Gardasil Social Marketing Approach

Case Profile
Gardasil was the first drug designed to prevent infection of the most common strains of HPV linked to cervical cancer and vulval cancer approved by the U.S. Food and Drug Administration in young women ages 9 to 26. [1,2] The key to the promotion of Gardasil was in the response of policymakers, health care providers, parents, and women, to make sure that all those who could benefit from the vaccine had access to it. Policy makers were a key audience because they had the authority to make Gardasil mandatory. Physicians were also a focus to Merck to educate and motivate women in the target age group (or their parents) to ask for the vaccine. Similarly, young women and parents were of focus so they would recognize the vaccine as a necessary preventative measure. Through education and commercialization, Merck targeted these audiences in its media campaign.
Merck's marketing campaign was divided into two parts: the unbranded, disease awareness and education, and the FDA post-approval, branded approach that urged women to get vaccinated. The company worked with advertising agency DDB and public relations firm Edelman on both pieces.[3]
“Make the Connection” was the first phase of the disease awareness effort. Unveiled in early spring 2006, “Make the Connection” focused on educating the public of the connection of HPV and cervical cancer. The conduit for that connection was beaded bracelet kits that girls could order over the Internet. [4] The stringing together of beads represented stringing together the facts about HPV and cervical cancer that was included in an accompanying educational packet. [3] Merck also pledged to donate $1 to the Cancer Research and Prevention Foundation for each kit ordered. Furthermore, Merck included links in their Website to personal stories from a diverse group of women explaining how they discovered the HPV–cancer connection and provided e-cards, which can be sent with customized messages to help visitors spread the word about HPV's role in causing cervical cancer in women. [6]
The next evolution of Merck’s campaign was “Tell Someone.” The unbranded, testimonial-style TV and magazine ad campaign was launched in late spring 2006 and employed viral marketing, urging women to tell others about the link between HPV and cervical cancer. [5] Like “Make the Connection, the “Tell Someone” Website encouraged girls to send out personalized e-cards, imprinted with the question: “Did you know that cervical cancer is caused by certain types of a common virus?” [3] Merck’s approach also included magazine pull-out postcards in English and Spanish, and informational materials for doctors’ offices. [5] This disease awareness drew on themes of safeguarding children to parents and empowerment for young women.
In fall 2006, Merck issued the “One Less” campaign, with the first ads to mention Gardasil by name. The ads used a documentary style approach to portray a message of empowerment, with girls running, jumping, and dancing while pledging to be “one less” cancer statistic, while their supportive mothers stood beside them. [3, 4]
Merck also funded PSAs in spring 2006, developed by the Cancer Research and Prevention Foundation starring actress Kimberly Elise, Susie Castillo of MTV's TRL, Stacy London of the cable fashion reality show What Not To Wear, Maria Shriver and Elizabeth Rohm. [4, 6]
Additionally, Merck targeted physicians in a four-page print ad to run in medical journals, including American Family Physician and the Journal of the American Medical Association that included information on Gardasil, in spring 2006. [4] Merck’s professional outreach also included online channels like video-detailing as well as encouraging physician-to-physician communication. Merck targeted these education efforts to three different specialties: Pediatricians who knew how to give vaccines but were less versed in the nuances of HPV, gynecologists who were familiar with the disease but their practices weren't set up to offer vaccinations and family practitioners who skewed somewhere in the middle. [3]
Finally, Merck provided unrestricted educational grants to professional societies to help physicians address issues ranging from vaccine inventory, to legally required patient forms, to reimbursement. Vendors specializing in continuing medical education also identified experts who could communicate with other physicians about the vaccine. [3]
The launch of Gardasil represented the first time a drug or vaccine could offer the hope of cancer prevention. Although Merck has been working to develop Gardasil over the last ten years, the media campaign began in late 2005. Merck's research prior to the initiation of the media campaign showed that only five percent of women and girls surveyed could make the link between HPV and cervical cancer. After the campaign, awareness “rocketed to approaching an excess of 50 percent.” [3]
On the policy front, there has been broad professional and governmental endorsement. Eighty percent of those publicly eligible and 94 percent of insured individuals now have vaccine access. Among physicians, about 50 percent of pediatricians are stocking the vaccine, for example. Among consumers, awareness has increased “10-fold, and sales of the vaccine were $70 million in the third quarter” of 2006. [3]
Merck is planning the next phase of its campaign to target how the vaccine can benefit women ages 26 to 45, as well as its efficacy in boys and men, 10 percent of whom will have at least one episode of genital warts in their lifetime. [3] Merck's researchers are also looking at long-term efficacy data as well as the vaccine's ability to offer “cross-protection” against other cancer-causing strains of HPV. Finally, Merck is studying its concomitant use with other adolescent vaccines. [3] Although this was a corporate campaign, it used many social marketing strategies and achieved a behavior change that benefited society.