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Widgets Beware!

August 13, 2010 By jfisher Leave a Comment

From Ian DeMeritt, Senior Medical Writer, Palio

In what may be the first DDMAC letter to focus on Facebook, Novartis Pharmaceuticals was just warned that its use of Share Widgets on the Tasigna (nilotinib) Web site was illegal and that it misbranded the drug. Tasigna is “indicated for the treatment of chronic phase and accelerated phase Philadelphia chromosome positive [Ph+] chronic myelogenous leukemia (CML) in adult patients resistant or intolerant to prior therapy that included imatinib.” The Tasigna PI contains a boxed warning and the FDA required a REMS program for Tasigna to educate healthcare providers and patients about proper dosing strategies to avoid serious risks.

The Tasigna Web site contained several Share Widgets. By clicking on these icons, visitors were able to quickly and easily share information about Tasigna on Facebook, Twitter, or other social media sites. A short description of Tasigna (including its indication) and a link to the Tasigna Web site would then appear on the user’s Facebook page visible for all of his or her friends to see. Although users were unable to edit the Novartis-generated text, they could include comments along with the post.

While I applaud this use of social media by Novartis, there was only one problem with this approach that anyone familiar with recent DDMAC communication in this area could predict (except, apparently, the Novartis regulatory team): no safety information was included on the Facebook pages of visitors who shared the link. Even though a link to the Tasigna Web site was present, DDMAC has made it pretty clear over the past couple of years that when it comes to social media, it doesn’t recognize a so-called “one-click rule.”

To my knowledge, this issue was first addressed by DDMAC in the 2008 untitled letter regarding banner advertisements for Diovan; this letter was also issued to none other than Novartis. That letter clearly stated the need to include safety information in on-line communications, and that a link to safety information is insufficient to communicate risk information:

“The [Diovan] banners, however, entirely omit all risk information, including the warnings, precautions, and the most frequently reported adverse events from the PI. We note that a link to the PI and Patient Product Information (PPI) is included at the bottom of the banners. However, this does not mitigate the misleading omission of risk information from the banners.”

Not surprisingly, DDMAC’s position hasn’t changed in the past 2 years. The following wording from the latest letter is nearly a direct copy-and-paste from the letter issued in 2008:

“We note that the shared content contains a hyperlink to various Tasigna product websites, which do contain risk information. However, the inclusion of such a hyperlink is insufficient to mitigate the misleading omission of risk information from these promotional materials.”

Given the previous communications between DDMAC and Novartis, I find it curious that they continue to test the “one-click rule.” Whether this latest misstep was intentional or not, it highlights the fact that the issue of pharmaceutical advertising in social media is not going away. Until DDMAC releases its guidance on social media these issues will continue to surface and DDMAC will continue to issue letters to companies who fail to comply.

Until then, I wonder if DDMAC will accept my friend request.

Palio is a full-spectrum global pharmaceutical and consumer advertising, marketing, and communications agency that excels in brand creation and specializes in brand strategy, product launches, global marketing, and digital and integrated media.
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Filed Under: Advertising, Medical Strategy Tagged With: DDMAC, Novartis, one-click rule, Risk Information, social media, Tasigna, warning letter, widgets

“What’s up, doc?” The FDA Bad Ad Program wants to know.

May 28, 2010 By jfisher 1 Comment

From Jim Mittler, Medical Director, PhD, Palio

We’ve all seen bad drug advertisements – confusing concepts, poorly written or too much copy, disconnected visual elements, etc. The FDA is now stepping up their monitoring for bad ads, but not for the creative aspects or connection to the brand. (Although, in some cases I wish there was an organization that could pull poorly executed creative.)

Last week, the FDA announced the launch of the “Bad Ad Program,” which is an educational outreach effort to encourage physicians to do what the Division of Drug Marketing, Advertising, and Communications (DDMAC) can’t necessarily do – monitor what is communicated during face-to-face interactions with pharmaceutical representatives. Traditionally, DDMAC reviews promotional materials developed by pharmaceutical companies (eg, journal ads, TV commercials, sales aids, or slide kits) to ensure that information is on-label and accurately portrays the efficacy of a drug while clearly stating the potential risks so that physicians can make informed prescribing decisions. Through the Bad Ad Program, DDMAC will seek to educate HCPs on what constitutes inappropriate promotional activities and will encourage HCPs to report possible violations. So not only is the content of promotional materials monitored, but by using HCPs as their agents, how these materials are used and the information articulated can also be monitored by DDMAC.

What this means is that verbal communications that occur in promotional settings such as sales representative office visits and industry-sponsored dinner and speaker programs could be under scrutiny. In the current conservative environment, sales reps are careful not to discuss off-label use or overstate the efficacy of a drug. Now, glancing over the safety data in a sales aid or the Important Safety Information slide during a presentation is frowned upon, as it should be. However, the increased scrutiny by HCPs could deter sales reps from deviating from a predetermined script and they could lose meaningful conversations out of fear that they could misspeak or be misinterpreted, and subsequently be reported to DDMAC. It may be difficult for DDMAC to determine what was discussed in a private meeting; however, according to FDA officials, if there is systematic misrepresentation, FDA reviewers will be able to spot similar complaints about a drug coming from multiple doctors, which would signal DDMAC to investigate.

The question remains if HCPs will take the time to report anything they feel is misleading or inappropriate. Additionally, will this enhanced surveillance lead to increased enforcement? The FDA has gotten tougher on promotional materials developed by drug marketers. Issuance of enforcement letters is higher than it has been in the past, with 31 warning letters already issued by DDMAC through May 2010 (which is on pace to exceed the 41 letters issued in 2009 and tops the 21 letters issued in 2008). However, if a high volume of complaints arise, there are questions regarding how the FDA will be able to investigate and issue timely corrective action due to the limited resources within the FDA. Regardless, even if DDMAC enforcement is logistically problematic, the Bad Ad Program could be a deterrent and improved compliance to DDMAC regulatory principles on the part of the pharmaceutical companies is sure to follow.

Palio is a full-spectrum global pharmaceutical and consumer advertising, marketing, and communications agency that excels in brand creation and specializes in brand strategy, product launches, global marketing, and digital and integrated media.
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Filed Under: Advertising, Medical Strategy Tagged With: Advertising, DDMAC, FDA, warning letter

Aggressive Driving or Who Let the Ducks Out?

May 7, 2010 By jfisher Leave a Comment

From Peter Hopper, VP, Account Services, Palio

Just the other day, in my local newspaper, there was a front page story about how the local police authorities are stepping up patrol of a main expressway heading into the city due to a significant increase in “aggressive driving.” Not to suggest that aggressive driving is appropriate behavior in any context, but obviously drivers are on notice: this particular stretch of road is going to be that much more on the radar screen, so to speak.

The appropriate response is to be mindful of the increased vigilance and ensure you are extra cautious to avoid getting pulled over and suffer the consequences: a ticket, extra points on your license, increased insurance, legal fees, perhaps even your name in the newspaper.

What about the duck?

For our industry, the name in the paper was Novartis, its oncology product Gleevec, and two disease-awareness Web sites actually registered to Novartis AG. The two sites’ disease-state content and clinical data were specific to the Gleevec indication. The FDA Warning Letter cited, along with other evidence, that the unbranded Web sites were “perceptually similar” to the Gleevec brand by look and feel, each included the Novartis Oncology logo, and each presented well-known facts that the medical community would easily recognize as referring to the branded product: if it looks like a duck….

In addition to blurring the lines between disease awareness and product promotion, the letter noted the omission of risk, as well as the inclusion of unsubstantiated dosing claims.

It is not news that DDMAC has substantially increased its resources to scrutinize branded and unbranded communications in the marketplace, and that those resources are good at their job. The FDA has posted over 30 letters specific to promotional materials to date in 2010, already eclipsing the entire count for 2008. This latest letter demonstrates the agency’s prowess, and every letter posted reinforces its determination, regardless of anyone’s opinion about how clearly defined, or not, the rules are.

One of our jobs as professional marketers is to seek out the appropriate opportunities and venues for our clients’ communications plans – and to offer sage advice on how best to leverage those opportunities – and, just as importantly, to keep our clients out of the unfortunate headlines.

Palio is a full-spectrum global pharmaceutical and consumer advertising, marketing, and communications agency that excels in brand creation and specializes in brand strategy, product launches, global marketing, and digital and integrated media.
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Filed Under: Account Services, Industry Trends Tagged With: FDA, Gleevac, Novartis, warning letter

What’s In a Name?

April 22, 2010 By jfisher 1 Comment

From Ian DeMeritt, Senior Medical Writer, Palio

“What’s in a name? That which we call a rose by any other name would smell as sweet.” – Romeo and Juliet (Act II, scene II)

What if that rose didn’t have a name, yet claimed that it smelled sweet?

Late last week, DDMAC issued several regulatory letters to pharmaceutical companies, bringing the total number of letters it has issued so far in 2010 to 22, already topping the 21 letters sent in 2008. Of interest was a letter addressed to GlaxoSmithKline for an unbranded, single-page ad (also shown above) placed in the Journal of Clinical Oncology last December.

The simple ad announced that a “New Treatment Option for Refractory Chronic Lymphocytic Leukemia (CLL)” was “NOW APPROVED.” A footnote clarified the treatment was for CLL “refractory to fludarabine and alemtuzumab,” and a disease-specific Web-site address (www.cllinformation.com) and the GSK logo were included on the bottom of the page. That’s it. No efficacy data were included, no overt promotional claims were made, and no fancy images of happy people walking along a beach were present.

Most importantly, however, no safety information was contained in the ad, despite its unbranded nature.

Even though the name of the treatment was not provided, DDMAC considered the ad misleading because “the characteristics of the product promoted in the ad can only describe Arzerra,“ the only drug recently approved by the FDA to treat refractory CLL. Because the promotional material could only apply to a single product, the ad was effectively considered a branded advertisement requiring full disclosure of safety and risk information.

In our line of work, the response to what we perceive as unfair feedback from a client’s regulatory team is often jokingly along the lines of “can’t we just turn this into an unbranded campaign?” thinking that by simply removing the branding elements, the regulatory requirements will also magically disappear.

However, one of the important lessons to be learned from this letter is that a pharmaceutical brand comprises more than just a logo and color pallete. The totality of the message being conveyed must also be considered a key branding element, especially in the eyes of the FDA.

This latest DDMAC letter provides a useful reminder that failing to call a rose by its name doesn’t make it any less of a rose.

Palio is a full-spectrum global pharmaceutical and consumer advertising, marketing, and communications agency that excels in brand creation and specializes in brand strategy, product launches, global marketing, and digital and integrated media.
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Filed Under: Industry Trends, Medical Strategy Tagged With: DDMAC, FDA, oncology, regulatory, warning letter
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