UPJOHN ADVERTISING: TEEENIAUWDPDKTWT Thesis for the Degree of M. A. ’ MICHIGAN STATE UNIVERSITY ROBERT WARREN ROYLE 1964 llllllll IHIIMIIIIIIIIIIMII !\/ 14 280 3 1293 10 3 l ‘34-? WI manna” , 173-“ W“ [\JUL13197IB26 7 €906®31 1:524 { Upjohn l medicine . . . designed for health . . . produced with care A. ‘I‘.,‘ -. ‘ l 1 ‘3‘ ‘ V‘ M 9 $M I v «'5' ‘;'I“\%' H“ m The Upjohn Company Kalamazoo, Michigan ABSTRACT UPJOHN ADVERTISING: THEN AND NOW by Robert Warren Royle Upjohn Advertising; Then and Now presents no problems, documents no field research, offers no original marketing plans. It is a report dealing only in established fact with a minimum of opinion. Its sub- ject is The Upjohn Company of Kalamazoo, Michigan, and the several facets of its marketing operations. This subject is discussed in depth, considering the company's past and present and touching briefly on its future. A considerable number of sources were employed in the preparation of the report. Of particular value were the author's own past papers concerned with The Upjohn Company, the book Medicine Makers of Kalg- ‘géggg by Leonard Engel (McGraw-Hill, 1961), and various conversations with several executives of the Marketing Division of The Upjohn Com- pany. The report is roughly Split into two parts: a case history of Upjohn advertising and a case study of several areas of present con- cern. An appendix is included with the text of the report which con- tains a number of samples of Upjohn advertising among other informa- tion. Part One of the paper includes the first four chapters, which trace the company's marketing activities from their inception in 1886 to the present. The development of the company as a whole, of speci- fic products, and naturally of promotional activities are all consid- ered. One of the chapters in Part One is devoted to the story of the Robert Warren Royle development and marketing of Phenolax, a product which was vital to the company's growth. Part Two of the paper considers a number of areas of Special importance to The Upjohn Company and special interest to the author. The question of government regulation of the drug industry in general and The Upjohn Company is discussed at length. The various approaches to drug regulation taken by the Federal Trade Commission, the Food and Drug Administration, and the Kefauver Subcommittee on Antitrust and Monopoly are considered in relation to their effect on drug advertising. The success of Orinase, the first oral antidiabetic agent, is considered in depth. Diabetes and the development and marketing of antidiabetic drugs from insulin to Orinase are discussed. Further, some interesting parallels are drawn between two of the company's greatest successes, Orinase and Phenolax. The paper then considers the emergence of consumer advertising and reports how a firm strongly oriented to ethical drug promotion discovers the importance of the consumer in a changing marketing com- plex. A considerable loss in market share by a leading product, Unicap, is documented,and the resultant exploratory test marketing and eventual national consumer advertising efforts are reported. The paper concludes with a brief statement of The Upjohn Company's present position and a few thoughts on its future. This final chapter summarizes the paper's observation of the problems, opportunities, and successes of the drug firm that grew from a two-man company in 1886 to Robert Warren Royle a 7,517-man corporate complex in 1963 and from gross sales of $50,000 in 1886 to nearly $192,000,000 in 1963. As the paper presents no major problems per se, it solves none. Its purpose, simply stated, is to bring the advertising and marketing of The Upjohn Company into reasonablysharp focus for the interested reader. UPJOHN ADVERTISING: THEN AND NOW A Combined Case History and Case Study of the Advertising of The Upjohn Company of Kalamazoo, Michigan By Robert Warren Royle A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF ARTS Department of Advertising 1964 HEX/Dino 1&4 {ti/“W’V6/ % ~ [WWI/i ACKNOWLEDGMENTS The author is especially grateful to a number of people who contri- buted materially to this report and to whom it is dedicated: To Dr. Kanward L. Atkin of Michigan State University's Advertising Department, without whose encouragement the author might never have begun this work. To the pleasant, cooperative, and capable personnel to be found at all levels of responsibility at The Upjohn Company. To my family, who watched the paper slowly grow to com- pletion over a period of nearly three years. Especially to my Dad, without whose understanding, en- couragement, and help of many kinds this report would never have been completed. \ b ii TABLE OF CONTENTS Page ACKNOWLEDGMENTS . . . . . . . . . . . . . . . . . . . . . . ii LIST OF APPENDICES . . . . . . . . . . . . . . . . . . . . iv PART I. THEN Chapter I. BIRTH AND BEGINNINGS, 1886-1906 . . . . . . . . . 2 II. THE PHENOLAX ERA, 1907 . . . . . . . . . . . . . . 9 III. THE EXPANSION ERA, 1908-1938 . . . . . . . . . . . 15 IV. CONSOLIDATION AND MARKETING GROWTH, l938-PRESENT . 26 PART II. NOW V. GOVERNMENT REGULATION AND THE DRUG INDUSTRY . . . 36 VI. THE ORINASE STORY . . . . . . . . . . . . . . . . 57 VII. THE EMERGENCE OF CONSUMER ADVERTISING . . . . . . 65 VIII. CONCLUSIONS AND PROJECTIONS . . . . . . . . . . . 75 APPENDICES O O O O O O O O O O O O I O O O O O O O O O O O 78 B IBL IOGRAPHY o o o o o o o o o o o o o o o o o o o o o o o ' 123 iii LIST OF APPENDICES Appendix Page 1. Brief Chronology of The Upjohn Company, 1884-1964 . . 79 2. Organization Charts . . . . . . . . . . . . . . . , . 89 3. Domestic Branch Offices . . . . . . . . . . . . . . . 98 4. Foreign subsidiaries . . . . . . . . . . . . . . . .100 5. Kefauver's Bill (S. 1552), Provisions in Brief . . .101 6. FTC Resolution Directing Investigation of Drug Industry . . . . . . . . . . . . . . . . . . . . .103 7. Selected Examples of Current Uijhn Advertising . . .112 iv PART I THEN CHAPTER I BIRTH AND BEGINNINGS, 1886-1906 "Medicine--designed for health, produced with care. Fine pharma- ceuticals since 1886." These words represent The Upjohn Company, one of the largest drug manufacturers in the world. Yet there was not always such a thing as a "drug manufacturer." At one time doctors and pharmacists were their own drug suppliers. Each supplied whatever drugs or medical compounds were required for his own practice. The drug industry really began when certain of these doctors and pharmacists established themmelves as suppliers to others as well as themselves. Some of these new manufacturers produced their products for, and distributed them directly to, the consumer himself. These manufac- turers grew into the giant proprietary drug houses of today. Mast Of the drugs produced by these manufacturers were originally known as "patent" medicines. They were so called because kings, cen- turies ago, granted exclusive permission for patents to manufacturers of secret medicinal compounds. As late as the end of the nineteenth century U. 8. Patents could be granted to drug manufacturers without requiring disclosure of the ingredients or the techniques necessary to produce the drug. Leonard Engel in Medicine Makers of Kalamazoo quotes Stewart H. Hollbrook as referring to this as the "Golden Age of Quackery." Products like "Donald McKay's Indian WOrm Eradicator" and "Autumn Leaf Extract for Females" found wideSpread distribution and acceptance. In addition, "Syrups containing morphine were sold as tuberculosis cures; alcohol*was used so liberally in numerous nostruma that more alcohol was sold (according to one disgusted physician) as a medicine than as a beverage."1 Other new manufacturers concerned themselves only with the produc- tion and distribution of pharmaceuticals to be used under the direc- tion of medically trained professionals. These people supplied the products that were to become prescription drugs. Pharmaceuticals produced by these manufacturers were, however, little more effective than the patent medicines. Although the emer- gitg ethical drug companies manufactured their products in line with specifications Offered by the United States Pharmacopoeia, methods of control were so primitive that little could be found in the way of uniformity and predictability among drugs then on the market. Pills produced by these manufacturers, for example, were so hard that they Often passed right through the patient's system'without even beginning to dissolve. And it was this prOblem which was attacked and finally solved by a thirty-one year old physician from Hastings, Mich- igan, in 1884. His name was Dr. William;Erastus Upjohn. Dr. Upjohn was the son of Uriah Upjohn, who was also a physician. Uriah Upjohn had come to the United States at the age of twenty-four, Obtained a medical degree, and begun his practice in Richland, Michi- gan, in 1835. Of his twelve children, his oldest daughter Helen and three of the four boys, Henry U., William 3., and James T., became 1Leonard Engel, Medicine Makers 9f Kalamazoo (New YOrk: McGraw- Hill Book Company, 1961), p. 23. doctors. All received their degrees, as would generations of Upjohns to come, from the medical school of the University Of Michigan in Ann Arbor. The Upjohn children had spent most of their life on a farm. The resulting familiarity with, and interest in, farm machinery prompted Dr. W. E. Upjohn to experiment with machinery in his spare time. It was this experimentation that resulted in a machine which opened the way to a revolutionary new method of pill manufacture. Dr. W. E.'s machine was essentially a revolving pan. A "seed" was alternately sprayed with powdered chemical ingredients and moisten- ing agents until the pill had been fully formed. In this way the re- quired amount Of each ingredient could be carefully controlled. Fur- ther, and more important, these pills were certain to dissolve in the system and thus reach the blood stream. They could, in fact, be easily crushed with the thumb. Although the patent on this process (No. 312,041) was not granted until January 10, 1885, Dr. W. E. began producing his "friable pills" (capable Of being easily reduced to powder) in his attic in 1883. The market for his pills was good and sales rose. Soon Dr. W. E. found it necessary to move his "factory" to an abandoned feed mill in Hastings.‘ But the business outgrew even this location and the Doctor again was forced to move. This time the move was to Kalamazoo and into a partnership with his brother, Dr. Henry Upjohn. Shortly thereafter Dr. W. E.'s other two brothers, Frederick Upjohn and Dr. James Upjohn, entered the newly formed Upjohn Pill and Granule Company. Though the Company really began its operation late in 1885 in a basement in Kalamazoo, its first price list was not printed until early in 1886. Thus the slogan, "Fine Pharmaceuticals Since 1886." This price list, the Company's first communication.with its public, offered 186 different pill formulas compounded from 56 assorted drugs. Thus The Upjohn Company began its adventure in production and marketing by Offering two valuable commodities to its customers. One was, of course, the friability of Upjohn pills due to the new method Of manufacture. The other was quality. In a market hard hit by in- tense price competition, The Upjohn Company early established a repu- tation for quality. In fact, throughout the plant then and in years to come could be seen signs reminding employees to "Keep the quality up . . . W. E. Upjohn." To demonstrate the friability of its product, The Upjohn Company adopted as its trademark a picture of Dr. W. E.'s thumb crushing a pill. As Leonard Engel suggests, "It gave Dr. W. E. the most widely reproduced thumb in history. In one form or another, the thumb trade- mark . . . appeared in thousands of advertisements and on tens of mil- lions of package labels."2 The Company's gross sales in its first year of operation were $50,000. It is interesting to note that Dr. W. E. Upjohn, as head of the firm, enjoyed a salary of $1200 a year and his brothers Frederick and James received $900 and $600 respectively. Unfortunately, in January of 1887 the Company suffered the loss Of Dr. Henry Upjohn to typhoid fever. The subsequent reorganization 21bid., p. 27. brought John M. Gilmore (the uncle Of the man who was to become presi- dent, then board chairman, of the Company) and three others in as partnerS. Later in the same year the Company was incorporated with capital stock of $60,000. Its officers included Dr. W. E. as president, Dr. James as vice-president, Frederick as secretary, and John Gilmore as treasurer. The market expanded, physical facilities grew, and in 1890 Upjohn gross sales reached a peak of $132,500. However, the following year (1891) compressed tablets (simply powdered drugs compressed in molds of any shape) hit the pharmaceuti- cal market and The Upjohn Company found itself without a "unique sell- ing proposition." To meet the competition, The Upjohn Company made two very impor- tant moves. .First it expanded its product line to include "buyer's label" goods, special order goods (in bulk quantities), preparations for hypodermic injections, fluidextracts (concentrated plant extracts), tinctures (diluted fluidextracts), elixirs (Spiced and/or sweetened fluidextracts and tinctures), syrups, ointments, and even medicated wines. By 1900 the catalOgue listed more than 700 different items. In 1902 the Company officially acknowledged its broader approach to the pharmaceutical market by changing its name from the Upjohn Pill and Granule Company to simply The Upjohn Company. The second move was the Company's recognition of the importance of advertising. General advertising describing the "Friable Quinine Pills" had been done in the medical journals of the day, chiefly the Journal of the American Medical Association (JAMA). But Upjohn ad- vertising first began tO assert itself during the late 1890's and early 1900's. The Company's entire advertising program during this period was, for all practical purposes, directed and operated by an imaginative and creative member Of the sales department, Mr. Frederick L. Childs. Mr. Childs seemed to have a gift for creating variations of standard formulas and giving them eye-catching names. It was he who designated Caripeptic Liquid (a mixture of malt enzymes and papaya enzymes de- signed tO aid digestion) "The Vegetable Digestant." This vegetable digestant proved to be one of the Company's best offerings to the market. Nearly twenty years later the Company's first director of research, Dr. Frederick W. Heyl, found that Caripeptic Liquid really had little effect in protein digestion. Nonetheless, its sales continued to run into tens of thousands of dollars annually. During its period of inception, from 1900 to 1905, Upjohn adver- tising under Mr. Child's direction consisted largely Of sampling adver- tising. By the use of this technique, certain Upjohn products (Cari- peptic Liquid being prominent among them) with a value estimated at $5.00 were offered to doctors and pharmacists for $1.00. The vehicles for these ads were quarter pages in the JAMA showing the product or products and using the headline "$5.00 for $1.00." This technique was an excellent means of distributing samples with the potential customer absorbing part of the cost. The campaign proved itself an immediate success. Dr. L. N. Upjohn, looking back on the campaign some fifty years later, noted that it was so success- ful that mail had to be brought from the post office in.buShel baskets. And in each envelope was a dollar bill.3 In 1905, however, something happened which was to have a serious effect upon Upjohn advertising. At that time the Council on Pharmacy and Chemistry was created by the American Medical Association to regu- late advertising in the JAMA and generally act as an authority on drugs. The creation of the Council was an apparent attempt to clear the mar- ket of the innumerable drugs and drug mixtures which had little or no value in the treatment of disease. Unfortunately, the Council's regulations affected a number of ethical drug firms as well as the manufacturers of patent medicines. The Upjohn Company was among these firms, for the sampling technique which the Company had been using since the turn of the century was prohibited by the Council. As the JAMA was the only medical journal of any consequence at that time, its removal from the Company's media schedule actually brought all Upjohn professional advertising to a halt. A year later in 1906 Congress passed the Pure Food and Drug Act, which also affected the pharmaceutical industry. As far as advertis- ing was concerned, however, the congressional ruling was merely a codi- fied complement to the regulations already established by the Council. It is interesting to note that regulations of a similar, yet dif- ferent nature would arise more than a half-century later to create an even greater complex Of problems for The Upjohn Company and its adver- tising. 3Dr. L. N. Upjohn, interoffice memo dated July 7, 1945. CHAPTER II THE PHENOLAX ERA, 1907 The Upjohn Company's first real triumph in pharmaceutical market- ing occurred in 1908. It began with the manufacture and promotion of a small mint-flavored laxative wafer. This was the product that was truly to establish The Upjohn Company as a major force in the rapidly growing drug industry. The product was Phenolax. Frederick Childs, the designer of Caripeptic Liquid, discovered that a small midwestern drug firm was producing a tasteless laxative which he thought might have possibilities for The Upjohn Company. Analysis revealed that the laxative's active ingredient was phenol- phthalein, until then used solely as an acid-base indicator (turning red in an acid solution and colorless in an alkaline solution). This laxative was also being marketed in Germany, which was the world's primary, and almost sole, producer of phenolphthalein. How- ever, it had met with no real success either in Germany or in this country. The Upjohn Company decided to combine this laxative with one al- ready in the product line to form a "superlaxative" with "built-in multiple action." Samples were prepared, and the new product was dubbed "Phenolax." The new product was presented to Dr. W. E. Upjohn. He liked the name Phenolax immediately. He did not, however, see the marketing ad- vantage Of a mere compound laxative pill. He suggested rather a flax vored wafer, which would provide a unique, pleasant-tasting laxative. Working from this, the Company's research production and sales departments combined to place on the market a product that became known 9 10 in virtually every household in the nation. It was the pink, rectan- gular, mint-flavored laxative wafer Phenolax. Initially the Company marketed the product only to physicians. The physicians saw the product, liked it, ordered, then reordered, then reordered again. Realizing the possibilities for Phenolax, the Company began a national introduction. A novel advertising device, which has since become commonplace in pharmaceutical promotion, was employed. The Company sent a post- card containing an advertising message and ten Phenolax wafers (under a strip of parchment) to every physician in the United States. If the physician would try these samples himself, it was assumed that the mint flavoring would do the rest. It did. As well as trying the wafers themaelves, doctors gave the samples to their patients with the suggestion to pick up some Phenolax at the drugstore. The public developed an immediate liking for Phenolax and orders poured in. In fact, sales results were almost too good. The production department soon found itself hard pressed to keep pace with the influx of orders. But the Company, as in other past and future situations, proved flexible enough to adjust to the problems and opportunities brought by booming sales. Production caught up and, in spite of entering com- petition, The Upjohn Company continued to lead the rapidly growing mar- ket for flavored laxatives. The drug industry and the public were happy and things were going well for all when the world found itself unwillingly plunged into WOrld War I. The war's effect was immediately felt by the laxative ll manufacturers, for it was the German chemical industry which supplied the world with the phenolphthalein so vital to the manufacture of Phenolax and competitive products. Older drug firms which were not so dependent upon a single prod- uct apparently failed to sense this complication introduced by the war. But the farsighted management of the young Upjohn Company proved itself, for it had purchased large stocks of phenolphthalein in anti- cipation of the war shortage. The result was that The Upjohn Company became,for all practical purposes, the nation's sole producer of flavored phenolphthalein-based laxatives. Phenolax controlled a market all its own until the early 1920's. When the war ended and phenolphthalein again became available from the German chemical industry, a flood of competition struck the market. Upjohn management, recognizing the danger to Phenolax, moved to stop or slow the competition and retain its product's share of the market. To accomplish its objectives, management called upon advertising. Upjohn needed to establish a secondary, rather than only a primary, demand for its product. Product differentiation and identification became not only desirable, but necessary, to the survival of Phenolax. A number of devices were employed to establish identification. The first move was imprinting the word Phenolax on every wafer. Fur- ther, red and yellow celluloid window cards were printed and distri- buted to druggists. They were 12 x 18 inches in size and read, "No substitution in This Store--We Sell the Genuine Phenolax Waferse-In Original Bottles Of 30." Service contracts were also designed to al- low various amounts Of "free goods" to druggists upon their purchase 12 of Phenolax in gross lots and their agreement to display the product prominently. The new policy encompassed Upjohn's first serious effort to adver- tise directly to the public. The Company employed lay advertising because the job simply could not be done by its sales force, at least not fast enough in a market suddenly flooded with competition. In spite of the success of consumer advertising, however, Upjohn did not use this form again to any appreciable extent until half a century later. Possibly the most powerful device used in the Phenolax campaign was a point-of-purchase display conceived by L. M. Crockett, later to become a vice-president and director of the Company, and executed by William Donahey, creator of the weekly comic strip "The Teeny Weenies" (which still appears in some larger Sunday newSpapers). Donahey pre- pared a three-paneled display showing the elf-men constructing a house of Phenolax wafers. The display was an immediate success and was much sought after by the larger drugstores and chains throughout the nation. The display was so effective that Phenolax became a household word. According to Leonard Engel, "Doctors' sons dubbed their jalopies 'Phenolax' instead of 'Leaping Lena.‘ An Upjohn salesman spotted a thoroughbred trotter named Phenolax (but never reported how well the horse made out)."4 NO matter how the horse did, the product did very well. During the period from 1908 to 1925 Phenolax was the bread and butter of The Upjohn Company. It contributed as much as twenty-five per cent to the aEngel, p. 44. 13 Company's total sales. The peak year for Phenolax was 1924, when 182,393,660 wafers were manufactured for total wholesale sales Of $795,252. In 1925 Phenolax sales began sliding. They continued to slide until the product was finally all but abandoned by the Company. As late as 1949, however, Phenolax sales were still well over $100,000 per year. Among the least concerned over this loss was Dr. W. E. Upjohn. His philosophy was that there is a vogue in drugs just as there is in women's fashions. He felt that "a product, a procedure, even aIppp, may be good, but it (or he) must never be considered indispensable."5 Dr. W. E.'s son Harold, who had been instrumental in the success of the most popular pharmaceutical product Of its day, formally con- cluded the Phenolax success story when he returned from a trip to his father's winter home in Pasadena, California, in the mid-1920's. An Upjohn official reports that Harold summed up the Phenolax situation as follows: "Well, boys, the Phenolax problem is solved. The answer is, no more oxygen treatment, no more advertising, no more displays, service contracts, deals, free goods, or price cuts. Just forget Phenolax."6 And so the Phenolax era came to an end. It covered what was probably the most important part Of the Company's history. Profits from what Leonard Engel calls "Dr. W. E.'s 'Big Thing'"7 allowed for 5Stanley Morris, "Upjohn Advertising and Sales Promotion Since Five-Teinwenty," The Upjohn Coppany Histopy, V (no date), 144. (Type- awritten.) 6Ibid. 7Engel, p. 40. 14 the building of an extensive research department and great expansion of the selling force. If any product from the thousands made by Upjohn then and now could be singled out as providing for the Company's greatest growth, it would have to be the pivotal product which was the turning point in Upjohn history, Phenolax. CHAPTER III THE EXPANSION ERA, 1908-1938 From 1905 to 1938 The Upjohn Company carried on its marketing program without the support of professional journal advertising. The AMA followed its ruling against sample advertising (which had been the mainstay of Upjohn advertising for several years) with a number of articles in the JAMA criticizing various Upjohn products. Apparently the AMA felt such measures could coerce drug firms like The Upjohn Company to return to the pages of the JAMA.with full obe- dience to the new standards set by the Council. The articles appeared at intervals over a number Of years. One by L. E. Warren, pUblished in the JAMA of April 17, 1915, publicly criticized Blaud Pills (used as an iron tonic), whose major manufacturer was The Upjohn Company. Another article published nearly 20 years later in the May 20, 1933, issue of the Journal criticized Citrocarbonate, Vitamin D, and a number Of other Upjohn specialties. The Company apparently had not realized that it was able to adver- tise at all under the new regulations and had terminated its journal advertising. Furthermore, the above mentioned articles did little to stimulate The Upjohn Company to investigate the matter. The question- able tactics Of the powerful AMA and the stubbornness of the young drug firm combined to create an enmity that kept Upjohn advertising from the pages of the JAMA until late in the 1930's. There is little doubt that this lack Of journal advertising did a good deal of harm to The Upjohn Company's marketing effort. However, during this period the Company entered two areas which were to very 15 16 greatly affect its later powerful market position. One of these areas was sales promotion. During this period the right men, the right prod- ucts, and the right markets combined to create and develop a program of sales promotion and detailing support that is perhaps the strongest in the industry today and is still growing. One of the most important figures in the growth of Upjohn adver- tising during this period was Mr. W. Harold Upjohn. Mr. Upjohn, the son of Dr. W. E. Upjohn, entered the organization in 1907. He felt strongly that advertising could be attractive as well as dignified and ethical. One of his first projects was redesigning the Caripeptic Liquid label. His action brought criticism from some members of the Company who felt that Upjohn had fallen from, and could never return to, its former position of severe dignity in packaging. Caripeptic Liquid's packaging may have lost dignity, but the product's sales began to mushroom. Compliments poured in from salesmen who commended the new design and hailed it as a boon to selling efforts. Harold Upjohn successfully continued his advertising work by creating an extensive direct mailing program. Promotional literature --leafleta, blotters, calendars, etc.--was sent to physician-customers twice a week. One popular direct mailing piece titled "The Doctor's Prayer" appeared in 1908. Mr. Will Brownell, a retired grocer turned free lance copywriter was selected by Mr. George McClelland of Upjohn to write the words. The text was as follows: Inasmuch as we have, to the best of our ability, relieved the physical discomfort of those who have called upon us when in trouble, may they whom‘we have ministered unto have a deep- seated, organic and absolutely incurable conviction that doc- tors, at the worst are simply human. May they realize that 17 the disease known as "Financial Cramps" is no respector of persons; that frequent applications of kind words and good wishes, while pleasant to take, do not in any way relieve the griping sensations of a run-down monetary system, and that while all flesh is grass, it takes real Uncle Sam money to buy hay* and prunes. May they to whose bedsides we have always promptly hastened when duty summoned, be suddenly and severely attacked with a softening of the heart and a loos- ing Of the purse-strings to the end that we, their doctor, may be able to hold up our head in the presence of our cred- itors, and to this end we most devoutly petition. *Here may be inserted the words "or gasoline." 8 The piece was very successful and gained wide acceptance among Upjohn's customers for many years. It was reprinted again and again in the form of small detail pieces, desk blotters, etc. Of course Upjohn advertising had to have something to sell, and here the success of Phenolax was again Significant. With funds fur- nished by Phenolax,the Company established a research department. It's first chief was Dr. Frederick William Heyl, who came to Kalamazoo from the University of Wyoming where he had served as professor of chemis- try. Heyl first set up a small control laboratory from which to oper- ate. At the time Dr. W. E. Upjohn remarked, "This is going to cost me $50,000, and I don't know where the money is coming from." Time would prove that the research department would more than compensate for its initial cost and for the millions of dollars spent building research into the backbone of the Company. Dr. Heyl and his small staff began their work with the problem of digitalis--a drug made from the powdered leaf of Digitalis purpurea or common foxglove. Digitalis is used as a heart tonic. It increases blood pressure by virtue of a regulatory effect on cardiac muscle. It 8Engel, p. 51. 18 is invaluable in the treatment of heart disease. Unfortunately, the clinical usefulness of digitalis involved two problems: (1) the thera- peutic dose was nearly equal to the toxic dose and (2) the drug lost about sixty per cent of its power in a year's time. After extensive investigation and research Dr. Heyl solved both prOblems. Careful control and standardization solved the toxicity problem. The discovery Of the effects of light and moisture on sta- bility was the key to the second problem. Dr. Heyl developed a sealed, darkened package containing a desiccator to remove moisture. Later advances led to the production of Digitora, an oral digitalis tablet which met with considerable success. About the time Upjohn sales promotion introduced Digitora to the market, physicians were developing an increasing awareness of the important fact that human blood was alkaline in nature. Researchers had found that many diseases upset the acid-alkaline balance id the bloodstream, which produced further complications. Sodium carbonate provided the solution because it returned blood to its alkaline state. However, large doses of sodium carbonate were difficult to take. Dr. L. N. Upjohn attempted to improve the taste of sodium carbonate by mixing Vichy salts (chiefly magnesium citrate) with it. The Vichy salts helped, but did not improve the product enough to suit Dr. W. E. Upjohn. In accordance with his policy during the developmental stages of PhenOlax, Dr. W. E. insisted on a better- tasting, more effective drug. Dr. Heyl set to work on the problem. In 1921 Upjohn introduced Citrocarbonate, an effervescent mixture of alkalizing salts, citrates, l9 and bicarbonates. Two years later the product's sales of $420,000 accounted for about one-eighth of the Company's business. This prod- uct backed by extensive research, good production methods, careful quality control and aggressive promotion changed The Upjohn Company's uncertain sales future to a bright, promising one. It was also in 1921 that Mr. Harry H. Freeman joined The Upjohn Company. Mr. Freeman had come to Kalamazoo in 1918 at the request Of Dr. W. E. Upjohn to help create a new city charter. Kalamazoo accepted Mr. Freeman's proposed charter and he became the new city manager. At the same time Dr. W. E. Upjohn was elected mayor. Thus it was hardly strange that, when Mr. Freeman resigned his position late in 1921, he came to The Upjohn Company. One Of his first assignments was a trip to London with Harold Upjohn in the fall of 1922. The Company was attempting to introduce Phenolax to Europe, but Freeman's mission was not successful. He returned in the late spring of 1923, having failed to establish Phenolax in the European market. He returned to the dual position Of editing the Company's house organ, The Overflow, and doing special work in sales promotion. He made a study of mailings to physicians and from this determined the policy that was to guide all future Company promotion and advertising. Freeman defined sales promotion as a supportive rather than sup- plantive effort. All promotion was tied closely to the detailing pro- grams of the salesmen. He attended sales conferences, where be acquainted the field men with the help being given them by the expand- ing sales promotion department. He further communicated his plans through.zpe Overflow, announcing campaigns, running sales contests, etc. 20 This was the kind of promotional support that, with no journal advertising whatever, was creating a legend of Phenolax and rapidly building sales of the new "big" product, Citrocarbonate. Citrocarbonate was, in fact, finding broader and larger markets than had been imagined for it. It was used in the treatment of dis- eases marked by an acid-alkaline imbalance in the blood. It was used as an antacid for gastric upset. Surgeons prescribed it for treat- ment prior to operations. They were sold by the excellence of the product itself and by its supportive advertising: "Preoperative alka- linization for postoperative comfort." The product even enjoyed some popularity as a preventive of the common cold. In 1925 Citrocarbonate sales outstripped those of Phenolax. One year later it became the first Upjohn product to attain gross sales of more than one million dollars. Its peak year was 1931, when sales of $2,081,000 constituted 25.4% of company sales. Citrocarbonate continued to report annual sales of over a million dollars as late as 1945. In fact, the product is still a very active member of the Up- john line, with a sales volume of $917,000 in 1962. By the mid-1920's the family partnership that had started in a Kalamazoo basement, aided by the almost storybook successes of prod- ucts like Phenolax, Digitora, and Citrocarbonate, had grown to a firm employing eight hundred employees and grossing four million dollars a year. In addition to the three "bread and butter" products the cata- logue listed a line of injectable drugs, a complete line of vaccines, and a cough medicine which, like Phenolax, was to become a household word. The cough medicine was Cheracol. 21 Cheracol was originally compounded with morphine. To the Comp pany's chagrin, however, it became popular with narcotic addicts (par- ticularly on the West Coast). The Upjohn Company hastily substituted codeine, a nonhabit-forming narcotic, for the morphine. The codeine was every bit as effective as the morphine, and thus again a good product with a pleasant taste found its way into the homes of America. Once more The Upjohn Company had employed what was later to be called the "marketing concept" to produce, create, promote, and distribute a product whose first concern from conception to consumption was the ultimate consumer. On.March l, 1926, Harry Freeman left the Company. Fortunately this man who had really made Upjohn promotional policy was replaced by a man equally capable, Mr. Stanley Morris. Morris had been with The Upjohn Company since 1920 supervising the production and distri- bution of detail materials. It was he who made the direct mailing program so effective by scheduling the two mailings each month to co- incide with the product(s) being detailed by Company salesmen. This was a difficult and extensive job, but Mr. Morris handled it with ef- ficiency and dispatch. (Practically all direct mailing by the Com- pany today is done internally by the Promotional Mailing department under the supervision of Mr. Jack VanDyke.) Unfortunately, just as The Upjohn Company seemed to have found the secret of successful sales promotion without journal advertising, it experienced a serious setback. On October 15, 1928, Harold Upjohn, who had been the power and creative inspiration behind all Upjohn ad- vertising since 1907, died. With him died nearly all Company adver- 22 tising, for the advertising program that he had made so successful lay dormant for an entire decade. At the time of Harold Upjohn's death Citrocarbonate was a well- established pharmaceutical. It had been advertised and prompted well enough that it could provide the Company with sufficient sales without the aid of continued advertising. In fact, the entire sales organiza- tion, then under the direction of Mr.!hflcolm Galbraith, was growing so quickly in size and efficiency that some questioned the need to advertise any of the Upjohn line. This question had come up before, but Harold Upjohn had always been able to sell top management on the need to advertise. Harold was the only member of the management team who did not have a medical background. He, probably better than the others, could see outside the research and production departments to the most important part of the business mix, the market. He knew the necessity of finding a need, filling it, and then telling your customers, through advertis- ing, that you had filled it. But when Harold died, his view of the market also died, and Upjohn management discontinued the advertising program. In all fairness to management, it must be admitted that one of the major reasons for the neglect of advertising was the fact that a more important need had arisen. The Company needed a vitamin product to compete with discoveries being made almost daily in the field of nutrition. Consequently, money was taken from advertising to pay for a nutritional laboratory. 23 However, the Company never returned the money to the advertising budget after building the nutrition laboratory because one year after Harold Upjohn's death the American stock market crashed. The country entered the greatest economic crisis it had ever known--the great de- pression. Pharmaceutical firms had to consider first things first, and research was most vital. Thus every available dollar of profit was spent on research. Throughout this period The Upjohn Company and the entire pharma- ceutical and medical professions had been vigorously pursuing the secrets of nutrition. First came vitamin A, isolated near the end of the 1910's through the efforts of a great many men of science, the first of these being Sir John Bland-Sutton, who discovered the use of cod liver Oil in the treatment Of rickets in 1889. The discovery of vitamin A led in 1922 to the discovery of vitamin D, which was also found in cod liver Oil. Vitamins were indeed becoming important to the pharmaceutical market. The Upjohn Company was able to take advantage of this market because of the work of Edwin C. Wise, chief of the newly formed nutri- tion laboratory. In 1928 the Company entered the vitamin field with a product that, unlike its competitors, boasted controlled potency and taste. The product was Super D cod liver Oil, and it enjoyed consider- able popularity as a food supplement for babies and children. In keeping with business tradition, competition found something better. By irradiating ergosterol, a fatlike plant substance, with ultra-violet light, scientists could form an almost pure concentrate of vitamin D. The Upjohn Company failed to obtain a license to produce 24 Vitamin D in this manner; but, undaunted, it searched for other ways to meet the competition. In 1936 Edwin Wise went to Europe, where he traveled extensively in Scandanavia for more than half a year. He set out to find the best source of cod liver oil available. He found it off the northern coast Of Iceland. The revelation of this extremely potent Oil was coupled with the discovery of ethylene chloride, an organic chemical capable of dissolv- ing vitamin D and thus isolating it from cod liver oil. The firm which made the discovery, International Vitamin Corporation, granted an exclusive U. 8. license to the process to The Upjohn Company. Super D concentrate was therapeutically superior to the ergosterol irradiated vitamin D, and The Upjohn Company again led the drug industry. Drug researchers were working not only with vitamins A and D. In 1926 Dr. Joseph Goldberger Of the Public Health Service discovered niacin (nicotinic acid). Vitamin C (ascorbic acid) was finally iso- lated in 1928. In 1931 Dr. Harry C. Sherman of Columbia University isolated vitamin B2 (riboflavin). In 1935 Dr. Robert R. Williams of Bell Telephone Laboratories isolated vitamin B1 (thiamine). Working to combine all these into a single vitamin product, The Upjohn Company introduced its first multivitamin in 1930. Myeladol was a combination of iron, bone marrow, malt, and cod liver oil. It provided clinical efficacy but was somewhat less than a smashing sales success. Continued research produced Cerelexin in 1937. Cerelexin combined liver extract, iron, and an excellent source of B-complex vitamins, yeast extract. Cerelexin proved to be a popular and rather successful contribution to the multivitamin market. 25 In 1938, the year The Upjohn Company returned to the pages of the JAMA, Teleostol Compound C was introduced. This multivitamin was a combination of crystalline thiamine chloride, ascorbic acid, and concentrates Of vitamins A and D. Like Myeladol, Teleostol Compound C failed to provide the hoped-for sales. But the best was yet to come. The Upjohn Company was losing the race for the greatly increasing vitamin.market, so the research department went back to work. They came up with a small capsule containing the adult minimum daily require- ments of vitamins A and D, B1 (thiamine), B2 (riboflavin), C (ascorbic acid), pyridoxine, and niacinamide. This time a product "designed for health, produced with care," and prepared for an already established market was supported by the power created by a reawakened interest in sales promotion and advertising. In 1940 Unicaps exploded into the American drug market! CHAPTER IV CONSOLIDATION AND MARKETING GROWTH, 1938-PRESENT The year 1938 marked the end of The Upjohn Company's long absence from the pages of the professional journals. It was, in fact, the end of a decade of almost complete lack of any form of advertising. On June 2, 1938, the Company submitted a list of twenty-five products to the Council on Pharmacy and Chemistry of the AMA for con- sideration. It was accepted. A letter from Dr. Leech, then Secre- tary of the Council, dated July 29, 1938, stated that "The Upjohn Company will be considered a concern having accepted products as of September 1 . . . . The Secretary wishes to express on behalf of the Council, appreciation of your willingness to cooperate."9 It is interesting tO contrast this with a statement from another letter written five years earlier by Dr. Leech: "The Upjohn Company has never cooperated with the Council on Pharmacy and Chemistry. At times the firm has indicated its intention of submitting products to the Council, but no product has ever been accepted for inclusion in New and Non-official Remedies."10 Although this letter was written to a physician, it is easy to see the change in attitude, both of the Council and the Company. AMA acceptance was, of course, a major factor in the re-emergence of Upjohn advertising. However, as at other points in The Upjohn Com- pany's history, a man also played a key role in the Company's progress. Mr. C. V. (Pat) Patterson began his career with The Upjohn Com- pany in 1925 as a salesman in Kansas City. In 1928 he became a sales 9Morris, op, cit. 10 Ibid. 26 27 supervisor. In 1931 he was elevated to the position of Secretary to the Director of Sales, Mr. Malcolm Galbraith. This led to a promotion to Assistant Director of Sales and shortly thereafter to Sales Direc- tor of the Company. Mr. Patterson concluded his active career with The Upjohn Company on January 4, 1960. He retired from the position of Executive Vice-President, but he continues to serve as a consultant and remains a member of the Board of Directors. Mr. Patterson was keenly interested in the role played by adver- tising in Upjohn's sales, and he was instrumental in alerting manage- ment to the growing importance of advertising and sales promotion. At his insistence the Company again undertook a fairly ambitious program of direct mailing in 1938 and 1939. At this time the Company entered into its first agency relation- ship. It hired McManus, John and Adams (presently agency of record for both the Pontiac and Cadillac divisions Of General Motors) to work on the creation and production of Company advertising which appeared in the JAMA in 1939. McManus also engineered the Company's direct mailings. These mailings were done entirely independently Of the detail work (i.e., the personal selling effort). A comprehensive study was made of this effort which proved that direct mail is considerably more effective when used to support detail work, rather than supplant it. Applying this principle and others slowly gained from experience, the Company proceeded with its advertising program. In 1940, apparently in favor of retaining an agency, but disenchanted with McManus, The 28 Upjohn Company switched the handling of its account to the L. G. Maison agency of Chicago. Dr. Maison himself acted as account executive. In this year (1940) twelve separate mailings were made and a series of twelve 4-color inserts was run in the pages Of the JAMA. Copies of these twelve ads, "Studies in Avitaminoses," were made avail- able to physicians in portfolio form. Revisions of this portfolio re- sulted in the publication of two books, Clinical Aspects Of Avitamin- oses, published in 1943, and Vitamins in Medicine, published in 1947. Both‘were made available free tO doctors. (An even later publication, The Vitamin Manual, published in 1953 and distributed at no charge to professional people, teachers, etc., was written from material in these two books.) In 1941 The Upjohn Companx,still experimenting with the powerful new tool of advertising, changed agencies again. The new agency was Campbell-Ewald of Detroit, among whose clients presently is Chevrolet Division of General Motors, one of the largest single advertisers in the world. Mr. Karl Pittelkow acted as account executive. Ten direct mailings were made in 1941 and a journal schedule sim- ilar to that Of the previous year was maintained. In addition, two new features became a part Of the advertising program. The first was a series of institutional advertisements run in national magazines. These ads discussed the theme "Why Your Doctor Knows." The series constituted one ad each month from September, 1941, through May, 1942, in SaturdaygEvenipggPost, Time, Parents, and flygglg. Like the "Avitaminoses" ads, these nine ads were later reprinted in book form and distributed by salesmen to physicians. The suggestion 29 was made to make the books available to patients by placing them in physicians' waiting rooms. The second new feature of Upjohn advertising was §pppp, intro- duced in October, 1941. This prestige periodical was intended as a quarterly journal, but in reality it was rarely published that Often. gpppEDcontained news and feature articles Of interest to the physi- cian, as well as advertising. It was distributed free to doctors. Unfortunately, due to its high production cost and erratic publication schedule, Spppg was discontinued with the December, 1957, issue. Scope's successor had been born two years earlier. On January 2, 1956, the Company published the first issue of Scope Weekly. This tabloid newSpaper featured brief articles on current news stories con- cerning the medical and pharmaceutical professions. Gone were the prestige, "class" feature stories of the coated stock journal. Like the magazine, Scope Weekly was distributed free by mail to nearly all the approximately 175,000 physicians in the nation. Librar- ies of the country's leading medical schools also received it at no charge. William Douglas McAdams agency of New York handled entirely the services of reporting, producing and distributing Scope Weekly at a cost of $1,500,000 a year. An expenditure of this size, however, could not be made long no matter what the return (which Upjohn studies showed was far from great). Consequently, with the November 2, 1960, issue Scope Weekly died. With it died any attempt to distribute a house organ to doctors. The McAdams agency (not to be confused with McManus, mentioned earlier) was hired in early 1943 to create and produce all Upjohn ad- 30 vertising except national lay advertising, which was left with Camp- bell-Ewald. WOrking with McAdams, The Upjohn Company increased its 1943 mailings to fourteen and expanded its journal advertising. In December, 1943, the Company adopted the "Your Doctor Speaks" national lay campaign proposed by McAdams, which ended the association with Campbell-Ewald. "Your Doctor Speaks" dealt with diseases often encountered by physicians and told of the progress of medical science in the treatment of these diseases. Each ad was illustrated by a four-color fine art painting. The Company employed the aforementioned four national magazines for the series for the next three or four years. Other magazines were occasionally included in the schedule, among them Life, Colliers, Newsweek, and Fortune. In 1944 twenty-four mailings were made and journal advertising expanded further. Twenty-nine mailings were made in 1945. In this year the first ten advertisements of the "Your Doctor Speaks" series were published in book form. Every physician in the United States received copies of the book for use in his waiting room. During World War II The Upjohn Company included slogans like "Buy War Bonds" in its national magazine advertising. Ads like these were also occasionally placed in the Kalamazoo Gazette. In 1946 a series of two-page ads called "Civilian Medicine During the War Years" was placed in the JAMA. McAdams prepared these ads, which discussed diseases and conditions for which progress in treatment 31 had been made during the war years. Some years later the theme Of this series was changed to "Recent Advances in Medicine." In 1946 forty-eight mailings were scheduled, probably the most ever attempted in a single year. Journal schedules remained about the same. In 1948, 1949, and 1950 the Company cut its mailings almost to the point of discontinuation. Journal advertising remained steady. Institutional national advertising declined somewhat. During this period of growth, from 1938 to the present, profes- sional and direct mail advertising were not the only promotional wea- pons the Company employed in its assault on the drug market. Detail materials (printed materials used as props for sales presentations and/or as "leave-behinds"), window diaplays, and Special promotional exhibits also figured prominently in The Upjohn Company's promotional armamentarium. In 1920 the only advertising used was a group of detail materials. The area of detail materials has, of necessity, grown tremendously since that time. The flow of new products has required great amounts of detail materials to introduce these products to the doctor or drug- gist and to aid the salesman with his presentation. Much of the Company's detail material comes from ideas submitted by salesmen. These ideas range from simple black-and-white charts to elaborate leather-bound booklets with celluloid envelopes containing photographs, charts, graphs, outlines, etc. Through the years detail pieces have become more elaborate and colorful. In 1948 mechanical gadgets were added to the Company's detail effort. Presently the Com- 32 pany is experimenting with slide projectors and motion picture projec- tors to be used in presentations made by detail men. In 1940 the detail cards, blotters, folders, leaflets, and book- lets were ordered in quantities of 50,000. By 1948 these items were ordered in quantities up to 200,000. This is still true in 1963. Upjohn's first use of window displays has been mentioned in the Phenolax "success story" in Chapter II. Displays were used intermit- tently from then until the late 1930's. Beginning in 1938 the Com- pany prepared vitamin diaplays annually for use in drugstore windows. These centered in a human interest painting and featured Upjohn vita- min products . In 1939 the Company commissioned Normal Rockwell to do a group of paintings. Among themeere a painting of a small boy measuring himself by marks on the wall and a country doctor writing a prescrip- tion for a mother and her three children. Reproductions Of Rockwell's works may still be seen in doctors' Offices across the nation. Window displays also featured paintings from the "YOur Doctor Speaks" series of national advertisements. Other special product displays were prepared as the need arose. Advertising through medical exhibits began in 1892 with a small booth at the Chicago World's Fair. The booth, run by Dr. W. E. Upjohn himself, showed the advantages of the "friable pill." Stickpins (min- iature bottles containing layers of vari-colored pills) were distri- buted to interested onlookers. The pins were attached to a card upon which.was printed "Compliments of the Upjohn Pill and Granule Company." 33 Special exhibits appeared intermittently from that time until 1947, when major exhibits on Gelfoam, an absorbent and absorbable surgical gelatin qaonge, were shown at medical conventions in Buffalo and Chicago. Registration cards written on the spot provided a natural follow-up for Upjohn salesmen. Exhibiting increased in 1948 to cover eight national, eleven state or city, and three specialized medical conventions. Upjohn built exhibits which could be adapted from a Gelfoam presentation, for example, to one on the adrenal cortex products. Even veterinary medi- cine was represented: three exhibits in 1947 and four in 1948. Certainly one of the Company's most ambitious exhibit efforts .has been the construction and display of The Cell. This tremendously magnified model (twenty-four feet in diameter) of the most fundamental biological unit of life has been displayed at a number of conventions across the nation. It resides now in Chicago's Museum of Science and Industry. The Cell contains over two-thirds of a mile of special acrylic plastic tubing in 2,200 separate pieces, which are glued and clamped together. One mile of electrical wiring provides lighting for the effect of life within The Cell. The model has left the Museum only ones. In 1959 at the urgent request of the British Broadcasting Company it was flown to England to be the star of two one-hour television programs on cancer and can- cer research. Actually The Upjohn Company has experienced what is probably its greatest growth period in the last ten years, for example: 34 1952 1962 Gross Sales $75,958,000 $173,181,000 Net Sales 8,405,000 23,255,000 11 Total Number of Employees 4,267 7,025 The Upjohn Company owned sixty-six buildings in 1950;12 the current total is 149. The estimated 250 professional journals used by Upjohn in 1950 has been trimmed to about twenty, but the number of advertising agencies employed has increased. Since 1950, when McAdams was the only Upjohn agency, five agencies have been added: RObert A. Becker, Inc., McCann-Marshalk (Division of Interpublic), Aves Advertising (to reach the agriculture and drug trade), Fitzsimmons, Inc., and L. G. Maison (the same agency which had been retained earlier in the Company's history). Perhaps of greatest interest is the increase in advertising ex- penditure from $666,000 in 1950 to $5,198,000 in 1962. This represents a significant increase in advertising as a percentage of sales from 1.04% in 1952 to 3% in 1962. These figures do not, however, belong to the history of Upjohn advertising, but to the present. They reflect the constant and contin- uing growth of a company that, through extensive research, efficient production, and aggressive marketing, has established itself as a world leader in the manufacture and distribution Of pharmaceuticals. 11The Upjohn Company, Annual_Rep9rt, 1952 and 1962. 12Ibid., 1950. PART II NOW CHAPTER V GOVERNMENT REGULATION AND THE DRUG INDUSTRY In 1957 a painful and torturous era began for the drug industry as major attacks against it were leveled from.at least three direc- tions. The question involved was one of drug regulation; and the drug f irms, whose very reason for existence was the prevention and cure of disease and, therefore, the health of every man, woman, and child in the U. 8., suddenly found themselves pictured to the public as villain- ous, profit hungry individuals, who were more concerned with selling ineffective or, worse, harmful medicines to the poor overworked physi- cians and an unsuspecting public. Taken unawares, the industry could only gape at the charges. Here was an industry that had grown by leaps and bounds over the past thirty years. Most companies had begun, much as Upjohn had, as small firms handling the manufacturing of medicines as directed by the physicians. As Lawrence Lansing, writing for Fortune magazine, put it, "Formerly the pharmaceutical industry made only what the doctor prescribed; now the doctor prescribes what the industry makes. In the last 30 years or so, medicine has encompassed more advances than in the preceding five hundred."13 Thus an industry responsible in part for making this country one of the least disease-ridden countries in the world was being attacked for allegedly taking advantage of an un- suspecting public in order to secure greater profits. As the attacks took form, several basic reasons for them became clear: 13Lawrence Lansing, "Laws Alone Can't Make Drugs Safe," Fortune (March, 1963), p. 3. 36 37 l. The Federal Trade Commission (FTC) charged six companies, Upjohn among them,'with unfair methods of competition and unfair acts and practices. The charge made particular reference to the marketing of various forms of tetracy- cline, a broad-spectrum antibiotic. 2. The Food and Drug Administration (FDA) felt that it was not able to adequately control the marketing of new drugs being placed on the market. 3. The Kggauver Commpgtee (full title: Senate Subcommittee on Antitrust and Monopoly [; part of the Senate Judiciary Committe27,whose chairman.was the late Senator Estes Ke- fauver of Tennessee) aimed its attack at the excessive profits Mr. Kefauver was convinced the drug companies were making. The attack eventually broadened into ques- tions of controlling not only those profits, but also advertising content and marketing methods as applied to products on the market. As the industry reeled, searching for reasons for the attacks and for weapons to combat them, it became clear that a good deal of the blame for the assaults lay with the industry itself. Its notable lack of institutional and corporate advertising and Of public relations and lobbying, activities so vital to big business, had left it vulnerable. Senator Roman L. Hruska, then himself a member of the Kefauver Committee, explained it rather clearly when he said, "The prescription makers had in the mind of the public no reservoir of good will, no general awareness of their phenomenal service to mankind. Their story 38 had never been told. In the popular jargon they had no 'image.’ To the inquisitors, they were not just fair game; they were sitting ducks. So they were duly nominated for assault."14 To compound the problem of the Pharmaceutical Manufacturers Asso- ciation (PMA), which represented the industry, all three federal at- tacks came within the same Space of time, roughly the two years 1960 and 1961. Though the three manifested some interplay, one affecting the other, this report will consider them separately for purposes of reader clarity and convenience. The Federal Trade Commpssiop. In a speech before the Proprietary Association convention at White Sulfur Springs, West Virginia, in May, 1961, Federal Trade Commission Chairman, Paul Rand Dixon, cited a report that revealed an unfavorable trend with respect to pharmaceuti- cal advertising. It appears that ten years ago the Commission.was issuing only about five complaints a year against proprietary drug advertising but that the number of these complaints has increased to the point where 19 were issued in 1960 . . . All five members of FTC are deeply troubled by the content and tone of the thousands of letters complaining about advertising that we receive each year from the public. Many of these are forwarded by senators and congressmen who add their own expressions of concern. Thus on July 13, 1961, the FTC put forth a "Resolution Directing Investigation of . . . Corporations Engaged in the Sale and Distribu- tion Of Drugs and Drug Products": 14Senator Roman L. Hruska. Address before the New Jersey Pharmaceu- tical Companies, Far Hills Inn, Somerville, New Jersey, November 16,1961. 15Paul Rand Dixon. Speech before the Proprietary Association Con- vention, White Sulfur Springs, W. Va., May 14-17, 1961. 39 Now, Therefore, Be It Resolved that the commission in the exercise of the powers vested in it by law, and pursuant to its published procedures and rules of practice (16 CFR, 1958 Supp., 1.1 et seq.), and with the aid of any and all compul- sory processes available to it, do forthwith proceed to in- vestigate, for the reasons and purposes stated herein, the organization, business, conduct, practices, management, and relation to other corporations, partnerships, and individuals of corporations engaged in the manufacture, distribution and sale of drugs and drug products. 16 To the Upjohn Company's credit, Dixon's investigation of "good" and "bad" ads (chosen chiefly from then current issues of the JAMA) listed advertising for two Upjohn products, Monase and Orinase, as "good." No Upjohn advertising appeared on the "bad" list. Even this admission, however, was given grudgingly. Concerning an Orinase ad in the May 6, 1961, JAMA, FDC Repprts quotes Dixon as stating that "although the color of the print describing the side ef- fects and contraindications is distinctive, the print is too small to be read without eyestrain."17 This, then, would be the tone of all government investigation to follow: inquiry into hundreds of small considerations which, before it was over, would involve a considerable loss of time and money and eventually partial loss of freedom Of advertising and marketing for The Upjohn Company and the industry as a whole. The FTC investigations were not, of course, concerned solely with advertising, though advertising is naturally our major consideration here. The entire scope of these investigations is discussed by Raymond 16Federal Trade Commission. Resolution Directipg Investigation of Pricing Practices, Policies, Allowances, Service Discounts, Terms of Sale and Adpertising of Corporations Epgaged in the Sale and Distribu- gipn of Drugs and Drug Products, July 13, 1961. 17FDC Reports, September 11, 1961. 40 Moley in Newsweek. He considers FTC hearings in which six companies (American Cyanamid, Bristol-Myers Company, Bristol Laboratories, Pfizer, Olin.Mathieson, and Upjohn) were charged with "unfair methods of competition and unfair acts and practices" with reference to the marketing of various forms of tetracycline. After extended hearings, according to Malay, Robert L. Piper, examiner for the FTC, prepared a 195-page report, which was "an exhaustive survey of the technical and commercial aspects of the manufacturing and marketing of these drugs. His conclusions clearly exonerated the companies from the charges."18 The Food and Drpg Administration. Perhaps the greatest peril to drug advertising, if not to the drug industry as a whole, lay in the investigations and actions of the FDA, especially as it was affected by the Kefauver Committee. The FDA examined the question Of labeling regulations and eventually of certain advertising and marketing regu- lations. Printer's Ink expressed the FDA position this way: "By a wild stretch of its authority, the Food and Drug Administration has decided that advertising is the same thing as labeling and thus should include all the warnings required on labels."19 Actually this FDA ruling did not apply to all advertising. The PMA Bulletin clarified the FDA position: Any labeling Of a prescription drug distributed by or on behalf of the manufacturer or distributor (this would in- clude promotional mailings) that furnishes or purports to furnish information for use or suggests a dosage, must also contain adequate information on side effects, contraindica- 18Raymond Moley, "Wonder Drugs and Law," Newsweek (December 4, 1961). 19 Printer's Ink, Editorial (December 22, 1961), p. 71. 41 tions, precautions, etc. If the drug is the subject of an effective new drug application, this informational material would be that contained in the "Official brochure." This requipement applies to all prescription drugs, whether "new drugs or not, and regardless of whether the ordinary prac- titioner commonly knows these facts. 20 Advertisements in medical journals and other similar publications were thus not considered labeling since they do not directly contribute to the distributional scheme of the product considered. If, however, reprints of these ads were used by detail men or as direct mailing pieces or if they furnished information for use and/or suggested dos- age, they then became "labeling" and were subject to the provisions Of the FDA ruling. Changing Times treated the labeling issue somewhat humorously: "Truth in labeling can go too far. Imagine Omar Khayyam'wooing his girl friend with 'a loaf of bread, calcium propionate added to retard spoilage, a jug of wine, color added, and thou.'"21 Many saw very little humor in the FDA ruling and its possible ex- tensions and consequences. An editorial in Printer's Ink warned of these extensions and consequences: The FDA has authority over the labeling of foods and cos- metics as well as drugs. Will it, sometime in the future, require full disclosure in food and cosmetic advertising? Government control over deception in advertising is one thing, and it is welcome. Government dictation of the con- tent of truthful advertising is another, and it is a danger- ous precedent for the advertising business. 22 20Pharmaceutical Manufacturers Association Bulletin NO. 60-13, August 10, 1960. 21Changipg Times (May, 1962), p. 2. 22Printer's Ink, Editorial (December 22, 1961). 42 Whether a dangerous precedent or not, the new FDA interpretation of the law became one more regulation threatening to seriously inhi- bit the free competition of the American drug industry. As potentially threatening a situation as this was, however, it did not Offer the greatest danger to the drug industry. That was the danger Of ppp legislation, which was to arise from the much publicized hearings be- fore the Senate Subcommittee on Antitrust and Monopoly. The Kefauver Committee. When Senator Kefauver began his attack upon the drug industry in 1959, it was based on the premise that the drug firms were realizing too great a profit on their products Och and above the cost of their manufacturing. He cited examples of drug markups from 1,000 per cent to over 10,000 per cent. His charges made headlines and the headlines immediately created an unfavorable picture of the drug industry: Drug Firm Accused of Boosting Product Price 7,000 Per Cent Asthma Drug Price is Found Eleven Times Cost23 Without a doubt, Kefauver's methods Of attack were highly unor- thodox, and as a result the Senator received nearly as much criticism as he gave. But his attacks were primarily geared to hit the head- lines, and the press gobbled them up as an anteater would ants. The drug industry was at a big disadvantage. As Raymond Moley reports: Since the business of a big company is complicated, rebuttal takes time and misses the headlines. Months passed before federal agencies respOnsible for administration of existing laws wereluard, and the professional and trade associations appeared much later. 24 23Hruska, op,cit. 24Raymond Moley, "Kefauver's Inquisition," Reader's Digest (Decem- ber, 1961), p. 69. 43 Even before the drug firms could answer the excessive profit charges leveled by the Committee, they found that the original attack had poured into other areas, chiefly patenting, licensing, and adver- tising. The drug industry offered considerable opposition to the Com- mittee's evident desire to change the existing law, and after a long struggle it was able to retain the status quo in the areas of patent- ing and licensing. On May 8, 1962, the full Senate Judiciary Committee defeated the patent and licensing provision of the proposed Senate Bill #1552 by a vote of seven to three. Raymond Moley offers perhaps the briefest and most concise report of the initial stages of Senator Kefauver's investigation into drug advertising: Kefauver . . . first summoned the presidents of the drug companies, who were confronted with "when-did-you-stop- beating-your-wife" questions cunningly designed to make sensational headlines in the press. Then miscellaneous witnesses offered charges against the industry--generally wild, irresponsible, and sometimes untrue. 25 The investigations lasted some two and a half years, with testi- mony published in twenty-six volumes comprising 16,505 pages.26 It is interesting to note at this point a comment from Senator Hruska, a member of the Republican minority of the Subcommittee: In the course of all its dreary history prior to the drug investigations the Subcommittee has burdened the library shelves of Congress with 26 volumes of transcripts. Of these weighty tomes, the steel industry hearings accounted for three; the automobile industry for two; and asphalt roofing for one. 27 25 1 26 0.. Ibid., p. 70. 27Hruska, op. cit. 44 As the hearings ground their way slowly but surely to a close, the Subcommittee met in the Senate Office Building on January 20, 1962, to question Dr. Arthur M. Sackler and Dr. DeForest Ely, Chairman of the Board and President, respectively, of William Douglas McAdams, Inc., New York, one of The Upjohn Company's several advertising agen- cies. The topic at hand was drug advertising and the effect Of the proposed hill 8. 1552 upon that advertising. In his opening remarks Senator Kefauver outlined the reason for this last session of hearings: The bill contains several provisions relating directly to drug advertising. Thus it would prohibit the making of ex- cessive claims as to a drug's efficacy. It would require the inclusion in all advertisements and descriptive matter of a full and correct statement of a drug's "efficacy" as well as a warning of "any dangerous or harmful property or effect thereof." It would also require the inclusion in advertisements of "the official name, presumably the generic name, like 'Tolbutamide' rather than just ’Orinase' printed in type at least as large and prominent as that used for any trade or brand name thereof" . . . . The problem lies in the quality of advertising and promotional material directed to the physician. Specifically, the complaint has been that the claims of a drug's efficacy are frequently excessive in terms of its actual performance and that cautions concerning a drug's side effects are Often wholly absent or far from adequate. 28 Though the industry as a whole was attacked on several fronts during this session, Upjohn specifically was questioned on only a few items. One of the first charges involved a series of nine ads for Medrol (a leading Upjohn corticosteroid) which employed in each case two 28Hearings Before the Subcommittee on Antitrust and Monopoly of the Committee of the Judiciary United States Senate Pursuant to S. 1552, January 30, 31, February 1, 6, and 7, 1962, Part 6, Advertising Provi- sions. 45 x-rays. One showed a patient prior to treatment for a specific condi- tion; the other showed a patient following treatment for that condi- tion. Most of these ads were clearly labeled with "before Medrol” and "after Medrol" captions or similar captions. In one ad, however, the first x-ray showed and labeled the condi- tion (in this case, ulcerative colitis) and the second showed a patient "following successful therapy." The implication was, of course, that the therapy had been Medrol. The fact was that the two x-rays were not related as to time (before and after), were not even of the same patient, and were in fact shots of patients, neither of whom had ever been treated with Medrol! Though some twelve pages of testimony are exhausted on the sub- ject, the issue is really clear-cut. The Upjohn Company had been caught trying, by implication, to convince the physician that something that was not necessarily so, in fact was. At the worst this form of advertising was "false, deceptive, and misleading." Even assuming the technique was necessary to meet printing deadlines or for some other reason, it was, at best, suspect--a little on the shady side. A second Subcommittee inquiry into Upjohn advertising practices resulted in only four pages of testimony concerning the question of vitamin B advertising. 6 An Upjohn ad appearing in the September 10, 1958, issue of Scope Weekly had suggested that vitamin B6 is the "Happy Baby Vitamin" and makes a contribution to the well-being of babies under six months of age. The copy had informed the physician that "that's why basic baby 46 vitamin supplementation calls for Zymabasic, the formula with all four: A, D, and C, plus B6." The ad was based upon a paper published in the July, 1957, issue of Pediatrics in which Drs. Hansen and Bessey reported their work with B The paper stated that "it would seem wise to give Special atten- 6. tion to the needs and intakes of vitamin B6 of infants less than six months of age." This statement the ad quoted. However, the paper went on to say that this B need is, in most cases, adequately pro- 6 vided by the baby's daily diet. Senator Kefauver was evidently trying to suggest that there is something inherently evil about quoting out of context in advertising pieces. However, as this had been done by all parts of American busi- ness at one time or other and as the Senator really hadn't much of a case, this issue, like many other even smaller barbs and attacks, was dropped from discussion almost as soon as it appeared. This particular sesSion of the Subcommittee also leveled separate attacks on the industry as a whole. For example, criticism was directed at the drug advertisers who, because of differences in stand- ards set by medical journals, sought to place the same ad in two maga- zines,each giving different information. Kefauver charged that this was, in effect, misleading the physi- cian. Dr. Sackler countered by pointing out that, because trade maga- zines had different standards, that did not necessarily indicate that any one was right and the rest wrong. Nor, because the ads had to in- clude some information for one magazine and exclude it for another, did this mean that either ad was all right or all wrong. Rather, the 47 advertiser was attempting to present his product as honestly as pos- sible within the requirements specified by each magazine. Kefauver also attacked the approach of drug company detail men. He suggested that a detail man inform a physician on all products, whether or not they were produced by his company. Incredible as it may seem, the Senator actually appeared to feel that the proper func- tion of the detail man, who is after all a salesman, is to act as a part of a giant information service to the medical profession by im- partially praising and/or criticizing competitors' products as well as his own. Certainly it is the work of the detail man to supply the doctor with information on new and existing drugs; it is one reason he is so important to the busy physician. But the detail man's primary pur- pose, the job for which he is being paid, is to sell his company's products. It is not the job of the drug manufacturer merely to edu- cate his customers any more than it can be his job only to put forth a hard sell of his product. The "education" of the physician is an accepted, and important, by-product of the selling job. But it is only a by-product, a secondary function. There is certainly no reason that selling 23g education cannot coexist. Dr. E. Gifford Upjohn, Board Chairman of The Upjohn Company, expressed his feeling,and no doubt that of most pharmaceutical execu- tives,by objecting to "the implication that pharmaceutical promotion is necessarily contrary to or in competition with or opposed to educa- tion." He went on to state his feelings about the possibility of too 48 much regulation, which might curtail the usage Of promotional and ad- vertising tools in the drug industry: If we could not encourage full use of our products, making them known and understood by physicians, we could not hope for nationwide sales to finance the research establishments that have yielded today's advanced drugs and from which our future drugs will come. Remember that in America, unless we can sell our products, we cannot get them used. Unless they are used there is no point to discovery, invention and research. These are dismal prospects, for life and health are involved. All that we have accomplished, all that we have which makes our system superior to any other, and all our hopes for fu- ture breakthroughs in the cause of health are financed by money from sales. Sales in turn fluorish to the extent that our products are known, understood and used. Restrict com- petitive promotion and distribution and you will restrict sales. Restrict sales and you will surely wreck the whole edifice. 29 Senator Kefauver, however, rather obviously disagreed with this philosophy. He even carried his own thoughts a step further and indiu cated that drug advertising should seek to draw comparative studies with competitors' products and that all products be mentioned by name. That is, Kefauver was suggesting that drug firms make it their busi- ness to undertake lengthy comparative studies of all drug products on the market and, naming names, furnish doctors with thorough reports on each drug classification. The drug companies would thus, in effect, be working together to make the doctor's decision for him. This would perforce be done with no thought of profit in mind, but for purely a1- truistic reasons. 29E. Gifford Upjohn, "Promotion Versus Education," Bulletin of the New York Academy of Medicine, Second Series, XXXVIII, No. 1 (Jan- uary, 1962), 59-63. 49 The Senator apparently made his suggestions with no thought to previous testimony, which had indicated that advertising which uses comparative studies to offer disparaging and critical comments about a competitive brand, which it calls by name, is unfair advertising and in extremely bad taste. Many trade journals, in fact, refuse to allow this form of advertising to appear in their pages. Dr. Sackler's answer to this statement reveals the situation that the drug firum were facing: I said before that we are damned if we do and we are damned if we don't. In one situation we have put in the names of the products. In the other situation you say that we have tried to hold back information in respect to our products. It is quite clear that there is a difference of Opinion, since you hold two different positions at the same time. 30 The questions and answers about advertising, the thrusts and counterthrusts, and the accusations and denials continued, as they had for months and months previously, finally concluding on February 7, 1962. Naturally much of the testimony during the hearings did not in- volve advertising and therefore is not applicable to this report. In any event, it would be futile to try to recapture the drama, excite- ment and personalities present during the Kefauver subcommittee ses- sions. There is, however, one more quotation that should be included. It is the advertising philosophy of the McAdams agency, which Dr. Sackler was permitted to read into the record. We would like to explore with you briefly the function and effectiveness of prescription drug advertising. We do so against a very positive background--the American people are 3oSubcommittee Hearings, op. cit., p. 3108. 50 healthier, not sicker; our children have less disease, not more, our lifespan has increased, not decreased. Good ethical advertising depends on sound and useful pre- scription drugs. Advertising is no substitute for product performance, and no amount of money or promotional ingenuity can match demonstrated benefits for patients from good pre- scription drugs. The prescription drug which does not ful- fill the claims of its promotion cannot be a success either medically or commercially . . . . The function of ethical pharmaceutical advertising is to promote the use of a drug within its therapeutic potential for the alleviation of ill- ness, and to do so in accord with good medical and good business practices . . . . Ethical drug promotion, moreover, is never the sole source of a physician's information of prescription drugs. But (brackets) in bringing information about new therapies to the attention of the practicing phy- sician, ethical drug promotion serves to close the time gap between discovery and use of such new developments. 31 On February 7, 1962, hearings on S. 1552 concluded. Shortly thereafter the bill was reported to the parent Judiciary Committee and thence to the floor of the Senate, where it began the last leg of its journey to the desk of the President and-its position as a law of the land. The bill that left the Subcommittee was one considerably weaker than the original, as the struggle put up by the formerly helpless PMA had its effect on the proposed legislation. The drug industry was somewhat reassured and was beginning to offer claims of victory in its long, drawn-out battle with the government. In view of this, it is perhaps not so strange that criticism of the Senator's handling of the hearings picked up momentum and that magazines and newspapers which had supported him or remained silent throughout the testimony began to reevaluate the handling of the drug industry investigations. 31Ibid. 51 Criticism of Senator Kefauver came through various channels, chief among which were magazine columns and editorials. Raymond Moley wrote some of the most vehement attacks on Kefauver. He stated that, while the Subcommittee was supposed to limit itself to monopoly, mono- poly was not proved nor even charged. He also stated that the main question of the controversy was whether the public was paying exces- sive prices for drugs and added that "by comparison with other repre- sentative industrial companies the drug manufacturers are,ppp_making excessive profits. This is the record despite Kefauver's effort to make it seem otherwise."32 Henry Hazlitt, in an article in Reader's Diggpp, pointed out to Senator Kefauver that the average person spends no more of his health dollar, and a smaller portion of his income, for drugs today than he did in 1929. This, of course, suggests that in fact drug markups are down, not up. Some members of the medical profession, the group that was theo- retically being victimized, also ventured opinions. Dr. Morris Fish- bein, former editor of the JAMA said: "My personal opinion is that Mr. Kefauver is clear off the beam. He is not getting very good scientific advice, if he is getting any."34 But an even more powerful attack came not from magazines, not from doctors, but from Senator Roman L. Hruska, himself a member of 32Moley, op, cit., p. 71. 33Henry Hazlitt, "Criminals or Benefactors?" Reader's Diggst (December, 1961), p. 71. 34Printer's Ink (July 14, 1961), p. 14. 52 the Subcommittee. He was extremely disillusioned with Kefauver's in- vestigation and in fact titled a speech that he gave to New Jersey pharmaceutical companies in November, 1961, "The Anatomy of Congres- sional Investigation, or, The Disillusionment of a Senator." In this speech Hruska launched a vehement attack against his col- league (Kefauver) and his handling of the drug investigations. This attack covered the major areas Kefauver had attempted to investigate. As to the investigation as a whole Hruska stated: While protesting its concern for the welfare of the patient and the future of medical care, it is undermining forces largely reaponsible for the most productive life-preserving generation in the entire history of medicine . . . . No gen- eral in his right mind would ever sabotage a combat team that was winning and on the march. In war, it would be called folly and treason. 35 One of Senator Hruska's primary concerns with the drug investi- gation was that it seemed to him a dangerous attack on this country's free enterprise system. The fact that this attempt at drug regulation was another step toward socialism was apparently obvious to him. Sev- eral quotes from his speech indicate that he found this an extremely dangerous precedent for the United States government to set. He said: The committee has conducted snooping expeditions into areas of industry which are none of its business, or the business of anyone else in government unless we have already abandoned our basic system of free enterprise in favor of the corporate state . . . . There are those who would have us believe that profits mean greed. Nothing could be further from the truth. Profit means opportunity--Opportunity to grow and to prosper. The profit system is the genius of American economics. 36 35Hruska, _p, cit. 36Ibid. 53 These quotations serve to show the depth of feeling surrounding the Kefauver investigations and in part sum up the bitterness and dis- taste that was left in the mouths of many of those involved in the proceedings. But, as stated, the pharmaceutical companies put up a consider- able fight and gained some ground with S. 1552. The bill had been considerably watered down, the patent section had been scratched, the drug lobbyists had influenced enough people to prevent any truly major changes in the existing laws, and despite the harassment that the drug industry had had to put up with for more than two and a half years, it looked as if it might be the one to score a victory. And then a tragic situation occurred; tragic not only for the thousands of deformities it caused, but also because it aroused the American government, spurred on by vigorous public opinion, to turn the tables on the drug manufacturers. A pill, introduced by Chemie Grunenthal in Germany under the trade name Contergan, so perfect and so harmless that it was called "The Sleeping Pill of the Century"37 was discovered to be responsible for phocomelia (a malformation in newborn babies resulting in either loss of some or all limbs or the appearance of imperfect, seal-like appendages). Some 7,000 babies were afflicted and the cause was directly related to Contergan, known by its generic name as thalidomide. Thalidomide, though it was for the most part kept out of the United States, was brought to the attention of the American public by a headline hungry press. The drug manufacturers were caught standing 37§gy§pggk (August 13, 1962), p. 52. 54 in a glaring spotlight, unable to dodge the questions and the unwel- come publicity thrust upon them. As Newsweek put it: What medical testimony and government investigation failed to achieve in thousands of hours and hundreds of reports, the thalidomide tragedy has accomplished with strong and sudden impact. Dramatically, vividly, the pill-taking pub- lic has learned that drug-makers and doctors are not infal- lible, that present laws are lax, and that the stream of new pills which flood the market at the rate of about one every three days are not necessarily wonder drugs. 38 The Chicago Daily News came out with what it reported was the "full story" on the thalidomide tragedy and the drug investigations. As the Daily News told it: Senator Estes Kefauver (D-Tenn.)--in a story not previously told--killed one huge lobbying campaign in the battle over a new drug bill with a single, well-timed thrust. At the crucial moment in the campaign, after his own tough bill appeared dead, Kefauver carefully planted a dramatic, front-page story his subcommittee had been researching for more than two months. It was the story of Dr. Frances O. Kelsey and her heroic battle against private industry pressures to keep the baby- deforming drug thalidomide Off the market in the United States. The drug control issue caught fire. Within weeks the tide shifted, as Kefauver had expected it might. His tough approach was saved. The incident--common1y thought mere happenstance--came as a fitting climax to a rough, tough 2-1/2-year battle between Kefauver, as chairman of the Senate anti-trust and monopoly subcommittee, and the Pharmaceutical Manufacturers Assn. 39 The Kefauver-Harris bill (Rep. Harris initiated a bill similar to s. 1552 in the House of Representatives, which was later absorbed in 381bid., p. 52. 39James McCartney, "How Drug Lobbyists Lost Big Battle," Chicago Daily News (Wednesday, October 10, 1962). 55 the Sentate bill), now rigidly constructed and with most major issues included, passed both the House and the Senate unanimously and was signed into law by the late President Kennedy in October, 1962. Prior to the final enactment of the bill the advertising regula- tions of S. 1552 which had been withdrawn were put back in the body of the bill. This was due primarily to the impact of the thalidomide tragedy. These regulations were reported in Advertising Age. The basic advertising amendment adopted by the committee specifies that all ads and descriptive matter for prescrip- tion drugs, issued by manufacturer, packer, or distributor, must disclose (l) the generic name of the drug "printed prominently and in type at least half as large as that used for any trade or brand name"; (2) the formulas showing quan- titatively each ingredient of the drug; and (3) information about side effects, contraindications and effectiveness. 40 This, of course, is an oversimplified explanation of a lengthy and complicated bill, but it does serve to explain the three major provisions of the advertising amendment in the new legislation. In the final analysis the results of both the Kefauver-Harris bill and the new FDA ruling have been far-reaching. The effects have been felt in every drug company in the United States, whether it is a giant corporation or a small private concern. As Printer's Ink puts it: The consensus adds up to this: The drug makers can live with the bill-~now law. They'll have to work harder. Some will advertise more, others less. And drugs will probably go up in price, which ironically, was one of Kefauver's major complaints when he began his drug probe. 41 40"Congress Puts Teeth Back in Drug Bill," Advertising Age (AUSUSt 13, 1962), p. 1. 4¥££$2§2£L§_l§§ (October 19, 1962), p. 15. 56 Whether or not the provisions of the new legislation are essen- tial, or even important, to the state of the nation's health and well- being is open to debate and personal opinion. The greater question of whether or not this legislation opens the door to other, more danger- ous government control of business is a question that only time can answer. It is a possibility that is considered by many to have poten- tially very serious consequences. Even the champion of government control, Senator Kefauver himself, said, "If you regulate one industry, then you would soon be regulating something else, and we would have all-out regulation, which should not be done, except in time of war or great emergencies."42 Certainly in the minds of many the end was justified by the means. However, the suspicion remains that Kefauver, the FDA, and FTC,in their separate but closely related attacks on the drug industry and its ad- vertising,more closely approached "show business" than legitimate gov- ernment investigation. After a number of years of trying, these gov- ernment agencies had remained unable to prove the drug industry and its advertising to be the villains they had arbitrarily defined. With or without strong government controls, one thing remains cer- tain. In the words of the then Chairman of the Board of The Upjohn Com- pany, Dr. E. G. Upjohn: "Promotional effort which is grounded in fact, designed to assist, and executed in good taste, is . . . ultimately in the best interests of the medical profession and the public."43 42Nation's Business (August, 1961). 43Upjohn, op. cit. CHAPTER VI THE ORINASE STORY Exactly half a century after the development and subsequent impressive success of Phenolax, the now firmly established Upjohn Com- pany came up with another outstanding drug contribution. The new product was Orinase, the first and still leading oral antidiabetic drug. The production and marketing histories of the two products are remarkably similar. Phenolax came along when the Company badly needed a big product to supply it with capital for survival in an increas- ingly competitive market. And it was Phenolax money which paid for The Upjohn Company's first research laboratories and allowed it to prosper and grow. Orinase, though not essential to the continued life of the Com- pany, was necessary to its continued growth. Though it was working on several research fronts at the time, the Company found itself standing relatively still in a business where day-to-day existence depends upon progress. To understand fully the impact of the new drug, a little back- ground on diabetes, the condition it treats, and on its forerunner (and still an important antidiabetic agent) insulin is necessary. Diabetes mellitus is a condition wherein the afflicted individual is unable to metabolize carbohydrate properly. The primary cause is believed to be an inability of the pancreas to release the amount of effective insulin that is required to support normal metabolism. As a result of this inadequacy there is an impairment in the entry of 57 58 blood glucose into individual tissue cells concerned with converting it to energy. The decreased utilization of glucose results in an in- creased blood glucose level and an attempt by the body to eliminate the excess via the kidneys. The more common symptoms of diabetes mellitus include excessive thirst, hunger, weight loss and excessive fatigue. In responsive patients Orinase controls these symptoms by stimulating the release of native insulin via normal channels. A control for diabetes was somewhat slow in coming. Probably the first treatment was prescribed by Dr. John Rollo, surgeon general of the British Royal Artillery, in 1796. This was the controlled diet. "The diet," he claimed, was "to consist of animal foods principally."44 A century and a quarter later, in 1921, Drs. Frederick Banting and Charles Best of the University of Toronto pursued some research done a year earlier on the pancreas by Dr. Moses Barron of the Univer- sity of Minnesota. Their study resulted in the isolation of insulin, one of the greatest breakthroughs in medical research. In recognition of their work they were awarded the Nobel prize. Insulin was immediately accepted as a miracle drug, which saved many lives and allowed thousands and thousands of diabetics to return to reasonably normal existences. Unfortunately, insulin is destroyed in the digestive tract and so can be administered only by injection. It has the further drawback of being introduced into the body in massive doses rather than slowly, as the pancreas does in the normal system. 44Milton Silverman, "Good News for Diabetics," The Saturday Even- ing Post (August 24, 1957), p. 46. 59 And so the search went on. Later in the 1920's Germany produced an oral antidiabetic drug called Synthalin. However, testing of the new drug was inadequate and it was found to cause serious liver damage in forty to fifty per cent of the patients who tried it. It was not for another twenty years that an antidiabetic drug again appeared, this time by accident. In 1942 Dr. Marcel Janhon, a French physician, treated his typhoid patients with a newly developed sulfa drug called 2254-RP.45 The new drug was remarkably effective, but erratic. It produced positive results in some patients and tremb- ling, dizziness, and heavy perspiration in others. Puzzled, Dr. Janhon consulted with Dr. Auguste Loubatieres at the physiology laboratories of the University of Montpelier. Dr. Louba- tieres concluded that the effects Dr. Janhon described were caused by the lowering of the sugar concentration in the bloodstream. He sup- ported his diagnosis with extensive research with animals and proved his thesis. He then further discovered that the drug was effective only if the pancreas was intact. Dr. Loubatieres published his stud- ies, which pointed the way to another breakthrough in the struggle against diabetes, but no one apparently paid any attention. Milton Silverman, in the August 24, 1957, Saturday Evening_§ost, quotes an American drug company official as saying, "We knew about his research for more than ten years. Until my dying day I shall continue to wonder why we didn't pick it up."46 451mm. 46Ibid. 60 More than a decade later, in Germany in 1954, the drug firm of C. F. Boehringer and Sons discovered a long-lasting sulfa drug, car- butamide. It was given routine tests as a germ killer by Dr. Karl Fuchs of Boehringer. His testing revealed the drug's value as an oral antidiabetic agent. Rights to the drug were purchased by Eli Lilly and Company of Indianapolis, a major Upjohn competitor, who designated the new drug 8255. Testing in this country showed promise for the new drug until the results of tests on thousands of patients revealed that B255 was toxic in five to nine per cent of the cases tested. As a result, the drug was never introduced into the market. Almost simultaneous with the development of carbutamide was the development of its chemical cousin tolbutamide by the Hoechst Dye Works of Germany. Tolbutamide was a little different from carbutamide--it was not toxic! This was supported by Hoechst's testing in 1955 of tolbutamide, designated D860, in five German clinics on 781 patients. However, American drug companies seemed unimpressed. Apparently convinced by the failure of BZ55 that an oral antidiabetic drug could not be found, no American drug company was interested in the new D860. No company wanted to gamble on the new drug. No company, that is, except one. "In Kalamazoo The Upjohn Co. did gamble, betting boldly on D860. It poured over a million dollars into one of the greatest clinical investigations in history. Hundreds of physicians from coast to coast used up three tones of the new drug, now called Orinase, on more than 20,000 diabetics."47 47Paul de Kruif, "A New Day for Diabetics," Reader's Digest (April, 1958), p. 131. 61 The tests proved the product, the federal government passed it for prescription sales, and Orinase was on its way to being the big- gest thing since Unicaps. Orinase was completely safe. It could be taken orally, which eliminated the need for regular injections. Finally, it was not an insulin substitute; it caused the pancreas to release insulin slowly and naturally. Thus the danger of shock caused by excessive massive doses of insulin was reduced. Orinase was to become a real boon to the millions of diabetics in the United States. The American Diabetes Association estimated in 1957 that there were one million known cases of diabetes in this coun- try, another million undiagnosed cases, and nearly five million poten- tial cases. The Association estimated that about 65,000 new cases were diagnosed each year.48 (Orinase, in fact, became an aid in diagnosis because it lowered the blood sugar concentration of the normal system much more than that of the diabetic.) And so, again armed with a new product with a unique selling pro- position, The Upjohn Company entered the market with Orinase. After months of market research, background and preparation of promotional materials, Orinase was introduced to doctors in June, 1957. A total advertising budget of $598,000 was allocated to the last half of l957--the first six months of Orinase's promotional life. This figure represented 17.1% of total Upjohn product advertising ex- pense for the year. Of this amount roughly $100,000 was allocated to 48American Diabetes Association, Inc., "Fact about Diabetes," New York, July 18, 1957, p. 25. 62 Orinase announcement literature in the form of blotters, diets, book- lets, and other detail materials. The remainder was spend on journal advertising, scientific displays, direct mail, samples, and production expense. Reasonably enough for a new product's introduction, the percen- tage of advertising budget led the percentage of sales, which in 1957 was 5.2%. Though a comparatively small percentage of total sales, Orinase sales amounted to some $5,781,000. In December, 1957, average daily sales for Orinase amounted to $93,000. In January, 1958, this figure had risen to $103,000. . Three different forecasts were made for 1958 Orinase sales. The original, made in the fall of 1957, estimated $12,200,000. The second, made on May 22, 1958, was for projected sales of $17,000,000. A final forecast, made in June, 1958, as sales looked better and better, was $20,000,000. The actual total sales figure for Orinase in 1958 was $17,820,000, more than the first two estimates but over two million dollars less than the third. The high $20,000,000 estimate might well have been achieved if competition had not entered the market. On November 1, 1958, Diabi- nese was introduced by Chas. Pfizer and Company. This pr0duct, though it captured only a 1.2% share of the total antidiabetes market versus Upjohn's 44.1%, caused a 20% decline in Orinase November sales as com- pared with October. In 1959 the Orinase advertising expenditure of $982,000 repre- sented 24.6% of all Upjohn product advertising expense. Sales in- creased from the 1958 level to $24,430,000, 18.5% of total sales. From 63 1959 on, this percentage of total advertising slowly declined and leveled off at about 10%. Sales during the same period rose consis- tently. The 1963 Orinase marketing effort concentrated on internists, as these 16,000 specialists (out of 150,000 M.D.'s--approximately 10%) treat 27% of all diabetes cases. They further average 6.2 pg! diabetic patients every six months versus only 2.8 for general practitioners. Advertising was designed to establish and maintain The Upjohn Company as Egg oral antidiabetic house. The sales message was told through journal advertising, films, direct mail, samples, and of course the all important personal selling of detail men. The new healthy journal advertising support consisted of forty-eight two-color pages,which appeared in eleven professional journals. This aggressive marketing effort, coupled with a good product reaching the right audience, resulted in 1963 sales of roughly forty million dollars and a dominant market position. Orinase's total mar- ket share of 20.7% in 1957 rose to an estimated 55% in 1963. Most of this gain was naturally at the expense of insulin, whose market share dropped from 79.3% in 1957 to roughly 30% in 1963. The Orinase share of the 2531 antidiabetic market was in excess of 80%. It is interesting to note at this point that, although Phenolax's peak sales were only $795,252 and Orinase's roughly $40,000,000, both contributed over 25% of the sales of all Upjohn products in their time. In 1964 it is estimated that Orinase will account for about 10% of all Upjohn product advertising expense. Total Orinase sales for 64 the year are estimated at $42,000,000, 28.6% of total gross sales. This means that, for a company in business for over three-quarters of a century, nearly one of every three dollars spent for its products will be spent for a product which is less than seven years old. (In fact, well over 75% of all Upjohn sales are made on products less than ten years old.)49 Thus the now mature Upjohn Company has been able to take advantage of the research, production, and marketing lessons it has learned so well over the past eight decades. It has been able to find a need and fill it, to keep pace with one of the fastest moving industries in the world, and to supply the nation and the world with one more weapon in the continuing fight against disease. 49Figures from The Upjohn Company, Marketing Research Department, July 15, 1964. CHAPTER VII THE EMERGENCE OF CONSUMER ADVERTISING National advertising direct to the consumer has been used very little and very carefully by The Upjohn Company. There are two pri- mary reasons for this: 1. The Company must consider how the physician will react to the advertising. 2. Upjohn is an ethical pharmaceutical house and in the past has chosen (with a very few exceptions) not to engage in direct consumer advertising. In the past several years a few forays into consumer advertising have been made on behalf of nonprescription products like Unicap, Zymacap, and Mycitracin. The media employed have been almost solely women's service magazines like MbCall's, Ladies Home Journal, and gggd Housekeeping. However, the Upjohn consumer advertising of twenty years ago had a broader reach than the above approaches. In the early 1940's dual interest, as well as Special interest, magazines were running twelve time schedules for three or four years in a row. These included pub- lications like Life, Colliers (which unhappily ceased publication not too long thereafter), Iimg, and Fortune, as well as "naturals" like Parents and Hygeia. And so for the last dozen years or so The Upjohn Company coasted on little or no consumer advertising. The philosophy was, and to some degree still is, that the ethical (prescription) drugs are the main business of the Company and should receive the advertising support and 65 66 that the OTC (over-the-counter or nonprescription) products, supported by the Upjohn name, can take care of themselves. Nor did Upjohn management have far to look to support this phi- losophy. Unicap, the vitamin sales leader of The Upjohn Company and the entire drug industry, had enjoyed multimillion-dollar sales and a dominant market position since its introduction in 1940. The peak year for Unicap was 1958, when its sales were $11,006,686. But then, something happened! Sales began slipping--slowly at first, then more rapidly. The year 1959 found sales down more than half a million dollars; in 1960 they slipped over two and one-half million; and in 1961, nearly three million. By 1961 the 1958 market share had dropped from 28% to 20%.50 The reason was not readily apparent to the somewhat conservative, ethical drug-minded management of the Company. However, the answer soon became clear. In 1959, for the first time in the history of the industry, a competing multivitamin product exceeded Unicap in drug- store sales. The product was Miles Laboratories' "One-a-Day" multiple vitamins. Miles had successfully exploited the incredibly powerful, and still new, medium of television. Using as vehicles highly rated network family shows like "The Flintstones," Miles had carried its story direct to the consumer. Miles had learned its lesson from consumer advertisers, not ethi- cal advertisers, and had dislodged the former giant, Unicap, from its 50The Upjohn Company, Marketing Research Report, July 15, 1964. 67 twenty-year leadership of the field. From that day to this, Miles' continuing program of consumer advertising has enabled One-a-Day to hold the position of sales leadership in multivitamin products. It took a six million dollar sales loss within the short Space of three years to do it, but Upjohn management was at last alerted to the need to reach the consumer directly. Once more the Company found it- self in a new situation, faced with the need to adapt to that situa- tion. However, the now mature and established corporate complex that was The Upjohn Company was neither able to, nor inclined to, rush into the new problem on a "let's take a chance" or "let's try this" basis, as had the younger Upjohn Company with Phenolax, for example. It directed McCann-Marschalk, one of its advertising agencies and a part of the Interpublic complex, to test Unicap consumer advertising in the Denver and Kansas City markets. The campaign, relying on spot radio and point-of-purchase materials, was tied to a "give-away" pro- motion. The promotion ran during July and early August, 1961. During this period consumers in the Denver and Kansas City markets were of- fered 124 Unicaps at the 100 capsule price. Results of the promotion revealed several things: (1) consumer advertising could, and did, increase product movement and lower inven- tories; (2) consumer advertising could, and did, again move Upjohn to the number one Spot in market share; and (3) consumer advertising, eSpecially on a test basis, is very expensive. In Denver the promotion stimulated product movement approximately 55% beyond normal levels for the period. Further, Unicap inventory 68 levels were reduced 21% from prepromotion levels. Finally, market share rose during the test from 34% to 40%, which outstripped One-a- Day's steady 38%.51 In Kansas City the same promotion.was conducted simultaneously, but without the use of spot radio. Here sales rose 10% above normal levels (versus Denver's 55%) and inventories dropped 8% (versus Den- ver's 21%). Share of market was not significantly affected.52 It is also important to note that the major sales gains brought about by the promotion were through the grocery chain stores-~a heavily ggnsumer-oriented retail outlet. Sales through independent and chain drugstores, the "normal" retail drug outlets, were considerably less than anticipated. Unhappily, but reasonably enough, a comparison of sales gain and promotional expense showed a net loss to the Company of more than $9,000 in Denver and about $3,500 in Kansas City. Thus from a strictly economic viewPoint the test was a failure. There were, however, several extenuating circumstances involved in this failure: 1. The promotion ran in midsummer, the lowest seasonal point in the vitamin market. Probably at no other time of year are customers less concerned with vitamins. 2. The offer of 24 free Unicaps could not really be consid- ered a new or unusual or especially compelling offer, as SIR. L. Pernice, "Results of Unicap Consumer Promotion," The Up- john Company, Marketing Research Report, August 28, 1961. SZIbid. 69 other drug companies like Squibb had been employing this technique for years. 3. Point-of-purchase and Spot radio (radio in Denver only) were the media employed for the promotion. Radio was used primarily because it was felt to be less offensive to the medical profession than other media. Yet it is interesting to contemplate what might have happened if the more powerful medium of spot television or the stronger local medium of newspapers had been considered. 4. There is considerable question as to whether retailers, especially drug chains, supported the promotion fully. Certainly stronger retail support would have changed the picture considerably. In spite of these circumstances, which doubtless had an adverse effect on the promotion's success, the fact remains that in both test markets sales went up considerably, inventories went down, and market share improved. In the words of Mr. Ralph Pernice of Upjohn's marketing research department: While the results of this experiment, one of Upjohn's first ventures into the consumer area, must classify as discour- aging, it would be shortsighted indeed to accept them as an across-the-board indictment of the potential promise of lay advertising of our over-the-counter line. This experiment has clearly indicated that Unicaps will respond to consumer advertising, that such a program can reduce inventories, and that this can be achieved without alienating the medical profession. 53 53Ibid. 70 Satisfied with the results of the test, Upjohn management made the decision to enter the area of consumer advertising on a national basis. On September 7, 1961, W. F. Allen, vice-president and market- ing director, and W. C. Sugg, director of Upjohn domestic sales, met in New York with G. L. Williams, senior vice-president of McCann- Marschalk, to plan national consumer advertising strategy. On September 21, 1961, the agency submitted a proposal for an ad» vertising campaign to support the "124 Unicaps for the price of 100" promotion on a national basis. The proposal called for radio spot ad- vertising with some TV spot activity in the top fifty markets. This broadcast activity was to be additional to the point-of—purchase cam- paign planned by The Upjohn Company. Upjohn budgeted $350,000 for the broadcast schedules and $40,000 for point-ofnpurchase. This money, plus the $15,000 broadcast produc- tion cost and $3,000 point-of-purchase production cost, brought the total budget expenditure to over $400,000. The promotion was to begin January 8, 1962. Upjohn presented the proposal to its branch sales managers on October 9, 1961. During this meeting several sales managers questioned the coverage of a radio schedule. The entire program was reviewed and discussed at length, and an important decision was made to move the bulk of the budget to network television participations. At last The Upjohn Company was making a positive effort to reach the consumer by advertising through a consumer medium. The Company hoped the new departure would not meet opposition (which to date it 71 (has not) from the medical profession. A November issue of Advertising Age reported the schedule in its entirety: Upjohn Co. will break into radio and television advertising for the first time in its history . . . . Unicap multiple vitamins will be promoted in participations on NBC-TV's "Saturday Night at the Movies" and on its daytimers "Say When," "Concentration," "Jan'Murray Show" and "Loretta Young Show" from Jan. 6 through the end of February. During the same period, 30-second commercials will be run on NBC Radio's "Monitor." The new scheduling, and the addition of extra coverage of the Kalamazoo-Grand Rapids market, brought the broadcast budget (including production costs) to roughly $372,000. This plus the $43,000 in point-of-purchase made a very respectable advertising expenditure over the two-month period of winter promotion. The campaign began on January 8, 1962, and admirably accomplished its goal of reaching large numbers of consumers with Unicap's sales and promotion message. The agency reported these results from Niel- son: Date Show Ave. Rating Ave. Share Jan. 9 Say When 6.8% 38.4% Jan. 9 Concentration 12.8% 52.8% Jan. 8 Jan Murray 6.4% 25.3% Jan. 8 Loretta Young 8.3% 31.8% Saturday Night Movies 21.8% 34.8% "This means, in the instance of the movies, that 21.8 per cent of TV homes in America (total 49,000,000) were tuned in to NBC-TV. Thus, our audience totaled 10,682,000 homes. The average number of viewers per set is 2.1 so the number of viewers,according to Nielson,is 44,322,000."54 54John N. Patterson, McCann-Marschalk Co., Inc., letter to J. S. Campbell, The Upjohn Company, January 24, 1962. 72 During the January-February period the Cowpany aired a total of forty television commercials and twenty-four Monitor radio commercials. The results of the promotion.were impressive. Added sales covered all but approximately $100,000 of estimated profit for the period. How- ever, though this was money spent, it was not money lost. The normal 7.8 months' supply of inventory had shrunk to 6.9 months' supply, all time high sales to drugstores were recorded, market share and position improved considerably, established Upjohn customers increased their purchases, and an unknown number of new customers were added. The Upjohn Company had at last discovered the value of advertising direct to the consumer. In the fall Upjohn again entered television.with daytime televi- sion commercials and a five-minute health show, which was featured once a week on NBC's "The Today Show." According to a general list notice to Company employees, dated October 2, 1962, Upjohn commercials could be seen on these shows: ABC Yours for a Song QB§_ Calendar Jane wyman Theater I Love Lucy Camouflage The Real McCoys Day in Court Pete and Gladys Seven Keys Love of Life Queen for a Day Password Who Do You Trust? House Party Millionaire ‘NBQ The Today Show Secret Storm The weekly "News of Your Life" health show was narrated by Howard Whitman, who had narrated several Upjohn-sponsored Medical Special Events films. Purpose of the show was to keep people up-to-date on the latest developments in the field of health. The weekly show was featured at a different time and on a different day each week. 73 The Upjohn Company was now beginning to feel a little more con- fident about consumer advertising. Its program for 1963 began with a three-month schedule which included daytime network television, "News of Your Life" on "The Today Show," and sponsorship of "Chet Huntley Reporting" and the four-part "Profile of Communism" series done by NBC. The "vitamin season" schedule ended with the last of the Commu- nism series on April 10. However, positive sales results prompted the Company to extend "News of Your Life" by seven weeks, the last tele- cast being May 16. Broadcast advertising was then suspended again until the fall of 1963, when Upjohn sponsored a part of "The Today Show" and added spon- sorship of "Exploring" on Saturday afternoons and another series of specials, "The Saga of Western Man." "The Sage of Western Man" was a four-part series produced for ABC-TV. Counting one repeat per show, it ran evenings at irregular intervals from October, 1963, through April, 1964. Ideas, men, and events culminating in the American Revolu- tion, provide the dramatic material for "1776," second of the four-part series, The Saga of Western Man, Sunday, Dec. 8, from 6:30-7:30 P.M. EST (ABC-TV). The first of the four-part series, "1492," was received warmly by teachers, students, and the general public. Sub- sequent programs, following "1776," will deal with "1898" and "1964." The series is being produced by Helen Jean Rogers and John H. Secondari for the ABC News Special Pro- jects Division. It'is sponsored by The Upjohn Company. "1776" is narrated by Secondari, who has also written the script. Prof. Henry Steele Commager (Amherst) served as historical consultant. 55 55Howard L. Hurwitz, "Teleguide," Scholastic Teacher, LIII, No. 12 (December 6, 1963). 74 Consumer advertising planning in 1964 has considered a move away from sponsorship of network shows into spot television and radio in the top thirty metropolitan markets. A five-week campaign utilizing 30-second radio spots and 20- and lO-second TV spots to promote the "24 free Unicaps" idea is scheduled to get underway in September. The radio spots will run during heavy driving hours, 7 to 9 AWM. and 4 to 6 P.Mt; the television spots, during heavy female viewing hours, 9 to 11 A.M. and 3 to 5 P.M. Medical journal advertising will be closely tied to the spot broadcast effort in an attempt to draw doctors into the picture by telling them about the free offer and stressing the economy of vitamin supplementation. As The Upjohn Company's experience with consumer advertising broadens, it is apparently recognizing the now established trend away from direct association with one or several shows (due in large part to rising costs) and is moving to extend its reach, at the same time concentrating on key markets, through the use of spot broadcast adver- tising. And so, although not the first this time, nor the biggest--and with its approach to the unknown tempered by the caution gained with maturity-~The Upjohn Company has entered that area of almost incalcu- lable potential, consumer advertising. a CHAPTER VIII CONCLUSIONS AND PROJECTIONS We have traced the promotional activity of The Upjohn Company from its first ads in trade journals, which carried a picture of a thumb crushing a friable pill, to its present position as a multimil- lion-dollar advertiser employing a wide variety of ads and commercials which are carried by nearly all the communication media from trade journals to spot television. ' We have seen the many occasions when an organization in the vital business of protecting the nation's health has found a need and filled it. we have considered two of these contributions to the nation's and the world's well-being in depth, as we examined the research, produc- tion, and promotion of Phenolax and Orinase-~products completely dif- ferent, yet strikingly similar in their contribution to the prosperity of The Upjohn Company. We have examined in detail the cause and effect of government regulation upon The Upjohn Company and the drug industry as a whole. We have seen that this regulation has forced drug advertising to be- come more informational and instructive and somewhat less persuasive and sales directed. Perhaps this is good, perhaps not. At any rate the drug industry, apparently not too hampered by federal regulations, continues to supply the country and the world with better weapons for the never-ending battle with disease. Finally, we have watched The Upjohn Company awaken to a competi- tive danger to its position of leadership and slowly but surely involve itself in the important and growing area of consumer advertising. 75 76 We have, in short, observed the problems, opportunities, and suc- cesses of a drug firm which grew from a two-man "Pill and Granule Com- pany" in 1886 to a 7,517 employee corporate complex in 1963; from a Kalamazoo basement in 1886 to over 150 buildings including 20 domestic offices and 17 foreign offices in 1963; and from gross sales in 1886 of $50,000 to 1963 sales of $191,748,042 with net profits of $25,770,991.56 we have watched a company more than three-quarters of a century old which has refused to stagnate in its research, production, or mar- keting programs--a company which is making 77.2% of its sales on prod- ucts less than ten years old.57 It is, then, a company that has grown, is growing, and will con- tinue to grow in the competitive drug market. The Upjohn Company's future, according to Merrill, Lynch, Pierce, Fenner, and Smith, is bright. The New York brokerage firm suggests several reasons for this: Its inherent strength as a broad line major drug manufac- turer with a strongly-established marketing organization and an excellent reputation for quality within the medical pro- fession; Its demonstrated effectiveness in maintaining its position in major drug markets despite intensified competition and somewhat static demand, as illustrated in the still leading position of its Unicap and Zymacap brands in the ethical vitamin field; The broad scope of its research program, which the company is increasingly coordinating with management and marketing goals . . . 56The Upjohn Company, Annual Report, 1963. 57D. H. Sanborn, The Upjohn Company, Marketing Research Report, July 15, 1964. 77 Its expanding operations in . . . foreign markets, which should enable it to realize more fully the complete poten- tial of its strength in research and chemical process devel- opment; and Its modern.plant facilities, which are regarded as second to none in the domestic drug industry, and its strong, liquid financial position, which should permit future growth.with- out dilution of the stockholder's equity. 58 The facts revealed in this report force us to agree with Merrill- Lynch. It is abundantly clear that The Upjohn Company has answered, and will continue to answer, its responsibility to protect the health of the nation and the world by producing and marketing "Medicine-- designed for health, produced with care. Fine pharmaceuticals since 1886." 58"Brokerage Firm Rates Upjohn High; Thorough Study Indicates Growth in Years Ahead," Intercom (The Upjohn Company, Kalamazoo, Mich- igan),II, No. 7 (July, 1964), 6. APPENDICES APPENDIX I BRIEF CHRONOLOGY OF THE UPJOHN COMPANY, 1884-1964 1884 1885 1885 1885 1886 1886 1886' June 1886 1887 January 1887 November 1887 1887 1888 1888 1889 Dr. William E. Upjohn, a young physician in Hastings, Michigan, makes experiments to try to produce a pill more soluble than others on the market. Produces a "friable" pill. Dr. William E. Upjohn and brother, Dr. Henry Upjohn, form partnership, including wives. Production begins in basement of building in Upjohn Block on South Burdick Street, Kalamazoo. First price list issued, including 186 items. Frederick L. Upjohn joins company. Dr. Henry builds two and a half story brick building at rear of Upjohn block to house pill factory. Dr. James T. Upjohn joins brothers in Company after graduating from School of Medicine, University of Michi- gan. Company makes early selling and advertising efforts. Dr. Henry U. Upjohn dies. Business incorporated as stock company with capital of $60,000. Officers elected. Company hires first Upjohn salesman, named Booth. Lazell-Dalley & Company become Upjohn distributors in New York. Truax-Greene & Company become Upjohn dis- tributors in Chicago. Archie Stone, another Upjohn salesman, hired. Building now known as No. 4 built on East Lovell Street. Four stories. Charles Little employed in production department. 79 1890 October 15 1890 1891 1891 1891 1892 1895 1898 1898 February 1899 1899 1900 1900 1902 1902 1904 1904 1905 1905 1905 80 New York branch opened. F. L. Upjohn, manager. Severe competition encountered with new compressed tablet. Period of financial strain begins which lasts until after turn of century. First listing of tablets made by Upjohn. H. Sanford Mead, salesman, employed. Building No. 5 built next to No. 4. Four stories. Fluidextracts first manufactured. Dr. W. E. Upjohn purchases Babcock farm near Augusta. Calls it Brook Lodge. Dr. William Abbett, Indiana salesman, employed. Hall Brothers and Company, Kalamazoo pharmaceutical manufacturers, destroyed by fire. Arthur Crooks, Albert Latson, and Frederick Childs employed. (All three had worked at Hall Brothers Chemical Company.) DevelOpment of tinctures, elixirs, syrups, cordials, wines, ointments. John S. McColl employed as bookkeeper. William F. Little employed in tablet department. Palmo-Dionin, first cough syrup, developed by Fred Childs. Reorganization as The Upjohn Company. Caripeptic Liquid first listed in catalog. Dr. L. N. Upjohn employed. E. R. Lewis appointed first sales manager. Fred Staley employed in assay laboratory. Walters H. Sellman Opens agency in San Francisco. Beginnings of cost accounting. 1905 1906 1906 December 1906 1907 1907 1907 1907 1908 1909 1909 1909 1909 1911 1911 1911 March 8 1912 1913 1913 1913 1913 81 Establishment of Council on Pharmacy and Chemistry interrupts Upjohn advertising in Journal of America Medical Association. Dr. L. N. Upjohn made sales manager. Dr. L. N. Upjohn goes to New York as branch manager. George C. McClelland becomes sales manager at Kalamazoo. Dr. W. E. Upjohn works out plan of bank insurance. F. L. Upjohn retires. W. Harold Upjohn enters company. Dr. S. Rudolph Light employed. (October 1, 1907.) Phenolax Wafers announced. Sales conferencing initiated at New York. First Overflow issued. Kansas City branch opened with Malcolm Galbraith as manager. Company reorganizes after withdrawal of Dr. J. T. Upjohn and F. L. Upjohn. Dr. S. Rudolph Light becomes production manager, succeeding Dr. J. T. Upjohn. San Francisco agency changed to branch. Waters H. Sellman, manager. Lewie M. Crockett joins company. Plant swept by fire. Formation of American Drug Manufacturers Association. White Office built. Pilot laboratory begins Operation. Percolating distilling building unit built. Dr. F. W. Heyl employed to organize research department. 1913 1914 1918 October 18 1919 1920 1920 1921 1922 1924 1925 November 18 1926 1926 1928 1928 October 15 1930 1930 1931 January 2 1932 October 18 1933 82 F. G. Varney employed. Dr. M. D. Hart joins Company as reasearch fellow in chemistry. First sales conference in Kalamazoo. New York branch building built. architect. Hobart Upjohn, J. Bryant Fullerton, Stanley Morris, and E. D. Mayo employed. Fluid packaging building built. Citrocarbonate announced. W. Harold Upjohn and Harry H. Freeman go to England to arrange for manufacture there of wafer like Phenolax to be called Mylax. Building No. 18 completed. Warren K. Allen joins organization. Contact department organized. Two Congress playing card factory buildings purchased, to be known as Buildings 19 and 20. Dr. H. S. Adams appointed plant superintendent. W. Harold Upjohn dies. Dr. S. R. Light resigns. Development of soft elastic capsules described. Memphis branch opens a6 299 South Front Street. F. W. Griffis, sales manager, W. G. Freeman, office manager. Dr. w. E. Upjohn dies. Research Industrial Fellowships announded (first series). 1933 1933 1933 1934 1934 1934 1934 1934 January 2 1935 November 1 1935 1936 1936 1936 April 1 1937 1937 1938 1938 January 2 1938 September 1 1940 83 Bank holiday begins. Loose leaf catalog adOpted. Dr. John F. Norton employed as head of bacteriology department. First history of The Upjohn Company written by Dr. L. N. Upjohn at the request Of the American Pharma- ceutical Association. Dioramas loaned tO Smithsonian Institute at Washington, D. C. Concentrate building erected. Kalamazoo branch Opens as separate entity. Dallas branch Opens at 901 McKinney Avenue. W. Fred Allen, sales manager, D. H. Dowell, office manager. Toronto branch Opens at 384 Adelaide Street. Violet Braiden, office manager. Administration building (NO. 24) and power plant erected and occupied. Tincture Mercresin and Oral Pentacresol introduced. New production building (NO. 25) completed. Atlanta branch Opens at 25 Fifth Street. W. G. Freeman, sales manager, D. H. Dowell, Office manager. Medical department established. Personnel department established. F. G. Varney, manager. H. E. Turbeville made assistant personnel manager. R. C. Byce, sales manager, Located at 1740 Chester Cleveland branch Opens. F. O. Chapman, Office manager. Avenue. Council on Pharmacy and Chemistry of the American Medical Association announces acceptance of first fifteen Upjohn products. Dr. L. N. Upjohn talks on Company history to foremen and supervisors. 1940 January 2 1941 1941 1941 1941 1941 1941 December 1 1942 1942 1944 1944 1945 1945-46 1945 1945 February 20. 1946 1946 August 7 1946 84 Boston branch Opens at 11 Deerfield Street. H. W. Bowdoin, sales manager, J. J. Neylan, Office manager. Printing department expands. Steel sheds erected for cod liver Oil storage, two miles north Of Kalamazoo. Rosenbaum property on East Lovell Street purchased for additional parking Space. Research Industrial Fellowships announced (second series). SCOPE, journal for physicians, begins publication. Minneapolis branch Opens at 110 Fifth Street. F. L. Tritle, Jr., sales manager, H. J. White, Office manager. Soft elastic capsule building completed. Joldersma & Klein prOperty purchased for expansion of medical department. Dr. F. W. Heyl resigns. fill vacancy. Dr. M. C. Hart appointed to Physics laboratory established. Oliver Woods, director. Transferred from production to research division on May 1, 1945. New revised group insurance adOpted. Building planned for production Of antibiotics by sub- merged culture method. Trademark, "thumb crushing pill" given up. New trade- marked - name UPJOHN. Joint seminar of research and medical grOups starts series of meetings. UPJOHN NEWS begins publication. First meeting of Basic Operating Committee with D. S. Gilmore, M. C. Hart, E. G. Upjohn, C. V. Patterson, and W. F. Allen present. Film, "We, The Upjohn Company," produced. 1946 1945-6 1946-7 1946 1947 1947 1947 1948 1948 1948 January 2 1948 January 2 1948 1949 1949 1949 1950 1951 1952 85 Electron microscOpe purchased. New manufacturing plant on Portage Road planned. First buildings of Portage Road plant erected - antibiotics and adrenal cortex buildings. Temporary power plant erected at Portage Road. Disposal plant erected at Portage Road. John S. McCOll resigns as treasurer. Succeeded by D. G. Knapp. R. S. Jordan and R. G. White visit Latin America. H. B. Roberts goes around the world. Catalog simplified. Chicago branch Opens at 1001 East 87th Street. John Schma, sales manager, F. O. Chapman, Office manager. Portland, Oregon branch opens at 1333 N. E. Union Avenue. J.A.S. Rodda, Sales manager, M. C. McDonnell, office manager. " . , Fine chemicals department established. Dr. M. C. Hart visits EurOpe. Folic acid manufactured. This project represents the first really significant venture of this Company in the field of synthetic chemical manufacture. Printing department enlarged. R. G. White visits Mediterranean and Near-East markets. R. S. Shhreiber appointed vice-president and director Of research (May). Stanley Morris, first manager of the advertising depart- ment and editor of The Overflow, retires (Jan.). New Portage Road production plant Opens (June). Export Division established. R. S. Jordon named to head activities. Upjohn makes cortisone by new process, microbiological synthesis. 1952 1953 1954 1955 1956 1957 1958 86 Dr. L. N. Upjohn retires as chairman of the Board Of Directors (September). Donald Gilmore elected to chairman of the board and managing director. Dr. E. G. Upjohn elected president. Mrs. W. E. Upjohn, wife of the founder of The Upjohn Company, dies at 87 years of age (October). Solvent recovery unit added to Portage Road facili- ties. H. W. Bowdoin retires as sales manager of Boston branch. The Upjohn Company of Canada moves to new quarters at 865 York Mills Road, Toronto. Dr. F. W. Heyl retires as director Of research. Disneyland Opens. Upjohn drugstore included on Nine- teenth Century Street. Brook Lodge estate and 160 acres purchased. Construc- tion Of guest cottages begins. Memphis branch moves to new quarters (December). First South American subsidiary established in San Paulo, Brazil. Washington, D. C., branch Opens (April). Conference hall at Brook Lodge constructed. Long Island branch Opens. Orinase released for general sale after two years' ex- tensive clinical evaluation. Sixteen hundred acre farm acquired and placed under direction of Veterinary Division. New branch buildings in Kansas City and Minneapolis Opened. International Operations, Inc., a management service organization founded. Upjohn Overseas Corporation and Upjohn Inter-American Corporation founded. Columbia subsidiary established in Bogata. 1958 1959 1960 1961 1962 1963 87 Tuco (Pty) Ltd., founded in Johannasburg, South Africa Upjohn stock sold publicly through secondary offering Of 2,410,000 shares. C. V. Patterson, executive Vice-president, retires. R. T. Parfet and P. 8. Parish elected executive vice- presidents. New pharmaceutical production plant Opens in Sydney, Australia. New San Francisco distribution center Opens at Menlo Park, California. New production building dedicated in Mexico City. Two new subsidiaries founded in Europe--Upjohn S.A. in Milan, Italy and Upjohn S.A. in Brussels, Belgium. D. S. Gilmore retires as active head Of the company. R. T. Parfet elected president and general manager. H. B. Allen, corporate secretary, retires. Michigan Agricultural Company formed.~' Chemical development building completed. General office building on Portage Road completed and occupied. Controlling stock interest in Anodia S.A., BuenOS Aires, Argentina, acquired. Assets of The Carwin Company, an organic chemical manufacturer with plants in North Haven, Connecticut and Houston, Texas acquired. L. M. Crockett, vice-president for engineering, dies. Leslie HarrOp, vice-president and general counsel, retires because of ill health. G. Thomas appointed general counsel. J. C. Gauntlett elected vice-president for pharmaceuti- cal marketing. R. M. Boudeman, president of Upjohn International, elected a vice-president. 88 1963 C. H. Ludlow elected treasurer. Gordon Knapp retires as treasurer. C.P.R. International Corporation, Torrance, California, fabricators Of polyurethane foam, acquired. New manufacturing building in Puurs, Belgium, completed. 1964 C. P. Continental S.A., cosmetic firm in Mexico City, acquired. A. H. Howard Chemical Company, Canada, manufacturers Of agricultural products, acquired. Joint venture in Spain established. APPENDIX II ORGANIZATION CHARTS Selected Organization Charts Showing Top Management and Marketing Structure 89 90 also... .Qu’l ‘ >C¢.=u3 as: a n'ui-Vd In! .. ably cud... I... I‘m! 5‘: l0 ’1luoi all: In »lefla'e av.- uauggu a I bl'a! IND pl‘p! 9V. lei—4d;- i. unto! 41v.§-Illlil I: viva-IL «was hrudsa u a I. $114.. an ulvuiulL uh... o It .INSIKX « .- >l§l u”. Dir-3.08.. .o‘ #45 a .. i. - I‘I»C= “a at: I: h! I»; _ ul‘ai n9.- 52.5w... 55‘ .u a a; iii-Pad g 5833' ‘ Fun-4s u I 3.50 .3.) £43 a o 5.30 an ‘53.: u u negag 91 1.53:! 3'. 0.5 a Unit.- I'- nua .- III I _ DIE“..- . _ g I I I _ I I . I II II.) III... I I... In! III III: {I I I... ‘16! Ig‘iu as. a: 1....» .51 :d a; g. a Ed I id! 3 3‘6 gn Bug cc; a ~~~~~~ $858 Elks pppppp BIC-o CUE—Do =95 EDI»! g :41 kg S! Shh—>1...» it?” a; #1:, Hrs... 55 g pad“ is '5 3% it; I I I III is I I II I I II In! .- 4 I .— u .3! .- s I g!“ “C; I -I I II I I I I goo-II. I III at u I l, is! 4 ,q ‘88.. s i :8 3.29 3 £1.8- ggs Iv! 2H5 gag 35.64 dig—E a: g 3 g. g. s.- g a. g .l I I I I 0'11 I III I .I I I In slal- IB 1:.- a. I I! d! I u ._ pa. I... s 5 4;”? £3? 92 u 3 g: ‘4»! .- gg .5; 8e 28 g glam! I! Eat 954.0! :3 dab—Lag. g 5!! I I .I '5'. III! 4‘! A < a a 8' I I I II III III 3 i: ‘l a; g g‘ as: g“)! g 92 II III- ._:. III! II II III I I E kl E .33.... F 53.2 LEI. _...si...._ Illa... F [ls-3.... III E g g g g ISL; g E .3 E53 .3 5 g E 2. 5.»! g 3 an»; E: 5 3‘4 5 Eng '6' g g g 2 III Isl-I gum in IIIIIIIII aI IIIIIIII. II llIlIllI. Iva-I031 .II» III . _ 1'. In! El» _ .I IIJS . . IIIIIIIII i384 .IIIIIIII '49! .IIIIIIII '3 Budd is; s; 93 , it‘d iJiJ . IF 5“ .‘d3 iota a in... gdi ua‘dn g‘.‘ E‘J 4;“ ldl 5'60 P5344 l | III III l I III l l g g E g g 1;! g! g! PHI—“3 is g: g E: g is. g4: g 18- .‘t g g i 53 = .350: 3532.82 satan— smut— -3 one Ema—emcee 5 one HES—Cognac: £338.81 £23.38 8 525:8 .6303 E @3835 a Show—oer .88uu< 3.302 3398a :03 .5832: 8 mm was .5326 museum... 532.5» 9303.. 3.302 523— a Sat waist 9.3 35883 on :51 E 9.04 6802",. a 38:8 3.392 95 .3 .3332“ focuses—£338.“ 38?? do.» .383.— 383: E omsé :3 05 83—38% 83 BuoEb> you 8585 608350“. .3 1:58 sum—OE 32.5mm Eunice» .883< 3.302 ups—us Eases been: 53 ”E. N— =_ 3.8.9 «meter. is. a. s atree-a. step 655... 93333 c: I Baa—E u... 52 Eons; .u.38< .965! 5t; 73:»: an!- «more .559! 393v»... . 3 :5 a :2 35...... I 3... .o l I; III-cies.: .33 .598 8. a s 5 B. «8.0 Eiséa a... 02 3c. on 3 8.:8 c. 0:. w «0333 00m 2;. 09 .om .0 82.8 c. .-E v .333! .83! 8" v:- om 3 8.88 E 803-... .0535...— 5.! .23! om .0 828 s .9: 2 8m 2:. 8“ .0m 3 353 c. .uE v 09 we» om 3 8:33 E .mE N 503-... .360! i «it... I. .32 15 3r .3 .3; .9: fist in. 03) .00 m c. _ .uU\.uE ON «.9; .00 m 2. a: 5 .3503: 8:2 9. .8 d s as 3 08 2. 8" .o :93 s .228: ES: .33: .3 .3. .23 .5. a... ‘1?! ' ‘1 . .. J . gs. lit . . u .. C u 4.. . ‘ 115 :35... 60360—1: {loo 510: 1.. .32 Zola-o 23.50.2303 2: §.3t.6-BI;_*: E a... u: n ......................... sgghE—ba .g M ......................... Orig; v.5 ' ................................. cxcagui “E ' ................................. gha—%:u0' as. m .33 52:88 a... m n 2 5.22.5.8. 22.3 £qu02 a... m .33 59.59. a... an 2 30.530313 £2.53. a... 2 ......... s. c .58... 558.52.... v.2... .32: a... m. N ...... .83. o. .53 58.85.... .2... .23. 2......8 E. 551$. .2380 82¢ final #3. o mh06 0:50.. 5:0 2:25.. 5:05 22.0 0. 52000. 0:00.. 0300098 .0 .0..:00 .95.: .5502. .3 50.00 -..0E00 0.0 00020.55 :9...) 50.025... 0. .2230 £96.00: 2.0.0.50 0:. 9.58:8. E.05_.0> .2200... 3522002 02.5.0 29.2.0 5:0 -_0..:0u 6:0 :. 5:0 250855050: 63:08.05 0.05.0000 .0 £00500 r2020 :. 52025:. 0. .2202... 0:0.02:50..0.>£0E. E..05...0> 0.0.005. .0522 50.00000 :03 2.02.2500 0.0 5:0 255 500.00 05:22: .5. E5550) 000:. 60:0. :05 5:35 000. 2:08.50 :0... .6005 000. .5053. m. 22:00 85.00.503.385. .0522 0... .0 3.2.00 b0.0EE2.:.-::0 .0260 65.0 .58.... .250: :. 5:20. 0:0 05 00.0.2...» 0000 E.05..0> 05 000003 5000.08.05 .0 .0250 SEQ: 0530.: 6.0.000 0:202:52: -3505. E.05..0> .0.0.00< .0502 5:0 E.05..0> .0.0.0o< 5.502002 «32.58.... 52.55.353.313 33:18:32.; §§§§§§§ gigs-553.8... 81.8.8. £583.53... .5... z 858.... 3508....- 59... 5..- 2330 88:8 =- ‘8! 8.2.8 5.8:. 8.6:... 3.88.. n = 5.2.58»... 3 33¢. 038.80 69.... 28.68... 58.9 5... .0 25.. .8... B... 80.31.50.250: .32.... 5.8... £25.... 885852331. 2 8.0!... 58-58:... 2:288 85:3 2:88 60:93. £3! :- ase-.83.. 08.: dot-0:09 38.5.33. B. it! 8.. 5...: .985- 3}...- E 8.. 5.8.33 gan.-58.5. .o E... a. .8! 0.3.8.3595... 8 0:03...- I..uo=. 8 6...: 8. 23:08... 8.558.085.0532.§§.=.=ESE..0£§ ggsgcaatggstggn .5. 2.0.8.5.. .8558 2.2!... 5..- .653235 .8: .05.... 58.. 80.358... .86 .0 8.50:8. .83 i ‘ lilo 5.. a. 53.53 3.. i=8...» 8. {.82. «2...... 5.9.... 8...... .28... .38.. .3 5.... .38 a... $5. .358. 82832358.. 2.8...» E .2225 5322... :3. d8... 2...... 58.3.8... 8...... s .255 .22.. 2....- ._....8. 58:258.. 5.: 2.... 8.... n a . 3835.8 .. £3.35 38.5.5385 .8... s 3.. 2: 5.... .2 s. u... z 9.05:0) .0.0.0o< 6502-002 gamma SS. E9500: .0 2.05 a 5:0 50>0Eoo 0.02. 550:» .300. 0.... 0.080. 5.0.00)... :0 .0 E200 Eu: 0:. :0 00:00 5505.5. .0 2508.05 .0350 050< ”Liam: 5.2.5.... 5.8.2.82 5.... 2.... a =. .28... 5.525.. 5555 'Iudmbovoud O n ‘U'Iuo H a W hounoo 116 antibiotic-reinforced antibiotic mrImMUQ—m Panalba in olilis media Broad-spectrum tetracycline. reinforced with novobiocin to protect against resistant staph. Reminder ldvertiument Pie-u soc cultu- . V V V h-I Biro-I cfck-d insert for detailed product mlomuhon. my». n1...M illicit-13.11.301.191: .82 6h..dol<_fllai<.~.d.~.§d .32; . all-Ira ...-8.8.61 ....conifiostfiflu « . ... E14114: Inning-.118 .2 .213... . ... . 331.86....ui.88ua I. accuse-aodgulmfiJcS-aiigmnggflj 8131188339....1888 “cians.“ditlliltti gimbaifllasggsuazovigafi Jan-.....Ba... ..__._._=_..__ ._ __ .2... giggifioflaé 1.1280 9:...» ..................... 381282 igéiagnhio Jaws-«1.1.3.6....» .89:3§1!!1:8§1 .8... ............................ :11.» 981 aggtiguufisu 192.895.: ixgzgjg ............................ i c 883 13.: .83:388813!1£8 3:: ...giilgilt .32. _ ”313M183; 1.3.8.8355 Egagsiaovtgugfiié 3:8 :1... .32.... 11:31:58.3... 121.881.: [...—851...: 32393 gan.—8395:1153! 33858.3 .l.8§3§8:8.8lo . 8. Liargughggfigsvflgagig .81 ”:8“! ... 1.1.11“.- ”815.. . 31..“ 5.8.0.8. a .015 an n< Sana—888 02.8.6 low a; igflxgsui.i 6.108 .Sacsuooisslflcvfilom 81832553513 ”:81... tising“! “a: ..gcgasgviaac igusginioctgcoflovinflghgsm ............ . 2 . .. .. “11% ......... 88218152LEF§DB .nwo : : 988.”:qtofln ...}.Saaogufiuussqoflufigfifiuifla . 331852818315. . 2 L .8221: .516 gag-BI- }..88 .45 1383838 0! cg ........ HM .................... $3 ”an“. . ..31.....:.oe:..18.§:”..55..1onu ~.§3~§35§£=E ..... 3:85:91: 8. 3 . 8.28: . 2.2 ...................... 333815.... .51.. 85:83.82 5:2 531.58. .832... ...... .5. 28.... 3. 8.88 :32 588.51.888.82 6.1m... . _ I: : 3:...-:8... .1263; gnmfiousgflsagQE-Eg 2 ..................... a: It“. ......... gegga c! . ....‘CES ugo ........ . .............. S a... 13:53:35.3.8: is... ...... 883 438...... 35 3.3.8»... :3. 98... S. 88 39.395 833.. 2 NJ . 0c. 5 . m6 .... . . _ :.<:.Es.> ......ii... .553... so an a no.— ..» a a. Ills-3:888 its-331...... I ...... .4 "o . o... ' 7 u €3.13»... «$618.85 .38....3211 $333.18. 3.x .... .. .1 1...... y $§§£A®§m ......ngaéfifofix m SQ: 118 002.61.101.32} giggiii 0.0 .00 its-g —= 4.08.09.10.01 000208.011..00.I¢20Ig.00=00.¢.u0290¢0.00001! 60.2.. 60.26 8:35 it} 10.5 I F! .9008 $352080 800:0: [(0000 60:35. 9.0.0 .3050 03.0 6! 3 t 0.. 0332.0 .130. I . . 6.3101!!!- 000 ‘00. 00.. 0:070:14 0.00:0 00.0 06.0.: c9153 .0 00:09.05 In... .90 9.. .0! 0,. s .09..- 1.015020; so). .0 .60..§Lo0¢9...8050¢£ .01... .903 ago-3.00.50.95.03 3 ‘0‘. £000.00 00.0000 .0890... .0... .50 2.0.3.:00 0.11.00 A, H 4:.“ ”1.. .J Ila-0.0 v.) .5531]... .20. 6.2.0.102 02.000000 60.20.1001. ‘30-. ...- .. l .. _ {020905315 0. 8.5000603 002.000.. 0:20.00 0.09:0 0.00.0.0 _. . . , i .. 0.8.1:}... 8.80.: 6.8.3.8... 2:! s .8933 8: 0:810. 80810110318338.8536: . fi 0 000 02.090. ...-:80: 8.0.30 0090.. 0.00.9... 0.9.20.6 600049.00 00.002508200813000 .. 3.081.358.0332... 3235890; ICE: ighii’lnpssgag I 0.018....«Coulis-8.30.81.02.10; 201....30 13110.2.10005300060800; o . .59.; .68 .... .8 .28: .9... N o. c . .p . i do n 2 w .0 8:00.... 383.25... 0000 0.9...- .90026000 020:0: o )0 w w 080 35.1.... .....QWQ U 12.8.8 itgm . ...: ...... 0000000000 .352... 3:...-av 0.898. 8:31... .. ... .. .1882: 3:21..” ... 22.8 6...... , 2...... ...Gfiegzgzs 1.23.1.8... 3:...... ... 29...... 111.331; 3:......" . 28.. as... 122...... ... . ... .. . . . 8:8...» ..a®$ 059.33. ... . . 38...... ......... 28.380 3.0.3002.» gun—0.0.1.5: .8215}!!! d, .8 "d ... ...-0.6 0.6.! .8353... 900500 5.0.0: 0:... 119 salvageablo... Provera 80%de uinguflo mum!” 00:0 pnurnd' - N00 0 W, unable: Intrumncuu Owe-Frown! R0mlnd0v 0dv0nl00m0m. H0000 000 puns: Hum tor dol0|l0d room In! m0flon. l. . 0.0.. .: '0"! 0nd QMJMM 03-00:.) 900. O—hnnd of mommy “0:000 m0, Upjohn. M2010. 1962. m» Cancun . Mum. lichlpn. y 120 80.0081. 0.00.08 20...: 0.0. .5. £00.88 5.0.0: insists 00.. .0... 000 1.2.0.0.... ig.§5130fi ...—..T—D 000...... .8 000 a .0 00.83 0. 60:80.0 ....0 3 .............................. 00.0.0598. ”00.0.02. .03.. 0000 0.00 0... x. 020...... .080... 8.... 000.20. 20.0... 5....- 000 00000.0 .02. 00.3.3.0... 6.... 0.2.0.. 0 ... 02.38 8...... .0223... 000....0 2 00.0.0. 80.5.0. 8.0.0 iofizoloofizcoicoaeilfiobfi 5.0.3. 2.000.. .0 00.. £000.00. 0.. 2 000000 0'20 0.6.. 0030006 $8.2! .000 0. 000000000 000 0.00.2 ... 8.8.5. 2.000.. .0 00.0.... £3.08. . 00.00000 000.. 00.. .03.. 00:00:. .000. 00 0.00. ..0 0.0000... .00... .0 0.5.3000 .00.. 32...... .0 0.00» .00. 00.... 0.0... 00.50 00.0.2033 00000.00 .00 ... 0.00.. 0... .3 0.2.3 .0253 08... ...... 00.. 2000.060. 00 0. 0.00000 000000 5.0.00. 10.0.5 00:00:80... 0.. 3.6... 0005.0 .50.! 0.3.80 .0. 00.0 0.... 0. 00.50.02 02.000.50.00 0.00 00... .508 .....- .000000... $00.50.. 5...... .2260! 1.0.000... 0.0 3.2.0.00 330000.300. .0 .50....3 .8... ..0..00..... ...... 0605.00 030...... 000.500.. .00... 030 0.90:0 0..» 0.000. .000 000.00.. 000.»... ... 3.0.0.5500 0. 08.. ...00 .06. 0... .o 0.2.0. 000000.500. 8 000300. 0. 000000 00....- 0000000.... 00.0.0.2. ..0... ....0 .080 2.. .o 00.0 0... 2 00.0.0. 00 0. .0080 050000.. ....0 .5300! 6005.... ...... .3900 000000. 000000.30... 35.00.59.000 00... 0800.00.20... ...... 0.80:0 0.00:0. ....0 050000.. (9.0050... 35.00.58.000 .0 0.8.8.... ...-08 000 0.30.. 000.000 0 .0 .00 b.0303 0.0 0000.5 0. 0.0.800. 0.009.... .050 .8055 o. ......0... 0.0.. 02:000.. .0 02.0.. 0... 00...... .88 o. as... . §33§.§§0580§ . . “......- 20... .20 0.0.8008... 0.050.. .o ....0 230.55... .. . .00 8 08...... ....0 0.0.2.0.. 0:... 0.0 .8000 00.0 000.0000 85080000..0>0..0.000000A0.u.0§2 "0.2.0... 00.80... .o 00.5 0.0.... .o 0.00.2... ..080 .5090 .0 3.00.5. 0.....2 0.00:2. ... 00.8.3.0: .08 0. 0005.0 8.0000 00.0 000 0808.00.00.80 00003023053000.0203 0 0......0 03050.8 2.03.. 0. 0.0005. 002.082.... ..0 .0805 0.32.0025 08......8 .o. 00.00.... 55.330005520230030 ......0... ... 098...! .228 .05.... 0 ...... 000000 0.00.... 0..- ...8 ... ......0... 832.00.... 9 ..0... 0.00: ”03.0000 0. 0000.5 0. 0000000. 00 00.0000 .0. 3.0.8 .05.... 0 ...... 008 0.30... ... 02.300. 0.8 0. 8 0.0.5008 0 .....- 000....O 20...... ...-...... 8 s B. .8200 83...... v.0 5.3... 02.0.8 . - I 00:00.... a :0... 000.. ......0... 0......80. 000...... . - . .J . .. . . .3803 0.25.00 . SIS—3‘ 8 90080... 0. 00020....) 4:. «0.43 .00. 0... .0 0050.50... .0 00.0.6. .08.! I302! ..0... 0. 080 0.0.. 0.: .0030. «180 0.00 ”no. . .00. 7.! 000000 .0030. 01.00 I... 302.0. 00 ...-1.000.808 0.0.... ... .... .0 00...... 0... ..... ..o 0.3.... .. 13500300000050.0030.E0.2000200 ......ffirww ..-... ,..........,..._...,.H .. 53.80.335202530008 .. r, 08031.050323830 . -... .70.... 2A.. .............. ....” ---. {011.302.323.300203002030 . .....TCJ 0. . ...... ..0 0.500020 C0000 .000... .0 00:00.0. 0... 5000 00.:300:8..I.....00.00.000_0030.00_00!.:O ... A... .... 08.8.2. .0250 0... "0.0000. 0.0 0000000... . . . 121 iii}! iii! E 08180080831808.0880}... 1:...3‘0000333 02188003108500.3010 000.005.00.053!!! 52235055033003.8328! 0.3003858208008000. 0.... 2.0.000. 80.00... >00 00.00008 0000 0.6... 00.5000. 0.00000 00.6300 ”00.0.0980. 0.00.00. .00.. 2.0.. 9.0.0.0000 00.80000. .9030. 005.000 000.. 0.....0... .0 .80.. 0... 00 .830. 0.5050 00.00.0300 .00 0. 000.30. 00m 0902.000 .000 £000. 0 3:000... 05 0.0.. 000.0000... 00... O 0.... .0260 .0. 5000000.. ..0 00.39.00 00.0 0 :0 00.00.. 00 02300.0 00.00000 0000 00.00 0. 000 0... .9E00 .00 0.... o. 00000000 06 .....00 80:00 ...... . .0 000000 00.30. 00 00:00:00 8.0.00. 8.30.0 ...o 0.: 20338330008358.030008800035 09588338338838.2230585. 0.0030200800253088000000000000 .0 0008 0.0.. 0.00000 00.000.82.00 003.000. ...... .0.00...000.00.00.00000..00.5200.0£.>.00.0.08< 0.58 0... 5290.... 80.0.5... .0 00000.6... .0 005.. 200.03.002.080020030030gsi0z. 028008.... 00.08.. 80.50 0.005.. 00.50.39. .80....o.8.0..0.0.0...0§00..0....o.0...000.0.00..2.< ....00 ...... . .0 000.000 5.... 026.000 000. .0008 000 000500. 00..- »000... 0000.00 00:00.0... 0.00 2.... 9 o. .... 0.300. 00 .00.. 00... 000 .0003: 0.... 0. 0000! a .0... 0.02.00 00.30 09.0.0.0. 3.0.000»... 0500 00... 0.000030 0.... 0.00 .0000 300.00 0.0.0.800 .0 000.0000 0023.009. 00! U 0.2 .500... 00.0.2.0. 00» 0.00 0...... 0. .....3... ..o .00 000. .0002. 00. 000 00000.0 00! 80.0... .05 00.0.0.0. 0:38.... .3 ......00 ...... 0 0.. 088.8. .06.... .0... 000.8 0... ..8. ....9. ... $.00 ...... 0.. 0. 000000 82.5 .0 0000.00.00 00000000000 00.00000 00000000 .000. 0000.00 0. 00.6 .05.. 0.00. 00.... .0. 000.8500. 00.. .0008 0000 .00. 0.0 no 0.... .< ....00 .030. . 0. 002.00. 00... 000000 00. .08. 0000.00 0. .000 000000 00 =03 0.0 .0000... 00... .030. 00.0000 0 0. 0060.02.63 .0 0... .050 00. 0>._ 00000.... .00 000 .o 0.0. .0008... 0|?0I 0|. .000. .IVO‘. ....00 .0030. w. ....0 . .o 080 0 ...... 0000.388 000. .0008 N00... .3003. ... 0.0.0... 800.5 2 0000.000: 00... 0.0000 00k .....000. 00 08.0.0 00! 000 0.500020 000 0000029000. 000.. o. 00568.0 00... o... .80. 080.26: c. 08000.0 .0 080,... ......0. 0 ...... 0.3889. 0.9.01.8 0 0. .o .... .0... 1: t‘ll'll‘ i A 3:...... ... 2...... m 330:. 00.3 000...... .. 122 £030.52: >335 5? cancel .50 E quEEEua on 2:9? .855 3.32 82.: ..on .8 new $.88 .... 605... E cater—o a. bit out: .855 .ME on .o :2:th a ~05 :30...» on: 00:02:38 _ao_c__u c2630: son a .uE cm“ 2 a: woman. .8on co 2.63... 2:90.33 5 mouamoo .E .3 V ab 23 ".... a e t 3...: ...... 8 25 ......mxooi on no 95. an .2 =03 ms 03525 new Ezflfloa ma; . . . oEE .8233...“ 5.3 “3.3033 cofimoaaam 8:23: 35 Sou 32: Eat nouaficoo mm; a... ”$.an .3305 33m 25 c. ..to; 8 moacacon. x220 65:2: acaE .o>o US$32 m. 3205 20:3 momma oEom c. 480 -35 .865 no ous—:32. 350cc .5» m. c2322....» 2:25.. 2233“. 68523.5. 2. 532.5 n.~.co_85m .2 :82“. .35.; .355 55 m3. Ema; use.” .coEou on.» 26: 353» vcznéfiaou 85° 50... £220 .0 cozuo “canneaazuézuoaao 05 ..o c0325: .50 ucobm m_ at: 40% 3003 a :o 383 8c 22> 2.332. 02.5 as: «on. 2: w. 3522.83 3.32:3 5 ..uj .9: on £220 co 9.003 58 E coco .3. A 3 02:25 :- «no. 3532. 222326 cw .33» u:=n.o_n:on «:39. a c. .3. 5 25 ...EE: 3 2:2 2:. BIBLIOGRAPHY Articles and Periodicals Anderson, Jack. "Drug Battle Gains Kefauver Followers," Detroit Free Press, October 31, 1961, p. 99. "Brokerage Firm Rates Upjohn High; Thorough Study Indicates Growth in Years Ahead," Intercom (The Upjohn Company, Kalamazoo, Michigan), II, No. 7 (July, 1964), 6. Changigg Times. ‘May, 1962, p. 2. "Congress Puts Teeth Back in Drug Bill," Advertising Age, August 13, 1962, p. 1. DeKruif, Paul. "A New Day for Diabetics," Reader's Digest, April, 1958, p. 131. Detroit Free Press. December 8, 1961. FDC Reports. May 22, 1961, September 11, 1961, and March 19, 1962. "Fishbein Joins Forces with AMA in its Tilt with Kefauver," Printer's Ink, July 14, 1961, p. 14. Hazlitt, Henry. "Criminals or Benefactors?" Reader's Digest, December, 1961, p. 71. Hurwitz, Howard L. "Teleguide," Scholastic Teacher, LIII, No. 12 (December 6, 1963). Kalamazoo Gazette. February 26, 1886. "Kefauver Unit Probes Free Plugs for Drugs," Advertising Age, February 12, 1962, p. lff. Lansing, Lawrence. "Laws Alone Can't Make Drugs Safe," Fortune, March, 1963, p. 3. Moley, Raymond. "Kefauver's Inquisition," Reader's Digest, December, 1961, pp. 69-72. . "Wonder Drugs and Laws," Newsweek, December 4, 1961. McCartney, James. "How Drug Lobbyists Lost Big Battle," Chicago Daily News, Wednesday, October 10, 1962. Nation's Business. August, 1961. Newsweek. August 13, 1962, p. 52. 123 124 Pharmaceutical Manufacturers Association, Bulletin No. 60-13, August 10, 1960. PMA Newsletter, IV, No. 10 (March 9, 1962), No. 16 (April 19, 1962), and No. 19 (May 11, 1962). Printer's Ink. October 19, 1962. "Should Ads Tell All?" Printer's 133, December 22, 1961, p. 71. Silverman, Milton. "Good News for Diabetics," Saturday Evening Post, August 24, 1957, p. 46. Upjohn, E. Gifford. "Promotion Versus Education," Bulletin of the New York Academy of Medicine, Second Series, XXXVIII, No. 1 (January, 1962), 59-63. "What Does FDA.Mean by 'Full Disclosure' in Drug Ads?" Printer's Ink, November 24, 1961, p. 18. "What Kefauver Wants From Business," Nation's Business, August, 1961, PP o 33'35ff 0 Reports American Diabetes Association, Inc. "Facts About Diabetes," New York, July 18, 1957, p. 25. Prescription Drggs and the Public Health. A digest of the presenta- tion by the Pharmaceutical Manufacturers Association before the Senate Subcommittee on Antitrust and Monopoly, December, 1961. The Upjohn Company. Annual Report. 1950, 1952, 1959-1963. "Will It Legislate Better Drugs?" Pamphlet distributed by the Pharma- ceutical Manufacturers Association. Books Engel, Leonard. Medicine Makers of Kalamazoo. New York: McGraw Hill Company, Inc., 1961. Other Sources Deal, John L. Packaging Drggs Today. Paper presented at the 28th AMA National Packaging Conference. Palmer House, Chicago, April 15, 1959. 125 Dixon, Paul Rand. Speech before the Proprietary Association Conven- tion, White Sulfur Springs, west Virginia. May 14-17, 1961. Hruska, Senator Roman L. Address before the New Jersey Pharmaceutical Companies, Far Hills Inn, Somerville, New Jersey. November 16, 1961. Pharmaceutical Manufacturers Association. Letter to the Official Cor- respondent and to Representatives on the Law, Medical and Pharma- ceutical Contact Sections. March 24, 1961. Public Documents Federal Trade Commission. Resolution Directing Investigation of Pric- igg Practices, Policies. Allowances,,Service§, Discounts, Terms of Sale and Advertising of Corporations Enggged in the Sale and Distribution of Drugs and Drug:Products. July 13, 1961. Hearings Before the Subcommittee on Antitrust and Monopoly of the Com- mittee on the Judiciary United States Senate Pursuant to S. 1552, January 30, 31, February 1, 6, and 7, 1962, Part 6, Advertising Promotions. Unpublished Materials Figures from The Upjohn Company, Marketing Research Department. July 15, 1964. Morris, Stanley. "Upjohn Advertising and Sales Promotion." Patterson, John N. (MeCann-Marschalk Co., Inc.). Letter to J. S. Campbell, The Upjohn Company, January 24, 1964. Pernice, R. L. "Results of Unicap Consumer Promotion," The Upjohn Company, Marketing Research Report, August 28, 1961. Royle, R. W. "Case Study: The Upjohn Company." Paper prepared for Advertising 305, Michigan State University, East Lansing, Michi- gan, June 2, 1961. . "Organization Problem: The Upjohn Company, Inc." Paper prepared for Economics 386, Albion College, Albion, Michigan, March 31, 1959. . "Government Regulations and the Drug Industry." Seminar paper prepared for Advertising 820, Michigan State University, East Lansing, Michigan, June 8, 1962. 126 Sanborn, D. H. The Upjohn Company, Marketing Research Report, July 15, 1964. Upjohn, L. N. "Cumulative History, Advertising." Dictation intended as part of the record of Cumulative Upjohn Company History. Kal- amazoo, Michigan, July 17, 1945. . Interoffice memo. July 7, 1945. "I7'1!111117111111711'“