Lilly Overtakes Pfizer as Biggest DTC Advertising Spender!

Lilly Overtakes Pfizer as Biggest DTC Advertising Spender!

According to cegedim Strategic Data, Lilly overtook Pfizer in total direct-to-consumer (DTC) spending in April, 2012. The chart below shows the top 10 DTC spenders between July 2011 and April 2012.

Pfizer spent nearly $900 million in DTC advertising in 2011. $220 million of that was for Lipitor. I predicted that Lipitor would hold the "Key to DTC Ad Spending in 2012" (see here) and this chart proves it.

Lilly's Cymbalta and Cialis were the #2 and #3 highest in DTC ad spending in 2011. It looks like they will be #1 and #2 in 2012.

War on Counterfeit/Illegal Drugs Hobbled by Same Demons as Real War

War on Counterfeit/Illegal Drugs Hobbled by Same Demons as Real War

Pfizer Intelligence Uncovers $200 of Counterfeit Viagra In Manila Raid!

"Armed with a tip from pharmaceutical company Pfizer Inc., several dozen government investigators carried out a series of rapid fire raids one day last month on what were supposed to be the key suppliers of counterfeit drugs in the city [Manila]," reports the Wall Street Journal (read the story here).

"The net result of the raids, touted beforehand as likely to be one of the largest counterfeit drug busts in the city this year, was $200 worth of fake Viagra, Pfizer's erectile-dysfunction drug."

This intelligence gaffe reminds me of the Bush-era Iraqi weapons of mass destruction intelligence gaffe that propelled us to war in Iraq. I'm wondering if the "war on counterfeit drugs" is similarly based on faulty intelligence?

Another similarity between these two types of war is the unbridled optimism expressed by those in charge. "I think we are making a dent in the problem, but it's a slow process," said Scott Davis, senior director for global security in the Asia Pacific for Pfizer and a former special agent for U.S. Customs. Smells or sounds like victory, but it's no where near actual victory.

Here's yet another analogy: the war on counterfeit (or illegal) drugs seems to be as hobbled by rampant corruption of officials as is the war in Afganistan (or Iraq). In the case of the Manila raid, an owner of a couple of the target warehouses "bragged that he knew the NBI's [the Philippine's National Bureau of Investigation; i.e., the country's FBI] lead investigator on the counterfeit drug case and the deputy director who authorized the raid." After the raid turned up practically nothing, "the owner and the government agents walked a block away to lunch at Maxim's Tea House, a Chinese restaurant, according to people close to the investigation." That lunch probably cost more than $200!

It was interesting that the raiders found what they thought was counterfeit Cialis -- an ED drug marketed by Eli Lilly. Unfortunately, they did not have a search warrant for that illegal product, so no one was arrested.

It appears that Pfizer and Lilly did not share their intelligence data in this case, otherwise the NBI could have had a more inclusive search warrant.

This begs the question: Is the drug industry working together as allies in the war on counterfeit/illegal drugs? Are they sharing intelligence? Or is this also "proprietary" information that each company wants to keep close to its vest?

Physician Bailout: On Average, Pharma Pays Every US Physician Over $750 Per Year

Physician Bailout: On Average, Pharma Pays Every US Physician Over $750 Per Year

The pharmaceutical industry has been very generous in making payments to physicians. Last year (2010), for example, a mere dozen pharmaceutical companies paid $760 million to physicians and other health care providers for consulting, speaking, research and expenses, according to ProPublica's "Dollars for Docs" project. ProPublica has taken "translucent" -- ie, difficult to analyze -- data reported by pharmaceutical companies and created a single database that makes comparisons simple (see here).

The database contains information about payments made to about 500,000 doctors. That's about half of ALL doctors in the US (including Peurto Rico). That works out to about $1,520 per doctor (or about $760 per EVERY doctor in the US), on average.

Of course, some doctors were paid MUCH more than this -- eg, pain specialist Gerald M. Sacks raked in $270,825 from Pfizer, Johnson & Johnson, Lilly and Cephalon in 2010, up from $225,575 in 2009. And some doctors received only $50 for lunch. At least 20 doctors, however, received "meals worth $2000 or more from Pfizer between July 2009 and March of this year," said ProPublica reporter Charles Ornstein.

According to the ProPublica database, Pfizer paid my doctor -- Catherine Spratt-Turner -- $388 for meals and $1,500 for speaking in 2010. This worries me because she wants me to come in and discuss my high cholesterol. Apparently, generic pravastatin is not doing the job and I suspect she wants to switch me to another anti-cholesterol medication. Will she suggest Pfizer's LIPITOR? I'll let you know when I see her. Previously, she was hot to get me on AstraZeneca's CRESTOR, which I resisted because of its published side effects. BTW, Spratt-Turner did NOT get any money from AZ last year.

This is exactly what worries some physicians who receive payments from pharmaceutical companies. As more and more searchable data becomes easily available to the public, they fear that patients will rebel and resist their advice if it appears that payments are influencing that advice. Oh, well! Welcome to the social media age!

The table above shows physician payments made by some pharma companies compared to sales. Surprisingly, Lilly spent about 2 times as much as did Pfizer despite having only about half Pfizer's sales volume. Perhaps Pfizer is more efficient than Lilly in targeting influential physicians? Nah! Viagra sales don't need much physician goosing to prescribe, whereas Lilly's Cialis needs as much help as money can buy. [I suspect, however, from the fees paid to pain docs like Dr Sacks, that Lilly is more concerned with promoting Cymbalta for pain.]

Overall, it appears that pharma companies tend to spread payments among physicians such that there is a more or less direct correlation between the number of physicians in a state and the amount of payments made to physicians in that state (see chart below).

Of course, $760 (or $1,520) per every physician is not going to improve a physician's lifestyle very much (although I am sure YOU and I would be happy to have an extra thou to spend every year!).

No, this money is central to what I call pharma's "prescribing recovery act" designed to grease the drug prescribing economy.

[This post originally appeared in Pharma Marketing Blog. 

Make sure you are reading the source to get the latest comments.]

How FDA Warnings & DTC Advertising Increase Sales of Sexual Enhancement Dietary Supplements

How FDA Warnings & DTC Advertising Increase Sales of Sexual Enhancement Dietary Supplements

Here's an example of how the Internet and direct-to-consumer (DTC) advertising empowers consumers.

For several years now the FDA has been issuing warnings to consumers about "dietary supplements" that claim to enhance sexual performance or treat erectile dysfunction. According to the FDA, although it has issued "many alerts about these types of supplements over the past several years, ... their number seems to be growing" (see "FDA Consumer Corner: Cautions about Sexual Enhancement Products").

Using the Internet, FDA now has a much more direct line of communication to consumers. And consumers use the Internet to buy dietary supplements. This concerns drug companies and the FDA.

What concerns the FDA about these products? FDA states:

"FDA has found that many of these supposedly 'all natural' products actually contain ingredients that aren't on the label, and these ingredients could lead to serious and even fatal effects."

Is FDA talking about rat poison? That's what Pfizer says MAY be in such products sold over the Internet (see "Was a Rat Harmed in the Filming of This Pfizer Commercial?" and "Unsafe Drugs: Is It Counterfeiters or the Supply Chain That's the Problem?").

Nope.

FDA isn't saying that these products contain dangerous ingredients like rat poison. It is claiming that they contain dangerous ingredients such as the ACTIVE ingredients of VIAGRA, CIALIS, and LEVITRA -- all FDA-approved Rx drugs.

"An FDA investigation of a number of these sexual enhancement supplements found that a third of them actually contained the same or similar ingredients to the class of prescription drugs that includes Viagra (sildenafil citrate), Cialis (tadalafil) and Levitra (vardenafil HCl)."

Hmmm... so if I buy one of these products, the chances are 1 in 3 that I will get the same active ingredient as found in Viagra/Cialis/Levitra?

OK, I know that these active ingredients can be dangerous even when sold as Viagra, Cialis, or Levitra (is Levitra still on the market?). But the TV commercials make these products sound pretty safe to me. In fact, the commercials tell me exactly what I should be concerned about: e.g., "Don't take Cialis if your take prescription drugs that contain nitrates, such as nitroglycerin."

Thanks FDA for alerting me to the fact that these dietary supplements may contain active ingredients that you have approved for human use in Rx drugs and thanks DTC advertising for educating me about the risks.

Excuse me while I search online for the best selling Sexual Enhancement Dietary Supplement.

In fact, I found a handy side-by-side comparison easily via Google search on "Sexual Enhancement Dietary Supplement" (see below). Unfortunately, I had to black out the rating symbols that appear on the original chart (which I found on JournalScopereviews.com, here) because Consumers Union (CU) lawyers informed me that the "rating symbols ... are confusingly similar or identical to Consumer Reports' trademarked icons and Ratings symbols. When consumers see your (sic) chart, they will not know if there is some connection between Consumers Union and the creator of these ratings. Obviously, there is not. The confusion this can engender is all the more pronounced given that Consumer Reports does write about dietary supplements, and has recently published information relating to sexual enhancement dietary supplements in particular. Needless to say, our views do not necessarily mirror yours, or those of the originator of the chart. This makes it still more crucial that all such confusion be avoided. To that end, therefore, we ask that you remove this chart from your blogs and refrain from using these particular Rating symbols in the future. Using some other shape or design will help ensure there is no confusion as to the source of the ratings."

BTW, I look forward to seeing CR's report on sexual enhancement dietary supplements. I wonder if the report includes the FDA warnings?

The CU lawyers also wanted to know how to find the original chart. It seems they are not as adept at using Google as am I!

Anyway, here's the blacked out version of the chart:

Sex, Lies, and the Media: Did Businessweek Distort the Relation Between ED Drugs and STDs?

Sex, Lies, and the Media: Did Businessweek Distort the Relation Between ED Drugs and STDs?

The headline in a recent story reported in Bloomberg Businessweek tells it all: "Men on Viagra, Cialis Show Triple Rate of Sex Diseases in Study." This was duly summarized in the Blogosphere on PharmaGossip:

"Men on Viagra, Cialis Show Triple Rate of Sex Diseases in Study - BusinessWeek

"Men taking drugs for sexual potency showed almost triple the rate of sexually transmitted diseases compared with those not taking the medications, a Harvard University study found.

"The results, from an analysis of the health insurance claims of men aged 40 and older, may have more to do with the nature of the men using the impotence drugs than with the medicines leading them to have riskier sex, the research report said. The study, looking at men taking Pfizer’s Inc. Viagra and Eli Lilly & Co.’s Cialis, was published today in the Annals of Internal Medicine."

Reading just the headlines and summaries such as the one above, you might be lead to believe that ED drugs CAUSE unsafe sex, which leads to more sexually-transmitted diseases (STDs). Right? WRONG!

You have to read down to the 11th paragraph of the 16 paragraph story to learn that the study does NOT prove that taking ED drugs leads to more unsafe sex. Quite the contrary: users of these drugs actually showed a DECREASE in STDs AFTER taking the drugs compared to BEFORE taking the drugs!

That paragraph states the study results: "The risk of getting HIV in the year before taking the pills was 3.32 times higher in drug-takers and 3.19 times greater in the year after, compared with those not taking the pills." [Find the article here.]

In other words, the groups of men who were prescribed ED drugs were in a high risk group BEFORE being prescribed ED drugs. In the abstract, the study authors were careful to point out "Significant changes in STD rates from the year before to the year after the first ED drug prescription was filled were not documented." [Find the abstract here.]

Pharma often complains that the media are "anti-pharma" and often emphasize the negative aspects of clinical trials, advertising, etc. (see, for example, "What's the Cause of the Drug Industry's Bad Reputation?"). The BusinessWeek article is just one case where I have to agree, although overall I sense that the industry gets a lot more positive traction from the media than negative (see, for example, "Academics Exaggerate, Journalists Regurgitate. What About Bloggers?").

What do YOU think?

Does the Media focus too much on bad news about the pharma industry?
	Yes, definitely
	Absolutely not
	Maybe, sometimes
	More often than not
	It's pretty much balanced