Vaccine Marketing Gardasil 9 – Case Study Series (transcript below)
Therapeutic vaccines vs. preventative vaccines
Many therapeutic vaccines are for chronic disease and involve daily or weekly use. Consumers are close to the product and learn more about the treatment, which can influence their decision to continue or switch.
Though therapeutic vaccines are becoming more prominent, vaccines are generally associated with preventative care and marketers of preventative vaccines work to drive consumer awareness of the risks and prevalence of the disease and then motivate the public to take preventive action. This can be difficult if past vaccination campaigns have been successful in eradicating a target.
Conveying an accurate perception of the benefit–risk ratio is another challenge when marketing preventative vaccines and for some products we need to consider seasonality and timing. Government entities and independent organizations also play a large part in preventive vaccines because they often subsidize R&D.
The focus of this session is on HPV vaccinations: Gardasil and Gardasil 9, where we’ll examine the marketing of those products in terms of timeline and digital avenues.
Background: In 2006 both Merck and GSK launched HPV vaccines with the aim of preventing cervical cancer. GSK launched Cervarix first in European countries and secured patents for Africa. In the US, Merck’s Gardasil was approved by the FDA. At initial launch, Gardasil protected against HPV 16, 18, 6, and 11, but with Gardasil 9 they successfully included 5 additional strains.
The purpose of this session is to examine this from a marketing perspective as there have already been several ethical, moral, and legal analyses on this topic.
Marketing initiatives: Gardasil and Gardasil 9
The first step of their marketing process began during the time in which Gardasil was in clinical development and prior to FDA approval. Merck was working to develop health-economic evidence to obtain positive recommendation for vaccination and public financing.
Next, physician educational programs and unbranded DTC campaigns were initiated and this was several months prior to launch. A total of $841,000 was spent on those marketing efforts (Seirs-Poisson, 2007a).
“Make the connection” was the initiative where Merck partnered with non-profit organizations to raise awareness of the disease and encouraged readers to connect 1. HPV with cervical cancer and 2. with their family and loved ones. You’ll notice that they utilized “Make the Connection” bead kits and if we think about the fact that the target demographic for Gardasil was young girls, this was a pretty innovative approach.
“Tell someone” was a television advertisement that featured several women that were encouraging viewers to “tell someone” about the disease. Again, here they were trying to raise awareness of the disease. We’ll leave all the links in the transcript if you’re interested in examining those ads in further detail.
After FDA approval and positive vaccination and public financing recommendations, Merck then targeted states and insurers with market access programs and pushed for state mandates, which only succeeded in certain states. While doing so, they launched their branded physician and DTC campaigns as well.
Vaccine marketing (present):
These are the display ads for Gardasil 9 that were running previously. They’re targeted towards Canadians though the ad at the bottom was showing activation for only a day. In Canada, girls between ages nine and 13 can receive free HPV vaccinations no matter where they live. Four provinces currently or will soon also offer the vaccine to boys as well. We can get a general sense of timeline of these ads and piece together the bigger picture in terms of marketing as we see that Merck relaunched their controversial TV commercial around mid-April of 2017. (Most other countries don’t allow DTCPA at all, but Canada does allow ads that mention either the product or the indication, but not both)
The “Mom, Dad, did you know?” ad was launched to increase awareness of HPV and its relation to “certain cancers”. It involved a boy and a girl around their 30’s that got HPV-related cancers and they then had the actors age in reverse to an earlier point in their lives at around 9 years of age where they ask their parents “Mom, Dad, did you know?” implying that it could have been prevented (with a vaccine). From the data, we see that an estimated $41M was spent on the ad for a 2-month duration. Launching a controversial ad might not seem like a good move, but if you consider their product portfolio and corresponding earnings estimates, it’s easy to see why they made this decision; however, we will not be examining those details today.
Why launch controversial ads and why the controversy?
Though this was the purpose of the ad, the problem mainly had to do with the fact that the public felt like they were being attacked and labeled as negligent and their children would get cancer as a subsequence. This was enough to spark outrage at the time of launch in ways that brought awareness to the disease, but adequate measures needed to be implemented to counter combative consumers through social mediums.
The situation had propensity to spiral out of control due to misinformation and this has been known to happen before—and not only in this industry, but those that are successful in managing negative public sentiment typically generate a response on the same platform within 24 hours of occurrence (J&J and Tylenol) as silence generally leads the public to believe that their accusations were correct.
A term that gets thrown around often is that we’re in the “Era of the Informed Consumer.” People will talk about this in relation to finding out about their own diseases or medication prior to consultation with HCPs, but the same also applies to fact checking and research. It’s easy to forget that web history stays around forever, so that is something to account for when assessing the benefit to risk ratio of launching a controversial ad.
The ad has been criticized as false advertising, but that’s not exactly true. The verbiage of the ad is carefully crafted where they did choose to phrase information in a way that could be perceived as misleading to the public. This marketing strategy would have been more effective in the past where these types of ads would generate a lot of buzz through word of mouth and worried parents would then consult with their PCPs, but it is more challenging now that so much information (some false) is readily available online.
The more scientific of consumers can get information about Incidence vs. Mortality of Cervical Cancer and see that it’s rather low in the US compared to other countries and then make assumptions based off this one piece of information.
The purpose of their advertisement campaign was to increase awareness of HPV and potential for progression to cancer if left untreated and that is reason to continue to run the campaign. In the US, Gardasil 9 is the only HPV vaccine on the market because GSK’s Cervarix exited late 2016 due to low market demand. However, the (reformatted) global sales data from EP Vantage shows that Gardasil sales are decreasing and Cervarix increasing.
Regardless of whether people agree with the way this was implemented, no one can deny that it has brought awareness to the disease in the shortest amount of time—60 seconds. However, with launch of a controversial advertisement should be anticipation of and planning for social media communication and PR management on multiple channels.
Seirs-Poisson, J., (2007a). Setting the Stage: Part one in a series on the politics and PR of cervical Cancer.