M e d i c i n e A ve 2 digital-centric or dot-com agencies surfaced across the marketing services industry revolution: IMC2, iFrontier, and Cadient Group are three such examples. Larger ad agency networks such as Razorfish, WPF) Omnicom, Interpublic Group, and Havas all started or acquired small interactive shops, viewing this new media channel as a significant opportunity to grow their business in different, innovative ways. But none of these start-up divisions were able to match the explosive growth of the independent, entrepreneurial digital healthcare agencies. The Internet Explosion In 1997, restrictions on the use of DTC promotion of prescription products eased. This unexpected regulatory change suddenly created new promotional opportunities to connect and communicate directly with patients/ consumers. For the first time, pharmaceutical marketing began to evolve from a "tell and sell to the physician" process, to personal interactions with patients and consumers. The Internet, a 24-hour-a-day, seven-days-a- week information resource, fueled a major shift in human behavior, changing the relationship that consumers have with healthcare information and resources. Today's consumer media environment consists of hundreds of television channels, Web sites numbering in the millions, and several social media venues, all competing for a consumer's attention. Furthermore, consumers now control media on their terms through on-demand streaming services such as Hulu and time-shifting tools such as Tivo, or by purchasing programs for a premium through iTunes in order to view them with advertising removed—1 hour of programming in an efficient 40 minutes. To be successful in this media landscape depends on a combination of creativity, credibility and content that engages consumers in meaningful ways, ways that cut through the traditional clutter and noise of messages 112
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