On September 11, 2001, 19 terrorists associated with Osama bin Laden’s al-Qaeda group hijacked four planes and carried out suicide attacks. Two planes crashed into the World Trade Center towers, one into the Pentagon in Washington, D.C., and the fourth plane crashed in rural Pennsylvania due to heroic behavior of passengers and crew. The terrorists’ intended fourth target was the US Capitol. These terrorist acts killed more than 2,900 people and injured more than 6,000 people (History Channel, 2018; Hodge, 2002).

These coordinated terrorist attacks had a dramatic social-psychological impact on the US people that forever will be etched in memory and known simply as 9/11. It created an atmosphere of apprehension and uncertainty, and was one of the greatest crises in US history (Burke, 2005; The economic consequences of the new global terrorism, 2002).

About three weeks later on October 4, 2001, Florida health officials announced that Robert Stevens, a photo editor for American Media, Inc. had received a diagnosis of pulmonary anthrax. This extremely rare disease has a high mortality rate (Meyerhoff et al., 2004). This was the first such case in the USA in almost 25 years, and initially was attributed to natural sources. He died two days later on October 6, 2001, and almost immediately, the anthrax story became front-page news (Holmes, 2001).

Shortly thereafter, two Washington, D.C., postal workers died from inhalation-type anthrax. Other cases began to appear in New York, Connecticut, New Jersey, and Washington, D.C. Anthrax-tainted letters arrived at various government and media locations (such as the offices of Senators Tom Daschle and Patrick Leahy, and NBC anchor Tom Brokaw), causing great concern among postal employees, government officials, and media professionals.

Within two weeks, government officials realized these were multiple bioterrorism attacks. All Federal mail delivery in Washington, D.C., stopped, and mailrooms, congressional office buildings, and US Postal Service (USPS) closed and decontaminated its facilities for a period of several months at a cost of tens of millions of dollars. By the end of November 2001, anthrax-tainted letters stopped arriving at various locations, and the first bioterrorism attack on US soil in the twenty-first century seemed to have run its course (Center for Counterproliferation Research, National Defense University, 2002).

Bioterrorism attacks were rare in the USA, and government readiness or lack thereof was based on rare historical accounts and modern risk assessments. In 1972, there was an effort to contaminate the water supply of several Midwestern cities. In 1984, salad bars in Oregon were contaminated with a form of salmonella, which resulted in 700 cases of food poisoning. The USA lacked experience in dealing with a large-scale psychological or physical bioterrorism (Hodge, 2002).

The effect of the first major bioterrorism attack on the USA in the twenty-first century was amplified by the September 11 attacks that occurred a few weeks earlier. The size, impact, and perspective of the two historical terrorist attacks on people in the USA were enormous in respect to monetary cost and psychological effect. Bioterrorism incidents pose more of a psychological threat than physical. While they are not very good at destruction, they do create public panic and loss of confidence in government (Moscrop, 2001).

In addition to the bioterrorism psychological effect, it was all learn-as-you-go for government, law, and health officials responding to the tragic events. Pulmonary anthrax was rare in the USA. This meant emergency room physicians lacked experience in diagnosing it accurately and in treating it properly, while government officials lacked experience in responding to such scenarios. Also, first responders initially lacked adequate resources and capabilities to handle such attacks. Health and Human Services (HHS) and Center for Disease Control (CDC) officials had difficulties providing information on how to identify and treat anthrax infected individuals (Wechsler, 2001).

The early cases were treated as isolated cases stemming from natural causes. Some were misdiagnosed. Initially, health officials failed to link the anthrax incidents, and it took about two weeks for a different picture to emerge. Investigators realized early on that someone was deliberately spreading anthrax spores. Given the proximity to the September 11 attacks, the early national consensus was that the anthrax attacks might be from a foreign source.

Laboratories across the nation were inundated with test requests, and the CDC reported more than 125,000 tests within weeks of the initial discovery. Initial responses were at times inconsistent or inaccurate with the information coming from multiple federal, state, and local sources. The initial lack of information from the US government, the great deal of speculation by the media, and the psychological effect of bioterrorism attacks and the unknown perpetrator all exacerbated public confusion and panic.

The learn-as-you-go was fast, and government officials communicated with employees and the public with transparency and timely messages. This helped alleviate public concerns and reduce anxiety and fear among the public, while state and federal agencies gained experience with the response to such a massive incident. Investigators determine that the letters also posed a grave threat to postal employees and to anyone who came into contact with them. Office buildings, mail-processing centers, and other locations were closed and evacuated so the process of evaluation and decontamination could begin. At the time, the only antimicrobial drug approved by the US FDA for use in treating an infection due to a biological agent used intentionally, was the drug ciprofloxacin hydrochloride. Bayer AG of Germany marketed it under the brand name Cipro. The FDA approved it in 1987, and in 2000, it approved that particular medicine that specified effectiveness in treating inhaled anthrax (Enserink, 2001; Meyerhoff et al., 2004; Wechsler, 2001).

With the increased media coverage of the situation, Cipro gained national and international prominence. The CDC rapidly deployed antibiotics to affected areas, and at the peak of the outbreak, more than 30,000 people were taking antibiotics. Anthrax is treatable if antibiotics are administered promptly and continued for 60 days with a treatment regimen of two pills a day. On October 10, 2001, the CDC requested Bayer AG to increase production of Cipro, while a “run on Cipro” was occurring by an uneasy and concerned public. By November 8, 2001, the CDC reported that about 32,000 people were prescribed antibiotics as a precaution, but only about 5,000 people actually needed it.

Founded in 1863 by Friedrich Bayer and Johann Friedrich Weskott in Barmen, Germany, Bayer AG started as a manufacturer of synthetic dyestuffs. Its target market was the rapidly growing textile industry. After both founders died, around 1880, Bayer AG experienced an economic downturn because competitors were able to circumnavigate patents. Top management decided to diversify from the dyestuff industry and expand into chemicals and pharmaceuticals.

In 1897, Bayer invented what today people know as Aspirin and changed forever the market of fever and infection drugs. Launched into market in 1899, Bayer’s timing could not have been more opportune. Around 1900, several serious influenza epidemics in Europe made Bayer a household name in Europe and North America. Following media frenzy and positive reviews as the “drug of the century,” Bayer Aspirin gained tremendous brand equity and market share with the free and positive media publicity, and at minimal costs (Bayer, 2018; Jenneweim, Durand, & Gerybadze, 2010). A single brand can attain market value of more than the company’s book value (Jenneweim et al., 2010); thus, the company “built on aspirin” continued to grow and became a global chemical and pharmaceutical powerhouse.

The company’s fortunes changed dramatically when, in the summer of 2001, Bayer was forced to withdraw its cholesterol-lowering drugs, Baycol, in the USA, and Lipobay, in the UK, after 31 patients died. By September 2001, share price of Bayer AG sank by 40%, and Bayer AG executives were contemplating selling the pharmaceutical division (Charatan, 2001; Jenneweim et al., 2010). A month later, the anthrax attacks changed the USA forever and in the process gave Bayer AG a lifeline.

Today, Bayer AG is a global “life science company” with core competencies in the areas of health care and agriculture, employing more than 99,000 people worldwide. The Bayer brand was recently valued at 6.3 billion Euros (Bayer, 2018).

Relations between the US government and Bayer AG started a decade before the anthrax attacks. During the Gulf war in 1991, the US Army needed Cipro for its soldiers, since it was the only FDA approved drug for inhalation anthrax. Bayer ultimately donated 10 million tablets (Holmes, 2001). It also worked with the US government on research, studies, and emergency scenarios, while it increased production of Cipro as a precaution. As the bioterrorism attacks unfolded in 2001, Bayer was slow to respond publicly, since executives did not want to give the impression that Bayer was trying to leverage a crisis. On October 15, 2001, 11 days after the first occurrence, Cipro gained national prominence when NBC anchor Tom Brokaw held to the camera a bottle of Cipro during his national nightly news segment and announced, “In Cipro we trust” (Herper, 2001). Bayer put its factory in Connecticut on a 24-hour-a-day, seven-days-a-week production schedule of Cipro. Timing could not have been better for Bayer, and Bayer’s shares rose by almost 40% in the wake of the anthrax attacks.

With the US public in panic mode, and a major newscaster having visualized in their mind the only FDA approved anti-anthrax treatment, demand as well as anxiety skyrocketed. The same day, the government enquired with Bayer about supplying 100 million tablets (Holmes, 2001). Following the request, Bayer corporate communications organized a highly attended press conference. The single message was that Bayer would produce Cipro on a 24-hour-a day, seven-days-a-week schedule, and it would reopen another dedicated facility just for Cipro. The message was that Bayer always “fulfilled every order to date from the U.S. government with the requested delivery schedule, and we are prepared to work with the government to fulfill future orders” (Holmes, 2001, p. 6).

Bayer went to great lengths to convey that it would not take advantage of the bioterrorist attacks and would keep the same prices that were in place before the October attacks. Reassuring the US public of adequate supply, efficient distribution, and overall safety was key for Bayer. Top management wanted to avoid calls of “in Cipro we trust, but not in Bayer” (Fuhrmans & Winslow, 2001). Despite Bayer’s initial public relations efforts, Senator Charles Schumer of New York (D-NY) and consumer lobby groups called for the government to override the company’s patent so other manufacturers could assure supply of generic versions of Cipro at reasonable prices. Bayer’s Cipro was protected for a period of 20 years by the Trade-Related Aspects of Intellectual Property Rights (TRIPS), but the agreement allows governments to override intellectual property rights during national health emergencies or unfair pricing (Fidler, 2002; Lancet, 2001). The Canadian government, under pressure from the Canadian generic-drug maker Apotex and public anxiety, went further. The government announced that it “will override Bayer’s patent on Cipro and invite generic drug manufacturers to produce close to a million tablets” (Holmes, 2001, p. 9) because it wanted to build a stockpile of drugs adequate to treat 100,000 people (Harmon & Pearoct, 2001; cf., Pesik, Gorman, & Williams, 2002).

The drug industry accused the Canadian government and Apotex of “opportunistic behavior,” since no anthrax case had appeared in Canada (Stewart, Denny, & Clark, 2001). The outcry did not hold back BristolMyers Squibb, Johnson & Johnson, GlaxoSmithKIine, Abbott, and other drug manufactures from offering to supply free medication to the government to treat anthrax, linking it to gaining formal FDA approval of anti-anthrax medicine (Charatan, 2001; Wechsler, 2001). This was a shrewd strategic move because it would allow them to gain entry and market share of a lucrative market, while improving their public image.

In addition, some accused Bayer of having created a monopoly for Cipro by signing an agreement in 1997 to pay Barr Laboratories an estimated $30 million a year to hold off production of generic Cipro, and paying Barr Laboratories and two other generic-drug makers a total of $200 million to abandon efforts to bring generic Cipro to market. The pressure mounted when it was revealed that 78 Indian-based pharmaceutical companies could produce generic Cipro for about 10 cents a tablet, as opposed to Bayer’s $1.77 wholesale price before the September 11th attacks (Charatan, 2001; Herper, 2001; and Mokhiber & Weissman, 2001).

With postal workers getting sick, the public realized that letters targeting politicians and media personalities are not the only ones affecting possible victims, but that anthrax could contaminate anyone who handles the mail. With high anxiety and an uncertain atmosphere, public outcry for overriding the Cipro patent increased greatly, and some suggested Bayer did not respond adequately to the crisis. Following this, the Canadian government bought one million tablets from the Canadian generic manufacturer Apotex. A New York Times article questioned Bayer’s ability and readiness, and an op-ed in the Los Angeles Times called pharmaceutical companies “war profiteers.” Some even called for Bayer to distribute Cipro for free (Holmes, 2001, p. 10; The Cipro circus, 2001).

The risk for pharmaceutical companies in general and Bayer in particular was high. Cipro represented $1.6 billion in worldwide sales a year. Patent overrides would open the door for low-cost generic drug manufacturers. This would lower drug prices and increase competition from companies that have a superior cost structure because they do not have to spend millions of dollars on research and development. The average cost of developing a new drug can be $500 million (The Cipro circus, 2001). Without the protection of intellectual property rights, pharmaceutical companies lack the incentive for innovation, and these moves would undermine research on new drugs.

After about two weeks of no decisive response to the crisis, Bayer’s top German and US management team, working with Kekst & Company, a pre-eminent strategic communications firm, established and implemented a strategy to ensure safety of the US public, while protecting Bayer’s brand image and market position. The objectives were to ensure ample supply of Cipro; work with the US government to build a stockpile of Cipro; assure the US public of its commitment; and reinforce Bayer’s brand image as a caring, responsible, and patriotic company. The strategic communication plan consisted of several elements: establish proactive government relations efforts to facilitate a Cipro contract, communicate directly with the public through advertising, educate the media about Bayer’s commitment, educate healthcare professionals on the appropriate use of Cipro, and develop communication channels for patients and consumers (Holmes, 2002).

Bayer’s strategic approach went into motion within days. Bayer executives engaged in proactive government relations to secure a Cipro contract. Bayer global CEO Helge Wehmeier and the President of Bayer North America Wolfgang Plischke went to Washington, D.C., without an invitation, to meet with government officials and to show commitment, urgency, and efficiency. They met with the Director of Homeland Security Tom Ridge and members of the US Congress to provide reassurance of Bayer’s commitment. They were in constant communication with US Health and Human Services (HHS) Secretary Tommy Thompson and other US government officials, assuring them and the public of Bayer’s resilient commitment and production capabilities. Bayer executives made numerous television appearances, made daily phone calls to editors and reporters, and launched an internal campaign for “Bayer cares,” distributing American pride buttons, US flags, and t-shirts to employees.

Bayer also donated two million tablets of Cipro to US health workers and first responders, and 200,000 tablets to the Canadian government (Fuhrmans & Winslow, 2001; Holmes, 2002). It followed with a media blitz of press releases, interviews by Bayer executives with major newspapers, and stories regarding Bayer’s production efforts. This helped create the image Bayer wanted to convey of supply and safety for the US people. To reassure the US public, it placed full-page ads in major newspapers such as The New York Times, Washington Post, Wall Street Journal, USA Today, Miami Herald, Palm Beach Post, the Financial Times, and some local papers, at a cost of $3 million. The message was that “You can count on us” and that Bayer would supply enough Cipro, and do it in a timely manner and at a reasonable price (Fuhrmans & Winslow, 2001; Holmes, 2002). It also signed an agreement to supply the US government with 200 million Cipro tablets and significantly reduce the price from $1.77 before the anthrax attacks to 95 cents a tablet, which was equivalent to the generic Cipro price before the US anthrax outbreak (Cherney & Carlisle, 2001; Holmes, 2001, 2002).

The aggressive crisis brand management, which Kekst & Company directed, finally started to sway government and public opinion. After striking a deal with the US government, the Canadian government reinstated Bayer’s Cipro patent, bought a million tablets of Bayer’s Cipro and let Bayer warehouse the generic competition (The Cipro circus, 2001). As a result, media coverage was overwhelmingly positive in general, calling “big pharma” products “wondrous shields against the random horrors of terrorism” (Dickinson, 2001, p. 10). Editorials in the Financial Times, Wall Street Journal, Investor’s Business Daily, and The New York Times, among others, praised “Bayer’s patriotism, its ethics, and its commitment to doing the right thing” (Holmes, 2001), while Forbes Magazine stated “the U.S. may be best off sticking to the tried and true” (Herper, 2001).

The US anthrax outbreak of 2001 demonstrated the urgent need for safe and effective drugs to treat individuals exposed to biological agents used intentionally. In total, 43 confirmed anthrax cases were reported in Florida, Washington D.C., New York, and New Jersey; 22 people got sick, five people died, and 10,000 more people were considered at risk of possible exposure to anthrax (CDC, 2018). In the complex and ever-changing environment of the anthrax attacks and panic, Bayer AG had to navigate various marketing environment forces such as competitors, intermediaries, suppliers, regulatory agencies, and the public. By developing an effective marketing strategy, Bayer AG was able to be a good and ethical corporate citizen, placate the regulatory environment, impede entry for competitors, and enable the US government to provide the public with life-saving medicines.

The company that was built on Aspirin came back from the brink of economic disaster in 1900 with the brand known as the “drug of the century”–Bayer Aspirin. Almost 100 years to the day, Bayer AG came back from the brink of economic disaster with the Cipro brand based on timing, the right product, targeted strategies, public relations bonanza, and the strongest tagline in its branding history: “In Cipro we trust.”

• 1    Imagine you work for US government during the anthrax crisis. Develop for your boss, both talking points for why and why not to override the Cipro patent.

• 2    Assume you are the vice President of Marketing at Bayer AG. Produce a memorandum for top management outlining critical issues facing Bayer AG and Bayer Corporation’s marketing environment.

• 3    Produce a detailed recommended action plan to deal with Bayer Corporation and Bayer AG’s marketing environment. Address differences and similarities between two entities.

• 4    Develop talking points for CEO to address media during the crisis.

• 5    What do you think of the tagline “In Cipro we trust” and the impact it had? Please explain and support your opinion.

Gringarten, H. (2018). Leveraging national crisis for a public relations bonanza: Bayer, ethics, and the anthrax scare. In H. Gringarten, & R. Fernández-Calienes (Eds.). Ethical branding and marketing: Cases and lessons (pp. 69–79). Routledge Management and Business Studies Series. London and New York: Routledge.

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3. Center for Counterproliferation Research, National Defense University. (2002). Anthrax in America: A chronology and analysis of the Fall 2001 attacks. Washington, DC: Author. Retrieved from http://wmdcenter.ndu.edu/Portals/97/Documents/Publications/Articles/Anthrax-in-America.pdf

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5. Charatan, F. (2001). Bayer cuts price of ciprofloxacin after Bush threatens to buy generics. BMJ: British Medical Journal, 323(7320), 1023.

6. Cherney, E., & Carlisle, T. (2001, October 22). Apotex scores a victory with anthrax drug. Wall Street Journal. Retrieved from http://proxy.stu.edu:2048/login?url=https://search.proquest.com/docview/398763924?accountid=14129

7. The Cipro circus. (2001, October 25). Wall Street Journal. Retrieved from http://proxy.stu.edu:2048/login?url=https://search.proquest.com/docview/398943404?accountid=14129

8. Dickinson, J. G. (2001). Industry goes from villain to national asset. Medical Marketing and Media, 36(12), 10. Retrieved from http://proxy.stu.edu:2048/login?url=https://search.proquest.com/docview/228411521?accountid=14129

9. The economic consequences of the new global terrorism. (2002). Economic Bulletin. Deutsches Institut Für Wirtschaftsforschung, Institut Für Konjunkturforschung, 39(10), 327–332. doi:10.1007/s10160-002-0168-8

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11. Fidler, D. P. (2002). Bioterrorism, public health, and international law. Chicago Journal of International Law, 3(1), 7–26. Retrieved from http://proxy.stu.edu:2048/login?url=https://search.proquest.com/docview/237212498?accountid=14129

12. Fuhrmans, V., & Winslow, R. (2001, October 22). Bayer works to meet soaring Cipro demand as it starts campaign to keep patent in U.S. The Wall Street Journal, 1.

13. Harmon, A., & Pearoct, R. (2001, October 19). A nation challenged: Treatment; Canada overrides patent for Cipro to treat anthrax. New York Times. Retrieved from https://www.nytimes.com/2001/10/19/business/nation-challenged-treatment-canada-overrides-patent-for-cipro-treat-anthrax.html

14. Herper, M. (2001, October, 17) Cipro, Anthrax and the Perils of patents. Forbes. Retrieved July 19, 2018 from https://www.forbes.com/2001/10/17/1017cipro.html#163677ea7975

15. History Channel. (2018, July). September 11 events. Retrieved from https://www.history.com/topics/9-11-attacks

16. Hodge, J. G. (2002). Bioterrorism law and policy: Critical choices in public health. The Journal of Law, Medicine & Ethics, 30(2), 254–261. Retrieved from http://proxy.stu.edu:2048/login?url=https://search.proquest.com/docview/223499954?accountid=14129

17. Holmes, P. (2001, November 19). Bayer responds to Cipro crisis. Retrieved from https://www.holmesreport.com/latest/article/bayer-responds-to-cipro-crisis

18. Holmes, P. (2002, October 22). In Cipro we trust. Retrieved from https://www.holmesreport.com/latest/article/in-cipro-we-trust

19. Jenneweim, K., Durand, T., & Gerybadze, A. (2010). When brands complement patents in securing the returns from technological innovation: The case of bayer aspirin. Management International, 14(3), 73–85, 105–110. Retrieved from http://proxy.stu.edu:2048/login?url=https://search.proquest.com/docview/748835249?accountid=14129

20. Meyerhoff, A., Albrecht, R., Meyer, M. J., Dionne, P., Higgins, K., & Murphy, D. (2004, August 1). US Food and Drug Administration approval of Ciprofloxacin Hydrochloride for management of postexposure inhalational anthrax. Clinical Infectious Diseases, 39(3), 303–308. doi:10.1086/421491

21. Mokhiber, R., & Weissman, R. (2001, 12). Corporations behaving badly: The ten worst corporations of 2001. Multinational Monitor, 22, 8–19. Retrieved from http://proxy.stu.edu:2048/login?url=https://search.proquest.com/docview/208864135?accountid=14129

22. Moscrop, A. (2001). Mass hysteria is seen as main threat from bioweapons. BMJ: British Medical Journal, 323(7320), 1023.

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24. Pesik, N., Gorman, S., & Williams, W. D. (2002, March). The National Pharmaceutical Stockpile Program: An overview and perspective for the Pacific Islands. Pacific Health Dialogue, 9(1), 109–114. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12737427

25. Stewart, H., Denny, C., & Clark, A. (2001, October 23). Bayer bows to pressure on anthrax antidote. The Guardian. Retrieved from https://www.theguardian.com/business/2001/oct/23/anthrax.businessofresearch

26. Wechsler, J. (2001). Bioterror response to alter pharmaceutical development and marketing. Formulary, 36(12), 867–868. Retrieved from http://proxy.stu.edu:2048/login?url=https://search.proquest.com/docview/229931184?accountid=14129