Global medical credibility
A marketing challenge faced with migraine is a lack of new evidence/data relating to treatment or epidemiology that can be used to create dialogue. Line extensions provide minimal differentiation, so the key question is how can you turn small USPs or limited data announcements into a large amount of noise?

A handful of global neurology congresses happen each year that international key opinion leaders and health journalists attend. Creative initiatives at these congresses can provide an effective method for engaging your audiences but any hospitality activity must comply with our industry's new code of practice.

Internal support
On the whole, migraine treatments are not considered to be “sexy” or exciting - they are old products that treat a non life-threatening condition, so how can you rally your internal team behind your campaign? ‘Wacky' ideas may receive internal-attention, but return on investment will be the critical factor that the campaign is measured against. Rudimentary measures of coverage or footfall do not provide a valid measure of the real impact of a campaign. Consider building in measures of behavioural change to show that creativity is not just being demonstrated for its own sake.

Extend. Defend
In 2006, the UK saw sumatriptan switch from a prescription-only-medicine (POM) to an over-the-counter (OTC) product. This move was largely driven by the UK Department of Health's plan to make healthcare a personal responsibility in order to free-up GP consultation time.

This move simultaneously presents a threat and an opportunity for the pharmaceutical industry. Moving triptans into the pharmacy provides an opportunity for manufacturers with old products to extend their licenses and increase their potential market. The switch, while it hasn't done so to date, has the potential to reduce the prescription market.

In this situation, communication challenges are faced on both sides. Pharmacists need to be educated and encouraged to appropriately recommend over-the-counter triptans, using a pharmacy algorithm. Meanwhile, the public needs to be made aware of faster access to the medication and the pharmacist's ability to provide it. Brand managers of POM triptans need to ring-fence their market and provide GPs with information that informs them about the continued role of prescription triptans within this model.

In March 2007 the Department of Health launched a consultation on pharmacy and nurse prescribing of controlled drugs for pain management, which shows that the political climate is changing. What environment is your campaign launching into and how exactly will it change when government policy reshapes it? Will NICE produce guidelines on pain management? With migraine carrying limited amounts of gravitas, is it a condition that can demand, or defend, reimbursement?

Confined to a darkened room?
It is estimated that migraine affects approximately one-in-seven people worldwide and the majority of individuals with migraines are women. An interesting point to note is that the sex ratio varies with age. The most effective communication strategy needs to be flexible enough to account for this and contain adaptable messages.

Individuals who suffer from migraines are likely to be motivated to treat the symptoms and reduce exposure to triggers due to the temporarily debilitating nature of the condition. Nevertheless, many will have developed ‘coping mechanisms' and may not be receptive to new ideas.

An influential audience to communicate with in relation to migraine is the significant others of those people who experience the condition. As a migraine can last for up to three days, and on average are experienced 13 times per year, the onset of symptoms may seriously impact upon boyfriends, girlfriends, children, parents, partners, siblings and employers. These people will all be keen to ensure that the individual with migraine has adequate treatment to limit the impact of symptoms upon their shared quality-of-life. Face-to-face activity that allows you to communicate with these individuals and provides them with useful tips for managing migraine episodes will have a lasting impact. 

Communicate your vision
Campaign success relies upon the efficient identification of stakeholders, as well as developing communication mechanisms that will gain their attention. Stakeholders need to be informed, engaged, educated and empowered to take interest, but in the sometimes static world of migraine, usual communication mechanisms may not cut the mustard.