Thought Leadership
The American College of Physicians on the Nuances of Pharma Advertising


Craig Ternowchek
Digital Advertising Coordinator
American College of Physicians



For those of us not familiar with ACP (American College of Physicians), please tell us a little more about your website and core audience.

The American College of Physicians is a 101 year old medical association with a mission to enhance the quality and effectiveness of healthcare by fostering excellence and professionalism in the practice of medicine.  The ACP’s 148,000 members includes internists, internal medicine subspecialists, and medical students, residents, and fellows making the ACP the largest medical-specialty organization and second-largest physician group in the United States.


Since ACP is primarily visited by physicians and healthcare providers, it would make sense for your main set of advertisers to be Pharmaceutical or Biotech companies looking to reach them. Are there any other types of advertisers outside of the sector that you’ve worked with? (even if it may have been counter-intuitive at the start)

For the most part Pharma is responsible for the bulk of our advertising business.   Recruitment is another area where we tend to see a lot of advertising demand from large scale recruitment efforts like the Army and Navy down to hospital systems and private practices there is a constant need for physicians all over the country.  Industry meetings and continuing medical education (CME) opportunities are popular as well.  One of our biggest challenges is working with limited inventory due to the audience of our publications, as such we don’t have a lot of room for non-pharma advertisers.


The Pharmaceutical industry is one of the most heavily regulated industries in the US, where pharma sales reps are limited in the amount they can spend on gifts or outings for doctors. What types of regulations do Pharma companies face within the realm of advertising?

Pharmaceutical ads are extremely regulated.  All ad content requires stringent review by the pharmaceutical client prior to review by the FDA to ensure accuracy.  Treatments with a potentially deadly adverse reactions are required to carry a “black box” warning.  Any change made to an ad (color, size, font, etc) will send the ad back into the review process.  If an ad mentions the condition it treats it is legally obligated to also list all of the potential adverse reactions the drug may cause.  The efficacy of pharmaceutical products is also constantly scrutinized so changes and lengthy delays can occur at any time during a campaign. When it is all said and done, there are essentially two types of ads that we’ll carry.  The main type is extremely content heavy with scrolling product information and the second is content light but is completely unbranded.  The rules also vary from country to country making all of our pharma campaigns limited to only a U.S. audience.


The digital advertising industry also has regulations when it comes to targeting users with incurable or terminal diseases such as Cancer, HIV, etc. Due to this, using PII to target a user with such an illness is not allowed. Does this affect the way you approach targeting on your site, or do you primarily use content / context as a proxy for targeting users?

We actually don’t allow any targeting beyond geography.  As a member organization we take member privacy very serious and as such it has been our policy to not allow any targeting or tracking of our users.  We won’t even allow contextual targeting to prevent any possible implication that the advertiser influenced the content of our journal (native advertising is not even open for discussion).  There are certainly other publishers in this space that will allow advertisers to target specific individual physicians however that degree or targeting can present some significant inventory challenges where you’re dealing in a few hundred impressions (or less) depending on who is on the target list and how often they actually visit your site.


What does a typical ad buy with ACP look like? (print ads, digital ads, sponsored content / native, social sharing, email blast, etc)

We do all of our deals directly with buyers because their needs really depend on the brand and where the drug is in it’s lifecycle.  A drug that is launching will likely take advantage of any opportunity available, print, digital banners, interstitials, email, etc.   A brand nearing the end of its lifecycle may only target key publications during key times of year such as major conferences.  Different disease states also carry greater competition, so a plan for a Diabetes or a Cardiovascular treatment will look much different than something treating HIV.   As I mentioned earlier, native is not an option for us.  Our content is what makes us a credible organization and we’re not willing to jeopardize a 100 year old reputation to make a little extra revenue for a few months.  Research shows that physicians are very comfortable using mobile, especially in point of care situations, however there is so much information that needs to be included in pharma ads that mobile banner sizes are not really conducive to pharma ads for healthcare professionals.  Similarly, video never really took off in our space because of the cost and lack of significant inventory.


What are some must-use tools that you use at ACP in the context of advertising? (Doubleclick for Publishers, Google Analytics, Quantcast, comScore, AppNexus, a DMP, etc)

The main tools we use are DFP and Google analytics.  Comscore and Moat have both become increasingly important as viewability has become a big part of the equation but because we typically sit in the 70-80% viewable range with very low non-human traffic (around 3%) we rarely run into issues around those metrics.  We found that a lot of the tools for audience measurement like Quantcast or comScore’s media metrix really struggle with specialized audiences like ours.


As an independent, niche publisher, what is the biggest challenge you face today?

The largest issue for us is really the amount of inventory available for advertisers.  There are only so many physicians in the U.S. to generate the impressions we sell which can make things like balancing seasonal traffic trends especially interesting.  For example, there are only about 6,000 oncologists in the country which means that even if you have a high percentage of those doctors visiting a site regularly it will still be challenging to generate a significant amount of inventory to reach those individuals.  When advertisers try to apply policies based on trends impacting the internet as a whole to niche publishers it further reduces inventory and often times those trends are not as prevalent or indicative of what is occurring on a niche site.


How has ad blocking affected you? (or not)

While anything that reduces inventory is a concern when you’re a publisher with a limited audience, currently we aren’t viewing ad blocking as a top issue.  Our audience tends to be older than the reported profile of a typical ad blocker and we’ve always been very conservative with our ad placements to avoid a poor experience for visitors so at the moment we’re losing a few impressions here or there rather than large chunks.  It is something that we keep an eye on but for the moment we are not requesting users with ad blockers whitelist our sites.  While it’s frustrating for any publisher to essentially be punished by their users because of the bad habits of other publishers it’s very hard for us to make the argument that the loss of revenue is unfair when the majority of our users are already paying membership dues.


As a media seller, what is your process for reaching out to, or engaging with advertisers? Are there a set group of agencies / advertisers that you call on, or would you accept ads from people in an ancillary field as say financial products (for doctors)?

Our space is a pretty small world in the grand scheme of things and we have been around for a long time so it’s fairly easy to develop relationships with buyers handling pharma campaigns.  We try to position ourselves as an educational resource for people who are new to this industry because professional/academic publishing is so much different than targeting the general consumer population and for the most part our buyers know they need us just as much as we need them.  For non-pharma advertisers like financial services or luxury goods that might be interested in reaching a high net worth audience like ours, it’s really not an area we focus on.  Most of those advertisers are able to reach our visitors in other non-industry publications at significantly lower rates while casting a wider net to also capture other target audiences.


Lastly, what is your take on the future of monetization for independent, niche publishers?

This is a huge question because we’re living in a time where technology is changing behaviors more rapidly than many niche publishers are able to keep pace. I think the most important thing for niche publishers is to have multiple revenue streams because relying entirely on digital ad revenue is a recipe for trouble.  Most niche publishers won’t have the resources to chase after every new technology or platform that arrives on the scene, but the upside is that they can be more selective and deliberate in utilizing the ones that have staying power or make sense for your audience (for example we still don’t have an ACP instagram account)..  A lot of the ad tech out there doesn’t really fit the needs of the niche publisher so any innovative revenue generators will likely come from an entirely new technology.  For example, virtual reality could end up becoming a big part of our revenue model in the future but it probably won’t be until it’s become a normal part of day to day life with other larger publishers working out the best practices.  What works for niche advertisers is going to vary widely depending on their audience so while some may find subscriptions monetize the best others may need to focus on micro-payments.  If I had to guess though, I’d say the next significant monetization opportunity isn’t really on the radar at the moment and five to ten years from now people will be saying “How did I not think of that first?”



The American College of Physicians (ACP) is a national organization of internists — physician specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness.

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