages,
blogs, discussion groups, chat rooms, etc can infl uence sales, both positively and
What is BTL communication?
negatively. 12 Particularly in S. Korea,
As the marketing environment has become
which is one of the leading countries in
information technology, online marketing
into BTL and ‘ above-the-line ’ (ATL) based
expenditures in overall US industries, 13
print. 9 While ATL marketing is based on
than 70 per cent of their total marketing
sponsorship, sales promotion, etc. 10 This
classifi cation was coined based upon the
expensive traditional media, which meant
and as such is less effective. 11 According
measuring the effectiveness of traditional
instantly seen by just mining scanning data
for sales. This immediate sales-checking
electronic media ’ ; ‘ sport and event
sponsorship ’ ; ‘ in-store advertising ’ ; ‘ mini-
billboards in transit vehicles, on parking
short-term effects of marketing activities.
2008 Palgrave Macmillan Ltd 1745-7904 $30.00 Vol. 8,2159–168Journal of Medical Marketing
In addition, the effi ciency of traditional
media was successively discredited in the
comprised about 80 per cent of total drug
asserted that ‘ Mass media advertising as we
sales. 5 One of the interviewees cited in
know it today is on its deathbed ’ (p. 71).
this study reported that due to the steadily
They posited that the introduction of new
increasing portion of ETC in total market
sales, most pharmaceutical companies have
multifunctional media, resulted in the split
This has unsurprisingly led to an increase
in their marketing budget for doctors and
Similarly, Aaker 16 pointed out a key role
pharmacists. 18 To appeal to this specifi c
For example, by sponsoring athletes, teams
was more effi cient than ATL. This is one
or sporting events, some companies, such
could increase their brand awareness and
establish a strong, favourable and unique
brand image in consumers ’ minds. Besides
sponsoring sporting events, fi rms might
marketing, almost all marketing activities
Pharmaceutical Manufacturers Association)
important, effective and effi cient marketing
tools. For instance, corporate spending on
Review Board). 19 Given this reality, the
global sponsorship was estimated at $ 28bn
pharmaceutical marketers started searching
competitive the market is, the more necessary effective marketing communication strategies are. From this
WHY IS BTL PROMINENT IN THE S. KOREAN DRUG
of the most appropriate methods that can
of separating dispensing from medical practice was put into effect in 2000, pharmaceutical marketing activities have
THE ERECTILE DYSFUNCTION MARKET
the list after the separation policy came
into effect. 5 This is directly attributable to
availability of information about erectile
Journal of Medical MarketingVol. 8,2159–168 2008 Palgrave Macmillan Ltd 1745-7904 $30.00 How to reach consumers in a market where DTC is not allowed
dysfunction products, S. Korean consumers
have, however, for several reasons, shown
vigorous efforts to deliver their marketing
great interest in erectile dysfunction drugs.
First of all, the longer a human lives, the
effi ciently. In reality, S. Korean pharmaceutical
disease will occur. Erectile dysfunction
degenerative diseases. Secondly, S. Korean society has become more open about the
How erectile dysfunctional drugs apply BTL to their marketing
more willing to discuss their defi ciencies
In the erectile dysfunction drug market,
with others. In addition, new media such
as the internet has encouraged people to
specifi c brand preference than in other
share their personal information as much
as they want. All these social changes have
directly and indirectly. For this reason,
symposia, photo event promotions, online
promotions and sports marketing. 8 Based
very competitive. 21 Since Pfi zer ’ s Viagra
depth interviews, this study explores how
entered the same market within four years.
Cialis, produced by Eli Lily, has earned the
including BTL, in terms of both academic
second largest market share in S. Korea.
Bayer Health Care ’s Levitra and Dong-a Pharmaceutical ’ s Zydena have also joined the fray. Specifi cally, the domestic brand
Viagra has been the market leader since it
market share, which represents the fastest
growth rate in the market, despite the fact
2006. 8 Furthermore, more pharmaceutical
marketing efforts. To handle this problem,
competitive but profi table market. 22 For
launch their new erectile dysfunction drug
academic symposium. For example, Pfi zer
‘ SK-3530 ’ in 2007. Additionally, one
symposium with the theme of ‘ A new life
with Viagra ’ in 2005. In this symposium,
there was an extensive discussion regarding
how Viagra had affected the lives of the
middle-aged S. Korean couples, as well as
how the couple ’ s sex life had improved
over the last ten years. 23 Additionally, the
2008 Palgrave Macmillan Ltd 1745-7904 $30.00 Vol. 8,2159–168Journal of Medical Marketing
about ‘ strength ’ than speed with regard to
erectile function. Bayer marketers executed
expose the general public to their research
concept. In spite of the regulations, they
The one signifi cant deviation from normal
emphasise their company name rather than
their product ’ s brand name. The caption
‘ Middle-aged Koreans, let ’ s keep strong! ’ was so breathtaking that an advertising
Levitra ’ s representative marketing tactic is
Pharmaceutical Manufacturers Association
decided to withdraw the advertisement. It
Care distributed a promotional fl ash CD
titled ‘ Levitra Girl ’ to doctors of urology.
mention the brand name ‘ Levitra ’ in their
While this CD title provided information
advertisement. Although Bayer Healthcare
about Levitra and general marketing data
ceased using this advertisement, its effect
sex appeal called ‘ Levitra Girl ’ . Levitra
In addition, Levitra marketers sponsored
awareness of Levitra with the ‘ Levitra Girl ’
cited its research to show their product ’ s
game. The game was sensational enough to
effectiveness. Bayer Healthcare sponsored
catch the attention of both users and their
doctors. Later, Levitra marketers said that
Conference and released its results to the
it was the one of the few and fresh ways
press. People who read the article about
the conference were exposed to the effect
of Levitra. Accordingly, the company, Bayer
title was, however, later withdrawn due to
Bayer Healthcare, which produces Levitra,
failed to distribute to their target, they
the results of the 12th world congress of
because this sensational news story resulted
ISSM (ie International Society for Sexual
in broad exposure of their product to the
Medicine) that the erectile success rate
marketing concept to differentiate Levitra,
reported for Viagra. Regardless of whether
people believe this result or not, Levitra
S. Korea, from other competitive brands.
Korean, its concept was ‘ strong ’ . This
Journal of Medical MarketingVol. 8,2159–168 2008 Palgrave Macmillan Ltd 1745-7904 $30.00 How to reach consumers in a market where DTC is not allowed
Cialis is the erectile dysfunction drug
more than 36 h, this benefi t can appeal to
introducing their product concept through
a PR event. As the second erectile dysfunction drug brand launched in
different concept to the general public.
The concept of Cialis was a ‘ 36 h long-
lasting effect ’ . Despite the existing
restrictions, they held the ‘ Marathon race
to overcome erectile dysfunction ’ , which
effects of Cialis by positioning it as the
‘ Marathon drug ’ . To emphasise the ‘ 36 h ’
putting it in third place in the S. Korean
long-lasting effect, the marathon race was
erectile dysfunctional market. 31 Zydena ’ s
notation 3.6 to imply 36 h. The marathon
different from those of its competitors.
metaphor was used to illustrate the long-
lasting benefi ts of Cialis. This event was
sponsored ‘ the Love Shining Night ’ , which
participants and catching the attention of
newspaper readers, since marathons are a
museum of S. Korea. In this event, Zydena
rapidly growing form of popular exercise
take time to understand each other ’ s
slogan of this campaign was ‘ Over the top
with Cialis ’ , which was targeting middle-
aged couples who were usually at the top
of their respective fi elds. In the same
context, Cialis sponsored the ‘ Cialis Pro
with a unique approach to taking erectile
communications used by individual brands.
dysfunction medicine. To emphasise their 36 h long-lasting effect, their campaign slogan was ‘ Take Cialis before you ’ re home
CONCLUSION AND DISCUSSIONS
they could enjoy a normal sex life thanks
to Cialis ’ long-lasting benefi ts without
their partner. 30 In addition, Cialis held
marketing strategies and tactics used in
2008 Palgrave Macmillan Ltd 1745-7904 $30.00 Vol. 8,2159–168Journal of Medical Marketing Table 1 : Types of BTL marketing communication BTL marketing
competitive, it is necessary to look for
alternative marketing tools to effectively
— is strictly prohibited in the S. Korean
pharmaceutical market. In this situation,
couple of managerial implications as well. This study shows the overall picture regarding the marketing environment of
the S. Korean pharmaceutical industry. For
this marketing environment analysis could
provide fruitful information. Given that
change, the time is right for international
Specifi c marketing communication tools
are also interesting. Even though various
regulations banning direct contact between
exist, marketers use alternative marketing
tools to enhance consumers ’ awareness and
brand equity. More specifi cally, academic
direct responses from consumers. Although
companies. While their primary marketing
mass media advertising is believed to be
marketers also targeted the general public
tool, other alternatives can be effective
the strict regulations. This alternative
channel with the general public was press
perspective can also be applied to other
releases about their activities. Using press
releases, marketers successfully informed
As the case of the ‘ Levitra Girl ’ game
could, however, evoke ethical issues among
Journal of Medical MarketingVol. 8,2159–168 2008 Palgrave Macmillan Ltd 1745-7904 $30.00 How to reach consumers in a market where DTC is not allowed
between awareness increases and negative
6 Korean Ministry of Foreign Affairs and Trade ( 2007 )
29 July, available at http://www.fta.go.kr/, October 11,
responses. For a product entering a given
C . ( 2006 ) Interview with Kim, Seung Ho,
the CEO of Bo Ryung Pharmaceutical Co. Press
release data of Bo Ryung Pharmaceutical Co .
S . ( 2006 ) personal interview, October 11, 2006 .
should be careful about negative marketing
marketing: immoral or imaginative practice? Journal of Advertising Research35 (5) ,
opportunity for services marketers? International Journal of Service Industry Management6 (1) ,
academic research. Based on the fi ndings
S. Korean and even broader international
Research3 ,
Growth of Sales Promotion in the United States . International Journal of Advertising1 (6) , Advertising23 (4) ,
Sponsorship spending to increase 8.7 per
needs to be empirically confi rmed. Also,
IEG Sponsorship Report22 (24) ,
H . Y . ( 2006 ) personal interview, November 15,
explored in terms of the effectiveness of
their marketing communication strategies.
pharmaceutical consumer for prohibition drug over-
Finally, the effects of BTL communications
Monthly Korea Advertising Information ,
http://www.adic.co.kr, November 10, 2006 .
Focusing on life style drug market . Economic Briefi ng of Samsung Economic Institution ,
available at http://www.seri.org/, October 5, 2006 . Han Gyu Rye Dairy Newspaper .
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2008 Palgrave Macmillan Ltd 1745-7904 $30.00 Vol. 8,2159–168Journal of Medical Marketing
at http://www.sportsseoul.com/oldnews/2004/0704/
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