How do you accelerate demand for a product that lives in category (testosterone replacement therapies) that is perceived as clinically undifferentiated? And what if competing brands are less expensive, have better coverage, are supported by far more sales professionals and – even worse – promoted through aggressive direct-to-consumer advertising?

FORTESTA Gel, a topical gel for the treatment of Low T, faced all of those challenges. Endo Pharmaceuticals and the agency dug deep into customer insights to solve it. What we learned is that FORTESTA Gel had two untapped differentiators that mattered to both HCPs and patients. First, FORTESTA Gel is the lowest-volume testosterone gel. Second, it’s the only testosterone treatment that is applied directly to the front and inner thighs.

Unfortunately most patients weren’t even aware there was a testosterone gel that can be applied to the thigh. We had to get patients and HCPs at least talking about volume and application sites, so they could decide what product made sense.

And that’s when it hit us. What better way to reinforce the low volume and thigh than to provide an application tool in the form of a pair of boxer shorts that shows two small circles where FORTESTA Gel is applied? It’s something HCPs haven’t seen before, and it’s hard to ignore or forget. It was a playful message but appropriate in this therapeutic area. And because it’s an educational tool, it does not violate the Sunshine Act. With guidance from regulatory and legal, we kept it compliant by printing a full PI on the back of the boxers. We even stitched up the boxers’ waist so HCPs and patients couldn't wear them home. For less than $250,000 the campaign was conceived, printed, and delivered. So, in January 2013, the boxers hit the field and mailboxes of target HCPs.

The application tool worked. The boxers broke through the clutter. They differentiated FORTESTA Gel in a meaningful way. They changed the conversation about options for treating Low T. In fact, quantitative surveys proved the message wasn’t just delivered and retained, it was driving intent. Then we saw the real impact – a month-over-month increase of 64% in TRx. By March, that increase in TRx was sustained at 70%.