Over the years, comScore has published several studies – including one this past week – that illustrate how the click is often the wrong metric for measuring the effectiveness of online display advertising. We have also shown that simply being exposed to an online ad, even when a click does not happen, often drives meaningful lifts in site visitation, purchase behavior and other key performance metrics. These findings continue to change how success is perceived and measured in digital advertising. Just as with other media such as television, radio and print, marketers are beginning to understand that an action at the exact moment of exposure is not the only indicator of effective advertising. Accumulated exposures, even without clicks, provide value to brands that should not be discounted.

While the click is often a poor metric of success for branding campaigns, it should be noted that there are certain instances where clicks on banner ads do indeed matter. Most notably, for industries that deal heavily with direct response marketing, the click is the primary means through which the specific marketing call-to-action occurs, whether that is submitting an online quote or requesting more information about a product or service.

An industry where the click remains relevant, and one in which I spend a great deal of my time, is the pharmaceutical industry. In direct-to-consumer pharmaceutical marketing, the click is an important metric that correlates with a campaign’s ultimate success in driving patient and prospect conversions. Educating patients about a medical condition and how to treat it is not something that a banner ad or interactive ad unit can do alone, especially when one considers the amount of real estate that a drug’s accompanying safety information requires. Even a television ad faces challenges in conveying convincing and compelling information about a particular treatment in 30 to 90 seconds. Indeed, there are very few mass marketing vehicles that are as effective in educating patients about a particular treatment as a website. In our studies on pharmaceutical advertising campaigns, we have found it’s the depth of information provided on a pharmaceutical brand’s site or microsite that’s a key determinant of success in attracting and converting patients.

But what is among the more important drivers of traffic to these sites? The answer: clicks on display banner ads.

In the past six years, comScore has chronicled the correlation between various pharmaceutical ad campaign elements and conversions. We have found that, more than any other digital marketing tactic, getting condition sufferers to a brand’s website drives more visits to a doctor, more discussions about conditions and the brand, and ultimately more prescriptions. Overall, the best thing a banner ad campaign, interactive or not, can do to support this endeavor is to drive traffic to a dedicated site or microsite. That action is directly captured by our old acquaintance, the click.

This is not to say that our other research on lifts to be gained from simple exposures do not apply to the pharmaceutical industry. Banners also provide view-through value (although perhaps to a lesser extent) in increasing brand awareness and favorability. Users who might not click on banner ads may nevertheless end up on a pharmaceutical site by recalling the ads they’ve seen and searching for the brands that they saw or typing brand URLs directly into their browsers. However, direct-to-consumer marketing in the pharmaceutical industry just happens to be able to leverage the click differently, since clicks coming from ad campaigns can drive branded site visitation and site conversions. For pharma, banner ad campaigns are very important contributors of traffic to brand websites because they typically appear at targeted sites, whose visitors are likely to be seeking more information about a condition or treatment. In a sense, these pharma banner ads perform somewhat like search ads in that they are directed to a more qualified audience. The ad the audience sees is usually limited to an invitation to visit a site or microsite to learn more about the brand, since a good portion of the ad is taken up by federally mandated safety information. The only way to obtain the detailed information necessary to influence condition sufferers to take the necessary actions that ultimately lead to having a physician prescribe a treatment is to visit a branded website.

So while the amount of traffic that goes to a branded drug site from a click is relatively small, it is highly qualified traffic. As a result, while the click on a banner ad may not be an appropriate metric for many industries, it remains an important measure of ad effectiveness for the pharma industry.

This article was published in the January 2012 issue of the Marketing Disease Prevention + Awareness Magazine.

Today’s generation of teenagers and young adults represents a unique class of Internet users, born with the web at their fingertips and an innate ability to navigate it with agility. For this generation, the Internet was not a new technology upending other modes of communication – it was the norm. Most grew up learning to seek out information primarily through search engines instead of card catalogs, engaging with social networks to interact with peers, and watching online video for entertainment.

How will the early adoption of online behaviors among young people impact future activities such as managing finances and making health care decisions? As those under age 25 grow up in an increasingly connected world, one can surmise that these users will be able to quickly and seamlessly adopt online approaches to everyday matters more than any generation before it.

One of the defining issues of the next generation will be health, as we observe both the increasing incidence of many troubling diseases like diabetes but also extraordinary advances in medicine and health care. If we take a look at how young people currently consume health information online, it offers us some insight into what the future online health activity might look like and which content providers stand to benefit.

Young People Are Highly Social Entertainment Consumers

An analysis of U.S. Internet users between the ages of 12-24 reveals that they are heavy consumers of social media and entertainment. In October 2011, this age segment comprised 22.8 percent of the total U.S. online population and spent more than a quarter of their time on the Social Networking category of sites (26.6 percent) – a rate 58 percent higher than that for the average U.S. Internet consumer. Teens between the ages of 12-17 spent an even greater share of time – nearly 29 percent – on social networking, 71 percent greater than the average Internet user.

Next to social networking, 12-24 year-olds spent an eighth of their time on the Multimedia category, 91 percent greater than average. Meanwhile, 12-17 year-olds spent closer to 15 percent of their time on multimedia, more than double the average share. For both the Social Networking and Multimedia categories, 12-24 years old spent the most amount of time compared to other age groups.

Top Categories by Share of Time Spent Online for 12-24 Year-olds
Source: comScore Media Metrix, U.S., October 2011

_{*Index of 100 shows average representation.}

Among the sites visited most by young people ages 12-24, Google Sites ranked as the most visited property, reaching 90 percent of the demographic and accounting for 16.3 percent of all time spent online. Interestingly, YouTube accounted for nearly three-quarters of the time spent on Google Sites. Facebook, which ranked as the second-most visited site, accounted for the greatest share of time spent online at 23.2 percent. 12-17 years old spent an even greater share of their time on both Facebook (25.1 percent) and YouTube (13.9 percent).

How Young People Consume Online Health Information

In contrast to the aforementioned online activities among youngsters, 12-24 year-olds spent the least amount of time visiting the Online Health category when compared to other age groups. This fact is perhaps unsurprising given that older age segments likely have more health care concerns to manage – for themselves and for their families. Nevertheless, 12-24 year-olds represented 21 percent of Health category visitors -- the second largest demographic after 35-44 year olds – an indication that they are a demographic that ought to be addressed in this sector.

In October, 61.5 percent of the 12-24 year olds visited a Health site, a 9-percent increase from last year. Some of their Online Health visitation habits resemble that of the broader Internet population; for example, their most visited Health properties included WebMD Health, Everyday Health, and Livestrong - eHow Health.

However, the younger segment also exhibited some different browsing patterns. They were most likely to visit lifestyle-oriented health sites, such as Lifescript.com and Bliss.com, both of which ranked among the top 10 sites for 12-24 year-olds. Lifescript’s content is divided into five simple sections: Health, Body, Food, Life, Soul. Bliss.com also strongly communicates an integrated approach to health with its content sections: Eat Well, Get Fit, Head to Toe, Wellness, Sanctuary, Do Good. That younger Online Health consumers show an affinity for these sites suggests they may view health as an integrated part of their lifestyle and do not only go to health sites for informational purposes.

Top 10 Health Sites for 12-24 Year-Olds
by Unique Visitors (000)
Source: comScore Media Metrix, U.S., October 2011

Are online health websites really experiencing a slowdown in visitation? Contrary to recent survey findings reporting a decline (PDF), comScore shows that overall visitation to health websites has never been stronger. Ever since consumers gained unprecedented access to a wealth of information on the Internet, the demand for health and pharmaceutical information has only grown. Now, as connected devices such as mobile phones and tablets enable users to go online with even greater freedom, online health content is poised for continued growth. To better understand the prevailing trends in this sector over the past few years and where it appears to be headed, comScore analyzed several of the key dynamics in the industry today.

Health Site Audience Grows 60 Percent Over Past Three Years
Over the past three years, U.S. Internet users have shown a steadily increasing trend in visitors to sites in the Health category, which range from general health content sites to branded pharmaceutical sites. The number of total unique visitors accessing these sites on a monthly basis has increased from 86.9 million in June 2008 to 139.1 million in June 2011, representing a 60-percent increase.

Interestingly, the rate of growth in visitors to health properties over the past three years outpaces the growth of the total U.S. Internet audience by more than a factor of 4 (60 percent vs. 13 percent), showing the demand for health information continued to increase at a strong pace.

Even more telling is the growth in audience penetration of Health properties over the past few years. Three years ago, less than half of the total U.S. online population visited health sites. Currently, health sites now reach approximately 2 out of every 3 Americans going online monthly, an increase in penetration of nearly 20-percentage points since June 2008.

Key Health Domains and Pharmaceutical Sites Sustain Growth in Health Visitation
While this growth can be attributed in large part to the growing use of sites providing general health information, it’s important to note that it has also been bolstered by visitation to health content domains for major therapeutic areas (i.e. WebMD Depression, Healthline ED, etc.) and pharmaceutical product sites. Over the past three years, targeted health content sites have seen relatively consistent audience levels, even when considering seasonal traffic changes. Yet, a quick look at overall traffic for pharmaceutical sites hints at a slight decline over the past few quarters. Were audiences seeking less pharmaceutical information online over time?

* Content sites include sites in the following therapeutic areas: Acid Reflux/GERD, ADHD, AIDS/HIV, Allergy, Alzheimer's, Asthma, Bipolar, Bipolar Depression, Birth Control, Breast cancer, Cardio, Cholesterol, Cold/Flu, Contraception, COPD, CPG, Depression, Diabetes, Erectile Dysfunction, Fertility, Fibromyalgia, Hepatitis, HPV, Hypertension (HBP), Insomnia, OAB, Oncology, Osteoarthritis, Osteoporosis, and Rheumatoid Arthritis

This apparent decline actually has a fairly reasonable explanation: the launch of Google’s OneBox for Health among search results. In 2010, Google began taking the first unpaid search result listing on pharmaceutical searches to link to the National Institutes of Health (NIH) pages on the medications in question., as illustrated below:

This Google practice redirected a significant amount of traffic that would have once gone to main pharmaceutical sites, causing a decline in search-referred visitation. The chart below illustrates how NIH.gov’s share of visitation from organic search referrals increased from less than 1 percent of clicks to 4.5 percent of clicks after the Google OneBox launched, coinciding with a decline in clicks to branded pharmaceutical sites. Yet it is important to note that any resulting traffic still involved exposure to branded pharmaceuticals – just not on the branded pharmaceutical sites themselves.

This leads us to another key metric to consider when studying the growth in online health visitation – the volume of overall traffic brought to Health properties from web searches. An analysis of these traffic patterns over the past year shows an increase in the volume of search-referred traffic to Health properties, indicating no shortage of demand for health information from search queries. So despite the impact of Google OneBox on visitation to branded pharmaceutical sites, it would be incorrect to assume that the reason for such declines is a lack of consumer demand.

Mobile Access to Health Information Increases Prospects for Growth
Looking to the future of online health content, it is important to understand how the mobile channel is beginning to play an important role. In the three month average period ending June 2011, 13.1 million mobile subscribers in the U.S. reported accessing health information at least once in the previous month, a sizeable increase of 64 percent from a year ago.

A look at how these users accessed their information is also telling, as nearly two-thirds of them used browsers instead of apps to find health information. But while app usage accounts for less overall activity, the growth in the use of health apps outpaces the growth in visitation to health sites via browser (107 percent vs. 84 percent). As smartphone adoption continues to steadily increase, it’s possible that the use of apps will keep on growing at a faster rate over the next few years. What we’re seeing provides a glimpse into a future where connected devices could be increasingly valuable access points for audiences seeking health information.

At the end of the day, these trends we’re seeing from comScore data show the demand for online health information to be far from waning and the prospect for sustained health visitation to be strong. Consumers have never before had as much ability to find health information to inform their health care decisions as they do now, and with the proliferation of connected devices enabling greater access and constant connectivity, it is only likely that the use of online health sources to engage with health information will continue to grow.

Recently, I had the pleasure to speak at the 2010 ePharma Summit on how online direct-to-consumer marketing for pharma brands was driving increased treatment and adherence. It was a great opportunity as most of the leading marketing minds for the industry were in attendance. There was much to be discussed this year as 2009 saw increased activity from the FDA in both warning letters and hearing on online marketing. Below are my thoughts on the state of pharma online and the situation with the FDA.