40 Years and I Still Love My Job: An Interview with Pharma Advertising Guru Jay Carter

Jay?Carter?has spent 40 years in the medical advertising industry, and lives by his LinkedIn headline: “40 years and I still love my job.” In his tenure in medical advertising, he has launched more than 50 brands, 14 of which surpassed $1 billion in sales. Trained as a pharmacist, his vocational North Star is to always focus upon the patient’s outcomes.

Jay’s been honored many times, but three are most significant to him. In 2018, he was named Distinguished Alumnus and Lifetime Achievement Award winner by the University of Michigan College of Pharmacy. He was awarded MM+M Magazine’s Pinnacle Award in 2022, and also received a MANNY Award for Industry Person of the Year by?Med Ad News?in 2022.

Noah: Thanks for sitting down to chat with me today! For those who don’t know you, perhaps you can start by walking through your background and your journey to getting into the world of pharmaceutical marketing and advertising.

Jay: I spent four years interning in a retail pharmacy, fully aware that it wasn’t the path I wanted for my career. I had been contemplating graduate school when, in January 1981, I began my first clinical rotation on an oncology floor at St. Joe’s Medical Center (now Trinity Hospital) in Ypsilanti, Michigan. One of my earliest memories was when my first patient, who had just received chemotherapy, vomited on my brand-new shoes. Back then, chemotherapy was especially harsh, and we had very few options for managing nausea and no drugs for white blood cell support.

The patient had oat cell carcinoma, a challenging condition to treat even today. He reminded me of my high school football coach, and despite not knowing at the time that it’s unwise to form personal attachments with oncology patients, I couldn’t help but care deeply for him. While he went into remission, the aggressive chemotherapy compromised his immune system, leading to a fatal fungal infection and pneumonia.

A week later, I decided to apply for MBA programs, realizing that I didn’t want to work in a role where losing patients was a regular part of the job. During my time at Notre Dame, I worked with a colleague on my finance team who had previously written freelance articles for the Los Angeles Times. He wrote a piece about medical advertising agencies, which inspired me to send out seven resumes to those companies. To my surprise, I received responses from six of them. One contact suggested that I consider sales, which led me to take a position in Kalamazoo, Michigan after graduation.

After a year in sales, that same contact reached out with an opportunity. He told me, “I know someone looking for a pharmacist with an MBA and sales experience. Are you interested?” I flew out for an interview, was offered the job on the spot, and began my new role as an account executive at McAdams in June 1984.

As someone who grew up in a small town of 1,200 people, working in Manhattan and living in Montclair, New Jersey was exhilarating. One of my first major projects was launching an oral contraceptive, and my clients became my friends. In fact, that brand team remains close to me to this day. I discovered that I had a knack for advertising—a career where my non-conformist “round peg” personality fit well. I spent three and a half years in New York before moving closer to home in Chicago.

In 1988, I joined AbelsonTaylor, which at the time had only 21 employees. I was employee number 22. Over the next 35 years, I contributed to the company’s growth, and by the time I retired, we had expanded to 292 employees. It was an incredibly fulfilling journey.

Retirement didn’t suit me. After just five months, I found myself feeling depressed. Two weeks before, I had turned down a business development position at CG Life, but I couldn’t shake the idea. A week later, I made the call and accepted the job. Today, I’m proud to be working at CG Life, where the next chapter of my career continues.

Noah: In your LinkedIn headline, you talk about how you’ve loved your job for 40-some years. What do you love so much about advertising specific to the pharmaceutical industry?

Jay: I'd like to start my answer to that question by defining a clear professional philosophy. My background as a pharmacist has shaped my perspective. Pharmacists are trained to evaluate therapies based on cost-effectiveness and patient outcomes. Throughout my career, I’ve adhered to a guiding principle, my North Star: “Is this good for patients?” Following this principle has given me peace of mind and allowed me to approach my work with integrity.

As an advertiser, your role is to advocate for the brand while upholding your ethical responsibility. You must act as an officer of truth. Honesty is non-negotiable. Misrepresentation is not only unethical but detrimental to society. The goal is to create the strongest possible argument, presenting all relevant details and ensuring transparency, without unnecessarily highlighting areas of weakness. Ultimately, you trust the court of public opinion to draw its conclusions.

My work in oral contraceptives demonstrated this balance. Though the products were intentionally labeled similarly, there were still meaningful ways to differentiate them. That challenge made the work engaging and rewarding.

A pivotal moment in my career was in 1995 when AbelsonTaylor was brought on by Amgen to reposition Neupogen, which was then primarily seen as a means to keep patients out of the hospital. In conversations with frequent prescribers, we learned they used Neupogen because it enabled them to deliver more intensive chemotherapy to early-stage breast cancer patients, which improved outcomes. At the time, 40,000 women were diagnosed with early-stage breast cancer each year, but only 14% received Neupogen. Within five years, we transitioned to promoting Neulasta, an improved formulation that required just one injection instead of ten. This effort significantly increased the usage—56% of women with early-stage breast cancer received Neulasta.

Today, that figure has risen to about 86%, and treatments for early-stage breast cancer have evolved substantially with the introduction of therapies like CDK4/6 inhibitors. Still, few professional experiences match the sense of pride that comes from contributing to work that genuinely changes lives. I feel inspired by those working on cutting-edge medicines like Enhertu, which is currently transforming the landscape of breast cancer treatment. The impact of such advancements drives my passion, and I hope to be part of developing another life-changing therapy before I really retire.

Noah: What key lessons have you learned from your long-term agency experience and pharmaceutical product launches about effectively reaching and engaging with doctors and healthcare professionals to create meaningful connections?

Jay: Number 1 is always the customer insight. The most important factor is truly understanding what motivates people. From there, it’s all about creating engagement. Elements like design, layout, and headlines still play a significant role. People continue to invest in brands that capture attention and foster engagement.

Metrics like ATU - awareness, trial, and usage - and engagement are crucial because they are strong indicators of future market share, which is where the focus should be. I firmly believe in testing everything. Without listening to customers, you can’t understand their perspectives. While there are many talented individuals who excel in creative work far more than I do, I have had the privilege of contributing to some major campaigns over the years. Through those experiences, I've picked up valuable insights and would say that I’ve developed a solid understanding of what works and what does not.

Noah: Of all the campaigns you've contributed to, which ones stand out as your most rewarding or those you are most proud of, and why?

Jay: The campaign I’m most proud of is Neupogen. In 1996, we launched a groundbreaking marketing campaign that utilized a database and sent out 5 1/4-inch floppy disks for physicians to track data on their next five patients with early-stage breast cancer. The goal was to monitor if these patients received Neupogen, whether it was dosed correctly, and whether the planned chemotherapy dose was delivered on time. We called this initiative “Project ChemoInsight.” The results were significant: the data collected was used to present a paper at ASCO that year, showing that about 82% of patients received their planned doses on time, highlighting that 18% had delays, which reduced their chances of survival.

This stark finding captured attention and emphasized the importance of timely treatment. Alongside this, we ran the “Give Your Chemotherapy a Fighting Chance” campaign, which resonated strongly with our audience. At the end of the day, ensuring better patient outcomes is what truly matters.

Another campaign that stands out for me is the work we did for Aranesp. At the time, Procrit dominated the market and was synonymous with the color red—representing blood. Our challenge was to create something distinct. Every physician recognized the image of a hemoglobin molecule, so we placed it on a vibrant yellow background, symbolizing energy and the improved feeling that comes with increased blood levels. During market research, I remember sitting behind the glass when a doctor exclaimed, “If I were the head of Amgen, I would fire that agency right now.” I kept that tape for nearly a decade because it demonstrated how deeply our work could evoke emotion. As long as it isn’t harmful, I don’t mind if some people have strong opinions against our work. What truly matters is the impact: both of these campaigns made a meaningful difference in the lives of cancer patients, and that is why I am passionate about what I do.

Noah: What are your current perspectives on achieving meaningful breakthrough and authenticity in direct-to-consumer (DTC) marketing. We hear that a lot of these campaigns – whether for general medicines, specialty, or rare diseases – kind of run together.

Jay: I don’t believe that all DTC (direct-to-consumer) campaigns look the same, but they do often sound similar. This is largely because most broadcast DTC spots allocate about 40 seconds of a 60-second ad to regulatory fair balance requirements. It’s important to note that while broadcast remains a part of the strategy, its significance is waning as digital platforms take the lead. Online engagement is undoubtedly the future.

To address your question, these ads sound alike due to the extensive fair balance, which they are designed to include. However, there are strategies to stand out. A great example comes from the “ED wars” between Viagra and Cialis. One memorable Viagra ad featured a man washing a classic ’58 Corvette while the fair balance played. This creative approach captured attention and diverted focus away from the regulatory language. Some might say that this was contrary to FDA regulations… I’m inclined to believe otherwise.

That said, my objective isn’t necessarily to downplay fair balance; it’s to maximize the impact of the 20 seconds where you truly have the audience’s attention. There are effective ways to make those moments count, but it all comes back to insight—understanding what the patient needs to hear to take the next step. The goal isn’t to have them request the drug immediately, but to encourage them to move forward in their decision-making process.

Research shows that a critical measure of success in DTC campaigns is driving traffic to the brand’s website. This is why engagement metrics, such as website visits, are so significant—they represent the first step into the conversion funnel.

Noah: I'm just curious about how you look at omnichannel – what it means to you and how you talk with your clients about it.

Jay: The term “omnichannel” does not have a universally accepted definition. In my view, an interaction qualifies as omnichannel when the next point of engagement within an ecosystem is determined by automated processes, rather than being manually directed by a human. While human input guides decisions—such as clicking a button to trigger a response—omnichannel engagement automates these subsequent actions.

Another crucial aspect to consider when discussing omnichannel is the integration of AI. Artificial intelligence is a significant focus within omnichannel strategies. As someone who has been around a while with a naturally conservative approach, I appreciate that I work in an industry where caution is essential due to the potential impact on people’s health and safety. Mistakes can lead to severe consequences, including adverse reactions.

The synergy between AI and omnichannel is most effective when there are numerous potential outcomes. In practice, this means creating a variety of derivative content that varies slightly, and then matching each piece to the appropriate response. While I believe humans should oversee decisions on the next steps in engagement, AI excels at generating varied content efficiently.

The challenge that follows is approving this content for use. Regulatory review by medical and legal teams is essential to ensure content meets standards, as only approved content should be presented to customers. Efforts are underway to develop streamlined, responsible processes for reviewing AI-generated content.

When considering omnichannel, the main points I discuss include: (1) What does omnichannel mean? (2) What are your objectives? And (3) How crucial is the role of the sales representative? A key point to remember is that if omnichannel involves automated decision-making, the patient’s perspective must be prioritized. The rapid growth of our industry since 2020 highlights the increased opportunities for engaging patients more effectively and efficiently than ever before.

Tim: Do you have any views on AI or other emerging technologies when it comes to targeting HCPs and patients effectively, not necessarily the content creation, but who we get it to?

Jay: One of the main goals of omnichannel marketing is to create an ecosystem that effectively engages all potential participants. However, segmentation research often shows that about one-third to one-half of healthcare professionals may not be interested or may not treat the specific types of patients being targeted. The key challenge is understanding these HCPs’ unique characteristics and their patient populations to ensure the right HCPs see themselves as relevant stakeholders.

For example, in the case of Hemophilia B, which affects roughly 4,000 patients in the U.S., many patients may not know whether they have hemophilia B or A. The solution involved including all Hemophilia patients, identifying their treatment regimens, and guiding them accordingly. This approach did not require complex AI—it was simply a matter of asking the right questions and using the answers to determine the type of hemophilia, which effectively directed engagement.

Although AI and machine learning are frequently discussed in this context, not all technologies marketed as “AI” are new. Many of these tools have been around for over 15 years. This is not to discredit the valuable work done by those in the field, but to provide clarity.

In my view, the use of AI in this area has not yet reached perfection. I am cautious about relying on “black box” solutions and hesitant to invest in tools without a clear understanding of how they work.?

Noah: What KPIs should be considered when evaluating the effectiveness of omnichannel strategies? When you mention that it's difficult to pinpoint those who are excelling in omnichannel execution today, what specific metrics or benchmarks are you using to assess this?

Jay: Awareness, Trial, and Utilization (ATU) metrics are essential, proven benchmarks that often act as strong predictors of sales—the ultimate KPI. However, the specific KPIs you track should align with your strategic goals. One KPI I consider particularly vital is the performance of high-value assets. When we invest in creating customer-focused assets aimed at driving business, it’s critical to measure how effectively these assets deliver results.

The definition of a high-value asset can vary based on the context. For instance, I once spearheaded an impactful Hemophilia program where we developed a range of high-value assets. These assets turned out to be powerful indicators of patient conversion, shifting patients from competing treatments to ours. Although true confirmation comes with time, strategic allocation of resources requires making informed decisions—it’s not just luck, it’s a series of calculated bets.

This approach may sound straightforward, and that’s the point. I believe in keeping things simple, focusing on data that matters, and making smart investments that pay off in measurable, impactful ways.

Noah: What are some of the key challenges businesses face today in crafting a seamless customer journey across multiple channels? You’ve touched on what omnichannel is or could be, as well as how it’s measured—but what obstacles do you see when it comes to effective implementation?

Jay: First and foremost, achieving a “seamless” experience is costly. For instance, consider a rare disease with only a few thousand patients. The first step is to identify these patients, which requires a comprehensive understanding of their journey—where they go, the points at which they interact, and the critical moments where meaningful interventions can be made. Once this is mapped out, it’s essential to determine where they typically spend their time online. In today’s world, everyone is online. We’re having this conversation over hundreds of miles, and even before getting out of bed, many people check the news, weather, and emails on their phones. Everyone has their preferred online spaces, so it’s crucial to identify these and integrate them into your strategy.

Although “omnichannel” implies being present “everywhere,” there are tools available to facilitate broad reach. However, these tools are still quite expensive. While databases have been developed to help locate patients, these also come at a significant cost. Recently, I heard that mapping a disease thoroughly could cost between $8-10 million, which many organizations are hesitant to spend.

For the past decade, I’ve focused on smaller, non-big pharma companies and startups aiming to make their mark. This is an admirable endeavor, but many are still investing in multi-channel strategies with the intent of transitioning to omnichannel. I collaborate with experts who excel at cost-effective mapping, but the primary barrier remains funding—and understandably so.

I am aware of one group currently developing its own promotional ecosystem to create a smaller-scale omnichannel solution that is easier to adopt. This is both smart and innovative, and I anticipate that others will follow suit, fostering competition. However, building these ecosystems is inherently expensive and will continue to be so, as their value is well recognized.

Noah: What's your point of view on this new trend of pharma companies developing their own telehealth platforms? Do you have a perspective?

Jay: It makes sense, I understand the perspective, but I have concerns about ensuring reliable clinician interaction when prescribing known products. This trend appears to be a reaction to compounding pharmacies developing their own telehealth services. As someone frequently exposed to marketing for erectile dysfunction treatments—often managed by PAs rather than MDs—I question the regulatory oversight. Many of these services may not have FDA approval; for instance, some combine Viagra, Cialis, and apomorphine, the latter never having received FDA approval for erectile dysfunction. This raises ethical concerns about patient safety and the true intentions behind such practices. While these companies are often backed by strong legal teams, I’m not convinced that patient outcomes are always their primary focus.

There are certainly compounding pharmacies that prioritize patient well-being. For example, some prepare Brompton cocktails to provide cancer patients with effective pain relief during their final days, adhering strictly to legal and ethical standards despite the significant risks involved. Managing controlled substances such as cocaine and morphine requires meticulous compliance, and those who handle it responsibly deserve recognition for their service and dedication.

However, in the current context of shortages for medications like Ozempic, Mounjaro, and Zepbound, compounders have stepped in with legal solutions to meet patient demand. While this helps those who can afford it, it doesn’t eliminate concerns around safety and patient welfare. Ensuring ethical practices and prioritizing patient safety must remain at the forefront of any such efforts

Noah: A recent study highlighted the growing focus of pharma and healthcare companies on considering the “whole patient” approach. What are your thoughts on this trend and its potential impact on patient care and outcomes?

Jay: In the end, it’s essential to remember that patients are people, and understanding insights allows us to connect with them effectively. If leveraging insights is a reminder that some need, then that’s beneficial—although for me, it has always been second nature. I have consistently honed my skills with this understanding at the forefront. We have made great strides in truly grasping patient needs, which is commendable and something we should actively leverage.

I mentor pharmacy students and recently spoke with an exceptional young woman in her third year of pharmacy school and concurrently pursuing her PhD. Her ambition is to consult with pharmaceutical companies to help them more efficiently and effectively achieve diversity in patient engagement. I found her perspective inspiring—she truly understands the importance of this mission. I encouraged her to recognize the value of her expertise and to ensure that her contributions are rewarded accordingly. Such dedication to advancing patient-centric solutions is remarkable and should be supported.

The industry is making sincere efforts in this area. Speed to approval remains a key priority as it directly impacts ROI, which is crucial for maintaining financial health and fulfilling fiduciary duties to shareholders. Her challenge will be finding ways to accelerate these processes in ways that benefit patients while also meeting business objectives. While it’s easy to criticize delays in the approval timeline, even a single month’s delay can have significant financial implications. That said, I believe the pharmaceutical industry is making progress and learning to improve. The presence of vocal advocates pushing for change is beneficial, and I fully support their efforts.

N: So what else is on your mind these days, as you're still loving your job after 40 years?

Jay: There's a part of me that's still really embarrassed that I didn't plot out how to do retirement well the first time. So, a significant part of my focus now is on what’s next. I made a commitment to my boss, David Ormesher at CG Life, to dedicate a couple of years to the role. However, I was upfront that there would be an endpoint, and by then, I need to have a plan in place to ensure I don’t find myself feeling unfulfilled again.

I spend a good amount of time reflecting on this. On pleasant days, I dedicate at least an hour to sitting in my living room, settled in an armchair with my dog on my lap, appreciating the view around me. This time allows me to reconnect and enjoy moments with my wife. Yet, I’m fortunate to have a job that also takes me out on the road, giving me the opportunity to meet with colleagues and friends. This Thursday, for example, I’ll be in Boston with a packed day that includes breakfast, lunch, and I’m arranging a dinner to catch up with friends. These interactions keep me energized and remind me why, after four decades, I still find so much joy in my work.

Noah: Do you think you could retire? Because you've spent the last 50 minutes telling me about how much you love this mission of yours, and you have a mission, you have a powerful North Star, and it doesn't sound like you've necessarily got another mission on the horizon.

Jay: I’m actively planning for the future. While the advertising industry has been incredibly rewarding for me, it’s also demanding and competitive, which can take its toll over time. I’ve managed to negotiate a role that minimizes these challenges, but it doesn’t completely eliminate them. There will come a time when I no longer want to travel frequently, and when that time comes, I want to step away on my own terms.

I’m committed to planning this transition carefully, as my last experience was rushed—I was exhausted and knew I could afford to stop working, so I did. That approach didn’t work out as well as I’d hoped. This time, I’ll approach it more thoughtfully. To my colleagues at CG Life, this isn’t happening tomorrow—I’m looking at a horizon of a couple of years. However, at 66, I know it won’t be forever. For now, I’m enjoying my work and plan to keep doing so. If it stops being fulfilling, I’ll take a hard look at what’s next to ensure it’s something I find enjoyable.

One promising opportunity is already on my radar, and I’m in the early stages of exploring it. I’d also like to consider roles where I can mentor and teach young professionals. These are some of the paths I’m contemplating as I plan the next chapter of my career.

Noah: It sounds like you're keen to find and work on another brand like Neupogen or Aranesp, that you can talk about 20 or 30 years later and say, “we did really good”.

Jay: I’d love to have the chance to work with one of those groundbreaking drugs. While there’s no guarantee that will happen, it’s definitely an exciting prospect, and we’ll strive to position ourselves as a strong partner for them.

What’s equally fulfilling in my current role is having the opportunity to work directly on a brand again—something I stepped away from 12 years ago at AbelsonTaylor. I know my strength lies in bringing new business and guiding a brand’s journey, and now I have the chance to leverage that experience. It’s rewarding to merge my values with this work and continue contributing meaningfully to the field.