Is Pharma Ready for the “Total Market?”

Since 2011, direct-to-consumer (DTC) Hispanic marketing efforts by pharma companies have fallen off the radar. Measured media activity in Spanish-language media by pharma companies—which provides a strong barometer for overall Hispanic marketing investment activity—has fallen off from 2011 peaks of more than $100 million, as key players like Pfizer and Sanofi have significantly reduced their spending. Ironically, the level of attention being given to the Hispanic patient has increased significantly the last few years, mostly driven by Spanish-language media companies like Univision and the impacts of the ACA.

There is no doubt that Hispanic pharma marketing is still in it’s infancy, and that there is a major disparity—less than 2% of pharma advertising dollars is spent in the Hispanic market. The reasons for the low number varies, and I discussed many of them in a past article ( There are other reasons as well, including regulatory hurdles that are a challenge for many experienced Hispanic agencies.

While pharma has moved slowly to pursue the Hispanic opportunity, new marketing approaches have emerged in the multicultural marketing industry. A debate has ensued, centered on a new model for multicultural marketing called “The Total Market Approach.”

Total Market, Multicultural, and Cross-cultural:  What do they all mean?

In the past five years, a pivot has taken place in the world of Hispanic and multicultural marketing, more broadly, to a new lexicon and strategy of integration. The rapid growth of the Hispanic, Asian, African-American and other ethnic populations and the trend towards ethnic “minority majorities” has moved multicultural marketing out of the silos and into the C-suites of many large companies.

What was once a niche is now mainstream. This growth in ethnic markets has been accompanied by a shift in marketing strategies by major marketers towards efficiency and integration. The result has been the introduction of new marketing models that are changing the way organizations approach ethnic marketing—total market approach and cross-cultural marketing—and a debate over whether these two new models are more effective than the traditional ethnic-specific “multicultural” marketing approach.

Multicultural Marketing

What it is: Targeted marketing efforts to specific, clearly defined ethnic groups.

How it works: Multicultural marketing is ethnic-specific marketing that is precisely targeted to a particular ethnic segment (i.e., Hispanics, African-Americans, Koreans, etc.). Ironically, the “multi” really means separate and distinct (and often siloed). This model is the baseline that has historically underpinned the multicultural marketing industry for the last 50 years in the U.S. This model has led to the establishment of three predominant groups of multicultural marketing specialist agencies: Hispanic, African-American and Asian advertising agencies.

Putting the model in practice: Start with the general market then develop separate, distinct ethnic-specific marketing programs (connected to the general market by overarching brand attributes or key objectives).

Total Market Approach

What it is: One marketing program that is designed to reach all consumers, across general and ethnic markets.

How it works: The total market approach describes a controversial, yet increasingly popular new approach by many marketers, particularly by large national advertisers. According to the AHAA Total Market study, industry executives define the total market model as reflecting diversity in all their marketing (including using diverse talent), leveraging cultural cues and focusing on universal truths to gain efficiencies. While AHAA offers two models to Total Market, I feel that in practice, total market is about the “adaptation” model as a shift away from ethnic-specific targeting (multicultural marketing).

Putting the model in process: Start with the general market. Then layer or adapt ethnic elements.

Cross-Cultural Marketing

What it is: One marketing program that leverages ethnic markets to reach across ethnic and general markets

How it works: Cross-cultural marketing is a type of total market approach. The difference between total market and cross-cultural is subtle, but important. It’s all about the role of ethnic consumers, which in a cross-cultural model are front and center. Cross-cultural marketing starts with ethnic segments to develop marketing programs that cross over into the general market. By contrast, total market, starts with the general market and layers in (or more often than not, adapts) ethnic elements, usually talent. Ethnic markets drive the general market, versus the other way around, in both the total market and multicultural models. A “total market” ad is meant to run on large, general market platforms, like network TV, in English. By contrast, cross-cultural ads can run on mainstream and ethnic media.

Putting the model in practice: Start with ethnic segment(s) to develop programs that cross over into (a total market definition of) the general market.

Should Pharma Go Total Market (or cross-cultural)?

Considering their laggard position1 as it relates to Hispanic marketing, should pharma marketers leapfrog the traditional multicultural marketing approach and start to embrace the total market or related cross-cultural approach?

The total market approach seemingly addresses some of the major challenges that have kept pharma marketers from investing more heavily in Hispanic marketing, including:

  • A large percentage of the U.S. Hispanic population is now U.S. born, acculturated and English speaking—indicating a target well aligned with a total market approach.
  • The growing second- and third-generation Hispanic market is looking for health information online—in English—indicating the benefits of using a total market approach online.
  • A common model for implementing the total market approach is to have a one agency handle both the general market and Hispanic work—allowing pharma marketers to leverage healthcare-focused ad agencies who understand the ins and outs of DTC pharma advertising.

The problem for pharma is that a total market approach requires Hispanic market considerations—including patient insights, market dynamics, etc.—to be well defined, relentlessly updated and ultimately integrated from “inception through the entire strategic process and execution.”2 The limited Hispanic investment activity over the last three to five years indicates an industry that is not ready to implement a total market approach.

Multicultural Building Block Approach for Pharma

A total market approach is akin to a more advanced, nuanced and complex approach to reaching Hispanic and other ethnic audiences, which requires a solid base of multicultural structures, processes and insights that most pharma companies do not have. However, beyond structural challenges, the other fundamental issue with pharma taking a total market approach is that it would not help them reach underserved Hispanics and incrementally increase sales with new Hispanic patient populations—those not otherwise reached with general market ad spend.

According to Experian Simmons,3 almost 10 million Hispanics ages 35 to 64 have not used a prescription drug in the last 12 months. This segment is mostly unacculturated to partially acculturated, with an interesting mix of lower education (67% have completed high school or less) and higher income (61% have annual incomes over $40k). The segment of the Hispanic patient market most underserved by pharma: The segment that consumes massive amounts of TV on weekly basis (61% watch 20 to 39 hours a week), much of which is Spanish language.

Trends Make the Case for Hispanic-Specific, Multicultural Marketing

Beyond the structural and market cases against pharma embracing a total market approach, broad industry trends also indicate that a multicultural approach is most appropriate for pharma:

  • A recent PWC report4 indicates that the pharma industry needs to shift from a mass market to a target market approach to increase revenue—implementation of Hispanic-targeted marketing programs aligns with this trend.
  • Web and social media are the future and they are the most effective ways to target Hispanic consumers, contextually, behaviorally and demographically.
  • Building strong pharma brands imbued with human characteristics will be critical to countering the growth of generics. The Hispanic consumer’s strong affinity to brands provides fertile opportunity for pharma companies to boost sales by developing direct relationships with the growing Hispanic consumer.

While I am a strong advocate of the cross-cultural approach in general, in the case of pharma it doesn’t make sense. Pharma marketers can benefit from the incremental revenue opportunity of reaching underserved Hispanic patients in a highly targeted way.

While there are clearly opportunities for pharma marketers to take a more cross-cultural approach to their general market advertising, the biggest opportunity continues to be investing in multicultural, targeted Hispanic-specific marketing programs.


1. AHAA 2010 Hispanic Ad Spend Trends Report,

2. AHAA Addressing Total Market, Agency Round Table Report, April 2014.

3. Experian Marketing Services, Winter 2014 Simmons Connect.

4. PWC, Pharma 2020: Marketing The Future: Which Path Will You Take?

  • Jose Villa

    Jose Villa is President of Sensis, a cross-cultural advertising agency with digital at its core. Jose has extensive experience in healthcare communications, having worked with clients across the entire healthcare spectrum including insurers, hospitals, public health agencies and pharma.


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