Taking Birth Control Public : Ortho Ad Opens Door to Mass Advertising

As advertisements go, the print-dense one for birth control pills that premiered in consumer magazines last October wasn’t particularly flashy or dramatic.

“We’ve come full circle since 1960,” the ad for Ortho-Novum 7/7/7 proclaimed above a full-color close-up of 28 well-lit pills arranged in a circle. Readers were then treated to three pages of tiny type discussing the benefits and risks of oral contraceptives.

But that ad has probably changed the world of prescription-controlled contraceptives forever. In launching the first big national campaign for the Pill, market leader Ortho Pharmaceutical Corp. has opened a door through which other contraceptive makers will surely follow, analysts predict.

In fact, the marketers of all the newest birth control methods--both prescription and non-prescription--say they are considering advertising directly to consumers rather than relying on the more traditional method of targeting doctors, nurses and family planning clinics.

“It’s a whole new world,” said Mary Ann Leeper, senior vice president of development for Wisconsin Pharmacal, which hopes to receive the final nod soon from the Food and Drug Administration to begin selling the first female condom in the United States.

Even so, analysts expect that while American women will welcome new options, they are unlikely to embrace the new contraceptives as enthusiastically as current birth control methods.

The last two years have brought more changes for U.S. women in terms of birth control than occurred in the decade before.

The FDA recently approved Depo-Provera, an injection given every three months. That product will be launched Tuesday. And Norplant, a six-capsule implant in the inner arm that provides protection for five years, has exceeded expectations since its introduction in February, 1991.

Ortho’s multimillion-dollar foray has been “well received,” said Clare Castaldo, spokeswoman for the Raritan, N.J.-based drug manufacturer, a subsidiary of Johnson & Johnson.

“From our understanding, there’s a very good awareness of the ad,” which has run in such magazines as People, Glamour, Mademoiselle, Self and Health, Castaldo said. “We did get some very good feedback, very positive feedback from physicians who felt that it helped them in their practices and from patients who thought they learned something from the ad.”

Ortho has contended that the primary purpose of the ads is education, but company officials have acknowledged that it would be nice to sell a few more pills along the way. Castaldo said it is too early to tell if the ads will boost Ortho’s share of the U.S. oral contraceptive market, which analysts estimate has slipped to about 35% from 40% nearly five years ago.

But the fact that Ortho has spoken directly to women about a prescription birth control method, something tried previously only on a limited basis, has created a challenge to other contraceptive makers.

“I feel pretty confident that others will follow” and advertise directly to the public, said David F. Saks, a drug industry analyst with the Gruntal & Co. investment firm. “Nobody likes their competitors to be one up.”

Indeed, general consumer advertising is being contemplated by Wyeth-Ayerst Laboratories, which markets Norplant, and by Upjohn, maker of Depo-Provera. Over-the-counter contraceptives, such as condoms and the Today sponge, are already advertised directly to consumers, although major TV networks have yet to carry the ads.

“We definitely are considering that,” said Audrey Ashby, spokeswoman for Wyeth-Ayerst, a subsidiary of American Home Products that is marketing Norplant.

So far, Norplant’s success has exceeded the company’s expectations, drawing strength from an extensive education campaign for health care providers and word of mouth among women. In less than two years on the market, more than 500,000 of the implants have been inserted, Ashby said.

“This product has not been successful in another industrialized country . . . (and) the general feeling was that an implantable would not be successful in the United States,” Ashby said. “That’s part of why we have conducted this extensive training program. You have to sell the concept to both the patient and the health care provider.”

Wyeth-Ayerst does advertise a few other prescription products. Such ads must be approved by the FDA and must list the benefits as well as the risks of taking the drug.

“We’re not taking the place of the health care provider,” Ashby said. “It’s an opportunity for women to get more information and ask questions.”

Upjohn is keeping its marketing plans for Depo-Provera under wraps until a news conference launching the product Tuesday. But Upjohn spokeswoman Florence Steinberg said the drug maker is taking a close look at direct consumer advertising.

“We’re still working on all the details,” Steinberg said. “I can tell you that we intend to do an extensive education program with material for physicians, nurses and patients.”

Officials at Wisconsin Pharmacal say they also are considering advertising their non-prescription product. But no matter what, said Leeper, the senior vice president of development, Wisconsin Pharmacal has a big education job ahead of it for Reality, as the female condom will be called.

The sheath-like condom, one end of which is inserted like a diaphragm, recently received approval from an FDA advisory committee but has yet to get the agency’s final OK.

“Our first thrust, clearly, as soon as we get FDA approval, is to start working with a strong education program with the providers before we go to the consumer,” Leeper said, “so when they go to their doctors or their nurse practitioners they will have answers for (the patients’) questions.”

Advertising psychologist Renee Fraser said drug companies, particularly those introducing products, would be smart to go directly to consumers to create a brand awareness.

“Advertising is a way to inform as well as persuade,” said Fraser, president of a Los Angeles-based advertising company that bears her name. “I think that women have a right to make choices--informed choices.

“In this day and age, I think it’s appropriate to treat women as decision makers who are able to weigh the pros and cons,” she said.

But some people are concerned about advertising any prescription drug directly to the public rather than to the medical community. Critics worry that consumers might make judgments about prescription drugs based on advertisements that are ultimately designed to sell a specific product. Some consumer advocates have charged that the Ortho ads understate the risks associated with the Pill--a contention Ortho disputes.

The American Medical Assn. used to ban the advertising of prescription drugs; the stance was softened in June to say that such ads should be reviewed case by case. But the AMA has considered contraceptive advertising a special case that should be encouraged to provide information on risks and benefits.

Drug industry analyst Sharon Wagoner said it is difficult to judge the potential of Depo-Provera because Upjohn has yet to announce a price. Still, she said, the injection method and Norplant will have only a small impact on the overall U.S. contraceptive market.

“I think the people who are on oral contraceptives like the daily control,” said Wagoner, an analyst with Argus Research in New York. But these new contraceptives “would be appealing to women who have trouble with compliance. It certainly is easier for those people who would forget a lot,” which can be a problem for daily pill takers.