I nternational Growth Besides an increased corporate connection to consumer advertising conglomerates, another feature that characterizes American medical agencies in the 1980's and 1990's is their overseas expansion. L.W. Frohlich was a pioneer in this regard, setting up wholly owned subsidiaries in London, Frankfurt, Paris, Milan and Tokyo under the name L.W Frohlich/Intercon. Sudler & Hennessey also invested in the international field through a specialized unit, Arranz & Sudler, which in 1970 expanded its operations in Europe. After Frohlich's death, the agency's offices in Europe and Asia dropped the Frohlich name and were known corporately as Intercon. In 1980, the Medicus unit of B&B acquired the Intercon network and for a few years became, on the strength of these branches, the world's largest medical advertising agency. Soon others were buying or setting up agencies in Canada, Mexico, Europe, Asia and Australia or entering into joint ventures and cooperative arrangements with agencies in these regions. More and more American agencies were producing creative work for use or adaptation in marketing areas beyond the United States. As such, U.S. agencies exercised a strong influence on the style and technique of medical advertising outside this country, although this was not a one-way street since strong creative work from overseas was also gaining visibility here. Because clients are moving toward establishing pharmaceutical brands globally, it can be anticipated that the globalization of medical advertising will continue with U.S. agencies playing a leading role. /Another aspect of the American market with which American agencies have become involved and which has potential for export is expertise in selling to managed care organizations (MCOs). The early 1990's saw government and industry becoming advocates for MCO systems as a means of stemming the disturbing rise in the cost of healthcare. Pharmaceutical clients reacted by restructuring and decentralizing sales management, involving themselves with pharmaceutical benefit management companies (PBMs), initiating outcome and cost benefit studies, and a reordering of promotional priorities toward formulary acceptance. Agencies, likewise, staffed and reorganized for sales programs to MCOs. Sizable portions of the American market are governed by
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