How do you sell a product for a common medical condition few want to admit they have? Get your customers talking among themselves. Helping one in three women resume a normal lifestyle is EastMed’s goal. A $52-billion annual U.S. market is an added incentive

Don’t ask Dr. Scott Farrell what he was thinking when he came up with his big idea—he doesn’t remember. He was walking along a highway in Oregon in 2001, getting some fresh air after meeting with a company that makes medical products, when it popped into his head. It was an unconscious experience he can’t explain. Though he is always coming up with ideas, Farrell felt especially good about this one. On the plane back later that day, he drew a sketch.

Farrell’s wife, Karen, recalls he didn’t say much after getting back from that trip. He sat down at the kitchen table and started making a model out of their daughters’ orange Play-Doh. Karen dismissed it as just another one of his ideas; she certainly didn’t think it was an innovation that might solve a problem the World Health Organization (WHO) refers to as one of the last medical taboos.

Bladder leakage affects one in three women worldwide, primarily over the age of 30. The condition, known in the medical world as stress urinary incontinence (SUI), results from stress to the bladder caused by laughing, coughing, or any kind of exercise. Many women suffer in silence, embarrassed to tell anyone. For some, it leads to depression.

For the past 18 years, Farrell has been head of the urogynaecology department at the IWK Health Centre in Halifax. He has been treating patients and hearing their stories—from the woman who couldn’t play bagpipes anymore to the one who couldn’t lift her grandchildren. He also hears their frustrations with the current array of treatment options: pads, which are bulky and uncomfortable; a bladder-support device, which needs to be inserted and removed by a physician; and surgery, which is drastic and can’t be reversed.

It was while he was walking down that road in Oregon that he realized how to fill the gap in the marketplace: with an over-the-counter bladder support that women could administer themselves. So he designed one. The operation started at the Farrells’ kitchen table. Since Farrell comes from a medical background, he asked a friend, retired businessman Dave Alward, to help plan the finances. Karen, who was doing a master’s degree in health education at the time, would sit in and take notes.

In 2002 the three of them founded EastMed and created a model of the product, prototyped by Quebec–based VIF Moulds and Plastics Ltd. The next step was conducting a focus group with Halifax–based Novus Consulting to find out if there was a market. The overwhelming response: Yes, women wanted an easy solution to SUI they could manage themselves. And yes, they would pay for it.

The company needed to start thinking about a logo and packaging. EastMed hired marketing consultant Katherine Cosgrove to draft a business and marketing plan and Adam McKenzie from Dartmouth–based Form Media to create the design. They wanted something that looked clean and simple rather than sterile and medical. After numerous branding sessions, McKenzie came up with a white box adorned with pink tulips sprouting up from the bottom and the name: Uresta Continence Care Kit. Inside are three different-sized devices, and a small white carrying case.

In 2006 EastMed received $1.5 million from InNOVAcorp and BDC Venture Capital. The next company hire was Charlene Fekeshazy, as the full-time marketing director. Fekeshazy didn’t come from a medical background; she had worked in marketing for telecommunications companies and law firms, among other clients, and was nervous at first about speaking to the medical community. After taking the job, she learned that her mother suffered from the condition and saw the market need for Uresta. “I realized the issue is really taboo,” she says. “Because we don’t talk about it, women don’t know the problem is quite common and that they’re not alone. It’s the job of good marketers to figure out how to get that dialogue going.”

Fekeshazy’s challenge: to market a product for a condition women don’t want to discuss. Due to the sensitivity of the subject, a grassroots approach was essential. EastMed set up booths at women’s trade shows and marathons throughout the Maritimes, handing out Uresta water bottles and lipstick cases. “It was the swag that pulled them in,” says Fekeshazy. “Once they came over, we’d give them a brochure and try to start talking about the condition.”

EastMed hired Time + Space Media, a Halifax–based strategic media company that helped choose advertising methods based on the target audience—women aged 30 to 60 and health care professionals. A TV ad was developed with Halifax–based Egg Films that discreetly showed women’s limitations during certain activities. “We wanted to be subtle and not scream incontinence,” says Fekeshazy. “Our fear was that women would get embarrassed sitting beside their husband thinking, ‘that product’s for me.’ ”

Data from Statistics Canada shows that women are more likely than men to use the Internet to research health issues, because of its discreetness. So the company hired Halifax–based Modern Media to design a website, and Fekeshazy worked on concise explanations of SUI, videos of how the product works, and video testimonials from women who use it. In 2007 EastMed developed magazine ads with Halifax–based Sperry Design and online ads with Modern Media aimed at directing women to the website. The company also targets women at gyms such as Nubody’s and Curves, putting ads in bathrooms and dropping off brochures.  

 “We didn’t put all our eggs in one basket,” says Karen Farrell, EastMed’s vice-president of health education. “If women don’t read about us in a magazine ad, they’ll hear from a girlfriend or see a brochure in a gym.” Fekeshazy says this kind of viral marketing was essential because their research showed that people need to see something three to four times before taking action.

EastMed also marketed Uresta to doctors. Incontinence is often overlooked, says Fekeshazy, because women don’t tell their doctors about their problem and doctors don’t think to ask. The company set up booths at medical trade shows to explain the product to health professionals and visited medical offices to hold information sessions such as lunch-and-learns.

Though women tend to do their research online, studies also show they like to buy in person. Since Uresta is an over-the-counter product, EastMed focused attention on educating pharmacists. They hired an educational sales consultant to visit stores to talk about the product, sent mystery shoppers to test pharmacists’ knowledge, and provided information kits with six easy questions pharmacists could ask women to help identify whether they had SUI.

Since the product launch at Halifax’s Spirit Spa in October of 2007, EastMed has focused all of its marketing efforts in Atlantic Canada, enabling it to test strategies on a small scale before going national. So far the results are encouraging. The company won an international 2008 Medical Design Excellence Award (MDEA), and Fekeshazy says that three-quarters of the women who tried the product at a clinical trial in 2005 are continuing to use it.

Uresta is currently sold in 187 pharmacies in Atlantic Canada—more than one-quarter of all pharmacies in the region. It’s also available on the web, where 80% of sales come from Western Canada. EastMed hopes to launch the product in pharmacies across Canada in January of 2009. In October, Uresta was approved by the FDA in the U.S., opening a market in which incontinence products account for weekly sales of $1 billion. The company will also sell in Europe once it finds a distributor.

When Scott Farrell walked down that road in Oregon, he knew he had a good idea but wasn’t sure it would work. The thought of starting a business was daunting, but he was motivated by the chance to offer a positive solution to a serious problem. Karen Farrell compares growing the business to raising a child—you never know how much work it will be until you have one. “We weren’t thinking dollars and cents,” she says of the early days. “We wanted a good way for women to feel better.”

In that, they’ve succeeded. The day after Uresta’s launch, a woman phoned EastMed to say thank you, and to tell them that she had lived with SUI for 25 years and had finally found something that worked.