PMDD: Don't Suffer in Silence
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Holmes Report

PMDD: Don't Suffer in Silence

To regenerate interest in Prozac in the run-up to patent expiry and drive new branded sales opportunities, whilst minimizing potential brand damage, via a series of push-pull media-focused activities through the creation of the ‘Don’t Suffer in Silence’ c

Paul Holmes


The indication for premenstrual dysphoric disorder (PMDD - more commonly known as severe PMS) was a significant milestone in Prozac’s lifecycle and especially pertinent in its run-up to patent expiry. As a result, it was essential not only to fully leverage the opportunity, but also to minimise any risk of the media coverage being sensationalised or the issue trivialised. Cohn & Wolfe was briefed to develop and implement a UK communications strategy to raise the awareness of PMDD as a serious but treatable disorder, establish Prozac as the first prescription medication to receive a licence indication for the treatment of PMDD and help maintain Prozac sales prior to patent expiry.


  • To raise awareness of PMDD as a serious, treatable illness
  • To grow the PMDD market and encourage treatment-seeking behaviour
  • To position Prozac as the first prescription medication to receive a licence indication for the treatment of PMDD
  • To secure positive and balanced media coverage on the new Prozac PMDD indication
  • To help drive a significant Prozac sales uplift prior to patent expiry


To regenerate interest in Prozac in the run-up to patent expiry and drive new branded sales opportunities, whilst minimizing potential brand damage, via a series of push-pull media-focused activities through the creation of the ‘Don’t Suffer in Silence’ campaign championed by independent third parties targeting healthcare professionals and sufferers.


To drive the key messages, an integrated push-pull consumer and healthcare professional campaign entitled ‘Premenstrual Symptoms – The Silent Epidemic’ was developed. Under the direction of Cohn & Wolfe, all materials produced for the campaign  adopted a visual identity consistent with the Prozac brand, to facilitate a direct association between the PMDD therapeutic area and Prozac.

Independent Support:

Securing the support of all the below third parties was a core element of the campaign as it attracted media interest in the story and facilitated independent communication of the key messages whilst distancing Lilly from a potentially negative debate.

Third Party Organisations: Cohn & Wolfe identified the National Association for Premenstrual Syndrome (NAPS) as the key UK based women’s third-party organisation for PMDD. A ‘Working with the Media’ workshop was organised on their behalf to

help gain their support for the campaign’s activities and secure suitable case studies.

Key Opinion Leader (KOL) Endorsement: Appropriate KOLs were identified and their suitability for different media opportunities was assessed after a media training programme. The campaign was supported by a group of four UK based physicians whose expertise covered general practice, gynaecology and psychiatry.

Celebrity Support: As a key advocate of women’s health in the UK and a supporter of the work carried out by NAPS, the former Olympic and Commonwealth swimming medallist Sharron Davies also supported the campaign.


A consumer-focused PMDD awareness leaflet was created and endorsed by NAPS and carried their logo, helpline number and website address and details of the PMDD website. It was distributed by the Prozac salesforce to GP surgeries nationwide and accompanying surgery posters were also produced to advertise its availability. The leaflet was also advertised through Lilly direct mail and via the media and is currently available on the PMDD, NAPS and European Institute for Women’s Health websites.

A PMDD media report entitled: Premenstrual Symptoms ‘The Silent Epidemic’ was developed as a ‘one-stop’ media resource to focus on PMDD and raise awareness of its serious, but treatable, nature, thus positioning Prozac as the only prescription medication available for its treatment:

  • Contributions were made by key opinion leaders, the Chief Executive of NAPS and the case studies.
  • Distributed to over 1,000 key media and served as a core resource for the development of features and news articles.
  • Full complement of print media materials was developed to support the launch which was tailored to meet the needs of
  • the different target publications.

Healthcare Professional Medical Communications: A medical advertorial was developed for the October issues of General Practitioner magazine to raise awareness amongst the primary care community. The advertorial included diagnostic criteria for PMDD, symptomology, treatment options and details of the clinical data that supported the new licence indication.Reprints were also distributed to the Lilly salesforce. Supported by tailored media materials, a full media campaign was also implemented to drive placement of editorial and features in the medical media.

Press Briefing: The new indication was launched to the consumer and trade media at an evening press-briefing event held at the Atlantic Bar, London, and was attended by over 30 journalists. 

Invitations were distributed to the media as part of a teaser campaign, which included subsequent media and photo opportunity alerts

Launch saw the publication of the UK section of a pan-European awareness survey, PMDD media report and the website

On the day of the launch, a series of interviews were scheduled and recorded including live regional and national radio interviews, a five minute syndicated radio health programme and television interviews on GMTV and Channel 5 News

PMDD Consumer and Healthcare Journalist Website: Cohn & Wolfe developed a website (, which provided in-depth information on PMS and PMDD.

The website is split into a consumer and a password-protected journalist arm and includes sections on all the press materials produced to support the campaign, video presentations of the launch briefing and full details of the survey and case studies.

An e-advertising strategy was implemented to encourage visitors to the site. A four month campaign was run in association with New Woman Online and the Press Association’s online resource ‘PA Newscentre’.

Issues Preparedness: It was vital to identify key issues and prepare an issues management document to address potential situations that could arise from the launch of the PMDD indication. Therefore, in conjunction with Lilly, Cohn & Wolfe developed a set of core statements for internal and external use. Key issues training sessions for KOLs and Lilly personnel were also carried out prior to launch.

Internal Communications: To raise awareness of the campaign amongst the salesforce and act as a key motivational tool prior to patent expiry, Cohn & Wolfe produced a mailer to be distributed to all Lilly employees involved in the marketing and sales of Prozac in the UK. The mailer also complemented a series of salesforce focused e-mails in advance of and after the launch.


Coverage generated as a result of the PMDD indication launch press event was widespread and national coverage exceeded expectations. Below is a detailed breakdown of the results to date. 

  • 71 print, TV, radio and internet hits with an opportunity to see/hear of over 73 million
  • Almost 60% of coverage scored 10 or more on the key messages rating measure determined prior to campaign
  • The total opportunity to see and hear was equivalent to that generated by an advertising spend of over £220,000 vs. budget of £40K
  • The PR campaign alone drove a significant uplift in Prozac sales prior to patent expiry

Media: Opportunity to See/Hear Messages

  • National Newspaper 50,933,883 (69.4% of total coverage)
  • Consumer Media 10,980,102 (15.0%)
  • National Television 4,150,000 (5.7%)
  • Regional Newspaper 2,190,556 (3.0%)
  • Trade Media 1,966,782 (2.7%)
  • National, Regional, Independent Radio 2,303,000 (3.1%)
  • On-line Media 850,000 (1.2%)

Total: 73,374,323

Client Comment: “As Prozac is approaching a crucial stage in its life-cycle, it was imperative that the launch of the new licence indication for the treatment of PMDD was a success. The public relations campaign that supported the launch played an integral part in ensuring this. We have been delighted by the significant amount of accurate and positive media coverage surrounding the launch which has sustained the interest in Prozac. The programme surpassed its objectives, with Cohn & Wolfe creating a programme and delivering results which motivated both our customers and Lilly employees.” Jo Ashton, Product Communications Manager, Eli Lilly and Company Limited, UK.

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