included. In 1997, the FDA dropped this requirement for broadcast media and issued new guidelines for DTC advertising. These guidelines allowed pharmaceutical companies to engage in broadcast consumer advertising, provided it met an information requirement through reference to four possible sources: a doctor, a toll-free number, a magazine or newspaper ad, or a Web site. CDM's 1997 launch of Viagra for Pfizer, and the now-famous Bob Dole erectile dysfunction disease awareness ad, were part of a DTC advertising boom. With relaxed government guidelines, in the 10-year period from 1996 to 2005, DTC promotional spend increased from $985 million to $4.2 billion {New England Journal of Medicine 8/16/2007). Pharma corporate and product DTC spend was estimated to exceed $5.1 billion in 2007 (TNS Media Intelligence). With this explosive expenditure growth, many clients turned to large consumer-oriented agencies to develop their DTC advertising. Healthcare agencies within a holding company relied more and more on their consumer agencies to handle or partner with them in handling DTC assignments. Joint ventures such as DDB Corbett were typical of the consumer/healthcare agency collaborations during this period. During the same 10-year period, in a review of overall promotional expenditures (DTC advertising, detailing, medical journal advertising and sampling), only medical journal advertising failed to exhibit significant growth, with a decrease of 25 percent—going from $571 million in 1996 to $429 million in 2005 (New England Journal of Medicine, 8/16/2007). The healthcare advertising business has witnessed a remarkable evolution over the past 15 to 20 years. An evolution in size, target audience, media, clients, products, stricter regulatory guidelines, and a continued re-engineering of agency structures and services is successfully meeting Medicine Avenue's new challenges. 4^
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