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October 8, 2008

Milnacipran

More than Just a Pain Medicine

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Welcome and Introductions Paul Klein and Team

A Look at Our Agency Paul, Rich Roth, and Phil Silvestri

Milnacipran

Our Strategy Kate Persky, Kate Gill

Creative Ideas Kurt Nossan, Yvonne DeSanti

Strategies and Tactics Maureen Russell, Sue Maserjian

Approach to Measurement Kate Gill

Discussion Group

Agenda

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Our Strategic Process

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Market Momentum:

CBI Focus:

Consumer BrandCategory

Consumer

Brand Category

Creative Business Idea Approach

Research and Other Insight Feeds

Creative Business Idea

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What We Did to Prepare

Review of Secondary Resources

Review of MilnacipranBriefing Documents

Conducted Qualitative Adcept & Imagery Research: In-Depth

Interviews/Focus Groups

On-line Review:Monitored Chat Rooms, Analyzed

FMS Websites & Support Programs

Competitive Audit: Review of Category Communications and Competitive Brands

Interviews with KOL Rheumatologist Dr. John Nitsche

and Psychiatrist Dr. Lydia Fazzio

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The Consumer

Consumer

CategoryBrand

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_ “Even like brushing my teeth sometimes, pain in my hand from holding the toothbrush.”

_ “I cannot read a hardcover book; it’s too heavy to hold.”

_ “It affects everything you do. Combing your hair becomes a chore when your arms feel like lead and they’re burning.”

_ “A feather feels like a 10-ton truck.”

_ “It feels like this tiny tourniquet is turning all the time.”

_ “It’s like having the flu; everything aches.”

_ “It’s definitely about more than pain.”

It’s About Physical Pain…

Source: Euro RSCG Tonic Qualitative Research, 9/08

Consumer

CategoryBrand

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_ “It’s like nobody’s home. You ask me questions and I can’t even grab words.”

_ “I couldn’t get my brain focused.”

_ “If I just water the plants and take the dogs out, I’m exhausted.”

_ “It’s psychological, depression’s involved, lack of sleep…can’t work as much.”

_ “You feel like you’re in a fog…not functioning properly. You’re doing what you have to do but you’re not fully there.”

There Are Other Physical Symptoms

Source: Euro RSCG Tonic Qualitative Research, 9/08

MY BODY CALLS THE SHOTS

Consumer

CategoryBrand

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_ Universally, the most difficult part of the day is getting out of bed in the morning, when sufferers feel stiff, even “paralyzed”

_ Most have some type of “barometer” to evaluate the kind of day they’re going to have_ “I’m having a good fibro day or a bad fibro day”

_ Movement is important but the body doesn’t always cooperate

_ Managing the disease requires ongoing negotiation with their body…plus a pharmacopoeia of drugs and alternative treatments

_ A positive attitude and proactivity help somewhat

_ The constant grind wears them down _ “It’s like being punished, pummeled, being in the ring

every day”

It Changes the Way I Live My Life

Source: Euro RSCG Tonic Qualitative Research, 9/08

Consumer

CategoryBrand

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Source: Euro RSCG Tonic Qualitative Research, 9/08

It’s an Emotional Struggle, Too

The doctors said “you’re crazy, you’re

losing your mind”

“When they tell you you’re crazy, it infuriates you”

“I feel all alone and kind of trapped ”

“It’s all the time, like Chinese torture”

“Everyone with FMS is pretty pissed off”

“You start to wonder if they could be right; you start to

question yourself”

“There’s a lot of fury and a lot of rage”

“Keeping it secret makes my life

smoother”

Consumer

CategoryBrand

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I Have No Support

_ Sufferers feel discounted and misunderstood…even by medical community_ Can take years to be diagnosed correctly_ Often told “it’s all in your head”; feel

anger/frustration—at docs, friends, family who are skeptical or don’t understand

_ The invisibility of the disease leads to secrecy

Source: Euro RSCG Tonic Qualitative Research, 9/08

Consumer

CategoryBrand

focus group video

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_ Different symptoms exacerbate and reinforce one another with emotional consequences, leading to the need for medication plus support

Misunderstood

Self-blame

Self-doubt

FrustrationAnger

Exhaustion

Punished

Stress

Cognitive Problems

Depression/Anxiety

Fatigue

Sleep Disorders

Physical Pain

FMS

It’s a Vicious Cycle

Consumer

CategoryBrand

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The Consumer

Trapped in the multi-dimensional vise

of fibromyalgia

Consumer

CategoryBrand

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The Category

Consumer

CategoryBrand

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An Emerging, Yet Unformed Category

_ Significant potential as category projected to grow substantially

_ Influx of new medications and an upsurge in diagnosis rates

_ Lack of disease awareness and understanding among general population and medical community

_ No one owns the FMS relationship—PCP, rheumatologist, psychiatrist, osteopath, yogi—nor the brand

_ Opportunity to shape the conversation, as the dialogue is just beginning

Source: DataMonitor 2007

Consumer

CategoryBrand

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Lyrica: Legitimizing FMS

_ Beginning to shape the fibromyalgia space_ Communications live in the solution

_ Captures a real consumer insight with “the unique pain of fibromyalgia” yet fails to fully leverage the power of this idea

_ Focuses on the functional improvement and the reduction of pain the drug delivers, but doesn’t capitalize on the emotional aspect of the condition

_ Positions itself as the fibromyalgia medication not indicated for depression

_ Branded and unbranded communications

Consumer

CategoryBrand

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Cymbalta: Entrenched in Depression, Stepping into FMS

_ Recognizes the mind/body connection with “Depression hurts, Cymbalta can help” campaign — in the depression category

_ Depression heritage may limit Cymbalta’s potential to leverage FMS indication_ FMS DTC to date online only, and professional print

_ Anticipate Lilly to capitalize on existing relationships with HCP’s to promote the FMS indication

_ Prasugrel didn’t get approved; may free up money to allocate to Cymbalta

Consumer

CategoryBrand

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The Category

Efforts are just beginning to validate the condition, but no one owns the FMS relationship

Consumer

CategoryBrand

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The Brand

Consumer

CategoryBrand

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Functional Advantage

Ultimate Benefit

Functional Benefit

Strong Functional Advantage Creates Meaningful Benefits

Feel less trapped/more positive

A more complete treatment

Treat FMS symptoms more successfully

Consumer

CategoryBrand

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But Huge Need Gap Remains with FMS

_ Doctor/patient face-to-face time is as brief as six minutes (Source: medscape.com)

_ 72% of doctors interrupt the patient’s opening statement after an average of 23 seconds (Source: A. Suchman, Journal of American Medical Association)

_ Doctors remain key source of information, but access to them is limited — HCPs can’t fill the gap

_ “With FMS, if you just throw medication at them, and don’t give them the benefit of the time and counseling they need, I don’t think their treatment will be optimal” (Source: Interview with John

Nitsche, MD, September 2008)

Consumer

CategoryBrand

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Getting a Prescription Is Just the Beginning

_ 75% still seek information via talk, online, ads*Actions taken

after filling

Read the product information that came with the medicine 87%

Ask your pharmacist questions about the medicine 41%

Talk with a friend/family member who is taking the same/similar medicine

33%

Find yourself stopping to read/watch an advertisement for the medicine 29%

Look online for:

Information about the medical condition 38%

Information about the medicine 34%

Recontact your doctor to ask more questions:

About the condition or illness 25%

About the medicine 21%

* % who say they filled the prescription, when a doctor prescribes a medicine they have never taken before

Does not include read the product info that came with the medicine they saw or heard advertised

Source: Prevention magazine 2007 DTC Study

Consumer

CategoryBrand

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Information Overload, but Little Understanding of What to Believe

_ The search for chronic pain relief drives sufferers to seek the latest information and to be open to new medications/treatments

_ Seeking information can be overwhelming_ Google search: over 9MM results for fibromyalgia in .14

seconds

_ Media contradictions lead to patient confusion and become barriers to treatment/prevention

_ Even Dr. Frederick Wolfe, who first defined the diagnostic guidelines for FMS, now does not consider it a disease (Source: The New York Times, “Drug Approved. Is Disease Real?” January 2008)

Consumer

CategoryBrand

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Sufferers Need a Guide or Advocate to Help Them Navigate

_ The increasing complexities of medical care make it harder for patients to understand their condition and treatment options

_ “Getting reliable information is a source of comfort and empowerment…patients are even attending disease advocacy group meetings to hear about the latest research and meet other patients.” –Ken Schueler, Patient Advocate

They need someone to partner with them in managing their FMS—physically, mentally, and emotionally

Consumer

CategoryBrand

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Empathize

Body Is in Control Feeling of Personal Control

Meaningful Management

Giving sufferers greater control over the physical, mental, and emotional impact of FMS

EndlessStruggle

Reduced Symptoms, More Support

The Brand

Empower

Multi-dimensional Vise

Turning a vicious cycle into a virtuous cycle

The Milnacipran Brand Can Address These Needs

Consumer

CategoryBrand

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The Milnacipran Brand Can Redefine the Relationship

_ Milnacipran needs to become the:_ More complete treatment that goes beyond pain—to

treat the total fibromyalgia syndrome_ Ally: embracing the whole person—physical, mental, and

emotional_ Advocate: giving sufferers a voice and changing the

conversation about FMS: patient to doctor, patient to family, patient to peers

_ Partner: delivering a true personalized support program, with on-going dialogue and feedback

Insulating the brand from competitive encroachmentnow – and in the future

Consumer

CategoryBrand

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Source: Adcept Focus Groups

Functional Advantage

Ultimate Emotional Benefit

Functional Benefit

Extending the Strategy via a Personalized Support Program Makes for a Stronger Emotional Connection

Elevated Brand Benefit

A more complete treatment

Treat FMS symptoms more successfully

Feel less trapped/more positive

Better control of your condition

A more complete treatment/support

Treat FMS symptoms more successfully and manage

condition more successfully

Consumer

CategoryBrand

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Brand

Address the whole person in a whole new way

Consumer

CategoryBrand

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Consumer

Brand Category

The Creative Business Idea

Finally, a reason to be optimistic

Address the whole person in a whole new way

Beginning to legitimize condition, but no one owns the

FMS relationship

Trapped in the multi-dimensional vise

of FMS

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What is the challenge?To drive diagnosed sufferers to ask their doctor about Milnacipran and connect with sufferers on a more meaningful level, by demonstrating a keen understanding of the condition and their physical and emotional plight

Who are we talking to?Sufferers who have been diagnosed with fibromyalgia (primarily women ages 20–60) and are open to new treatment options to enhance their quality of life.

What is their mindset?Fibromyalgia is about more than just pain. It can include symptoms such as sleep disorders, fatigue, morning stiffness, anxiety, and cognitive problems—symptoms that can reinforce and exacerbate one another. It’s a vicious cycle and wears on sufferers physically, mentally, and emotionally, as they learn how to live with and manage the disease. Added to this daily grind is the frustration they feel as a result of often being misunderstood by their family and friends, and misdiagnosed and mistreated by the medical community. The disease becomes their secret—you can’t see it, and others are skeptical about it. Those who manage the disease best try to maintain a positive attitude and are more proactive about their condition.

The IdeaFinally, there’s a reason for fibromyalgia sufferers to be optimistic.

Reasons to Believe_New milnacipran does more than just treat pain: It’s a more complete treatment for the total fibromyalgia syndrome

_It’s proven to help you function better in your day-to-day life

_Milnacipran offers a true, comprehensive support program for the fibromyalgia patient

How should the brand speak? With conviction, understanding, and optimism.

MediaLead with print and deliver 360° idea.

Milnacipran Creative Brief

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Creative

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Strategies and Tactics

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Mass Awareness

Ask doctor for drug

Compliance

Infosearch

Click to websites

Peer-to-peer

Read articles

Transaction Model: Mass Awareness

Moving to a Better Model for DTC

Targeted Engagement

Ask Dr for drug LoyaltyFoster

understanding

Refer to doctor

Self-assessment

Discuss condition

with doctor

Compliance

Persistency

Relationship Model: Creating Better Patients

Start two-way conversation

Discuss drug with doctor

Advocacy

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Strategic Imperatives

FROM TO

Mass awareness Targeted engagement

Empower with information Empower with understanding

Drive to physician Start a conversation

Ask for drug by name Discuss condition and drug with doctor

Do not upset doctors Help doctors

Contrived messaging Relevance and richness of meaning

Acquisition Acquisition and real relationships

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Q4 ’08 Dec ’09

DDMACResponse

DDMACSubmission

How We Get There

Brand and agency collaboration: Obs/Strats, alignment

FDAApproval

Professional Marketing

Consumer Deep Dive – identify gaps, research, gain insights

Develop branded campaign

Unbranded campaign to educate and build database

Launch unbranded support program

Branded campaign launch: NEW 6 mos.

Convert unbranded to branded

Launch branded support program

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Approach to Measurement

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Measurement, Optimization, and ROI

_ Euro RSCG is known for creating integrated marketing communications that “move needles”

_ Approach

_ ETHOS: We deliver “applied creativity”; if it doesn’t work, it wasn’t creative. And we monitor all the indicators through the purchase funnel—from copy-testing through lead generation, and on to profitable share growth

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Measurement, Optimization, and ROI

_ GLOBAL ANALYTICS CAPABILITIES: Our Global Director of Marketing Science serves as lead on the group that manages Tracking studies, DR analytics, medical marketing research, author support statistics services

_ All of our below-the-line projects have built-in tracking and measurement

_ For larger projects, we can draw on the resources of Euro RSCG offices globally

_ FLEXIBLE PARTNERING: We can provide turnkey services across the marketing measurement cycle. Or we can work to integrate information streams from your databases and those of third-party vendors

_ A NETWORK BEHIND US: When customized analytics are required, we have access to our network for specialized analyses

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Thank you