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
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, 2 159–168 Journal 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 Marketing Vol. 8, 2 159–168 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, 2 159–168 Journal 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
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
the list after the separation policy came into effect. 5 This is directly attributable to availability of information about erectile Journal of Medical Marketing Vol. 8, 2 159–168 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, 2 159–168 Journal 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 Marketing Vol. 8, 2 159–168 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
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, 2 159–168 Journal 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 Marketing Vol. 8, 2 159–168 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, 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 Research 35 (5) ,
opportunity for services marketers? International Journal of Service Industry Management 6 (1) ,
academic research. Based on the fi ndings S. Korean and even broader international Research 3 ,
Growth of Sales Promotion in the United States .
International Journal of Advertising 1 (6) ,
Advertising 23 (4) ,
Sponsorship spending to increase 8.7 per needs to be empirically confi rmed. Also, IEG Sponsorship Report 22 (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 ,, November 10, 2006 .
Focusing on life style drug market .
Economic Briefi ng of Samsung Economic Institution , available at, October 5, 2006 .
Han Gyu Rye Dairy Newspaper .
from, October 1, 2006 .
22 Lee , Y . W . ( 2007, January 29 ) . more active in erectile dysfunction market . report on the World’s Top 50 Pharma-Companies .
anniversary of symposium for erectile dysfunction .
Pharmaceutical Executive Europe , Korea Pharmaceutical Association News ,, October 10, 2006 ., October 8, 2006 .
S . ( 2006, May 15 ) . The presence and the future Eighth Asian Urology, Asian males study . from, October 12, Pharmaceutical Association News , Environmental change and prospectus of Korean Seoul Economic Daily Newspaper ,, November 15, S . W . ( 2006 ) . The presence of FTA and its effect advertising of erectile dysfunction drug, a case of Health Industry Development Institution ,, October 5, 2006 .
2008 Palgrave Macmillan Ltd 1745-7904 $30.00 Vol. 8, 2 159–168 Journal of Medical Marketing
at Pharmaceutical Association News , pharmaceutical marketing, in the depressed economical Seoul Economic Daily Newspaper , Money Today Economic DailyNewspaper ,, October 15, 2006 ., October 20, 2006 .
Korean Pharmaceutical Association News , Sport Seoul Daily Newspaper , available from, October 5, 2006 . Journal of Medical Marketing Vol. 8, 2 159–168 2008 Palgrave Macmillan Ltd 1745-7904 $30.00
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