Paula Deen and Other Proof that Monetary Rewards Improve Adherence

Last month it was reported that celebrity chef and paid spokesperson for Novo Nordisk had lost 30 pounds in the six months since she signed on to help promote Novo's diabetes drug, Victoza (see "Paula Deen Loses 30 lbs. Urges Twitter Fans to Pig Out on Fourth of July!"). This was good for Deen and redemption for Novo Nordisk, which was criticized by me and others for choosing Deen -- who is notorious for her high fat, high calories recipes -- as a type 2 diabetes spokesperson (see see, for example, "Paula Deen & Victoza: Brilliant or Dumb?").

So how did Deen lose all that weight? On the ABC food show “The Chew” Deen said: “It’s really about moderation. I’ve said it for so long but I really started to practice that." She also started working out with weights and walking.

Well, I doubt "so long" goes back to before she started collecting money from Novo Nordisk in December, 2011, or thereabouts. I also don't put any stock into her statement: “It took me a couple of years to get to this point" (see "What’s the Secret to Paula Deen’s Weight Loss?"). The fact is, she lost the weight AFTER being signed on as a spokesperson.

Which proves that money is the best incentive for adhering to a healthy lifestyle. If, like Deen, I was paid a substantial amount of money to lose 30 lbs in six months, I have no doubt I could do it. In fact, I have lost 30 pounds in less than 6 months without any monetary rewards. But that's another story; ie, I have since gained back those 30 lbs :-(.

Even rewards as low as $1 or $2 per week can induce ordinary folks like you and me to lose weight. This was demonstrated by a UConn study in which patients who lost "at least a pound in a given week would draw from a prize bowl. The prize bowl contained 500 cards, 250 of which were prizes. Most of the prizes were valued at around $1, and some were of greater value, offering a chance at larger prizes such as an iPod or fitness equipment. The average cost per draw was approximately $2" (see "UConn Researchers Find Incentives Effective for Weight Loss"). Participants in the study also received "supportive counseling," which, I'm sure, Deen also is getting (free of charge?).

Anyhoo, at the end of the 12-week UConn study, the results showed an average weight loss of 6 percent of body weight in the group receiving awards, compared to an average body weight loss of 3.5 percent in the counseling-only group.

Let's do some math. A 6% weight loss for the reward group computes to about 11 lbs for an overweight 180-lb woman. That's over a period of 3 months. In six months, it would be 22 lbs -- pretty close to what Deen lost.

In the UConn study, participants were not guaranteed a reward if they lost weight and the reward was not commensurate with the amount of weight lost -- such a reward system might be unethical and cause people to starve themselves for money. Hopefully, that will not happen with Paula Deen. And hopefully, she, like me, will not gain back her weight when her deal with Novo Nordisk is finished.

My little poll (below) suggests that a plurality (not a majority) of people believe the Novo Nordisk deal with Paula Deen was a "Dumb" idea from a marketing perspective. Many people who were unsure may now think it wasn't such a dumb idea after all. What do you think?

From a marketing perspective, is the Novo Nordisk deal with Paula Deen Brilliant or Dumb?
	Brilliant!
	Dumb!
	It remains to be seen.

Phil Disclosure: Mickelson is a Serial Undisclosed Celebrity Endorser

Today, while reading an article about 5 Guys Burgers ("All in the Family") in the August 2012 issue of Forbes Magazine, I came across a reference to Phil Mickelson. In 2010, Mickelson gave a glowing, unprompted endorsement of Five Guys Burgers during a press conference at The Players Championship.

"What I’ve done the last five days, go to Five Guys Burgers. That place is so good. I can’t stop going there. This will be my sixth day in a row. I grew up on In-n-Out. I thought that was the best burger until I had Five Guys. That is hands down the best burger I’ve ever had" (see story here).

A few days later, fellow golfer Stewart Cink, a big fan of In-N-Out, directed this tweet at AP golf writer Doug Ferguson: “Keep in mind, PM owns SoCal rights to FiveGuys. Biased argument?”

[Keep in mind that Cink may shill for In-N-Out - his Twitter profile shows him eating an In-N-Out burger and fires.]

Cink was correct - Mickelson was biased. As reported on CNBC, Gaylord Sports Management, which represents Mickelson, confirmed that Mickelson was in fact part of a group that has purchased the rights for Five Guys franchises in Orange County.

A few months later, during the 2010 PGA Championship, Mickelson again made an "unsolicited" endorsement. This time, it was for ENBREL, the Amgen/Pfizer drug inicated for the treatment of psoriatic arthritis.

The subtitle to a NowPublic article titled "Phil Mickelson Arthritis: Will Play At PGA Whistling Straights", stated "Phil Mickelson Has Psoriatic Arthritis - Uses Enbrel To Help Manage Condition." The article (here) includes this quote from Mickelson: "I have no aches and pains. My back feels great. I feel stronger and more flexible than I've ever been."

At the time, I asked "Is Phil Mickelson Shilling for Enbrel?"

Well, the jury is out on whether or not Mickelson was a paid ENBREL celebrity endorser at the time he made that statement. But in a manner similar to his Five Guys Burgers outing by social media, it was later revealed that Mickelson was indeed a paid celebrity spokesperson for ENBREL (see "Phil Mickelson 'Opens Up' to Arthritis Today Magazine"). The Arthritis Today article claims that Mickelson "entered into a partnership with Amgen-Pfizer, an Arthritis Foundation sponsor, in November, 2010." Also see "Amgen Blows Its Marketing Budget on Phil Mickelson Campaign" for the Amgen press release announcing the deal.

As soon as Phil became a PAID spokesperson for ENBREL, he could not say these things because he became an extension of the brand and subject to FDA regulations. But at the time he said the above, I suspect he was giving his future benefactors a freebie! We don't know how long the negotiations were going on before the deal was signed, but this story could have been arranged to seal the deal.

BTW, my sons think Five Guys Burgers are "epic." They ate at a Five Guys joint every week while at Penn State. Of course, they are not paid by Five Guys nor do they own a Five Guys franchise.

So, I'm not saying that Mickelson lied when he said a Five Guys burger was "the best burger I’ve ever had" nor when he said he feels "stronger and more flexible than I've ever been" after taking ENBREL.

My concern is a celebrity who promotes a drug having dangerous side effects without revealing that he may have a financial interest in the product. When Mickelson first made his statements about ENBREL he may or may not have technically signed a contract, but it was obviously meant to get the work -- a demonstration of what he could do. Now that he is featured on ENBREL TV ads, everyone knows he is a paid spokesperson. I have no problem with that, especially that now his commercial speech is regulated by the FDA and he can no longer make outlandish statements.

UPDATE (8/16/2012): In a personal communication, a reader said: "I had to laugh when several times I thought I noticed Phil dropping a right hand wedge into his bag during the TV commercial. But look closely, it's true..." Phil is left-handed, so I guess the director of the commercial used his own clubs as props!

Paula Deen Loses 30 lbs. Urges Twitter Fans to Pig Out on Fourth of July!

Whilst on the supermarket checkout line, I noticed the cover of the latest, July 9, 2012, People Magazine that featured Paula Deen (see image below). "How I Lost 30 Lbs!" was the headline. Under the banner announcing PAULA'S GET-SLIM RECIPES, the magazine invites us to learn her "secrets": "After diabetes diagnosis, the southern chef finally changed her lifestyle and her pants style. Her secrets will surprise you!"

Deen is really looking good and I cannot wait to discover her "secrets." But, first, I should note that Deen lost those 30 lbs not immediately after she was diagnosed with diabetes over three years ago, but after she signed on with Novo Nordisk to be their diabetes/Victoza spokesperson (see "Paula Deen & Victoza: Brilliant or Dumb?").

Since then Deen and her sons have been creating recipes for "Diabetes Light," a Victoza-branded web site that features "Recipes from Paula with a Dash of Inspiration" (here).

BTW, Novo should get a more recent photo of Deen than the one it currently uses on the "Diabetes Light" website (shown on right). The current one shows a much heavier-looking Deen prior to her recent weight loss.

I wish Deen luck in keeping her weight loss. I know from personal experience that you can lose 25-30 lbs if you change your diet, but quickly gain it back once you regress to your old ways of eating.

Anyway, Paula's "secrets" include these changes in the way she says she eats:

• Fried chicken reduction. Deen says she eats fried chicken only once a month.
• No key lime pie. She says, “You couldn’t pay me to eat that pie.”
• Potato reduction. She has not cut out eating potatoes, but she has cut down on eating them.
• Eating vegetable from her own garden and creating healthy recipes.
• Butter reduction. She has cut her butter consumption in half.
• Eating Greek salads and baked fish.

Meanwhile, however, Deen has been promoting quite a different menu to her 786,000 Twitter followers:

Are y’all ready for Independence Day? Make sure you fix up one of these recipes for the big day! http://ow.ly/bULkY http://ow.ly/i/JuXN

One look at these carbohydrate-rich recipes on PaulaDeen.com and you understand why Novo is not sponsoring Deen's Twitter account:

• Sausage and Potato Salad
• Chilled Grilled Corn and Watermelon Salad
• Lemonade
• Curry Chicken Salad
• Oven Fried Potato Wedges
• Cheesiest Fried Chicken Empanadas with Chili Con Queso Dip
• Bacon Wrapped Grilled Corn on the Cob
• Watermelon Cooler

I suppose I can eat just one Cheesiest Fried Chicken Empanada with a touch of Chili Con Queso Dip, but how am I supposed to eat just a bit of Bacon Wrapped Grilled Corn on the Cob, which calls for 1 Lb of bacon for 8 ears of corn? That's 2 oz. of bacon (300 calories) per cob, not counting the butter I would likely spread on it!

Pharma Celebrity Multiple Personality Disorder (PCMPD)
In my opinion, this demonstrates what I'd like to call "Pharma Multiple Personality Disorder (PCMPD)" where a celebrity promotes one lifestyle under contract with a pharmaceutical company and then promotes the opposite for other business purposes (eg, as a Food Channel chef).

[Thanks to @Paullikeme from patientslike.com for suggesting MPD -- and not Schizophrenia, as I originally suggested -- as the correct DSM-IV diagnosis.]

The fact that Deen has lost 30 lbs is good news for Novo, which received a lot of criticism for its choice of Deen as a diabetes spokesperson. To date, my little poll (below) suggests that a plurality (if not a majority) of people believe the Novo Nordisk deal with Paula Deen was a "Dumb" idea from a marketing perspective. Many people who were unsure may now think it wasn't such a dumb idea after all. What do you think?

From a marketing perspective, is the Novo Nordisk deal with Paula Deen Brilliant or Dumb?
	Brilliant!
	Dumb!
	It remains to be seen.

Meanwhile, I invite you to listen to this conversation with Ambre Morley, Associate Director, Product Communications, Novo Nordisk, about why her company teamed up with celebrity chef Paula Deen as a spokesperson for type 2 diabetes treatment:

Listen to internet radio with Pharmaguy on Blog Talk Radio

Is Deen Positioning Herself as a Potential CHANTIX Spokesperson?
I just picked up a copy of People magazine and learned that "Paula's Next Challenge: [is] Quitting Smoking." She says she "thinks about quitting every day...My husband has quit for over a year now. Maybe one day I'll be ready. I pray that I will," said Deen.

If past experience is any guide, Deen will be "ready to quit" as soon as she closes a deal with Pfizer to be its CHANTIX celebrity spokesperson!

BI Dumps Celebrity COPD Spokesperson and Seeks Inspired Facebook Fans Instead

Today Boehringer Ingelheim (BI) sent out this tweet: "We have just launched a new #hcsm activity within Facebook....want to find out more? Check out all the details here http://t.co/gwLgMe0D"

The link leads to "COPD Inspirations - The BIG Picture," a FaceBook page that encourages fans to submit images that reflect "the positive fight against COPD and will inspire others to take back control of their lives. So to get involved 'get creative, get emotive, get artistic!' and upload your image," says BI.

Recently, BI handed over the keys to its public health initiative, Drive4COPD, to the non-profit COPD Foundation (see here). That initiative features racecar driver/celebrity Danica Patrick who is more well-known as a swimsuit model and expletive-deleted competitor (see "Pharma Celebrity Spokespersons: Unrepentant, Secretive, and (Expletive Deleted)!").

BI's new Facebook-based COPD awareness initiative/campaign may signal a trend away from the use of paid celebrities to the exploitation of real patients, who will not receive any compensation whatsoever for the use of their images and stories. BI will, however, offer entrants a chance to win an iPad 2. (Why not a third-generation iPad? Perhaps BI has a surfeit of iPad 2's they need to get rid of.)

Here are the eligibility requirements:

1. Entrants must be aged 18 or over. 
2. Entrants cannot be employees of Boehringer Ingelheim (BI), or respective affiliate companies / be an employee of any pharmaceutical company 
3. Entrants must have a personal connection to COPD – i.e. either have the disease themselves, or be a carer / friend / family member of someone who has or has previously suffered with COPD. 

Oh, I forgot to mention one other criterium for eligibility: you must be a Fan of BI on Facebook. So BI gets new fans and free images for its COPD campaign. Sweet!

Since I was eligible -- my mother-in-law, Irene, has COPD -- I thought I'd submit an entry and see what happens. It was pretty easy. I had a photo of Irene that I think is inspirational (see below):

Along with an image, BI requires entrants to submit an "inspirational" comment, so I wrote: "COPD does not stop my Mom-in-Law, Irene, from enjoying the beautiful world around her, especially when she is with her family. Her daughter, Debbie, took this photo while they hiked in Pine Creek Gorge, commonly referred to as the Grand Canyon of Pennsylvania."

While I was at it, I also posted the photo to my Facebook page (BI's terms and conditions have no qualms about me using my photo elsewhere). The terms, however, do state: "Each entrant grants a worldwide licence to BI to use the images in any way the companies deem fit (e.g. to feature any or all of the submitted images on their websites and/or in any materials it develops for media, HCPs or patients, with acknowledgement of the entrant. Images will be used by BI to highlight understanding and awareness of COPD. Again, the entrant may be contacted to provide further background to the imagery and will be notified ahead of use)."

The competition opened  today and will close on the 18th July 2012. So, hurry, and enter those photos or other creative images TODAY!

New Victoza Prescriptions Flatten After Novo Signs Deal with Paula Deen

New prescriptions written per month for Victoza -- diabetes treatment sold by Novo Nordisk -- have leveled off just after Novo signed on celebrity chef Paula Deen as a spokesperson. Prescriptions for the drug were rising steadily for a year and a half prior to that.

The two events may be coincidental (and the flattening may be temporary), but interesting nevertheless because it puts a hole in the theory that the return on celebrity endorsements of pharma products is worth the investment.

The Victoza Rx data comes from a chart I found in the petition filed by Public Citizen with the FDA that asked the agency to withdraw Victoza because of increased risks that patients may developed pancreatitis, serious allergic reactions and kidney failure (find the petition here).

The chart shows a plot of "Number of Prescriptions" of Victoza (liraglutide) versus Byetta (exenatide), a competing drug marketed by Amylin (see below):

It appears that the number of (new) prescriptions written per month has leveled off at about 150,000 -- a number that has not increased since about January 2012 when Novo announced that Deen would be a spokesperson (see "My Bad! Paula Dean Shills for Novo Nordisk, Not Novartis").

In its petition, Public Citizen states "As can be seen by subsequent FDA safety alerts issued for acute pancreatitis, thyroid toxicity, and kidney failure over liraglutide’s first year and a half of marketing, warnings have not succeeded in preventing serious adverse reactions. This is especially unfortunate because diabetics are already at increased risk for pancreatic and kidney toxicity. ... The number of prescriptions for liraglutide has been steadily rising, putting increasing numbers of patients at risk of adverse reactions to this drug. The increase in adverse reactions is seen in the continuing reports in the FDA’s database, making it clear that the FDA’s use of warnings is not sufficient protection."

Public Citizen, however, does not report that based on post-marketing data, BYETTA has also been "associated with acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis" according to the safety information that is part of its "package insert."

A couple of questions:

1. Will this new focus on Victoza safety information scare Paula Deen? 
2. Can she discontinue taking Victoza if she felt it was necessary or would her contract with Novo prevent her from doing that (she does take other medications to control her diabetes)?

Paula Deen Does Not Know Her Blood Sugar Numbers

Paula Deen, the TV celebrity southern-style chef and spokesperson for Novo Nordisk's diabetes treatment Victoza (see "Novo Nordisk Defends Choice of Paula Deen Over Anthony Bourdain (for example) as Celebrity Chef Spokesperson"), recounted for Prevention Magazine how she learned she had type 2 diabetes. Deen is featured on the cover of the May 2012 issue of Prevention (see cover on left).

When asked "How high was that blood sugar reading?" during a routine doctor visit more than 3 years ago, Deen said "I don't know. They just said it was high." Then her doctor said, "I'm going to start you on some medicine," and wham, bam, thank y'all ma'am, Deen started her secret life as a diabetic.

Furthermore, Deen does not remember her doctor saying anything about lifestyle changes. "Now, she might have," said Deen diplomatically, "but I don't recall coming out of that visit with a lot of literature. She just started me on the drug."

It's hard to believe any doctor worthy of treating a wealthy celebrity would not have given her a bit more education regarding living with diabetes. One important bit of education is "Know Your Blood Sugar Levels." That's the title of a National Institutes of Health National Diabetes Education Program pamphlet (see here). "If you have diabetes," says NIH, "keeping your blood glucose (sugar) numbers in your target range can help you feel good today and stay healthy in the future."

After Novo Nordisk approached her to be a spokesperson, Deen "asked the doctor if I could switch over from the [combo drug]" to Victoza. Of course, her doctor complied because Deen knows best, although she doesn't know her numbers (or choses not to say what they are). Or perhaps the doctor was also "approached" by Novo Nordisk.

Whatever! Deen is now taking not only Victoza but also metformin and "a small dose of Actos." I'm not an expert on diabetes treatments, but because Deen is on multiple drugs and because she hasn't revealed her initial high blood glucose reading, we will never know if Victoza is really helping her control her diabetes.

Deen has the right to keep her blood glucose levels and other medical information confidential. She also has the right not to reveal how much money Novo Nordisk is paying her. "I am being compensated for my time and work," said Deen.

But should pharmaceutical companies be required to reveal how much they pay celebrity spokespeople just as they are now required to reveal how much they pay physicians (celebrities or otherwise)? If Nike reveals that it paid Tiger Woods $105 million, why shouldn't pharma companies reveal how much they pay celebrities (including Phil Mickelson who is a paid ENBREL spokesperson; see here)? What are they hiding?

BTW, there seems to be a pattern of pharmaceutical celebrity spokespeople defending themselves in consumer magazines like Prevention. Mickelson, for example, "opened up" in an interview published in Arthritis Today (see "Phil Mickelson 'Opens Up" to Arthritis Today Magazine"). 

Of course, these magazines also make a lot of money from drug advertising. In fact, there is a nice 2-page ad spread for Victoza featuring Paula Deen in the same issue of Prevention as her less than "tell all" interview. In the ad, Deen is NOT depicted creating her famous bacon, cheeseburger, Krsipy Creme donut sandwich! (See the video of THAT here).

In a recent survey, I asked respondents to say whether they agreed or disagreed with the following statement: "Each pharmaceutical company should be required by law to publicly disclose how much money it pays every celebrity for being a spokesperson." 38% (N=112) said they "strongly agreed, " another 21% said the "somewhat agreed," and 36% said they strongly or somewhat disagreed.

One pharmaceutical company employee respondent made this comment: "What is the point of all this pharma reporting? If I tell you that Paula Deen is making $10M or $1M, what difference does it make? I'm sure she's making a lot of money. But that is driven by her market worth and the specifics of the contract (length of contract, number of events, etc.). There's no realistic way for the public to understand (or care about) that context. So what is the point?"

Full results of the survey will be published in the upcoming April issue of Pharma Marketing News. Subscribe now to get it free!

Charlie Kimball - Novo's Branded Spokesperson - Makes Expensive TV DTC Debut

Charlie Kimball, the Indy racecar driver spokesperson for Novo Nordisk's NovoLog Flexpen, which is used to treat Type 1 diabetes, made his debut as star of his first direct-to-consumer (DTC) TV ad. Not only does the ad feature Novo's product, it also promotes Kimball's Indy team Chip Ganassi Racing. A win-win!

I saw the commercial on the CBS evening News last night. Kimball did a great job.

I couldn't find a version of the commercial on the Internet, but I DID find a video titled "Charlie Kimball and Novo Nordisk" in which Kimball discusses how the commercial was made. One thing that the video demonstrates is why pharma spends so much money on broadcast (ie, TV) DTC. It's not just the loads of money spent on buying airtime on the major networks. It is also the cost of producing the commercial itself. This is what Kimball discusses in the video (embedded below).

Kimball is amazed by all the people involved such as director, assistant director, key grip, not to mention the production crew's four trucks, two motor homes, and catering trailer. All together, 50 people were involved said Kimball.

In the past, Kimball had only been tweeting (see, for example, "Novo Nordisk's Branded (Levemir) Tweet is Sleazy Twitter Spam!" - the #3 Google search result for "sleazy tweet"!) and making personal appearances, which is more of a PR effort than a marketing effort. My guess is that PR costs much less than marketing and employs fewer people compared to marketing's BIG item productions such as TV ads.

So, thank you Charlie and Novo Nordisk for helping America solve it's unemployment problem!

Pharma Celebrity Spokespersons: Unrepentant, Secretive, and (Expletive Deleted)!

I have documented the rise and fall of several pharma celebrity spokespeople (see, for example, this list) . This past week two such celebrities made the news: Paula Deen and Danica Patrick. These are two examples of celebrities with "baggage" that may hurt the image of their pharma company partners. Paula Deen's baggage concerns secrecy and her unrepentant recipes whereas Danica Patrick's baggage includes swimsuit and bikini pictures and colorful language. I just imagined Paula and Danica "switching" their baggage (ewww!).

Paula Deen continues to express no regrets about delaying her announcement that she has Type 2 diabetes for nearly three years until she secured a lucrative deal as "a paid pitch person for drug maker Novo Nordisk's new online program, Diabetes in a New Light, and for its pricy (sic) drug, Victoza, which she takes" (see USA Today article, "Paula Deen: no regrets"). She will continue to cook sugary, fattening meals as she always has done, declaring "I'm Southern by roots. I was taught (to cook) by my grandmother and nothing I can do would change that."

However, she said that "when she begins shooting new episodes of her show this spring, the recipes will offer something for everyone, including people who want healthier recipes."

Unfortunately, there will also be a delay before those new recipes are available because "filming and production schedules are set well in advance, it could take up to two years before those episodes are aired," notes the USA Today article.

Meanwhile, Deen remains silent about how much she is being compensated by Novo Nordisk to be a paid spokesperson, citing an excuse as American as her own "Savannah High Apple Pie" (see recipe, which includes at least 2 and a half cups sugar, one whole stick of butter, and 2 cups butter-flavored solid shortening (recommended: Crisco)):

"Yes, I am being compensated," she said Friday. "It's the way of the world. It's the American way. But I am taking a portion of that compensation and giving it back to the (American) Diabetes Association."

Deen would not reveal what portion of her compensation she would donate to the American Diabetes Association. That too is the "American" way?

To learn more about Novo's reasons for choosing Paula Deen as a spokesperson, I invite you to read the Pharma Marketing News article "Novo Nordisk Defends Choice of Paula Deen as Diabetes Spokesperson". You can download this article after taking a short survey that asks two short questions:

1. When it is proper to use paid celebrities - e.g., movie stars, TV personalities, sports figures - as spokespeople for drug brands?
2. Should pharmaceutical companies reveal how much they pay celebrities?

You can Take the Survey here and see the results to date afterward as well as getting a FREE copy of the article.

"Was das F**k!"

That's what Danica Patrick, spokesperson for Boehringer Ingelheim's DRIVE4COPD™ awareness campaign said after teammate Cole Whitt "nudged" her rear in the Drive4COPD 300 race this past Saturday. Actually, Danica spoke in English, but that is what I imagine Boehringer Ingelheim executives were saying when they heard about this latest news about their "bad girl" spokesperson.

"The (expletive) 88 hit me while we were in a big pack! What the (expletive)?" Patrick screamed. ESPN has the video and audio from her in-car radio (here).

"I don't think it's ever great when teammates come together," Patrick said. "So we'll have to figure out what happened and move forward." Patrick didn't complain, however, in the beginning of the race when another racer, Dale Earnhardt Jr., "pushed" her to the lead position at the beginning of the race. She dropped way behind after that and grazed the wall once on her own before the second incident occurred.

Coincidentally -- or maybe NOT! -- the DRIVE4COPD Web site (here) is undergoing a revision (see below). I entered my email address to be "notified when the new site is live." Will Danica still be there?

[UPDATE. 29 Feb 2012]
I was contacted by a Public Relations person at Boehringer Ingelheim Pharmaceuticals, Inc. who said:

"Just wanted to clarify an item in your recent post re pharma celebs. The DRIVE4COPD website has been "under construction" since December 28, 2011, as we work to revise it to reflect changes to the campaign going into its third year. Since 2010, Danica Patrick has helped drive education and awareness about COPD among NASCAR fans and has been a committed and passionate spokesperson for the cause due to her family’s personal connection to the disease. The status of the website has nothing to do with any specific recent events and is on track to be fully up and running by next month. "

Thanks for the update. I didn't really think one thing had anything to do with the other :-)

Paula Deen & Victoza: Brilliant or Dumb?

OK. I've written so much about Novo Nordisk's deal with celebrity chef Paula Deen that even I am tempted to say "Enough already! Move one." Well, there is one side of this story that I and others have not yet commented on. That is, what do Novo's troops (ie, sales reps) have to say about it? Specifically, do they think this deal will help them sell Novo's type 2 diabetes drug Victoza -- the drug Deen is a spokesperson for? Or will it hurt sales?

To get answers to those questions, I turned to the Novo Nordisk company board on Cafe Pharma (CP) - the notorious but always entertaining and enlightening pharma sales rep message board. I learned about some other issues that the "troops" discussed, including:

• Heredity vs. Lifestyle as contributing factor
• Is drug treatment the first option recommended when diagnosed with type 2 diabetes?
• The role of the American Diabetes Association (ADA)
• Will Victoza be prescribed off-label for weight loss?

One anonymous commenter,  had this to say:

"This is either the most brilliant marketing strategy ever or the dumbest."

That, of course, remains to be seen.

It's Dumb!
Interestingly, this commenter added some further remarks that offers intriguing insight into the possible strategy of Novo Nordisk's entire diabetes franchise:

"Just think," said this anonymous sales rep, "Paula and her fat fans go from victoza to levemir to novolog. I give her 1 more year and she is on insulin." Not that this rep thinks this is an honorable strategy for Novo to support. "Novo should do the honorable thing here and cancel this deal. Defeat diabetes my ass. They have just done more to cause diabetes than mcd's [McDonald's]. It is like Marlborough Man being a spokesman for Nicorette. Shameful."

Of course, it's possible that this anonymous rep was a rep from a competing pharmaceutical company and not a Novo rep at all. In any case, other commenters had similar things to say, such as:

"Wow. This is a PR disaster. Who were the brains behind this fiasco? Victoza is taking major hits in the media with the whole world now focused on price ($500 a month!) and questions being raised about drug safety and marketing ethics. Novo just bought itself a few million dollars worth of bad publicity. Time to pull the plug to save face."

It's Brilliant!
There were also plenty of posts in defense of the deal:

"Granted, she is still in denial, but she's on Victoza, she's already lost a dress size since starting and it's a Dean family endorsement. Which is even better because it shows it does take a village to help patients with diabetes treat their disease. This is a horrible disease that is difficult to manage. Everyone is playing into Novo's hands with all the press around diabetes and becoming more aware. Novo couldn't pay for all the ads they've gotten over the past week."

"First of all, this whole flap will be short lived. It wont be long before it's been long forgotten. Secondly, PD's hardcore fans couldn't care less about how long she took to reveal her diabetes. If Paula takes Victoza, guess what those hardcore fans are going to ask their doctors to prescribe for them. And there's millions of them too. Most of the critics are selling Novo's management short. Time holds the answer as to what will happen, but my money is on the whole thing being wildly successful.

"the posters who think its ridiculous are the competitors bc they are mad their idiot companies didnt do this first. Its brilliant. Brilliant bc we all know the success rates with Victoza. Our docs rave about it all the time. Theyre not going to write more lantus bc PD was hired by Novo.

"This is brilliant. Do you think Weight Watchers cared when Barkely supposedly trashed their endorsement by saying it was easy money to eat their meals and lose weight? No, it was good TV. This will be for Novo, too. Welcome to big pharma."

From a marketing perspective, is the Novo Nordisk deal with Paula Deen Brilliant or Dumb?
	Brilliant!
	Dumb!
	It remains to be seen.

Someone else pointed out that drug treatment is not the only solution for people with Type 2 diabetes ("T2DM"):

"It is not a 'horrible disease' – it is a disease of gluttony and sedentary lifestyle. T2DM is reversible with implementing healthier eating habits and adding exercise to your daily routine. The alliance with Paula Deen (spelled D-E-E-N) suggests that people can continue to eat what they want and take a drug to make everything all better. Don’t try and spin this alliance as social responsibility – your intentions are purely economic in nature."

You'll Hear More About Heredity and Type 2 Diabetes
The lifestyle change solution POV will be something that Novo and Deen will have to combat as they get deeper into this. In fact, they have already pinpointed "heredity" as the most important factor. This was re-iterated in a comment in response to the above:

"Heredity? Have you ever heard of that? But, what do doctors know? After all, you're an anonymous CP poster, so you know it must only be about gluttony and a sedentary lifestyle. Pick up a textbook some time...you might actually learn something."

In response:

"When diagnosed with t2dm, what are the first instructions a doctor should give to their patients according to the ADA? The answer: diet and lifestyle changes. Why is that? Is the ADA wrong? Are doctors wrong for following the ADA guidelines? Why even bother with this step if heredity is such a controlling factor? Your message to people with diabetes suggests that they can't help themselves without the aid of your pharmaceuticals."

Will the ADA be Caught Up in This?
I'll have to check up on what the ADA has to say about first options. I already know that ADA is part of the deal because the organization has said the Deen family will participate in select diabetes health expos the ADA hosts around the country. It has also been reported that Deen will contribute some of her Novo earnings to the ADA, although no specific monetary amounts were mentioned.

Is Weight Loss a Possible Future Indication for Victoza?
One last point concerns weight loss and whether or not Paula Deen will help sell Victoza for that purpose. CP comments relating to that include:

"She will drop 40 lbs over the next year or less and "bang" we have an unofficial weight loss drug. (no indication necessary) Frankly I think its brilliant, she is probably under contract to eat healthier and exercise....and write a a cookbook with healthier versions of her food. We should look forward to seeing her at the next national POA. May I suggest identifying and adding the weight loss clinic docs in your area to your universe, otherwise you will not get paid Bad press now...millions of dollars later. Laughing all the way to Denmark."

Of course, if Novo or any Novo sales rep were caught mentioning weight loss as a indication, they would be breaking the law and subject the company to hefty fines, as this commenter pointed out:

"glad to hear all the weight loss drug talk. Can't wait to see Novo pay all those off label promotion fines"

Should Pharma Disclose Payments to Celebrity Spokespeople?

In my podcast interview of Ambre Morley (listen here or read it here: "Novo Nordisk Defends Choice of Paula Deen as Diabetes Spokesperson"), Associate Director, Product Communications, Novo Nordisk, I brought up the subject of compensation for celebrity pharma spokespeople like Paula Deen, the celebrity chef who was recently hired by Novo Nordisk as a diabetes spokesperson.

Obviously, Paula Deen is being paid to do the deed, but she doesn't want to talk about money because it's ‘garish’ according to her. But for me, talking about how much money is spent in the different areas of pharmaceutical marketing is a valid topic. I’d like to get a better idea how much money the drug industry spends on celebrity spokespeople. I always ask the money question because the industry is criticized for spending so much money on celebrities and it takes away from other things that the money can be spent on.

When I asked Morley the money question, she demurred and said “We don't discuss compensation. If Paula was a regular, everyday employee, I couldn't tell you how much she is making. I can't tell you how much I'm making nor would I ask you how you're making."

Aside: Deen must have felt the heat about her compensation. It was reported that "she announced that she and her sons will donate part of their compensation from Novo Nordisk to the American Diabetes Association, and an ADA spokesperson confirmed that the Deens will be appearing without pay at upcoming events. (see here)"

A few years ago, the pharma industry could have used the same excuse for not revealing how much they paid physicians as speakers, consultants, key opinion leaders, etc. But today there's the Physician Payment Sunshine Act, which requires that all pharmaceutical companies reveal details about the payments they make to physicians (see "Proposed Rules for Physician Payment Sunshine Act").

Of course, the main reason why this law was passed was because of potential conflicts of interest -- physicians who are paid by pharma companies may be more likely to prescribe the drugs of those companies. Often, those drugs are more expensive than other, equally-effective products (eg, generics). Congress has a fiduciary duty to make sure that the government doesn't overpay for services such as Medicare re-imbursements for prescription drugs. Consequently, the impetus for passing this law.

Celebrities, however, do not have the power to directly prescribe drugs. But they are VERY influential. Morley admits as much: "When you talk about the pharmaceutical industry and it's spend on celebrities, it's interesting because you wouldn't see celebrities working on campaigns if it wasn’t a good investment from a marketing point of view."

Given the power of of celebrities to influence people, should pharmaceutical pharmaceutical companies disclose the details of payments made to celebrities like like they are required to do for physician payments?

That's just one of the questions I ask for your opinion on in the following survey. I also ask:

• Is it OK for pharmaceutical companies to pay celebrities to be spokespeople to raise awareness of medical conditions?
• How about celebrities being paid to promote specific Rx treatments? Is that OK?
• Do such celebrity spokespeople provide a good return on investment for pharmaceutical marketers? 

Please take a few minutes to respond to these questions in the following survey. At the end you will be able to view the de-identified summary of results to date.

Create your free online surveys with SurveyMonkey, the world's leading questionnaire tool.

Novo Nordisk Defends Choice of Paula Deen Over Anthony Bourdain (for example) as Celebrity Chef Spokesperson

Yesterday, I spoke with Ambre Morley, Associate Director, Product Communications, Novo Nordisk, who answered my questions about why her company teamed up with celebrity chef Paula Deen as a spokesperson for type 2 diabetes treatment (listen to podcast of the interview here). In case you don't have time to listen to the whole interview, here are my takeaways regarding why Novo Nordisk chose Deen.

I asked: "Why did Novo Nordisk decide to work with Paula Deen as a spokesperson? Did she or her agents approach you?"

Morley claimed that Novo Nordisk was looking for a celebrity chef they could hire to develop diabetes-friendly menus for people with type 2 diabetes. As one commenter said on the Diabetes Mine Blog: "Surely the drug companies could choose spokesmen who are role models for their community."

Why, for example, did Novo Nordisk choose Paula Deen, noted for her fatty, calorie-rich recipes, versus Mario Batali or Anthony Bourdain, both of whom are celebrity chefs with shows on TV (although not necessarily better "role models")?

"We wanted to take really good recipes and change them -- have them certified by dietitians. That's how it started. We then started to look for chefs that could help us promote this campaign. Honestly, Paula Deen popped into my head," said Morley. "How cool would it be," said Morley, "to challenge Paula to change some of her famously tasty, and butter-rich, and really unhealthy recipes?" Probably not much of a challenge if you throw her sons -- Bobbly and Jamie -- into the deal. The sons have broken with their mama and have their own Food Channel show titled "Not My Mamma's Meals." Paula tries to promote her sons every chance she gets. On the Today Show, for example, she tried to do it at the end of the interview but Al Roker cut her off (see it here). No biggie! Her sons are part of the deal with Novo Nordisk.

So, Morley et al called Deen; Deen did not call Novo Nordisk. Morley said that she had "no idea" that Deen had diabetes (she has people who can validate this story, she said), which I suppose is possible considering how secretive Deen was for three years about her condition while all the time promoting her "unhealthy" recipes.

Chef Anthony Bourdain, who has never been a fan of Ms. Deen‘s, told Eater.com: “When your signature dish is hamburger in between a doughnut, and you’ve been cheerfully selling this stuff knowing all along that you’ve got Type 2 diabetes ... it’s in bad taste, if nothing else” (see here).

Aside from getting a package deal with Deen and her sons, why else did Novo Nordisk choose her as a spokesperson?

Morley did not want to choose a chef based in food-snobby New York or Los Angeles, which are the haunts of Bourdain and Batali. "I can't say that a chef in New York -- even a chef with diabetes -- who has a hoity-toity fancy restaurant would have the same impact on people as Paula Deen would. It came down to: Who would the greatest number of people look at and say that person was like me?"

Regarding the incidence of type 2 diabetes, Morley went on to say that "there's a huge difference between New York and LA and the rest of the country." Reality in the northeastern part of the country is different than in the South, for example. "In the Southeast and in Middle America," said Morley, "when people are diagnosed with diabetes, they don't run out and shout and tell the world that they have it," said Morley. True that! But most people down South also are not TV celebrities and role models for millions of people. I have to agree with Bourdain. Deen exhibited "bad taste" (I would say "deception") by keeping her diabetes secret while hawking "unhealthy" recipes to millions.

Morley claims that a lot of criticism of Deen is unfounded and she implied that the criticism demonstrated a NY-LA bias and that other celebrities would not be subject to the same kind of personal attacks endured by Deen. I would have to disagree, because I for one have often criticized the use of celebrities by pharmaceutical companies. See, for example, my posts about Phil Mickelson (eg, "Amgen Blows Its Marketing Budget on Phil Mickelson Campaign").

My Bad! Paula Dean Shills for Novo Nordisk, Not Novartis

[Alternative title for this post: "Paula Deen and Diabetes Prevention: A Recipe for Disaster!"]

Last week I reported on a story that celebrity southern-style chef Paula Deen has type 2 diabetes and that she is a spokesperson for Novartis's diabetes franchise (see "Sanofi vs Novartis: Paul Sorvino vs. Paula Deen").

It turns out that the source of this information confused Novartis with Novo Nordisk, another pharmaceutical company famous for using celebs to shill for its diabetes treatments (see, for example, "Novo Nordisk's Branded (Levemir) Tweet is Sleazy Twitter Spam!").

"The rumors that Novartis has signed a multi-million dollar spokesperson deal with Paula Deen for a diabetes treatment are not true," a Novartis rep told CBSNews.com. "Novartis is not working with Ms. Deen."

It's official! Deen is now shilling for Novo Nordisk (see "Paula Deen Now Novo Nordisk Diabetes Paid Spokesperson" and Novo's press release). Yes, she's being paid for her new role with the drugmaker, Deen says. "Talking about money is garish. It's tacky. But, of course, I'm been compensated for my time. That's the way our world works."

Ha! Ha! Talking about money is "garish"! That's rich! Only people with lots of money can say that! Senator Grassley should investigate the money that pharmaceutical companies pay celebrities such as Paula Deen and push to have these payments made public just like pharma payments to physicians must be made public.

Deen uses Novo Nordisk's Victoza, a once-daily, non-insulin injection that may improve blood sugar levels in adults with type 2 diabetes when used along with diet and exercise. [my emphasis]

It appears that Deen will NOT change her lifestyle -- ie, eating habits -- much to encourage PREVENTION of type 2 diabetes.

"Type 2 diabetes is like 'Russian roulette' when it comes to whom it's going to strike, Deen says. 'It's about heredity. It's about age, lifestyle, race. I'm the only one in my family who has it. My grandmother cooked and ate like I ate, and she didn't have it.'

"Deen says she's not going to change the focus of her cooking shows because of diabetes. 'I suspect I'll stick to my roots but will say a little louder, Eat this in moderation.'"

Eat this Paula Deen donut-bacon-hamburger sandwich in "moderation:"



Novo Nordisk appears to be abandoning life style changes it has supported in the past or maybe it's just exhibiting a form of PR-Marketing schizophrenia.

Just this past November on World Diabetes Day, for example, the company issued a press release in which it announced that it was a partner in the World Diabetes Day campaign and that it "has planned or co-sponsored a variety of activities throughout the world...[all of which] are focused on increasing awareness and improving knowledge of diabetes and its prevention" (see "Dramatic increase in diabetes prevalence calls for action").

The two activities just do not fit together! The first (sponsoring World Diabetes Day) is a matter of public relations and the second (Paula Deen) is marketing's turf -- never the twain shall meet.

Novo and Paula have launched a new Website whose very name hints at the new emphasis: "Diabetes in a new light!™" (www.diabetesinanewlight.com/). Apparently, Novo Nordisk is more interested in helping people live with type 2 diabetes by treating it than it is in helping 26 million Americans prevent it.

IMHO, this shows that pharmaceutical companies are not very trustworthy when it comes to their public stance on disease prevention.

Sanofi vs Novartis: Paul Sorvino vs. Paula Deen

It is rumored that celebrity southern-style chef Paula Deen will soon announce that she has diabetes (surprise) and that she is a spokesperson for Novartis's diabetes franchise (see "Rumors Say Paula Deen Has Diabetes, Will Work for Novartis"). She will compete with Paul Sorvino and daughter who are currently the diabetes spokespeople for Sanofi (see "Diabetes Costars").

How Novartis plans to position Deen as a spokesperson for diabetes awareness should really be interesting. She's not much of a proponent for healthy lifestyle changes, which PhRMA recommends should be part of every direct-to-consumer advertising campaign.

According to the article cited above, "Deen has faced withering criticism for the high amounts of fat, salt and sugar in her dishes. When Deen’s cookbook for kids, 'Lunch-Box Set,' was published in 2009, Barbara Walters asked her, 'You tell kids to have cheesecake for breakfast. You tell them to have chocolate cake and meatloaf for lunch. And french fries. Doesn’t it bother you that you’re adding to this?'"

In 2009, I took a road trip down south with my son (see photos here). A highlight was when we had lunch  at "The Lady & Sons" — the restaurant Deen owns in Savannah, Ga. We ate the "fried chicken, ribs, cheesy meatloaf and sweet potatoes" for which the restaurant is famous. Here's the scene that day outside the restaurant (TIP: you may not have to wait for a table if you are willing to eat upstairs in the bar; of course, you have to be thin enough to fit on the stools, which may not work for most of these people waiting on line):

While it's a good idea to have an overweight person as a diabetes spokesperson, it's quite another to have an UNAPOLOGETIC overweight person who recommends cheesecake for kids' breakfasts! It's sort of like having a "vulture capitalist" claim he creates jobs!


**********
UPDATE:
"The rumors that Novartis has signed a multi-million dollar spokesperson deal with Paula Deen for a diabetes treatment are not true," a Novartis rep told CBSNews.com. "Novartis is not working with Ms. Deen."  See "Novartis rep: There's no deal with Paula Deen."
**********

[See "My Bad! Paula Dean Shills for Novo Nordisk, Not Novartis" for a followup to this post.]

There's Room for Only One Osteoporosis Celebrity Spokeswoman: Sally Field Is Out, Blythe Danner Is In

Amgen -- the company that along with Pfizer signed on Phil Mickelson to shill for ENBREL -- has now signed on Blythe Danner to shill for PROLIA, a drug to treat postmenopausal osteoporosis (see the press release here).

Here's Blythe on the "Act 2 Reduce Fractures" fully-branded web site (click image for larger view):

You are probably not OLD enough to know who Blythe Danner is, but postmenopausal women probably remember her in such classics as To Kill a Clown (1972), or as Robert De Niro's wife in the acclaimed series Meet the Parents, Meet the Fockers, and Little Fockers. If you are not yet of menopausal age, you no doubt have heard of Blythe's equallly environmentally friendly daughter, Gwyneth Paltrow.

Depending on the patent expiry of PROLIA, Gwyneth might one day also be a PROLIA spokeswoman. Gwyneth is currently 39 years old, whereas Blythe is 68. Hmmm... 29 years difference. By the time Gwyenth is menopausal PROLIA is sure to be off patent -- unless, that is, AMGEN comes up with a new formulation for the drug.

It seems there's not enough room in the postmenopausal osteoporosis celebrity spokeswomen market for two aging stars. Sally Field, who shilled for BONIVA for many years, is no where to be seen on the BONIVA web site. She has been replaced by generic postmenopausal women as in the screen shot below:

Cute, but no Sally Field!

Come to think of it, I haven't seen Sally on TV in a long while. I mean on a TV commercial for BONIVA. I look forward to seeing Blythe, however. Maybe Gwyneth will do a cameo appearance?

Unlike Sally, Blythe has never won an Oscar. Her spokesperson paycheck from AMGEN, therefore, must be much less than the one Sally received from MERCK. My guess is that AMGEN shot most of its celebrity spokesperson wad when it hired Mickelson (see "Amgen Blows Its Marketing Budget on Phil Mickelson Campaign").

Phil Mickelson is Now Regulated by FDA

Recall that last summer Phil Mickelson was quoted in the press as saying he was treating his Psoriatic Arthritis with ENBREL. He was also quoted as saying: "I have no aches and pains. My back feels great. I feel stronger and more flexible than I've ever been" (see here).

At that time, Phil may or may not have been in talks with AMGEN/PFIZER to sign on as a celebrity spokesperson, but the simultaneous appearance of multiple news stories featuring Phil & ENBREL sure looked like an audition to show AMGEN/PFIZER what he could do for them.

During last week's 2011 Masters Tournament, Phil finished tied for 27th place! Consequently, I didn't see much of him on TV hitting a golf ball. I did, however, see a lot of him on TV ads for ENBREL. Now that he is featured in ENBREL TV ads, everyone knows he is a paid spokesperson. I have no problem with that, especially that now his commercial speech is regulated by the FDA and he can no longer make outlandish statements such as the one above.

Instead, the best he can now say is "I'm surprised how quickly my symptoms have been managed" (watch the commercial here). Also included is all the scary side effects of this drug, which Phil didn't mention in his media interviews BEFORE becoming a paid spokesperson.

Obviously, ENBREL didn't help his game in last week's Masters.

BTW, I DID see Phil hitting golf balls on TV last week! But it was in an ENBREL ad! I noticed in that ad that Phil misses a chip shot! What's up with that? Seems to add insult to injury.

Maybe if the ad showed him getting the ball in the hole from the rough, the FDA might have sent AMGEN/PFIZER a letter complaining that this could be interpreted as overstating the benefits of ENBREL.

Actually, Phil is shown making a putt in the beginning of the ad, when recalling how he felt like he was at the top of the world. The missed chip shot appropriately came during the fair balance portion of the ad. The part that everyone hates!

I don't think the American public realizes the amount of thought that goes into these ads! If it wasn't for the FDA, much less thought would be needed and we wouldn't have people like me studying these ads and interpreting hidden meanings! (For the ultimate analysis hidden meanings in drug ads, see "Ruth Day and the Bees Repeat Performance at House DTC Hearing".)

P.S. Here's a little math/ROI problem thanks to a Twitter pal of mine. Assuming AMGEN/PFIZER spent $14 million to retain the endorsement of Phil Mickelson (not counting the cost of ad creative or media buys), how many ADDITIONAL doses of ENBREL will have to be sold to break even?

"On Course with Phil" Lacks Social Media Pizzazz!

This is NOT an attack on Phil Mickelson! I've already done that, been there (see Phil Mickelson "Opens Up" to Arthritis Today Magazine and Is Phil Mickelson Shilling for Enbrel?). So, relax and proceed to the back nine! This is about the "non-branded" disease awareness campaign just announced by Pfizer & Amgen, the companies that bring you ENBREL.

The centerpiece of the campaign is the "On Course with Phil" website, which is pretty lame by today's social media standards. Before I get to that, let me show you the homepage screen that I just captured:

In case you missed it, I circled the "money shot," which is not Phil hitting the ball in the hole, but the prominent link to a "treatment option." The link, of course, leads directly to the branded ENBREL website. Surely, this biologic compound that has a LONG list of things you need to tell your doctor about before taking (eg, "if you live or have lived in ...the Southwest") is NOT the first treatment option one should consider!

Amgen and Pfizer have teamed up (ie, given money to) the Arthritis Foundation and the National Psoriasis Foundation -- patient groups -- to form the "Joint Smart Coalition," which is responsible for the "On Course with Phil" campaign.

On the "On Course with Phil" website, Phil says that he first experienced pain right after the 2010 U.S. Open, which was held in Pebble Beach, California -- the same "Southwest" that the ENBREL package insert says you should tell your doctor about if you ever lived there.

Anyhoo, the website is pretty primitive. I was hoping to see at least a video clip of Phil shooting some balls or maybe even telling us personally about his experience. Instead, you have to click "1", "2", etc. to read what he has to say. Very BORING!

And that "SHARE" button in the upper right corner -- it's not what you think. All it is is a form whereby you can send an email to one other person. Where's the social media share button that allows you to share this site on Twitter, Facebook, etc? I can get code for that and not even pay a dime for it! Like this one:

Share |

Pfizer is often touted to be a leader in social media. But if Pfizer built this site, then it's not worthy of wearing that mantle. I think, however, the real reason this site is basic Web 1.0 is that AMGEN and PFIZER spent all their money on signing up Mickelson and they have none left over to do anything fancy like video or social media integration (see Amgen Blows Its Marketing Budget on Phil Mickelson Campaign).

I've often said that celebrities and social media is a "match made in heaven" for product promotion and that the drug industry is likely to use this combination more often (see "Use of Celebrities for PR and DTC Advertising"; use discount code: 71-01PMYFREE). So, it's a surprise to me that Pfizer and Amgen have not (yet) taken advantage of the synergies between celebrities and social media as other drug companies have done (see, for example, Danica Patrick: NASCAR Driver, Super Model, Superbowl Lingerie Ad Model, & COPD Spokesperson All Rolled Into one!). But, hey, it could still happen! 

Phil Mickelson "Opens Up" to Arthritis Today Magazine

Top pro golfer Phil Mickelson is featured on the cover of the Mar-April 2011 issue of Arthritis Today magazine (see photo).

Recall that Mickelson announced he had psoriatic arthritis last August in a news story titled "PGA Championship 2010, Whistling Straits: Phil Mickelson Has Psoriatic Arthritis - Uses Enbrel To Help Manage Condition."

In that story, Mickelson was quoted as saying "I have no aches and pains. My back feels great. I feel stronger and more flexible than I've ever been." (see "Is Phil Mickelson Shilling for Enbrel?").

When he made that statement, Phil was obviously demonstrating to AMGEN/PFIZER -- the companies that market ENBREL -- what he can do to help them promote their product. AMGEN/PFIZER were suitably impressed and signed him up a few months later (or so they say).

Now that Phil is a paid ENBREL spokesperson, his remarks are more balanced. Here are some quotes from an article in the Arthritis Today issue that features him on the cover:

"Phil tried taking prednisone [a generic drug], but the side effects were awful, he says." [His Mayo Clinic doctors prescribed "weekly injections of a biologic drug"; later in the article several brand name drugs, including Humira, Enbrel, Remicade, and Simponi, are mentioned, but the article doesn't reveal exactly which drug Phil is taking -- that's already on the record elsewhere. But we now know that he didn't like the generic medicine.]

"I like where I am physically and am optimistic about 2011."

"I might take the medicine for a year and then go off it. Then, when and if it flares up, I'd go back on the medicine. I'm OK with taking medicine the rest of my life if I have to."

At the end of this article is this NOTE: "This interview took place after Phil Mickelson entered into a partnership with Amgen-Pfizer, an Arthritis Foundation sponsor, in November, 2010."

So, Amgen-Pfizer not only has to pay Phil, they also have to pay the Arthritis Foundation to get his story published! No wonder AMGEN has blown its marketing budget (see here).

Elitist Pharmaceutical Marketing

After writing about golf pro Phil Mickelson being a "shill" for ENBREL (see "Amgen Blows Its Marketing Budget on Phil Mickelson Campaign"), I got into a conversation with a Twitter friend who shall remain anonymous. This person suggested that it is possible that golf and golf pro sponsorships consume more than 15% of a pharma company's DTC marketing budget. "15% for Golf is huge!", I said. "Not necessarily," said my friend. "The dollars also include other expenses besides endorsement such as internal PR costs."

I'm not sure what this person meant by "internal PR" costs. Some money obviously was spent getting the "Phil Mickelson takes ENBREL and feels NO pain" stories published in the "free" press.

I made my final point: "I think the bigger issue is the focus on golf endorsements rather than on patient support. It's just too elitist!"

This got me thinking about "elitist marketing." What did I mean by that?

First of all, let me admit that I think golf is an elitist sport although I am aware than many working class people play the game. Golf is a game that has many elitist tendencies such as expensive golf resorts, memberships, etc. that are geared to executives and not to the "duffer" riff raff. Phil Mickelson is a "hero" of the elite golf world.

A pharma marketing executive can easily achieve fame amongst his peers -- as well as achieve one degree of separation from TRUE fame -- by obtaining a celebrity endorsement. I mentioned this before in a post about another celebrity endorsement deal: "Are You Serious?™ A Good Example of Why Pharma Brand Managers 'Love Its' TV". In that case, actor/comedian Jon Lovitz was hired by J&J's Centocor to raise awareness for -- SURPRISE -- psoriasis! The product manager got his dose of elitist fame not only by schmoozing with Lovitz behind the scenes, but by actually playing a bit part in the TV commercials!

I'm sure the AMGEN and PFIZER ENBREL product managers have also schmoozed with Mickelson and may have even played nine holes with him at the Doral Golf and Spa Resort!

One wonders if advertising budgets are to serve the people credible information or to serve the ambitions of product managers? And when elite sporting celebrities are involved, does the advertising serve an elitist audience rather than the general population?

OK, now for the hate mail from all you golfers out there!

P.S. I've been told that Pharma Marketing Blog is blocked by AMGEN, who does not want its employees reading this blog. How elitist is that?

UPDATE (8 Jan 2011): The ROI Question

@MarianCutler, a "Jersey girl" and pharmaceutical/healthcare PR professional, tweeted this response to the above: "Couldn't disagree more @pharmaguy; question to ask is the ROI on the sponsorship."

So, I did ask a question: "How do you measure ROI of celebrity golf sponsorships?"

Every pharma marketer talks about marketing ROI (return on investment), but practically none "walks the talk" and executes a credible ROI analysis.

One of the major problems in measuring the ROI of a specific campaign like this one is that it's impossible to isolate other variables.

Another Twitter pal of mind said this golf campaign may be aimed at doctors who are notorious duffers. Well, I'm sure there is a whole array of other ENBREL marketing campaigns aimed at doctors going on at the same time. How do ENBREL marketers know if the Mickelson sponsorship is effective and what the ROI is?

I suppose they can see if there's an uptick in ENBREL scripts written that corresponds with the "launch" of ENBREL Phil. I guess it's possible that docs will prescribe the drug just because Phil is using it -- and what a pitiful reason to do so! What's more likely to happen is that pharma sales reps will be getting more access to docs because they have some golf-enhanced promotional literature and deals that docs will be interested in seeing. They will then open the door to reps.

OK, maybe there's a positive ROI considering that a single new script for ENBREL is worth thousands and thousands of dollars! How many NEW scripts will it take to pay off the $ millions(?) that Phil is getting from PFIZER and AMGEN? You do the math.

Amgen Blows Its Marketing Budget on Phil Mickelson Campaign

Back in August 2010, I asked "Is Phil Mickelson Shilling for Enbrel?" (see this post). My question was prompted by a couple of "news" stories, one of which proclaimed "PGA Championship 2010, Whistling Straits: Phil Mickelson Has Psoriatic Arthritis - Uses Enbrel To Help Manage Condition."

The story also included this quote from Phil: "I have no aches and pains. My back feels great. I feel stronger and more flexible than I've ever been."

That's quite a claim! If Phil made such a claim while being a paid spokesperson for ENBREL, he would have probably violated FDA regulations regarding unsubstantiated claims. He also would have violated FTC regulations regarding celebrity endorsements and testimonials by not disclosing "material connections" (payments or free products) between advertisers and endorsers – connections that consumers would not expect.

Well, Phil IS a shill for ENBREL after all! I missed this November 2010 AMGEN/PFIZER press release that made the announcement. In case that press release is no longer available, here's what it said:

Amgen Inc. (Nasdaq: AMGN), Pfizer Inc. (NYSE: PFE) and world-class professional golfer Phil Mickelson, have entered into a partnership to share Phil's experience with his diagnosis of psoriatic arthritis and treatment with Enbrel(R) (etanercept), and to encourage patients with similar symptoms to visit their doctor for proper assessment and care.


"This partnership with Amgen and Pfizer is important because being a psoriatic arthritis patient has motivated me to share my story," said Phil Mickelson. "I hope to encourage other patients to work with their doctors, learn about their condition and take action so that they have an opportunity to get back to some of the things that matter most to them."


Psoriatic arthritis is a form of arthritis caused by an overactive immune system that can affect not only the body's joints but also the skin. Approximately 600,000 Americans may have psoriatic arthritis. The main joint symptoms of psoriatic arthritis are pain, stiffness and swelling. Rheumatoid arthritis patients experience similar symptoms, however there are important differences between the two conditions, making it important to see a doctor.


Amgen and Pfizer were inspired by Mickelson's approach to managing his condition and by his continued drive to maintain his health. Those same qualities have kept him on top of the competitive world of golf and this is why the companies are excited to be partnering with him. Amgen and Pfizer believe his perseverance in the face of adversity will encourage patients to also work with their doctors to manage their condition and help them get back on course.


Further details and timing of future partnership initiatives will be announced in 2011.

I can't wait for these "further details" to learn more.

One thing I did learn from an insider is this: Amgen cannot afford to sponsor "a cheap and effective Web and cell phone-based patient adherence solution" because it has blown its entire marketing budget on the Phil Mickelson campaign.

It's worth more to AMGEN -- maybe PFIZER too -- to get the ENBREL brand associated with a celebrity and a golf tournament than it is to support patients who are already taking the drug. Considering that the demographic that is attracted to Phil -- mostly older, more affluent men -- it's also a slap in the face to more typical psoriasis sufferers who probably can't afford ENBREL in the first place!

Is Phil Mickelson Shilling for Enbrel?

The golf world was stunned by Tiger Woods' recent poor performance. Another bit of "stunning" news hit the golf world yesterday when the #2 ranked duffer Phil Mickelson announced that he suffers from Psoriatic Arthritis and is being treated with Enbrel. See "Phil Mickelson Arthritis: Will Play At PGA Whistling Straights".

The New York Times also ran a story: "Immune Disorder Could Be an Enduring Test for Mickelson".

Both these articles mentioned that he was being treated with Enbrel, a drug jointly marketed by AMGEN & PFIZER. The first article I cited includes the subtitle "PGA Championship 2010, Whistling Straits: Phil Mickelson Has Psoriatic Arthritis - Uses Enbrel To Help Manage Condition" and includes this quote from Phil: "I have no aches and pains. My back feels great. I feel stronger and more flexible than I've ever been."

Quite an "unsolicited" celebrity endorsement! Amgen/Pfizer could never quote what Phil said on its Enbrel website as in the following completely fabricated (by me) screen shot:

By the way, although you probably cannot see it in Phil's press conference image shown above, his eyes are completely BLOODSHOT, which indicates to me that he is taking something other than Enbrel to ease the pain (see larger image here).

The New York Times helped Enbrel's cause by supplying the following dire statistics about this medical condition: "As many as 7.5 million people in the United States have psoriasis, according to the National Psoriasis Foundation, and about 30 percent of those with psoriasis develop psoriatic arthritis. While psoriasis often appears between the ages of 15 and 25, the arthritis symptoms usually appear later, often between 30 and 50. When it does, there is no rhyme or reason as to which joints will hurt at any given time."

I am willing to bet that this bit of information came straight from AMGEN/PFIZER's PR people.

It probably did NOT come from the "nonprofit Psoriasis Cure Now" group, which issued a press release entitled "Phil Mickelson's Arthritis Shocks Golf World, Psoriasis Cure Now Says a Reminder That Psoriatic Arthritis Is a Serious Disease." That group, which includes Amgen and Pfizer as sponsors, claimed ONLY 1 million people (less than half the number cited in the NYT article) in the US have psoriatic arthritis. "... cases range from mild to what Phil Mickelson described this week. Fortunately, the man on the edge of being ranked the world's number one golfer is taking Enbrel, a biologic treatment that has transformed the lives of many people with psoriasis, psoriatic arthritis, rheumatoid arthritis and other immune system diseases."

My question is this: Is Phil Mickelson being paid as a spokesperson by Amgen or Pfizer either directly or through Psoriasis Cure Now?

I have surveyed readers about the "Use of Patient Testimonials in DTC & Social Media Advertising" (see survey here) and have also written about it in Pharma Marketing News (see "Real Patient Testimonials: An Effective Social Media Marketing Strategy"; use code 'SMOD239' to download it FREE).

P.S. Does Phil have a Twitter account? Will he do branded tweets like racecar driver Charlie Kimball has done for Levemir? (see “Novo Nordisk's Branded (Levemir) Tweet is Sleazy Twitter Spam!”).

P.P.S. Before you go off on a rant, let  me just say that I admire Phil Mickelson -- unless, of course, he is having an extramarital affair we do not know about! I also like Charlie Kimball and Sally Field and each and every pharma celebrity product endorser!