Chronic hepatitis B affects some 350 million people worldwide and mode of transmission varies from country to country. In some, it is mainly transmitted by men having sex with men or through hospital infections while in others, it is through mother-to-child transmission or IV drug use. And, since the disease presents with few, if any, symptoms, it is often not diagnosed until it has progressed to cirrhosis, liver cancer and even death. Diagnosed early, it can be treated and in some cases, disease progression reversed. However, less than 30 percent of chronic B carriers have been diagnosed, and less than two percent treated. The only sure way to determine if a person is infected is a blood test so getting people tested is the first step in improving hepatic health.
Bristol-Myers Squibb (BMS) manufactures and markets BARACLUDE® (entecavir), a drug that has demonstrated greater efficacy in treating chronic hepatitis B. BMS challenged TogoRun to create a campaign that would get more infected people to self-identify and get tested and, if appropriate, treated.
BMS provided TogoRun with market research identifying high prevalence markets – or “hot-spots”. Subsequently, TogoRun conducted research to better understand local patient populations, modes of transmission, local influencers (traditional and non-traditional), literacy and computer literacy rates, government programs and key opinion leaders. In addition, the firm analyzed several successful European disease education campaigns, particularly those dealing with highly stigmatized conditions. We determined that the most effective campaigns shared several common elements: 1) high-impact graphics to transcend literacy levels; 2) multiple vehicles to reach geographically diverse populations, and; 3) partnerships with local advocacy and governmental groups.
Based on this and other BMS competitive research, we identified the following objectives:
· Increase disease awareness by 20%
· Increase the number of people who identify as at-risk and visit their health providers and get tested for the disease by 20%
· Educate health providers on the importance of testing at-risk patients and treating to guidelines
Driving people to get tested is a complex challenge, made more difficult by the fact that the mode of transmission varies and by the fact that we would need to communicate in countries with varying levels of literacy as well as computer literacy and access. Secondly, we would have to make sure that the campaign transcended the stigma (e.g., unprotected sex, IV drug use) attached with the disease. And lastly, we would have to remain compliant with pharmaceutical marketing requirements in 14 different countries.
Thus, our strategic approach focused on providing local markets with a package of diverse and highly adaptable communications vehicles that would allow the campaign to be tailored for local impact.
The campaign’s centerpiece was the highly personalized umbrella theme, “Are You Sharing More Than You Thought?” packaged into an attractive “toolkit” that included dozens of images and vehicles for implementation and translation, including:
· Disease awareness Web sites in 11 languages
· Dozens of images of disease transmission – from pregnant women to men shaving to romantic couples
· A broad range of elements to repeatedly drive the message home, including transit ads, PSAs and slide kits
· Collateral for both physicians and patients: posters, postcards, signage, brochures
· Awareness materials for local physicians
· Community awareness meetings assembling diverse stakeholders
· Partnerships with nearly three dozen third-party organizations
· Local media campaigns
· Examples of local market “Are You Sharing More Than You Thought?” activities included: 1) transit ad campaign in the Paris Metro; 2) traveling disease education van in Greece and Italy; 3) partnership with a Dubai emirate football club, including local police distributing leaflets while directing traffic near stadium; 4) online blogging campaign in Russia, and; 5) brochure distribution through Boots Pharmacies in the UK
Evaluation of Success
BMS conducted pre-and post-testing in several countries to assess the impact of the “Are You Sharing More Than You Thought?” campaign. Results were overwhelmingly favorable in demonstrating the campaign’s effectiveness:
· Disease Awareness
o In France, one-third of the general public remembered the “Are You Sharing More Than You Thought?” disease awareness campaign
o In Turkey, there was a 22% increase in disease awareness among the at-risk population
o More than 400,000,000 media impressions with some 1,400 articles appeared in 10 languages
o 19 professional associations or health ministries partnered on campaign activities as well as 14 patient associations
o Some 500,000 unique visitors to the Web sites
· Disease Testing
o Across those markets where the campaign was implemented, there was a 275% increase in the number of patients tested for the disease
o The number of diagnosed patients doubled