You may recall seeing Dr. Robert Jarvik‘s pleasant face on your TV screen a few years ago flogging Lipitor, the biggest-selling drug on the planet at that time, earning well over $12 billion a year for Pfizer – the biggest drug company on the planet.
This partnership emerged just as the company was seeking to protect Lipitor from emerging competition by cheaper generics, and just before a U.S. Congressional investigation started looking into Jarvik’s credentials and his controversial role as paid pitchman for the cholesterol-lowering statin drug.
In one of his Pfizer commercials, Jarvik looks into the camera and says:
“I’m glad I take Lipitor, as a doctor and a Dad. Lipitor is one of the most researched medicines. You don’t have to be a doctor to appreciate that!”
It was a clever enough disclaimer, because it turns out that Jarvik himself is not a cardiologist, is not licensed to practice medicine, has neither treated patients nor even had the ability to prescribe Lipitor or any drug to any patient.
The early ads identified Jarvik as the inventor of the artificial heart, which was developed in the mid-1970s along with his fellow researchers at the University of Utah.
But despite this famous medical breakthrough, Jarvik ended his training after medical school instead of completing a medical internship. He admitted as much to ABC News after news of the Congressional investigation hit (and just before Pfizer pulled the Lipitor ads off the air), explaining:
“I am not a practicing physician, I have never been a practitioner, everybody has known for decades. I’m a developer of the technology. I am a medical scientist, not a practicing physician. I think it’s very upfront. I am a doctor. I have long experience with heart disease.”
Katie Watson, who teaches in the Medical Humanities & Bioethics Program at Northwestern University, explained the inherent ethical problem when a pitchman like Jarvik is hired for a drug company’s marketing campaign:
“To have a celebrity physician associated with cardiac health telling me I need Lipitor – that’s a physician motivated by a paycheque, not by patient health.”
How much was Jarvik’s paycheque? He told ABC Good Morning America interviewers that, while what he earned for the ads is not comparable to what a celebrity endorsement would garner, the amount he received would be “considered a lot by most people.”
He may have been acting coy about the money, but the House Energy and Commerce Committee and its Subcommittee on Oversight and Investigations happily released a copy of Jarvik’s contract with Pfizer, revealing that the company had agreed to pay him a minimum of $1.34 million over two years for serving as celebrity pitchman for their drug.
And it was largely because of this particular campaign that the Committee launched an investigation of “false and misleading statements and the use of celebrity endorsements of prescription medications in Direct-To-Consumer advertising.”
For example, the two-year Pfizer marketing endorsement deal began in March 2006 with a Lipitor TV commercial in which Jarvik was depicted as an accomplished rower vigorously sculling out on beautiful Lake Crescent near Port Angeles, Washington (which just happens to lie across the Straight of Juan de Fuca from my home here on Canada’s West Coast).
But I digress. Unfortunately for Jarvik, the New York Times reported that he was not in fact a rower, and that a Seattle rowing enthusiast and professional photographer named Dennis Williams had actually served as a stunt double in the Lipitor ads, which were broadcast for several months.
Williams declined to respond to The Times, but his role as Jarvik’s stand-in was described in a newsletter published by the Lake Washington Rowing Club, where he was then a member.
According to The Times, the Committee also contacted Jarvik’s former colleagues, who testified that he was not the actual inventor of the artificial heart, as stated in the Lipitor ads.
In a letter to Pfizer in August 2006, three former colleagues at the University of Utah complained that these ads erroneously described Jarvik as “the inventor of the artificial heart.”
That distinction, they said, should actually go to his mentor, Dr. Willem J. Kolff and his associate, Dr. Tetsuzo Akutsu.
Pfizer subsequently changed its ads to identify Jarvik as the inventor of the “Jarvik-7 artificial heart” only. Sadly, federal funding for that Jarvik project stopped in 1988, and artificial heart implantation was restricted to temporary implantation only. In 1990, the Food and Drug Administration withdrew approval for the experimental use of the Jarvik-7, citing poor quality control in the manufacturing process and inadequate service of equipment.
In 2008, Katie Watson wrote a piece called Ask Your Doctor If Ads Pay Off for the Chicago Tribune, including this memorable line:
“Robert Jarvik’s ads for Lipitor were an important source of patient education about a terrible disease – physician addiction to drug money.”
Katie further added her misgivings about these “Ask Your Doctor” Direct-To-Consumer (DTC) drug marketing campaigns:
“Patients are people who make decisions with expert partners, but once patients were recast as consumers, prescription drugs could be advertised as if they were tennis shoes.
“It was just a matter of time before a celebrity pitchman turned a drug like Lipitor into Air Jarvik.
“The pharmaceutical industry uses advertising to pull patients away from physicians – come in with your mind made up, and your physician is reduced to prescription writer.
“The industry undermines the other side of the patient-physician partnership by throwing money at physicians. This half of the divide-and-conquer strategy usually happens behind the scenes, but Pfizer’s partnership with Jarvik for mutual profit makes a widespread practice visible.”
Jarvik’s endorsement deal with Pfizer also illustrates a common lack of awareness on the part of both industry and their potential medical pitchmen about what we in public relations call the “optics” of an inherently unethical business relationship. While we can somehow get used to a golfer or actor or celebrity chef becoming a paid marketing shill, when those with the letters M.D. after their names step up to personally profit from flogging a drug or medical product, that decision clearly borders on an inappropriately self-serving conflict of interest.
And this applies also to high-profile docs who sell everything from vitamin supplements to “meditative mood spray” via their websites. (See also: When Doctors Go Retail).
Here in British Columbia, for example, our College of Physicians and Surgeons code of ethics clearly stipulates:
“Promoting and selling medical or non‐medical products to patients for a profit is not only unethical, it constitutes a direct conflict of interest.”
Dr. Sidney Wolfe, director of the Health Research Group at the Washington-based non-profit advocacy watchdog Public Citizen, worries that patients seeing any type of celebrity drug endorsements may ask their doctors for a drug because the celebrity appeal outweighs side effects or risks. He warns:
“It’s perfectly legal; it’s just completely immoral.”
In Katie Watson’s words, “doctors’ financial conflicts of interest have metastasized through the health care system”. In 1990, the New England Journal of Medicine decided, for example, not to accept any articles or editorials from physicians who accept money from a company whose product was featured in the article, but in 2002 the journal relented – because it couldn’t find enough independent authors.
The reason that drug companies often like to “partner” with celebrities on marketing campaigns is simple: they believe these familiar faces will work to help sell more drugs.
Celebs have long been lining up to feed at the lucrative Big Pharma endorsement trough in exchange for shilling their products. Consider, for example:
- TV’s southern fat-and-sugar queen (and newly diagnosed diabetic) Paula Deen and her sweet deal with drugmaker Novo Nordisk to promote its Type 2 diabetes drug, Victoza
- Sally Field ‘s relationship with Roche/GlaxoSmithKline’s bone density drug Boniva (an ad campaign criticized by Consumer Reports in 2009 as “misleading” because Boniva was “10 times the cost” and no more effective than cheaper generic bisphosphonate drugs) See also: The Myth of Osteoporosis
- Bob Dole and Pfizer’s joint efforts to sell more of the little blue pills called Viagra – let’s not even think about Bob, shall we? See also: Viagra Goes Generic: Then What?
- In Bruce (now Caitlin) Jenner‘s pre-Kardashian/pre-surgery life, he was an Olympic decathlete who in 2000 became the media spokesman for Vioxx, Merck’s top-selling arthritis drug. But in September 2004, Merck recalled its deadly drug in one of the largest mass recalls in history amid the scandal of increased risk of fatal heart attacks.
- Singer Barry Manilow‘s partnership with Sanofi-Aventis, maker of the heart drug Multaq, prescribed to treat the arrhythmia called atrial fibrillation. Multaq has been eloquently described by cardiologist Dr. John Mandrola like this: “Multaq simply doesn’t work to control atrial fibrillation. Nearly everybody that isn’t paid by Sanofi admits this.”
Show biz celebrities, politicians and sports stars may be palatable as hired guns. But still, to snag a real physician – somebody like Robert Jarvik who has been to a real medical school (University of Bologna in Italy) to help shill your drugs must have been an exciting accomplishment for your average pharmaceutical company’s marketing campaign.