Medical writers: Behind the scenes


Artwork by  Chloé Garner .

Artwork by Chloé Garner.

As a medical writer, many people I know do not understand what I do. I tell them I work in marketing, but specifically in the marketing of pharmaceutical and other healthcare products, which is a specialized (and also special) kind of marketing.

For comparison, think about advertisements for soft drinks: they focus on how tasty the drink is and how it quenches your thirst on a hot summer day. Even though there is nutritional information on the label for the product, this information does not need to be stated in its advertisement. We all know that consuming too much sugar over time can lead to weight gain and other health issues, but I’ve never heard of a case of anyone experiencing harm to his health directly from drinking a single soft drink.

Now, think about medications: patients generally have high hopes for them, because a person turns to medication to save his life or make him feel better. Unfortunately, medications are also associated with side effects, and can even cause death. As such, the promotion of a drug's benefits should be carefully balanced with information about its risks, so that customers can make informed decisions about taking a medication.

Cue the medical writer, who has the writing of this act down to a science!

Knowing the appropriate amount of cautionary content to include in an advertisement demands a familiarity with the regulations around advertising pharmaceuticals. Every country has different regulatory requirements. In Canada, it is the responsibility of drug companies to ensure their advertisements comply with the standards established in the government documents called the Food and Drugs Act and Food and Drugs Regulations. While not mandatory, Health Canada strongly encourages all drug companies (or "market authorization holders") to have advertising material go through a preclearance process. There are two review agencies that review advertising material: Advertising Standards Canada (ASC) and the Pharmaceutical Advertising Advisory Board (PAAB). As a medical writer, I work mostly with prescription products and so my dealings are most often with the PAAB.

The people I know (who don’t understand what I do) usually stare blankly at this point of my explanation; I can see their eyes glaze over as they think about what to have for supper. That’s why I try to make my explanation more relatable. Most people have watched TV, so TV is a relatable topic.

I explain my job like this instead:

Ever notice when you take a trip to the States that they have tons of commercials about prescription medications? (Important distinction: I am referring to commercials about prescription drugs, not over-the-counter products at the pharmacy.) It is such a part of their culture, that SNL bases skits off of them:

A satirical skit about a commercial for Abilify on Saturday Night Live.

You don’t see a lot of commercials for prescription medications in Canada. Ever wonder why? The rules are different here. In the States, someone could watch a commercial, learn what the medication is for, and then go to the doctor and request the medication by brand name. In Canada, if you think you have something wrong with you, you go to the doctor, describe your symptoms, and then your doctor will decide which medication you will receive (unless you happen to be well-informed and you demand what you want).

Most pharmaceutical marketing in Canada is directed to healthcare professionals (doctors, nurses, pharmacists, etc.) instead of consumers, because the rules for advertising to consumers are so restrictive. Advertising to Canadian consumers is only allowed if the advertisement follows what I unofficially call the “name-price-quantity rule”.  This means that the information in the advertisement is restricted to the name of the medication, its price and its quantity (although the price and quantity are details that are less interesting to consumers, so they are usually not mentioned.) Sometimes, you’ll see an advertisement that says something like: “Brand X. Talk to your doctor.” Remember this Viagra commercial?

A Viagra "confession" ad from Pfizer (Canada). Disclaimer: Viagra is a registered trademark of Pfizer Inc. This video commercial belongs to Pfizer Inc.

The creators of this commercial worked around the limitations of the name-price-quantity rule with the clever use of innuendo. A Viagra commercial doesn’t have to say anything more than “Talk to your doctor” because if you don’t know what Viagra does, then you might be living under a rock!

So, how could a medical writer be involved in the development of a commercial such as this one? (Please note that I was not the writer of this commercial. I am using it as an example of pharmaceutical advertising in Canada and how a medical writer may have been involved in its creation.)

A medical writer:

  • Understands what the medication does, as well as the risks associated with it.

  • Works collaboratively with the rest of the commercial-development team to come up with an attention-grabbing commercial that is in line with the demands from the market and the client’s marketing strategy.

  • Knows the advertising regulations and is able to inform the rest of the team in advance of any constraints in undertaking such a project.

  • Writes text for the commercials, including (at least parts of) the script, as well as any text that would appear on screen.

  • Recognizes the comprehension level of the viewers and translates complicated medical terms into consumer-friendly terms.

  • Liaises with the regulatory review agency in order to ensure the commercial adheres to regulatory requirements in the country where it will be broadcasted.

As I mentioned above, the rules for advertising to healthcare professionals (doctors, nurses, pharmacists, etc.) are different, and I will discuss that in more detail in a future post.