Dragged Over the Counter
Charting the future of public relations
Holmes Report

Dragged Over the Counter

WellPoint Health Networks successfully petitioned the Food and Drug Administration to hold a public hearing on whether or not the agency should convert Allegra, Claritin and Zyrtec allergy medicines to over-the-counter status.

Paul Holmes

WellPoint Health Networks, one of the nation’s largest publicly traded health insurance care companies, successfully petitioned the advisory committee of the Food and Drug Administration (FDA) to hold a public hearing on whether or not the agency should convert Allegra, Claritin and Zyrtec allergy prescription medicines to over-the-counter (OTC) status.  An unprecedented program, this was the first time that a non-drug-making company had ever petitioned the FDA for such a hearing, and our public relations program achieved a favorable outcome at the hearing in spite of powerful opposition. If the FDA abides by its advisory committee’s findings, not only would the ruling garner savings of up to $60 million for WellPoint, but millions of Americans will finally be able to afford the best treatment for their ailment, bringing the country a step closer to quality health care for all.
Challenge and Opportunities
This was a unique challenge; not only had this type of action never before been attempted, but it was also sure to receive fierce opposition from some of the most powerful and influential pharmaceutical companies in the world. A lot was at stake: prescription sales for the immensely popular allergy drugs topped more than $5 billion last year, a strong incentive for the makers of those drugs to fight against making the medicine available OTC before their patents run out in the next several years.  The drugs’ incredible popularity, mainly derived because they cause less drowsiness and have fewer side effects than any other treatment available without a prescription, was sure to keep demand high. WellPoint’s chance of success seemed remote.
For those patients without health coverage – or those with general health insurance but not pharmacy benefits – the cost of taking these medications is astronomical.  Effectively, these allergy sufferers are prohibited from taking the best drugs to treat their condition – drugs that are available OTC in almost every other industrialized nation at an average cost of $15 per month, compared with the U.S. prescription price of at least $80 for a month’s supply. In spite of the fact that the pharmacological composition of these drugs meets the FDA’s criteria for reclassification to OTC status, the drugs’ prescription status dictated that costs remain at levels that prohibit common use. 
Our campaign asked the following questions: 1) Why should uninsured or underinsured consumers be denied the most effective drug for allergies? 2) Why are these drugs available OTC almost everywhere except the U.S.? 3) If the drugs meet the FDA’s own criteria for OTC status, why shouldn’t the FDA Advisory Committee vote to change their status?
Planning Process and Statement of Objectives
Powell Tate brought together assets from several offices within the Weber Shandwick network to plan the strategic approach, which had the following objectives:
  • Position WellPoint as a progressive company with a thought-provoking vision on quality consumer healthcare to general and financial audiences;
  • Position WellPoint as the information resource on the issue, to regulators, the general public, and the media;
  • Generate public support for the effort via a comprehensive media relations program; and
  • Create an atmosphere conducive to a positive hearing outcome.
Explanation of the Strategic Approach
We anticipated that critics would claim that WellPoint was doing this only to save money by not having to pay the prescription costs for their insured patients. To diminish that message, we developed a multi-faceted strategy designed to reach our interested parties directly and through third parties to position WellPoint as a company that cares about its customers and is firmly committed to ensuring that all Americans have access to affordable and quality health care. To build support for WellPoint’s FDA petition, we determined that the most effective tactics
would be to argue in the court of public opinion that these drugs should be made available OTC via:
  • A media relations campaign surrounding that argument;
  • Recruitment of consumer-related third-party allies to support WellPoint’s FDA petition and validate their claims; and
  • Materials to educate audiences on WellPoint’s position from a regulatory and legal standpoint.
Description of Campaign Execution
The FDA’s Nonprescription Drugs Advisory Committee hearing was scheduled for May 11, 2001, in Washington, D.C. This season is generally known as the capital’s “prime suffering period” for those with allergies. 
For the media relations campaign, we shot b-roll of allergy sufferers around the Capitol building with cherry blossoms in full bloom in the background.  We complemented that misery with footage from a Canadian pharmacy that showed the drugs in question on the counter alongside the less effective allergy medications that are available in the U.S. without a prescription (e.g., Sudafed). We also conducted an interview with a Canadian pharmacist echoing our call for the drugs to be made available OTC in the U.S.
We then conducted a satellite media tour using this footage and headed by our spokesperson, Rob Seidman, vice president and pharmacy director of WellPoint.  Prior to the tour, Powell Tate’s media training specialists conducted several training sessions with Mr. Seidman and other WellPoint representatives.  
We also held a number of pre-hearing interviews with major national media, including The Washington Post, Los Angeles Times, Wall Street Journal and other trade and regional publications, focusing our efforts on the top-tier health and consumer reporters. We also targeted media outreach to the top network health correspondents, including Dr. Timothy Johnson of ABC Television and Robert Hager of NBC Television.
To complement our efforts, we helped develop and distribute a comprehensive white paper that addressed the legal and regulatory details of the switch.
Summary of Results
In an unprecedented move, the FDA Advisory Committee voted to recommend that the FDA make this class of drugs available OTC.  This was the first time a non-drug maker had successfully petitioned the FDA to hold a hearing and it was also the first time a non-drug maker had won a favorable ruling. If the FDA takes its advisory committee’s advice, the OTC switch stands to save WellPoint up to $60 million. The financial and investment community has heralded WellPoint’s move; when our campaign began, WellPoint’s stock stood at 80, it now hovers around 125.
On the media front, we received nearly 50 million impressions of the WellPoint brand within a six-week period.  The satellite media tour garnered over 38 million impressions, while our print media outreach resulted in over 11 million impressions through placements in newspapers including The Washington Post, Chicago Tribune, New York Post and USA Today. We helped to establish Rob Seidman as an authority on the matter.
Additionally, we secured the support of Families U.S.A., a national nonprofit, non-partisan organization dedicated to the achievement of high-quality, affordable health and long-term care for all Americans.
Due in large part to our public relations activities, this issue has not died.  The FDA is expected to act upon the Advisory Committee’s recommendation later this year. 
The WellPoint/Powell Tate program created such a stir that the National Highway Traffic Safety Administration (NHTSA) took notice and became concerned that because of the drugs’ prescription status, truckers suffering from allergies were drowsy at the wheel. NHTSA recently held a public hearing on this safety issue.
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