Allergan’s Latisse is an eyelash-growing drug prescribed to treat a condition called hypotrichosis. This is a condition of no hair growth (not to be confused with the condition of alopecia, which describes hair loss where formerly there was hair growth). That’s not how Allergan chose to describe the condition of hypotrichosis on its Latisse Patient Information sheet:
“Hypotrichosis is another name for having inadequate or not enough eyelashes.”
But as John Mack astutely notes in Pharma Marketing News:
“I imagine asking a woman if she has ‘adequate’ or ‘enough’ eyelashes is like asking a man if he has a ‘big’ enough or ‘hard’ enough penis. It is unlikely, therefore, that any woman wouldn’t want to try Latisse at least once.”
How then to get more women to ask more doctors to help sell more of this eyelash-growing drug? Hire a famous person to pitch your product! Enter professional celebrity-for-hire (Volkswagen-Ford-Coppertone-LaZBoy-Colgate-Tupperware) Brooke Shields, who explains on her Latisse video diary how she also became a paid shill for this Allergan drug: ,
“I thought I’d be a good candidate for Latisse simply because over the years I’ve just been ripping off my false eyelashes while on Broadway, and Allergan approached me and said ‘this is a product, it works, it’s FDA approved,’ and my interest just piqued!”
I’m betting her interest was also piqued when Allergan started talking money with her agent. Trouble is, in her ads for the product, Brooke left out the part about the annoying tendency of Latisse to cause alarming side effects. In September 2009, in fact, the FDA confronted Allergan because of product claims that downplayed the drug’s serious risks, which include:
- cornea infections
- hair growth outside of the treatment area
- permanent darkening of eye colour
Brooke’s ad campaign for Latisse even made the Top 10 Most Misleading Drug Ads list generated by Forbes last January.
Dr. Sidney Wolfe, director of the Health Research Group at the Washington-based non-profit advocacy watchdog Public Citizen, worries that patients seeing celebrity endorsements like this will ask for a drug because the celebrity appeal outweighs the side effects or risks. He warns:
“It’s perfectly legal; it’s just completely immoral.”
Alan Cassels is a drug policy researcher at the University of Victoria here in British Columbia and also the co-author with Ray Moynihan of Selling Sickness (about the role of the pharmaceutical industry in helping to create and market illness). When asked about celebrity endorsements of pharmaceutical drugs, Cassells told ABC News interviewers that there is a more basic problem with the paid celebrity sales pitch.
“Even when product claims are not exaggerated by a paid celebrity, I’m concerned that it can be hard for an audience to tell the difference between a clear-cut disease awareness campaign and an ad campaign funded by a pharmaceutical company.”
Consider another example of celebrity endorsement, this time featuring singer Barry Manilow and his lucrative arrangements with the drug company Sanofi-Aventis, maker of the controversial drug Multaq, prescribed to treat the heart arrhythmia called atrial fibrillation (AF). Manilow himself has AF; the awareness program he’s being paid to speak for is called Get Back in Rhythm.
But here’s yet another reason to reconsider taking the drug Multaq for atrial fibrillation, and it comes from electrophysiologist Dr. John Mandrola‘s excellent article called: “Get Back In Rhythm – Just not With Multaq”.
He cites the new industry-sponsored website featuring Mr. Manilow. Dr. John writes:
“It seems Mr. Manilow is advocating a rhythm-control strategy for AF. That’s reasonable.
“The problem here, my friends, is that he is partnered with Sanofi, makers of the expensive, poorly-tolerated, ineffective and embarrassingly over-hyped AF drug, Multaq. I’ve said it before, but I guess it has to be said again:
“Multaq simply doesn’t work to control atrial fibrillation. Nearly everybody that isn’t paid by Sanofi admits this.”
If you didn’t quite catch that drift, consider this blunt blog opinion offered by Kentucky cardiologist Dr. Melissa Walton-Shirley about Multaq:
“Seriously, the drug absolutely should not be used for permanent atrial fib, hemorrhoidal pain, or acne”
Meanwhile, Ray Moynihan (Alan Cassels’ co-author of Selling Sickness) wrote* in the British Medical Journal:
“The American public learned about irritable bowel syndrome from the star of the sitcom Frasier, Kelsey Grammer, and his wife, who has the condition. They appeared publicly on behalf of a foundation for gut disorders. The celebrity awareness-raising campaign was funded by GlaxoSmithKline, makers of the irritable bowel syndrome drug Lotronex (alosetron hydrochloride). Around the same time, that drug was withdrawn from the market after reports of serious side effects, including deaths.
“Actor Cybill Shepherd talked about menopause and a big-selling supplement for symptom relief. As luck would have it, Cybill was taking the supplement with ‘tremendous results’. That gig was funded directly by the supplement’s manufacturer, an Australian company called Novogen.”
“Both of these celebrity marketing campaigns were a huge success in the enormous U.S. health care market. The Frasier pair made the Today Show and Cybill made Oprah Winfrey.”
Moynihan also wrote about the trend towards drug companies sponsoring patient support and advocacy groups behind the scenes (just as we’re now seeing with Barry Manilow’s “Get Back in Rhythm” campaign).
Several years ago, drug giant GlaxoSmithKline, for example, funded the non-profit organization “Freedom From Fear” to generate sales, buzz and legitimacy for its antidepressant drug Paxil. Moynihan explained:
“A global survey from Britain estimated that two-thirds of all patient advocacy groups and health charities now rely on funding from drug companies or device manufacturers. The most prolific, according to survey results, is Johnson & Johnson and number two is Pfizer.
“While creating the appearance of corporate generosity, such sponsorship can bring many benefits to the sponsor as well. Chief among them is that patient groups are a way to help shape public opinion about the conditions (the) products are designed to treat”.
Two years, later, Moynihan also wrote this for the journal Public Library of Science Medicine:**
“Pfizer famously paid presidential hopeful Bob Dole to promote awareness of erectile dysfunction as sildenafil (Viagra) was hitting the market.
“Wyeth hired supermodel Lauren Hutton to hawk hormone replacement therapy.
“Glaxo Smith Kline contracted football star Ricky Williams to sell social anxiety disorder, helping make paroxetine (Paxil) – briefly – the world’s top-selling antidepressant.
“The stars’ remuneration package, though always confidential, can range from $20,000 to $2 million.“
Trouble is, adds Moynihan, unlike straightforward paid advertising campaigns, there is no formal requirement for stars or or their starstruck media interviewers to spell out any drug side effects along with benefits when celebrities are pushing products or conditions.
Lauren Hutton, for example, can be quoted, in magazine articles read by millions of readers, as saying:
“My No. 1 secret is estrogen!”
There is no need for her, or the magazine, to list the known dangers of the hormone therapy produced by her Big Pharma sponsor.
Barry Manilow, too, apparently sees no need to include cautionary warnings about the widely discredited AFib drug Multaq in his own campaign funded by Multaq’s maker, Sanofi-Aventis.
Drug marketing by hiring popular celebrities to shill for your company is not limited to pitching the sales message directly to patients. Some marketing campaigns target those who actually pull out the prescription pads in the first place.
Last year, for example, the Washington Times reported on the Swiss-based drug giant Novartis ($44.3 billion in revenue last year), who decided to hire sports icons (at up to $35,000 per appearance) as lures to entice physicians to attend free dinners where the company could pitch its drugs to them:
“Athletes such as New York Giants quarterback Eli Manning and baseball Hall-of-Famer Johnny Bench would show up at Novartis-hosted doctor events, give short speeches, answer questions about their careers, and then pose for individual photos with the 50-100 physicians attending each dinner. Drug sales reps would later bring the photos when they went to call on the doctors to sell their products.”
As I wrote here last November in Novartis Stable of Big Name Athletes Lures Docs to Drug Dinners:
“Drugmakers do not host expensive events like this out of the goodness of their hearts. In fact, demonstrably increased prescribing is the only reason Big Pharma spends $3-4 billion every year (yes, that’s billion with a ‘B’) on sponsoring professional meetings and events like these sports dinners.”
Surprisingly, and despite most physicians’ insistence that they are not influenced at all by receiving any Big Pharma freebies (such as celebrity sports dinners), a review published in the Journal of the American Medical Association showed that even the smallest of gifts does indeed influence the prescribing choices physicians make.
Dr. Jerome Kassirer, a professor at Tufts Medical School and an expert on the conflicts of interests between physicians and the drug industry, had this to say to The Washington Times about the Novartis sports dinners:
“They [the drug companies] will do anything to attract doctors to meetings to promote their drugs. They [the doctors] are clearly taking some kind of gift, the dinner and the photo and the prestige of meeting with a celebrity athlete in exchange for sitting through and listening to a drug sales pitch.”
Finally, a definition of the word shill might be in order here. The origin of the word shill is uncertain; many believe it might be an abbreviation of the Yiddish shillaber. Apparently, the word originally (as far back as 1914) denoted a carnival worker who pretended to be a member of the audience in an attempt to elicit interest in an attraction. Both illegal and legal gambling industries also use shills to make winning at games appear more likely than it actually is. These shills also often aid in cheating or disrupting the game if the “mark” is likely to win.
Fast forward to the computer age of marketing. In online discussion media, shills may express specific opinions in order to further the interests of an organization in which they have an interest, such as a commercial vendor or special interest group. Or, like Brooke Shields or Barry Manilow, they may be celebrity shills who are being paid for their implicit support of a company’s product or to attract consumer attention to a corporate-funded awareness campaign.
CELEBRITY SHILL NEWS UPDATE:
January 18, 2012: In what just might be the juiciest celebrity endorsement ever, the drug company Novo Nordisk has signed a lucrative deal with 65-year old celebrity Southern chef Paula Deen, who recently announced that she had been diagnosed with Type 2 diabetes three years ago.*
Diabetes experts say that being overweight (as Deen is), over 45 (as Deen is) and inactive (as Deen was) increase the risk for developing Type 2 diabetes. Growth of the disease in North America has been closely tied to escalating obesity rates. Deen also smokes, but says she considers her heavy-handed food “only one piece of the diabetes puzzle, along with genetics, lifestyle, stress, age and race.” No mention of her obesity, apparently.
After an initial explosion of sneering comments about Deen’s continued promotion during those three years of her unhealthy high-fat, high-sugar recipes as usual on her Food Network TV shows (like deep-fried cheesecake covered in chocolate, a quiche that calls for a whole pound of bacon, a baked French Toast casserole containing two cups of cream and a half pound of butter, or her signature bacon-egg-donut burger), she then announced that she’s suddenly decided to donate an undisclosed portion of her earnings from the endorsement deal to the non-profit American Diabetes Association. Too bad she didn’t make that announcement of philanthropy on the same day she revealed her diagnosis and the Novo Nordisk deal.
Deen takes the Novo Nordisk drug Victoza, a once-daily noninsulin injection for diabetics that costs approximatey $500 per month to take; the drug had global sales of $734 million in the first nine months of 2011. Both of Deen’s non-diabetic sons are, oddly enough, also on Novo Nordisk’s payroll now.
And, finally, in the words of outspoken chef Anthony Bourdain, who has called her a hypocrite for promoting an unhealthy diet along with a drug to treat its likely effects:
It is all bad. At least with drugs like Viagra you are dealing with a lifestyle choice drug. Whether men take it or not probably doesn’t matter (side effects notwithstanding). With something like AF which is potentially fatal, to have a celebrity endorse one form of treatment is at best just plain wrong and at worst potentially lethal.
Stroke prevention reduced to the level of cosmetics – oh well.
Thanks Dr. Joe – trouble is, Barry would likely protest that he’s not exactly “endorsing” Multaq, he’s just partnering with Sanofi on an “awareness” campaign. But Big Pharma wouldn’t be funding this campaign in the first place unless it worked to move product.
Looks like more “bad news” for Barry and Sanofi – Higher rates of stroke, heart failure and deaths.
sad part is.. Manilow knows that millions of people will take this drug simply because of this “awareness” campaign.
Hi Ron – I’m not so sure that celebrities-for-hire actually get that involved in the bottom line purpose of these campaigns. There has been a ton of press about Manilow’s PR campaign so far, virtually all of it gushingly positive, including from an Afib patient support site in the U.K. When I left a comment there re concerns about Sanofi’s Multaq, the editor of the site contacted me to let me know that he would NOT be approving my comment for publication “just because things are very different over here.”
Really? How different can things be for AFib patients in the U.K? Multaq is good for Brits, but not good for North Americans?
Way to go, Barry!!
I’ve seen a number of interviews where Barry Manilow has talked about atrial fibrillation (Afib) and the “Get Back in Rhythm” campaign, but he has never advocated, or even mentioned, Multaq, nor any other specific drug.
Instead, he talks about how his own condition was treated with multiple surgical ablation procedures (because the pharmaceutical approach did NOT work for him!). He emphasizes the dangers of leaving Afib untreated, and encourages people to see their doctors if they exhibit typical symptoms of Afib, which can be easy to ignore.
I agree Multaq can have serious side effects and may not be effective, and I’m certain that Sanofi Aventis isn’t promoting this awareness campaign completely out of altruism. However, Barry Manilow has never endorsed any particular treatment or drug in any part of the Get Back in Rhythm campaign, at least not directly.
Thanks for your comment, Suzan. But that’s the point – celebrities don’t even have to “directly” endorse a specific therapy to make this kind of industry-funded awareness campaign suspect. As I said earlier, Big Pharma would not be funding this campaign in the first place unless it worked to move product. Another recent example of this is the Bayer/Joy Behar “I Am ProHeart” partnership, at first blush just a women’s heart disease “awareness” campaign. Joy doesn’t have to even mention the word ‘aspirin’ to fix the funder’s product clearly in the consciousness of the public.
Don’t people realize that these celebrities are being PAID BIG BUCKS to say what they’re saying? A total sell-out, literally and metaphorically. What kind of idiots would buy a product merely because their favorite celeb gets their picture taken smiling about it?
Apparently, based on the popularity of paid celebrity endorsements, all kinds of idiots must be buying products that are endorsed by celebs!
For generations, we’ve seen opera singers, sports icons, clergymen and politicians, even Santa Claus himself, perfectly willing to take money as corporate pitchmen. The most disgusting are the ads using medical doctors pitching cigarettes, like the vintage 1930 ad in which a smiling white-coated doc smiles at the pack of Lucky Strikes in his hand, just below the caption that screams “20,678 Physicians Say Luckies Are Less Irritating!” Doctors are no different than any other celeb who sees nothing wrong with taking money from corporate marketers. Oh except for the unethical and immoral part.
I agree, Donnie-Ann. But that 1930 ad likely featured an illustration of a man acting as a doctor for advertising purposes. The cringe-factor is really off the charts, however, for the real-life docs who take advantage of those trustworthy letters M.D. after their names in a deliberate plan to make money pushing products.
Very interesting, see my blog on Paxil for more info about how GSK unethically marketed it
Ex-NFL player Ricky Williams (Paxil) goes public with figure paid to him by GlaxoSmithKline.