Direct-to-Consumer Advertising
Vioxx was released just months behind Pfizer’s competing drug, Celebrex, and both drugs were aggressively marketed to doctors and to consumers. Direct-to-consumer drug advertising is any form of advertising that targets potential users of the drug, such as television, radio, and magazine ads. Merck is reported to have spent more than $500 million on advertising of Vioxx, including maintaining and training a massive sales force.
A WebMD investigation concluded that direct-to-consumer advertising, aimed at inducing consumers to visit their doctors and potentially inquire about advertised drugs, has been shown to cause up to a 2% increase in doctor visits. Additionally, direct-to-consumer advertising attempts to create a positive impression of a new drug in patients to whom it has not yet been prescribed, which increases the likelihood that they will continue taking the drug after the initial trial period.
Examples of Vioxx Direct-to-Consumer Advertising
Vioxx was touted in every form of media as a safe and effective pain killer. Television ads featured figure skater Dorothy Hamill skating to the Young Rascals’ tune “It’s a Beautiful Morning.” Dorothy Hamill appeared in print advertisements as well, endorsing the benefits of Vioxx for osteoarthritis relief. Presumably, if this drug provided relief for someone who pushed the limits of her joints to the degree of a professional figure skater, Vioxx could easily handle the average case of sore joints. Celebrity endorsements are an age-old advertising method, creating unparalleled product recognition. Merck not only used Dorothy Hamill as a celebrity endorser, but the company pursued every other avenue of marketing for Vioxx, from television to radio to online sources.
Free samples are another type of advertising that is common to all drug companies. Free samples allow doctors to introduce patients to new drugs at no cost to the patient, which increases the chance that the patient will continue taking the drug once the free samples run out.
Selling Doctors on Vioxx
While direct-to-consumer advertising is the only kind we see as consumers, doctors are exposed to the most effective marketing techniques of all. Not only do doctors receive free samples, as mentioned above, but they often receive massive amounts of promotional material — pens, tissue boxes, notepads, coffee mugs — which increase name recognition and keep the medications on doctors’ minds. In addition, doctors are visited by pharmaceutical representatives, otherwise known as salespeople. These representatives make up the drug producer’s sales force; often, they are only moderately informed of a drug’s clinical history. Their job is to sell pharmaceuticals, and that starts with getting doctors to write the prescriptions.
According to a critical report in the New England Journal of Medicine (NJEM), Merck’s sales team was trained in subliminal techniques for gaining the trust of doctors and creating the image of a relationship between the doctor and the pharmaceutical company, which in turn made doctors more likely to prescribe their drugs to patients. An example of a subliminal technique is the mirroring of a person’s physical movements, which supposedly increases trust. The NEJM article reminds us that providing thorough and objective information about new drugs should take precedence over making sales.
Such techniques were publicly criticized after the Vioxx withdrawal brought Merck into the limelight. Even the Merck-sponsored Martin Report revealed that Merck’s marketing of Vioxx was overzealous, and ultimately contributed to the drug’s being over-prescribed.
As recently as May of 2008, Merck agreed to pay $58 million to settle a multi-state lawsuit accusing the company of deceptive advertising of Vioxx. If Merck hadn’t yet reconsidered its advertising strategies, this latest settlement surely made the drug giant think again.
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