Perhaps this is obvious, but drug advertisements are not intended to teach you the best way to treat a disease. Their main purpose is to sell a product, as explained on a previous drug direct marketing blog. And the newest drugs tend to be the most expensive, although some aren’t much better than older ones.
Therefore, usually the ads you see for drugs advertise the newest and most expensive, not the latest and greatest. And these displays differ greatly in how much precise, useful information is included and what information is left out. A recent ad for Xeljanz (tofacitinib) is a good example.
The ad: A focus on the morning
A woman is woken up by her son who is carrying a toy dinosaur. She gives him breakfast, he buckles on his dinosaur backpack and they walk out the door happily. We see her arriving at a museum’s dinosaur exhibition on the school bus with his classmates.
The first word you hear on this ad is the tagline: “Tomorrow is made for better things than rheumatoid arthritis.” I think we can all agree that this is true. But why is that a selling point?
Well, a standout feature of rheumatoid arthritis (RA) is morning stiffness. People with rheumatoid arthritis are usually much worse in the morning and struggle with stiffness for an hour or more before their joints loosen up. And in this ad, you’ve just seen the main character, a mother who presumably has RA, who jumps out of bed full of energy and is ready for the day.
The standard sequence for a drug display
This particular display follows a known order of
- Description of the approved use of the drug (“for adults with moderate to severe rheumatoid arthritis, when methotrexate has not helped enough”)
- with reference to the benefits of the treatment (“… can relieve joint pain and swelling, stiffness and stop further joint damage”)
- A quick listing of possible side effects that are similar to most of the newer and most effective treatments for rheumatoid arthritis, including “severe and sometimes fatal infections” (due to a decreased ability to fight them off) and allergic reactions. More unique to Xeljanz are the risks of blood clots and tears in the stomach and intestines.
Strange phrases are common in direct marketing and seem to divert blame on the drug: According to the ad, cancers, including lymphoma, have “appeared”. That might make you wonder if these cancers just “happened” while people were taking the drug, or if they were actually drug-related? “The ad leaves this question unanswered.
The unspoken news
Even at the very beginning of the trip to the Dinosaur Museum, words appear on the screen to sing the praises of this drug:
- “No injection or infusion.” This is important because many of the other new and most effective drugs for rheumatoid arthritis cannot be taken as a pill. For many people, the fact that Xeljanz is a pill is a huge benefit.
- It “… can be taken with or without methotrexate.” Some rheumatoid arthritis drugs are recommended only if ingested With Methotrexate, a common initial treatment. That doesn’t apply to Xeljanz.
- “The recommended dose of Xeljanz for rheumatoid arthritis is 5 mg twice a day or 11 mg once a day.” It is important to indicate this dose on the advertisement because sometimes higher doses of Xeljanz are prescribed (e.g. in patients with ulcerative colitis) and higher doses may be associated with a higher risk of side effects.
The big goal
The students pose in front of dinosaur skeletons while the mother takes photos. The voice-over returns to the morning theme: “Don’t let another morning go by without asking your doctor about the pill, which was first prescribed for RA more than seven years ago.” This last part is intended to remind us that while Xeljanz is a relatively new drug, it is not brand new. The longer the track record, the less likely it is that new side effects will be discovered.
The final result
This ad does a lot right about rheumatoid arthritis:
- Symptoms are usually worse in the morning.
- The mother – either a caregiver or a teacher – is active and has normal-looking joints, which rightly suggests that good control of the disease is possible.
- It is important to take a drug that not only relieves symptoms but also protects the joints from damage.
- While methotrexate is often the number one choice for treating rheumatoid arthritis, it doesn’t work for everyone.
But like most ads, some facts are not mentioned. For example, Xeljanz is expensive (in the $ 4,900 / month range, though insurance coverage and discounts vary). There are also more than a dozen other highly effective treatments, some of which may be even more effective and cost effective for you.
The next time a drug ad interrupts whatever you’re watching or reading, keep in mind that while the ad is accurate, it may not be complete. Consult your doctor, as indicated in the advertisements, if you think this product is suitable for you. But a word to the wise: the answer might be: “It is not so.” If your doctor thinks a medication is right for you, chances are they have already prescribed it.
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