Marie Lugano, president and founder of the American Menopause Foundation, is on a crusade. Torchbearer for the 50 million US women over 50 and the thousands of female baby boomers who observe that milestone birthday each month, Lugano has made it her mission to teach all pre- and postmenopausal women what they should know about their changing nutrition and health needs. And, armed with the message that this fast-growing segment of the US population constitutes a goldmine of well informed, discriminating consumers, she’s invited at least one pharmaceutical company to join.

A nonprofit organization founded in 1993, AMF is a New York–based advocacy and education group with a national network of support groups. One of its triumphs has been getting 15 states to declare September “Menopause Awareness Month.”

“One of AMF’s core concerns is that women may now live a third of their lives after menopause, yet the symptoms of menopause are frequently ignored or mistreated,” reports Lugano. “Even though 500,000 women die of cardiovascular disease each year, consumers worry much more about breast cancer,” which occurs far less often.

Enter Big Pharma Eli Lilly has supported the foundation’s educational programs since the nonprofit’s inception, co-sponsoring AMF’s annual fall symposium six times on topics ranging from osteoporosis to female sexuality.

When Lugano first envisioned a statewide pilot program in 1999, she approached Lilly with the non-product-specific project. “I presented it as a partnership, building on AMF’s second goal: to educate women all over the country by going to them directly, even in small towns,” she says.

Lilly agreed to fund AMF’s seminars, “Women’s Health: 40 and Beyond,” throughout Connecticut, in 20 different communities from Bridgeport to Guilford. The seminars—held in YWCAs, libraries, hospitals, and corporate offices—reached hundreds of women and drew rave reviews.

Based on that success, the organization asked Lilly for a second grant to fund a similar year-long program in New York State in 2001. Another 20 seminars are expected to reach hundreds of women there.

A majority of seminar attendees fall within the key target age range: 40–50. But Lugano is delighted to see younger women as well. “Their mothers are suffering greatly, and they want to bring the information home, know more, and prepare themselves,” she says. “We even get some women in their 60s and 70s.”

Taking It on the Road “Women’s Health: 40 and Beyond” is a free one-hour seminar, presented during a brown-bag lunch at a workplace or after-work gathering. Speakers include a registered nurse or dietitian and AMF’s executive director, and ample time is allowed for questions and answers.

“Lilly’s goal was to have women understand all the health issues associated with peri- and postmenopause, so they can make the best decisions about what products to buy,” Lugano explains. “As women become aware of all the symptoms and prevention modes, such as exercise and nutrition, they can go to their doctors and ask questions.”

“Lilly is a patient-focused company with a long history of working with advocacy organizations representing a broad array of disease classes,” says Lilly spokesperson David Murbaugh. “Those partnerships often include unrestricted grants to support education campaigns that raise public awareness about serious illnesses and are managed according to the highest ethical standards. Lilly believes that supporting those efforts is a worthwhile way for the company to return resources to the community. After all, those groups represent the individuals on whom Lilly’s research efforts are focused.”

Although Lilly won’t disclose the size of its grants, the reason for its interest in AMF’s target audience is clear: the company manufactures Evista (raloxifene), a leading bone-density regulator for osteoporosis-prone older women. According to IMS Health, Evista’s US sales in 2000 totaled $453,115—a 58 percent increase from 1999. Among the most heavily researched pharmaceutical products in the history of the company, Evista has been prescribed more than 10 million times since 1997.

“We go to women with a program they can easily attend, at no cost to their employers,” says Lugano. “We visit city agencies that can’t afford to pay for programs. Lilly has given us an opportunity to go to all levels of the American workplace, not just the Fortune 500 companies.” AMF has already held ten free brown-bag luncheon seminars at workplaces across New York State—from American Express to Estee Lauder to the New York City Department of Housing Preservation & Development (HPD). Its first program in Buffalo was so successful that it was invited to present a second. AMF’s seminars drew Citibank’s largest-ever audiences for a lunchtime event, in both its Manhattan and Long Island City offices.

“Lilly is very proud of this program, as we are,” says Lugano. “We call it a joint educational effort.” The grant covers all expenses, including advertising, mailings, postage, and a fee for the registered dietitian. All announcements and publicity bear the message, “Sponsored by an unrestricted educational grant from Eli Lilly & Company.”

Seminar attendees receive an information packet that includes two booklets, “Osteoporosis: Are You At Risk?” and “Beyond Menopause.” Neither mentions Evista by name, but both bear the Lilly logo. The osteoporosis brochure includes a questionnaire and a toll-free number readers can call to request additional information. The menopause booklet was developed jointly by AMF and Lilly.

Attendees are also asked to fill out an anonymous questionnaire. “We considered what questions AMF wanted answered and what Lilly would want to know,” says Lugano. “You have to have a measure to show a program is working.” Results, analyzed by a statistician, are seen by both Lilly and AMF.

Perspectives So far, AMF is delighted with the seminars. “Women walk out with a nugget of knowledge they can take to their doctors,” says Lugaon. “That might be, ‘I’ve got to look at my cholesterol levels and what I’m eating.’ We give them more than the two-minute bleep they hear on TV. We answer their questions—the practical ones, not the medical ones.” For medical questions, the presenters refer attendees to their doctors.

Audience members seem appreciative. Diane Baccash Fruchtman, account vice-president at a major brokerage firm, says, “The seminar was so informative and helped you make choices. It made me aware of how devastating osteoporosis is.”

Currently on estrogen replacement, Fruchtman discovered that too much soy could actually counter the benefits of her estrogen prescription. “When you see an ad about a soy product, they never give you that information,” observes Fruchtman, who often snacked on soy cheese. She now plans to talk to her doctor about soy and to ask her gynecologist and internist about having a bone density test, which was discussed in the seminar.

Kathi Elster, president of Small Business Strategy in Manhattan, says she “had no idea that the loss of estrogen affects your heart and increases cholesterol or that heart disease is a bigger killer than breast cancer.” Responding quickly to the seminar’s lessons, the premenopausal Elster now takes a regular calcium supplement and is watching for estrogen loss, osteoporosis, and higher cholesterol. “You can talk to your girlfriends, but I didn’t want a layperson’s point of view—I wanted to hear from experts,” she says.

Angela Blakefield, an associate housing development specialist now going through menopause, was also enthusiastic. “We heard that menopause is not a curse, and laughed, got wonderful information, and were grateful,” she says. “I learned that three million women in New York State are going through menopause. And we talked about the role of menopause in causing more women to die of cardiovascular disease than breast cancer.” Blakefield also commended the nutritionist for answering everyone’s questions about food, drugs, and vitamins.

More than 100 women attended a seminar at Buffalo’s Erie Community College sponsored by its Women’s Center. On the verge of peri-menopause, secretary Trudy Herkimer came away with a lot to think about—“things doctors don’t tell you and Oprah hasn’t mentioned yet! I’ll probably write my congressperson and senators to say I want more money for studies on menopause and its effects on women. I knew soy was good for you, but not its benefits at this stage in a woman’s life or that calcium helps prevent osteoporosis. I’m spreading the word.”

Joyce Grillo, owner of Grillo Management Group in New York City, can’t take HRT and says there’s a scarcity of gynecologists with expertise in menopause: “You have to do your own research. A seminar like this opens your eyes. AMF also gives help and information by phone and can make referrals to specialists. AMF is doing a wonderful thing in these seminars. More companies should offer them.”

Her praise is echoed by the program’s organizers. Delmira Kelly, director of special programs for New York’s HPD, who arranges health-related educational events for 2,800 employees, was impressed by both the program and its attendance—92 women and three men.

“The response was overwhelming,” Kelly says. “People were calling until noon that day to see if seats were available. It was the most popular show in town and the best turnout we’ve had for a health-related program at lunch time. Now we’re receiving phone calls asking for more information and another seminar!”

Opportunity for Pharma In her newest book, EVE-Olution: The Eight Truths of Marketing to Women, Faith Popcorn singled out Lilly’s AMF grant as an enlightened approach in marketing to women. She predicts such a program will improve the grant maker’s corporate image.

Observing that women have long been far more profitable than men to the pharmaceutical industry, Edie Weiner, president of the trend analysis/management consulting company Weiner, Edrich, Brown, claims that reaching out to women “is good not only for a pharma company’s profits but for its overall branding and public relations. Doctors often believe women’s physical symptoms are based on emotional turmoil. For the first time, the healthcare profession is addressing the true physical changes of menopause. That is likely to open paths for better understanding, research, and development of appropriate new products—for women and for men facing chemical changes due to hormonal shifts over a lifetime.

“It’s likely that hormones will be to the 21st century what vitamins were to the 20th,” says Barbara Goldberg, a media consultant at MagnetCommunications. “Product opportunities are opening for pharma companies. Willingness to address real concerns of women as they go through their life cycle will win them far more positive press than years of neglect, oversight and misprescription did.”

For that kind of public education program, she says, “image is the main value with several audiences: corporations, their employees—who are consumers and patients—and support groups—in this case, AMF. It’s a good investment for the grant maker, because the seminars are conducted and advertised in large corporations, spreading the benefit beyond the 20–100 women who attend. The subject may be covered in company newsletters. Even ‘watercooler’ discussions between those who attended and those who didn’t will spread the word.”

Farrell Fitch, a vice-president at Sciens/Nelson Public Relations, values unrestricted educational grants that present important information on disorders that are seldom explored. “The point of the program,” says Fitch, “isn’t to get someone to ask for a specific drug but to seek help, to understand the options. Smaller groups work well, because they provide a more personal experience than articles or TV news.”

“Although the seminars are noncommercial, women who attend take away facts—like a product name—to share with other women or a doctor,” maintains Joan Mansbach, vice- president of creative marketing at the B2Women division of CMA Consulting. “Giving information in a seminar builds brand trust. Women see the name on the material Lilly provides. In a society hungry for information, providing knowledge to women creates a positive experience, even if it’s indirect. Brochures and seminars make an impression. Eventually, that will come back to Lilly.”

Michael Rinaldo, group director of Fleishman Hillard’s New York Health Care Division, comments,“In public relations, we believe confusion brings opportunity. A complicated marketplace with a lot of conflicting messages leaves an opportunity to step into the fray and bring some definition. By bringing clarity, a company can take the leadership role.”

The Impact A simple one-page survey gives both AMF and Lilly valuable insights into the program’s impact. One of its ten questions is, “Did today’s program provide you with new information?” Almost 99 percent of respondents say “yes.” Between 85 and 90 percent expect to see their healthcare provider as a result of the program and almost 100 percent intend to discuss something they learned with their doctor.

What could the program mean to Lilly’s bottom line? “Women are communicators who love to share, so the seminars could have a small impact on sales,” predicts Mansbach. “I’m a great proponent of getting a name out there, even if the visibility is small. A message will be conveyed.”

Rinaldo, too, foresees a positive effect on Evista sales. “It’s a leap of faith,” he admits. “You have to trust the value of talking to people in that kind of setting. I don’t think companies would put money into such programs unless they believed they would have an impact on their business.”

Fitch concurs: “I think Lilly in particular is committed to the notion that people go to a healthcare provider for treatment. The job of an education program is to say, ‘This is the health condition, treatments do exist, go to a provider if you want to.’ Sure, they have a reason for doing it, but it’s a very worthwhile program—a great corporate investment in public health.”