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blogspectives – June 2, 2008

Welcome to our first issue of Blogspectives. Bi-weekly I will comment on health blogs that discuss pharmaceutical marketing, public policy, and consumer trends and behavior. This is not a blog recap per se, but my editorial spin, comment, rebuttal or agreement with those bloggers.

I scan what I believe are relevant blogs to the DTC Perspectives audience. There are hundreds of health blogs but about 10-20 that specifically cover our industry. I plan to provide Blogspectives twice a month for now and perhaps weekly in the future. What better way to start a blog on blogs than to report that John Mack of the Pharma Marketing Blog (5/27) wonders whether the little guy blogger can compete with corporate sponsored blogs such as Pharmalot and the Wall Street Journal . He believes that their resources allow them to report more scoops first. While that is true, the independent blogger can comment on news stories and create new perspectives about an event or issue. I do not usually discover news and see myself as adding depth to a news story. I have no doubt the independent health blogger is still needed. In recapping the House hearings of May 9, Pharmaceutical Executive’s Patri ck Clinton comments the hearings were inconclusive as expected. He believes the real issue is whether DTC causes inappropriate prescribing which he believes has not been answered yet. He also believes the industry claims that DTC educates in a balanced way is “mostly absurd.” I agree with Mr. Clinton. DTC for specific brands is meant to sell product as evidenced by management demanding positive ROI. It is not educational in its mission although PhRMA uses that term in its statements defending DTC. Branded ads may educate but that is not why they fund DTC. It is to sell more product. Nothing wrong with that, except it sounds better to say it is educational. I remember former Pfizer executive Pat Kelly wanting to replace the term DTC with HIFC, (health information for consumers), because of the negative associations with the DTC. It never caught on because it is what it is. DTC is advertising that contains health information. On the same subject, Merrill Goozner of Gooz News (5/12) references the hearings in asking who stopped the FDA from pulling Procrit ads claiming reduced fatigue from chemotherapy, a non FDA approved claim. He mentions Dan Troy, FDA counsel at the time, and now working for a firm representing J&J, Procrit’s maker. Goozner wrote the the Industry critical book “The $800 Million Pill,” calling into question the drug industry cited cost of R&D. Troy definitely was a champion of limiting FDA power while there but I believe he felt the limits were based on not violating commercial free speech and not because he was in the pocket of the drug industry. javascript hit counterAlison Bass, author of a new book “Side Effects,” the critical story of Paxil and GlaxoSmithKline, covered the House hearing in her 5/11 blog . Her take is that it is unlikely that new regulation will come out of the hearing. Her blog reports mostly on Professor Ruth Day’s negative testimony that side effects are presented in DTC to minimize comprehension. Ms. Bass ends with her bleak assessment “it looks like American consumers are going to continue to be distracted” citing Day’s example of Nasonex and the flapping wings of its bee icon during the side effects reading. CNBC’s blogger Mike Huckman (5/12) was perplexed by the new bed sheet Evista commercial that promotes reducing the risk of breast cancer as well as the old indication for Osteoporosis. He said “there was something about it that just doesn’t sit right.” He says the commercial was unsettling because of how many women looked like they were on Botox. I admit it is an unusual execution but as I said in my column on May 23 , I liked it for its stopping power and clear message. Mr. Huckman’s blog had a survey and 54% of the 507 respondents said the ad is fine, while 36% said it was kind of weird. Only Lilly will know for sure if the ad works but my guess is it will, weird or not. Maggie Mahar, in her Healthbeat Blog (5/21 takes on DTC for medical devices. Ms. Mahar, author of an excellent book on health care policy called “Money Driven Medicine,” feels J&J’s DTC for the Cypher stent can cause significant friction between surgeons and patients. Here, she says, DTC goes beyond pill ads because use of a particular medical device requires specialized knowledge. She also says the reason for DTC may be because the Cypher stent has a higher rate of problems and DTC demand creation can help put pressure on surgeons to use it. I doubt any surgeon will use the stent just because a patient mentions it because it is a more serious decision versus a pill choice. I also doubt a patient would push a surgeon on a brand of medical device, because this is not a simple choice of prescribing a consumer requested anti-histamine or proton pump inhibitor. In the Wall Street Journal (5/28) blog by Scott Hensley , he reports that a review of media stories on health yields unsatisfactory results. The study, done by , shows media stories fail to do a good job discussing cost, evidence of efficacy, alternative treatments, and risks and benefit trade-offs. They analyzed 500 stories and made their subjective assessment. While I did not examine 500 stories, it seems to me that consumers get a lot of coverage on high drug costs and risks of their prescriptions. The reviewers of the stories are doctors, public health experts and a professor of journalism. On , Jane Sarasohn-Kahn congratulates Viagra on its 10 th anniversary. She points out that Viagra “reshaped pharmaceutical marketing. The company used direct-to-consumer advertising to great effect.” I do not agree that Viagra reshaped marketing. It received so much
free publicity that consumer awareness was achieved without a lot of DTC spending. It did later use DTC to help add new users and probably had positive ROI. Like many observers of DTC, Ms. Sarasohn-Kahn overstates its impact. Viagra was a successful drug before any DTC money was spent. In fact so was Lipitor, also commonly quoted as a drug built by DTC.

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