Can an ad promote a drug even if it doesn't mention the drug by name? That's the topic we tackle in the video at right—the fifth installment in our AdWatch series of drug advertising critiques. The commercial highlights a smoking-cessation Web site called MyTimeToQuit.com, and it looks in many ways like a public-service announcement, at least initially. But wait—a logo at the end of the commercial reveals that it's sponsored by Pfizer. And the MyTimetoQuit site includes links that ultimately lead you to the Web site for Chantix (varenicline), Pfizer’s blockbuster smoking-cessation drug.
If this sounds a little sneaky to you, well, we think it is. But it’s also totally legal, and representative of a growing trend in direct-to-consumer advertising: the “help-seeking ad.” These are ads that, instead of mentioning a drug by name, address the condition it’s meant to treat–then drive you to a Web site or toll-free number that offers, among other information, the option to learn about a “prescription treatment option.” (For two other prime examples, see www.FibroCenter.com and www.PsoriasisConnect.com.)
Help-seeking ads can come in handy for drugs that have a particularly nasty list of side effects, since not mentioning the drug by name means you don’t have to list the side effects either, according to the U.S Food and Drug Administration. And Chantix, though remarkably effective, can have some bad side effects. A series of adverse-event reports to the FDA after Chantix came on the market linked the drug to “serious neuropsychiatric symptoms,” including “changes in behavior, agitation, depressed mood, suicidal ideation and attempted and completed suicide” among people who took the drug. It hasn’t been determined whether the drug alone caused those events. But the reports prompted an update to Chantix’s label in January 2008, to include a warning about the drug's potential psychiatric effects.
It gets stickier. The studies Pfizer did to get Chantix approved excluded people with any history of depression, bipolar disorder, or serious mental illness—groups with high rates of smoking, and the very people for whom Chantix might be riskiest, since it acts on certain processes in the brain. That might account for the number of adverse reactions that didn’t come to light until after the drug came on the market. And hence, the need for a change in advertising direction.
What should you take from all of this? When you see an ad or Web site with that PSA-like tone, listen or look to see who’s sponsoring it. If it’s a drug company, and you decide to visit the site, realize that the information, however useful, is there to help promote a drug. And be wary of the interactive options that these sites offer. For example, a Share Your Story section on the FibroCenter site requires you to sign a release basically allowing Pfizer to change your whole story to make it more “commercially viable.” So much for an authentic online community.
As for the My Time to Quit commercial, one place it does get it right is in portraying how very difficult it is to stop smoking. If you’re facing that arduous and admirable task, you can find independent, unbiased advice on all available treatments at Agency for Healthcare Research and Quality (including a free interactive PDA tool). Subscribers to ConsumerReportsHealth.org can view our Treatment Ratings. And if you decide to consider Chantix, make sure that you tell your doctor about any personal or family history of depression or other mental illness. Good luck.
—Jamie Kopf Hirsh, associate editor