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Healthy Skepticism Library item: 16647

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: news

Friede A
DDMAC losing patience
Medical Marketing & Media 2009 Sep 15
http://www.mmm-online.com/DDMAC-losing-patience/article/151038/


Full text:

In its August 2009 blizzard of compliance correspondence, DDMAC used some of the harshest language in recent Warning Letter memory to send what can only be interpreted as a message that its patience is wearing thin.

In a Warning Letter to Allergan about a journal ad for Aczone, DDMAC concluded that the ostensibly study-based claim that the product “works fast” to achieve a “24% reduction in inflammatory lesions at two weeks” is “a complete misrepresentation of the results of the Draelos study.” DDMAC was also troubled by the omission of the placebo response rate from a claim of effectiveness at 12 weeks: “The journal ad grossly overstates the efficacy of the drug by presenting only the most favorable result for ACZONE [48% reduction in inflammatory lesions] and ignoring the placebo response [42% reduction in inflammatory lesions].”

While the letter to Allergan was perhaps the most scathing, others from August contain their own pithy descriptions of the alleged violations. In a Notice of Violation to J&J on Ertaczo, and while acknowledging what it described as the drug’s “modest effectiveness” against athlete’s foot, DDMAC nevertheless concluded that the clinical study results “clearly do not support the claims that Ertaczo ‘wipes out’ or crushes, kills and destroys tinea infections.”

Characterizations such as these, whatever their underlying merit, reflect increasing frustration with marketers and suggest that FDA might weigh additional enforcement approaches. FDA has sought disgorgement of profits and consumer restitution in at least one case-that of dietary supplement-maker Lane Labs-and its authority to do so was upheld by a federal appeals court. Similarly, FDA’s approach to enforcement of good manufacturing practice requirements, including requests for injunctive relief and even appointment of a monitor, seems like another possible enforcement tool.

Nor are allegations like these by DDMAC likely to escape the attention of State Attorneys General and the private class action bar, potent enforcers in their own right. State AGs recently piggybacked on a Warning Letter issued to Bayer for Yaz DTC. The ensuing settlement required $20 million worth of corrective advertising – apparently commensurate with the original ad spend. Such court-ordered corrective advertising, agreed to “voluntarily” in order to resolve a State AG investigation, effectively bypasses the serious question of whether FDA itself has the authority to mandate corrective advertising, a now-familiar (yet judicially untested) component of every FDA Warning Letter.

All of this, coupled with new Commissioner Hamburg’s heightened focus on Warning Letter enforcement and FDA’s recently issued draft guidance, suggests that pharmaceutical marketers and medical ad agencies take heed. Now is the time for proactive approaches, implemented early in the creative process, to identify issues that might be raised by regulators and address them. This doesn’t necessarily mean more tepid, less compelling communications. On the contrary, it suggests that marketers, particularly those with robust supporting data, have an opportunity to shape their communications in creative ways-with the overarching understanding of how DDMAC is likely to interpret what they say. Such an intimate understanding may well turn regulatory compliance into a competitive advantage.

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909