Pharmaguy's Insights Into Drug Industry News
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Pharmaguy's Insights Into Drug Industry News
Pharmaguy curates and provides insights into selected drug industry news and issues.
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Who Said DTC Ads Are Not Effective? Those “Knotty” Linzess Ads Increased Sales by 30% Claims Ironwood Executive

Who Said DTC Ads Are Not Effective? Those “Knotty” Linzess Ads Increased Sales by 30% Claims Ironwood Executive | Pharmaguy's Insights Into Drug Industry News |

Since the approval of Linzess in 2012, Ironwood and Allergan have been changing the way patients talk about uncomfortable topics like constipation.


While the companies' original direct-to-consumer (DTC) campaign for the drug would be considered a success by virtually any measure, Ironwood and Allergan have not rested on their laurels. The marketing duo - which originally started out as Ironwood and Forest Laboratories before it was acquired by the company that is now Allergan - have now gone through three iterations of marketing campaigns for the irritable bowel syndrome with constipation drug, each more successful than its predecessor.


The original ad launched in 2014 and tested significantly higher in market research than the industry benchmark on motivation scores among IBS-C and CIC patients, according to the company. The campaign drove total prescriptions (TRx) up 21% compared with the pre-DTC-launch trend established in the 12 months leading up to the launch of the drug.


The next two campaigns, which ran in 2015 and 2016, respectively, received higher motivation test scores than the launch ad and increased total prescriptions by 27% and 30%, respectively.


The ad described the pain as a knot or bricks piling up in your stomach and used a blue string to depict the problem.


"As a marketer it makes my job a little easier in that I don't have to name all the things I'm trying to fix. I simply have to say what products that may not be working for you and that it could be solved with our product," said Mark Rossetti, a senior director at Ironwood and the U.S. brand lead on Linzess.

Pharma Guy's insight:

These data are very surprising considering some experts have said that DTC advertising is not as effective as it used to be. Read, for example, “Pharma is Spending More on DTC Advertising But Its Effectiveness is Decreasing, Says New Survey”;

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AZ's OIC Super Bowl Ad Gets a Below Average Effectiveness Rating

AZ's OIC Super Bowl Ad Gets a Below Average Effectiveness Rating | Pharmaguy's Insights Into Drug Industry News |
Advertising for the 2016 Super Bowl was disappointing, to say the least.  Of 61 TV spots evaluated by ABX:
  • Only 22 (36%) were equal to, or above, the “average” ABX Index for TV ads
  • Only eight (13%) were “excellent” based on ABX benchmarks

The ABX Index is an overall measure of ad effectiveness that has been shown to correlate to brand performance.  It is comprised of Awareness, Messaging, Reputation and Call-to-Action.  An ABX Index of 100 is average for all benchmarked ads, whereas an ABX Index of 109 is the average for TV spots.

The waterfall chart above, shows the ABX advertising effectiveness Index for each of 61 ads. Only a few exceed an Index of 120, which is the threshold for excellence.

AZ's Opioid-Induced Constipation ad, which has drawn a lot of criticism (, scored way below average (80) although it seems to have generated a lot of interest via social media ( 

Keep in mind that the "popular" press ad ratings for Super Bowl are really only "Likeability" ratings.  While Likeability can contribute to the success of an ad, it is not predictive of success. For example, among these Super Bowl ads, Likeability has a very poor correlation with Purchase Intent.

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White House Critical of Opioid Constipation Drug Advertising

White House Critical of Opioid Constipation Drug Advertising | Pharmaguy's Insights Into Drug Industry News |

The White House criticized a pharmaceutical industry ad airing during Sunday's Super Bowl, saying it could help fuel an opioid addiction crisis.

The advertisement was intended to raise awareness of opioid-induced constipation, and was paid for by two drugmakers marketing a drug to treat it. But in the midst of an administration proposal to spend $1.1 billion more on treatment for prescription drug and heroin abuse, a top White House official suggested that the ad went too far.

"Next year, how about fewer ads that fuel opioid addiction and more on access to treatment," said White House Chief of Staff Denis McDonough in a tweet Monday.

"The Obama administration has not done a good job of taking on the pharmaceutical industry on this," said Dr. Andrew Kolodny, the executive director of Physicians for Responsible Opioid Prescribing. "It's as if they woke up overnight to realize how serious this problem is."

"Now you have these ads coming out normalizing long-term use of opioids for a chronic pain problem," said Kolodny, a senior scientist at Brandeis University's Heller School for Social Policy and Management. "There's no question that their ads make this very dangerous and questionable medical practice seem normal."

The Super Bowl ad was funded by AstraZeneca and Daiichi Sankyo, two companies in a joint venture to market Movantik, a drug that treats opioid-induced constipation. The companies do not make opioids themselves.

Pharma Guy's insight:

Worse than the Super Bowl ad is this Movantik TV Commercial, titled 'Opioid Baggage' which shows a women enjoying a day in the park with her Opioid pill!  Need help with your opioid baggage; e.g., constipation? Movantik will help you overcome that and enjoy a day in the park with your opioid! See ad here:

Behavioral Health Network Resources's comment, May 28, 2016 12:35 PM
Did Political Agenda Plant Seed for Opioid Addiction Epidemic Pls share
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Cam Newton Was Not the Only One "Blocked" During Super Bowl 50

Cam Newton Was Not the Only One "Blocked" During Super Bowl 50 | Pharmaguy's Insights Into Drug Industry News |

If you’re like a plurality of Americans, you spent Sunday night watching the Super Bowl along with its celebrated commercials that technically take up more time than actual game-play. Those ads are incredibly lucrative; CBS–which is airing the game this year–is reportedly charging $5 million for 30 seconds of airtime. And what mega-rich multinational corporation wouldn’t jump at the opportunity? No other traditional television platform allows a company the opportunity to present its product to more than a third of Americans in one fell swoop.

Enter Big Pharma with its latest display of benevolence: A cure for “Opioid-Induced Constipation,” or “OIC” as the advertisement so expertly vanilla-labels the malady.

Yes, it’s a widely-known fact that heroin and its legal opioid prescription cousins can cause a pretty rough case of constipation. And, of course, big Pharma couldn’t be happier to provide you with a solution to the problem it’s created. In fact, it shelled out something like 5 mil to advertise said solution during the Big Game.

The ad (embedded here) looks like your typical big-budget pharmaceutical TV production, featuring a handsome lead, and with a pleasant male voice narrating, “If you need an opioid to manage your chronic pain, you may be so constipated it feels like everyone can go except you. You may have ‘Opioid-Induced Constipation,’ or ‘OIC.'”

Pharma Guy's insight:

The ad does not mention the product name, which is Movbantik. But this animated ad does: "Opioid Baggage"; It features a woman enjoying a day in the park with her Opioid! A screen shot from that ad made into my Gallery of Drug Advertising “Mascots”, which you can find here: 

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Is Vermont Governor Shumlin Misguided? Yes Says #Pharma: OIC Ad Will Stay on Air

Is Vermont Governor Shumlin  Misguided? Yes Says #Pharma: OIC Ad Will Stay on Air | Pharmaguy's Insights Into Drug Industry News |

Two drug makers are ignoring a demand from Vermont Governor Peter Shumlin to yank a television ad that he believes is a “shameful attempt” to exploit the opioid crisis.

The dispute arose last week when Shumlin released an open letter to Daiichi Sankyo and AstraZeneca after they ran an ad during the Super Bowl. The ad promoted awareness of opioid-induced constipation, a condition that can occur when someone is taking opioid painkillers.

Shumlin noted that a one-minute Super Bowl ad cost a reported $10 million — or more precisely, $5 million for each 30-second spot — and wants the drug makers to, instead, divert some of their promotional dollars toward prevention and treatment programs.

So what will the drug makers do?

A Daiichi Sankyo spokeswoman said in a statement that the drug maker acknowledges that opioid abuse is a “very serious public health” issue in the United States, but did not mention the possibility of pulling the ad. Instead, she wrote us that the company — along with AstraZeneca and five advocacy groups that also sponsored the ad — is “committed to raising awareness” about the condition.

In a letter to Shumlin, AstraZeneca wrote that “we believe our message encourages a clinically important conversation about OIC between patients and their doctors, which may also facilitate a broader discussion about safe and appropriate opioid use. While these discussions are separate and distinct, both are important for patients and their families.”

Their responses, however, did not mention pulling the ads or using advertising funds as Shumlin suggested.

“He’s way off base,” Richard Meyer, an industry consultant who writes The World of DTC Marketing blog, told us. “If he is so concerned about addiction, he needs to tighten the prescribing parameters and make it tougher for patients to become addicted.”

But another marketing expert disagreed.

“I suppose he, like many other state governors, is faced with increasing Medicaid costs and other expenditures related to opioid addiction,” said John Mack, who publishes Pharma Marketing News. “So, I don’t think he is the misguided one.”

Pharma Guy's insight:

My full reply to Silverman's inquiry ("Is Shumlin misguided?"): 

I suppose he, like many other state governors, is faced with increasing Medicaid costs and other expenditures related to opioid addiction. So, I don’t think he is the misguided one. The one who is REALLY misguided is Massachusetts Governor Charles Baker who eliminated $500,000 in funding for a program designed to curb the inappropriate prescribing of opioid drugs by physicians. Especially when police in his state (e.g., Gloucester; are fighting drug addiction and specifically citing pharma companies as part of the problem.

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AZ's OIC Ad Wins Super Bowl #Pharma Ad Competition, But Hurts Industry

AZ's OIC Ad Wins Super Bowl #Pharma Ad Competition, But Hurts Industry | Pharmaguy's Insights Into Drug Industry News |

Two pharma brands debuted on TV's biggest stage in 2016, sparking a host of unfortunate bowel jokes I'm sure you've already heard.

One of the spots, by Valeant's Xifaxan, introduced much of America to “gut guy”—the latest DTC character to either charm or disgust audiences in the service of patient empowerment. The other spot, from AstraZeneca and Daiichi Sankyo, got Americans talking about constipation and opioid use.

Give credit to AstraZeneca, which certainly got people talking about opioid induced constipation. Unfortunately, most of the generated dialogue wasn't good.

Then, unexpectedly, opioid addiction became a major campaign issue during the New Hampshire Primary—held two days after the big game. As the pols might say it, AstraZeneca's optics were bad.


On Thursday, Vermont Governor Peter Shumlin called for the ad to be pulled, writing a letter to the two pharma CEOs saying, "In the midst of America's opiate and heroin addiction crisis the advertisement was not only poorly timed, it was a shameful attempt to exploit that crisis to boost your companies' profits."

"For those of us in the community of addiction treatment professionals, the AstraZeneca ad's underlying message was as obvious as a blinking neon sign that read 'Use More Opioids!,'" wrote a professor and author of an addiction book in a Time web column. "It almost feels like the drug companies want to keep their flagship product (opioids) going full steam ahead by countering a major side effect with another drug. It's certainly in the best interest of the pharmaceutical companies to keep their clients satisfied enough to continue using their products."

The Washington Post headlined its coverage of the ad: "This Super Bowl ad proved just how much America loves its opioid painkillers."

Meanwhile, Pushed perhaps by the additional media coverage, so far the ad has been mentioned more than 38,000 times on social media, mostly on Twitter and Facebook, in the past few days, according to real-time TV tracker It also had a 50% positive Tweet rating and has been viewed more than 2 million times online, according to iSpot.

Read: "AstraZeneca and Daiichi Sankyo field backlash over Super Bowl OIC awareness ad"; 

Pharma Guy's insight:

Related: "White House Critical of Opioid Constipation Drug Advertising"; 

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Pain Pill Advocates Defend Opioid-Induced Constipation Super Bowl Ad. We're Not Junkies!

Pain Pill Advocates Defend Opioid-Induced Constipation Super Bowl Ad. We're Not Junkies! | Pharmaguy's Insights Into Drug Industry News |

Next to the game itself, probably the one thing people talk about the most to day after the Super Bowl are the TV commercials. 

One commercial that is making quite a few lists as one of the worst is by drug maker AstraZeneca promoting its opioid induced constipation (OIC) drug. The black and white commercial features a constipated man envious of others (even a dog) who can easily go to the bathroom.

“The Super Bowl is known for inspiring lots of eating and lavish spreads of food. So why would advertisers pay millions to air ads focusing on constipation?” asked Eric Deggans of National Public Radio.  “There may never be a great time to air ads like this, but to broadcast such spots in an event where viewers are eating stuff like guacamole dip and pizza surely is the worst.”

“Nothing livens up a Super Bowl like a commercial about opioid-induced constipation,” said ESPN’s Dan Graziano on Twitter. 

“Opioid Induced Constipation commercial during the Superbowl? Should have aired that during the Pro Bowl. Nobody gives a sh** about it,” wrote Don on Twitter. 

Most of the Tweets aimed for laughs, but one by comedian and talk show host Bill Maherquickly went viral – and not because most people thought it was funny.

“Was that really an ad for junkies who can’t sh**? America, I luv ya but I just can’t keep up,” wrote Maher.

The depiction of opioid patients as “junkies” really got under the skin of pain sufferers and patient advocacy groups, some of whom are sponsored by AstraZeneca.

Pharma Guy's insight:

I also got this email from Paul Gileno, Founder & President, U.S. Pain Foundation:

Bill Maher single-handedly labeled all people with pain as junkies. I take extreme offense to this statement. It is this ignorant mindset that is harming the 100 million Americans living with pain from receiving the adequate care they need as well as the support they deserve. In the current health care landscape, chronic pain patients are continually forced to "prove" their pain. They face backlash and ridicule instead of compassion and help.
U.S. Pain Foundation collaborated on this ad with other organizations to spread awareness and information. The intention was to provide hope and resources to those facing a serious condition brought on by following a legitimate treatment program. The goal - for all involved on this project - was to make sure people living with OIC do not feel embarrassed or alone. It therefore saddens and angers me that those with high profiles would choose to increase the stigma associated with chronic pain without researching the pain care crisis in America.
Mr. Maher, let me inform you:
  • According to the 2011 IOM Report, 100 million Americans live with chronic pain caused by many different illnesses, conditions or injuries.
  • Chronic pain affects all races, religions, sexes and ages. 
  • In 2015, The National Pain Strategy incorporated these four core beliefs from the Consumer Pain Advocacy Task Force into their plan.
    1. Chronic pain is a real and complex disease that may exist by itself or be linked with other medical conditions.
    2. Chronic pain is both an under-recognized and under-resourced public health crisis with devastating personal and economic impact.
    3. Effective chronic pain care requires access to a wide range of treatment options, including biomedical, behavioral health and complementary treatment.
    4. Denying appropriate care to people with chronic pain is unethical and can lead to unnecessary suffering, depression, disability and even suicide.
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