13 November 1998
EFA98\MULTIMED.MS
3,500 words

Fun and profit with medical entertainment
and direct-to-consumer marketing
How Jenny talked her way in to TV

NEW YORK--Writing for medical magazines is a hard way to make a living, so the Editorial Freelancers Association got a briefing on medical consumer marketing and film production on 12 November 1998. It's hard to break in, but if you do it's well-paid and glamorous. It takes an obsession with tailoring your writing style to the needs of your market, and an obsessive persistence. Even then there's no guarantee.

But there's a growing market for new media. How does a pharmaceutical company advertise a prescription drug on TV and also deliver the warnings that the FDA requires? By posting a web site, according to the new FDA regulations. (See, for example, Claritin (loratadine, Schering))

Most of those web sites are "lousy," said Jim Sandino, General Manager, Lowe McAdams Direct, New York. "They just take the print ad and put it on the site."

Brilliant presentation

Much of New York ad agency life consists of going to brilliant presentations by articulate, interesting, persuasive people. That's their job. The general theme of these presentations is, "How can we do a better job of persuading customers to buy our client's product?" Every presentation has to answer this question in a new and interesting way, and show, with humor and cleverness, how the competition is incompetent. Sandino didn't disappoint.

With bad marketing, even if you have a good product, you can't give it away, Sandino demonstrated. In fact, you can't even pay people to take it, even if it would grow hair on a billiard ball.

Chris Valentini, VP, Production, Unapix Entertainment Inc., of New York, San Francisco and Seattle, said that it's hard to break into TV, but even an outsider can do it by pitching a good idea. "I don't care if I get an idea from a gaffer," he said. He explained why he let a persistent freelance travel writer do her first script, and both speakers suggestions places to make connections.

"Medical Economics is making some editorial changes and is looking for new people," Sandino mentioned in passing.

Not like selling soap

Sandino's job is to "design, implement and manage" major advertising and marketing accounts for promoting prescription drugs directly to consumers. These campaigns, for products like Rogaine (minoxidil, Pharmacia & Upjohn), would include print ads, brochures, newsletters, TV, radio, CD-ROM, and the Internet. (For Internet marketing, see the New York New Media Association which has many job listings for writers.)

These direct-to-consumer (DTC) medical marketing programs are "far more complex," he said, than a consumer product like his first account, Coca-Cola's Tab.

"A prescription product is something you ingest that usually has some profound effect," said Sandino. Marketing "was considerably more complicated than Dove soap."

With a consumer product like Dove, all they need to know is whether it works, which they can find out by taking it home and trying it out. With a prescription drug, people want far more information about the product. "In many cases, they want more information about their condition," said Sandino. You have to give them whatever information they need to feel comfortable approaching their doctor.

"Unfortunately, a lot of people who write this stuff are turning out stupid, stilted, stubborn copy," said Sandino sibilantly. "If I were a consumer I would walk away from it."

The problem with bad copy, said Sandino, is that they don't show the consumer "enough value, enough information" that is "understandable and actionable."

Decision pathway

For Sandino, a tanned former skin-diving instructor, the model for a DTC pharmaceutical sale is that the consumer faces a series of barriers to buying a product. Each of those barriers is associated with fear, embarrassment, or at least inconvenience. The writer's job is to overcome these anxieties one step at a time. Sandino calls each step a "decision pathway."

In good copy, "the heart of those messages," throughout the entire campaign, said Sandino, is the decision pathway.

"If you're selling soap," said Sandino, the consumer walks down the supermarket aisle and sees, "Dove... a cleansing cream." You put it in your shopping basket, take it home, and try it out, "without great fear."

In contrast, with a prescription product, there are "a number of decision pathways."

"Understanding the decision pathway is the genesis of good writing and good communicating," said Sandino.

The first DTC drug was Seldane (terfenadine, Hoechst), said Sandino. That was an easy one. The message was, "There's a product out there that will treat your allergy and won't make you sleepy. Go to your doctor." And it's an easy prescription to write. (Unfortunately terfenadine had fatal interactions with other drugs and was pulled off the market.)

The problem with Rogaine

The problem with Rogaine, said Sandino, was that the original campaign, by a rival agency, would tell men who are losing their hair to go to their doctor for a prescription. They wouldn't go. Rebates didn't work. Even when they offered to pay men $10 in cash just to ask their doctors about Rogaine, the men didn't respond.

There were obviously barriers that the customers themselves couldn't articulate. Men would say, "Well, it's not a problem for me." In the focus groups, men with 4 strands of hair combed across the top of their head would say, "Well, I'll try it when it gets bad."

You can't move the product until you understand the barriers, and then overcome the barriers, said Sandino. Overcoming those barriers is the purpose of everything you write in a campaign. You have to make the customer feel comfortable about each of the barriers, so they can go on to the next step.

So a writer, getting to understand a new client, has to ask, "Have they identified those barriers that we have to get past?"

And for prescription drugs, the message "has to be filled with caution and balance and side effects," to meet regulatory and legal requirements.

"I can't do good communication with a writer unless they understand this process," said Sandino.

Right level of detail

Another writing problem is getting the right level of detail, education and sophistication. Some writers write down and don't give customers the information they want. Sandino's mother called and said, "I just went to a new doctor and he didn't understand my lipids. I have high HDL and he doesn't understand the relationship between the HDL and the LDL." You have to give enough scientific information to overcome the barriers. "You have to think about the decision point," he said.

One bad campaign, by a rival agency, was for an osteoporosis drug, said Sandino. The client did a "ton of research" and found out that people in their target market were terrified of osteoporosis. So the company did a campaign to fight the fear. "It was a dark and stormy night and you're afraid to walk down the path." People would "turn the page," he said. You must first get them comfortable. "It should be more hopeful and uplifting" than, "I'm afraid."

"The end that you have to have in mind is to make the consumer comfortable, not stubborn, with the decision points," said Sandino.

Medical entertainment

The second speaker, from a video production company, described how he finds his way to a land of glamour and dreams through a slippery path of commercial realities. It takes creativity and business acumen. Good writers can break in with great persistence and a willingness to work cheap, on spec, and perhaps on pro bono projects like video releases for non-profits.

Valentini has to come up with ideas that are interesting enough that networks like PBS will pay him $150,000 per hour for a series like "Great Minds of Medicine" or "Great Minds of Science," which he then farms out to independent production companies. And the ideas have to be interesting enough that they can remarket them through home videos and international sales to repay the actual $300,000 per hour production costs, and then go into profits. Their revenue is now up to $30 million, and they created 80 hours of non-fiction entertainment in 1997.

Because Unapix is publicly traded, a good description of their business is available in their 10-K form at the Securities and Exchange Commission.

"I am a producer and director of natural history and cultural programming," said Valentini. He's spent 12 years traveling around the world, overseeing production of CD-ROMs, web sites, and other interactive media.

"Unapix produces a variety of genres," one of which is medical films, said Valentini. With writers, he looks for someone "who can tell a story in an engaging manner that complements the visual material."

"There has been a lot of growth in wellness programs," said Valentini, whose PBS "Power of Myth" series grossed $10 million in video sales with Joseph Campbell, Deepak Chopra, and Andrew Weil. (But personalities like Weil didn't sell internationally.) "Great Minds of Medicine" covered topics like depression or cancer, with expert interviews and human stories. A 6-part series, "Cutters," featured 2 doctors treating patients. "The audience wants the drama of a human element," he said. "If we can follow someone through a particular disease, that is much more engaging."

How to break into TV

It's difficult to break into TV, but for a medical writer with a good print background and wonderful portfolio, who is tenacious and willing to start cheap, it's not impossible, said Valentini.

The nature of the business, said Valentini, is that they always have writers coming in and pitching ideas, which then go through a darwinian selection. "It is indeed a business and ideas are a dime a dozen," he said.

"If you are a writer who doesn't have a lot of experience writing for TV, make contacts in TV, said Valentini. "Watch TV. Look at the credits, see who the producers are, get on the phone and dial for dollars."

"No one is going to give you $300,000 to produce a program unless you've done that before," said Valentini. Anyway, the producer has to spend much of his time dealing with legal and business issues, and "as a writer you probably don't want to do that."

"You must be able to work with other individuals," said Valentini. Like the King James Bible, "TV is a collective medium," he said. "You're working with people who have a variety of views. You put your ideas on paper. You take that paper out into the field and shoot it. You come back and look at it," he said. You see what's wrong with it and rewrite it.

"Unfortunately, in TV, you're writing for the lowest common denominator," said Valentini. On public TV, the standard is a little higher, about 6th to 8th grade.

You have to entertain at the same time that you're giving information, said Valentini. In a CD-ROM, for example, you have to understand what your reader is doing on a particular screen.

"If I see a dog in a picture, you don't have to tell me it's a dog," said Valentini. "Tell me something about the dog."

Internet stories

"Story telling is wonderful, because a story has a beginning, a middle and an end," added Sandino. "On the Internet, sometimes a story goes on and on and on."

"We have to train writers to behave like an orchestra," said Sandino. Conductors have main themes and minor themes, he said. You don't write everything in the first program, because then you won't have anything left for the other programs. "We have to people how to pace."

"I have a creative director who's looking for people who do a certain thing, said Sandino. Writers who are looking for work should "look at the creative material that comes to you and see if you can do a better job."

If you're writing for a CD-ROM, for example, said Valentini, you should "look at the breadth and depth and how it fits into the information architecture." When you call up a word like "love" or "cancer," how much information are you going to get? The reader has to get something out of it that they couldn't get out of a book.

"If you can master brevity, you'll get far," said Valentini.

$3,000 to $12,000 a script

Valentini gave a rough idea of the payment at different levels of work. In cable, which is the usual entry point, the head writer who is responsible for the 15-page script for a 1/2-hour (22-minute) program would be paid a low of $3,000 and a high of $6,000. In national programming, they would be paid double that. The head writer for a series of 6 1-hour programs, who stylistically manages a group of writers, might be paid $75,000 for 6 months' work. On the other end, a copy editor for a 1/2-hour program might get $500 for a couple of days' work. "I hire a lot of freelancers," he said.

Valentini gets ideas for programs from writers, in the form of written proposals of 1 page or more. The idea might be, "We'll go to New York Presbyterian Hospital and follow a cancer specialist through his treatment of 3 patients from the beginning to the end." Then, Unapix will collaborate with the writer and try to sell the program to, say, the Learning Channel.

If you sell them on a good idea, but you don't have much experience, "We're going to put a head writer on it, and you can be the second writer," said Valentini. After you go through this process a few times, and learn how everything works, you move up to head writer. A good idea is one that can be developed into a second program, and then into a series. "We try to create a series that will have a long life," with VTR and international sales.

Neatness counts. "I have gotten a 1-page proposal, laser printed with graphics, that looks fantastic," said Valentini. If he puts that next to a 1-page typewritten proposal, "which am I going to look at?" he asked. "It's a visual business." Length doesn't matter that much. Proposals can be 15 pages.

"At Unapix, we have a weekly meeting," said Valentini. Each idea is assigned to someone who "owns" it. "That person is a spokesman who pitches the idea" at the meeting and tries to get a division of Unapix--the non-fiction, fiction, film, or new-age group--to buy it. "An hour costs $300,000 to produce, and the most we can get from a domestic producer is half that,"

Difficult to get in

"The difficult part is for somebody like you to get in," said Valentini. "The thing that helps most is passion. If you are passionate and tenacious, you will do well in TV. I have writers who only got in because of their tenacity." People want to "sit at a table with you and know that you are excited," said Valentini.

"Call me the next week," said Valentini. "If you don't get me, call me the next day."

"I am there to fill a need," said Valentini. "I have a need on Thursday, and if you call me on Thursday and you can fill that need, you'll get a job."

"You can send a resume, but unless I have a need I will not get back to you," said Valentini. It's better to send an idea. If it's a good idea, he can send it on to a writer, and you can get in on a collaboration. Unapix subcontracts its production out, and if he recommends you to the production house, they'll give his recommendation a lot of weight.

You have to know the market, said Valentini. "You're not going to pitch a medical show to Bravo, but The Learning Channel did very well with Trauma." It helps to have a voracious appetite for what's going on in popular culture. Like Shakespeare, they try to steal ideas from successful formulas. Steven Spielberg is working on a movie, "Memoirs of a Geisha." Unapix is producing a video on the life of a geisha. If the Titanic is big, you want to cash in on the Titanic wave. Had he only known, "we could have had a documentary on Viagra."

One EFA medical writer suggested a show on arthritis. Valentini shot it down. "Who could I sell it to?" That's a news story, not an entertainment story, he explained.

A CD-ROM is "very collaborative," said Valentini. For a slide show, an editor will say, "These are the images we want to match. Pick the best 7 and write about them. Tell me a story."

He hires people to rewrite. "We hire writers who can get information across but don't have a lyrical flow," said Valentini. "I'll hire a script polisher," who will fix the choice of words, add alliteration, and metaphor.

Jenny's big break

In San Francisco, Valentini was doing a film on Ireland. A travel writer who was freelancing for the San Francisco Chronicle heard about the project. She had no experience in TV. "She made a phone call," he said. "She was tenacious. She called again and again and again." Finally he invited her to his office. She was "very interesting and somewhat eccentric."

Valentini said, "Jenny, write this on spec. You'll get a credit and an opportunity to write, and if it's good I'll give you the next job." Jenny invested several months of spare time on it. She started with an outline, and wrote it and rewrote it into a script. "At the end of the film she had a credit."

But medical expertise doesn't count for much, said Sandino. "We do have to be able to tell the technical story," he said, but "I usually want to see it more from an emotional side."

One good way to break in is writing video news releases for non-profit organizations to be used as public service announcements, suggested Valentini.

Where to make contacts

Another good way is to meet people at the Direct Marketing Association, (which recently acquired the politically feisty Association for Interactive media). "I look for people who have direct marketing background, because they understand the process better," said Sandino.

(The next--expensive--meeting of the Ad Club will be on 19 November, 11:15am-2:00pm, "Strategies for Digital Branding," Plaza Hotel, 5th Ave. & 59th St. Members $75, Non-Members $100. Panelists: Marc De Swaan Arons, Director of Interactive Marketing, Unilever NA; Michael Janes, vp Electronic Commerce, Federal Express; Maureen McGuire, VP Worldwide Marketing Communications, IBM; Moderator: Beth Snyder, Advertising Age. Contacts: Jami Kelminson, (212) 533-8080 (212), 533-1929 (fax). The Ad Club has no web site.)

You can read trade publications like DM News, Medical Marketing & Media, and Medical Economics, said Sandino, and contact people who are written up.

People in this business are approachable, said Sandino, "I try to see as many people as I can, because I need new ideas."

"We have a lot of freelancers come by, and we like that," said Sandino. "We don't have to pay a fee to an executive search firm."

"I just paid someone $5,000 to do a fulfillment package," said Sandino. It included a brochure, letter, and business reply card, and took 3 days. "I had a writer who I quickly fired, who said it was beneath her to write a business reply card," he said. Reply cards are easy for a skilled writer, but they are important. "If I can't get a response, what good is it?"

--Norman Bauman

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