Is Type 2 Diabetes Drug Marketing Responsible for Misdiagnosis of Type 1 Diabetics?

A Wall Street Journal article documents several cases of people being misdiagnosed by general practitioners as having Type 2 diabetes when they actually have Type 1 diabetes, "a substantially different condition" (see "Wrong Call: The Trouble Diagnosing Diabetes"). According to the article:

"An incorrect diagnosis usually occurs in the offices of primary-care doctors, many of whom haven't received adequate education in medical school about rising rates of Type 1 in adults and how to diagnose it. 'It is not on their radar because they see so much diabetes and it is by far mostly Type 2,' said Irl B. Hirsch, professor of medicine at the University of Washington Medical Center in Seattle."

As I continued reading, I couldn't help but wonder if the current competition among drug companies to sell Type 2 diabetes drugs has something to do with this. Fierce marketing of these drugs - see box below - may be contributing to emphasizing Type 2 diabetes on GP's "radar screens."

The Three Type 2 Diabetes Drug "Amigos" Januvia - marketed by Merck Onglyza - marketed by Bristol-Myers Squibb/Astrazeneca Victoza - marketed by Novo Nordisk See "Three Companies Compete for Diabetes Market Share"

In each case cited in the article, misdiagnosed patients were taking oral drugs, none of which were mentioned by name, and none of which are effective or approved by the FDA for treating Type 1 diabetes. "For six years, Mr. Jones [a patient] treated what had been diagnosed as Type 2 diabetes. He changed his diet and took three oral medications daily." It's likely that at least one of those drugs was one of the "Three Type 2 Diabetes Drug 'Amigos'" mentioned above.

Of course, many GPs would probably misdiagnose patients as having Type 2 diabetes when they actually have Type 1 diabetes even without being bombarded with marketing for Type 2 treatments. But having multiple pills available to prescribe makes it easier, in my opinion, to avoid taking the patient down the path to a possible Type 1 diagnosis.

The ultimate responsibility for misdiagnosis, however, must rest with the physician and not the pharmaceutical marketer, unless of course, the marketer offers physicians inducements (ie, money or non-monetary rewards) for prescribing products.

On that note, I also read a story in today's WSJ about Pfizer and other drug companies bribing doctors to prescribe their drugs. Pfizer settled with the DOJ -- admitting nothing -- but paid $60.2 Million to "Resolve U.S. Allegations That It Used Illegal Payoffs to Win Business Overseas."

Of course, such things do NOT happen here in the U.S.

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.

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!

Novo Nordisk is Back on Pinterest with Patient Stories

Novo Nordisk is back on Pinterest! Recall that Novo "de-pinned" all its images a few days after I first discovered them on Pinterest (see "Pharma Pinterest Update: Bayer US Pins, Novo Nordisk Depins!"). Novo now has 3 "boards" and 15 images on the site.

The most interesting "board" is the one devoted to "Patient Stories." The images pinned to this board link to videos that feature narratives spoken by real patients who suffer from various forms of diabetes. Here are the images:

NOTE: Novo is smart to use videos that are viewable on iPhones and iPads. In a previous post I noted that Janssen Uses Digital Storytelling, Animation to "Bring Prescription Medicine Labeling to Life." But Not iPhone or iPad Life!

This, I believe, is a very good use of Pinterest by a pharmaceutical company and I expect others to follow Novo's lead. I am sure, however, that everyone is waiting to see what mischief will befall Novo. So to hurry this process along, I did two things:

• I reported one pin to Pinterest and "complained" that it lead to a "drug site."
• I added a comment to another pin asking Novo if the patient was paid to participate in the video.

I'm a trouble-maker, I know. But someone has to test pharma's use of Pinterest. Let's see if they pass the Pharmaguy Stress Test.

Currently, there is a lot of worry about spammers using Pinterest. Spam pins, for example, link to pages that only contain Google Adwords. Pinterest is trying to deal with this, but many people, like myself are becoming victims of their over zealousness.

Every one of my pins that has a link in the comment section is "blocked" by Pinterest when users click on the link. Pinterest says that the pin has been "reported" as being spam or leading to "objectionable content." All the links are to this blog.

I doubt that Pinterest has bothered to investigate "reports" to determine if they are legitimate or not. They are simply "blocking first and asking questions later." Actually, Pinterest doesn't even tell you that you are being blocked and they certainly haven't asked me any questions about whether or not I am a spammer.

So, I am testing Pinterest by reporting one of Novo's pins.

As I mentioned in the previous post cited above, comments are Pinterest's Achilles heel as far as pharma companies are concerned. It's as easy to make comments on Pinterest as it is on Facebook. We have seen how pharma has run away from Facebook because comments cannot be turned off. Will the same happen with Pinterest?

Meanwhile, you might be interested in taking the following survey. Afterward. you'll be able to view a de-identified summary of results:

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

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)?

Beware of Subtle Changes to Social Media Sites that Can Impact Your Brand; e.g., Novo's Levemir

Keeping up with all the changes implemented by social media sites such as Facebook and Twitter can be a challenge for anyone. But it is especially important for pharmaceutical marketers to understand how such changes can impact their use of these sites and potentially get them into trouble with the FDA. An example of this was Facebook's new policy about comments and the implementation of Timelines. I have covered those issues by interviewing experts (listen, for example, to these podcast: "Facebook Timelines for Brands: The Implications for Pharma Companies" and "Pharma Facebook Commenting Changes: The Final Story").

Some changes, however, are virtually unannounced and may go unnoticed by brand teams. Twitter, for example, has made some changes to how things are displayed on its website when people are viewing accounts like Novo Nordisk's @racewithinsulin Twitter account. This is a fully "branded" account that features a celebrity endorsement of Levemir, Novo's long acting insulin used to treat diabetes. It's tag line is: "Racecar driver Charlie Kimball partners with Novo Nordisk to prove his high performance career is possible with insulin."

The "Race with Insulin" branded Twitter account is old news (listen to this podcast "Novo Nordisk's Race With Insulin Campaign: It's Not Just About Twitter"). What is new, however, is how information is laid out on the screen. Here's a screen shot (click on the image if you need a better view):

What I noticed is that the box that provides the "fair balance"/safety information is partially hidden by Charlie's tweet stream. I commented previously how this information is virtually impossible to read even when it is fully visible (read "Can You Read This Fair Balance on Race With Insulin Twitter Page, or Is It Just Me Having Problems?"). Now, however, it is even impossible for people with perfect eyesight to read fully.

No matter how wide I pull the screen, the safety information is blocked by the tweet stream. I also cannot scroll down to bring the bottom part of the safety information into view because that info is a static image in the background and only the tweet stream middle section of the screen scrolls up and down.

Novo Nordisk has changed the background image since the last time I visited the @racewithinsulin site. Part of that change was to move the safety information further down, which has lead to the second problem I noted above.

The first problem, however, is likely due to the new design implemented by Twitter. Novo Nordisk has not updated the background image to be compatible with this new design.

It's possible that the FDA may look at this branded site and determine that it violates regulations because the display of major safety information is not fully part of the branded message, which clearly is that Levemir is used for the treatment of diabetes and that you can live a "high performance career" with Novo's brand of insulin.

Of course, the FDA would have to read this blog post to learn about this.

Pharma People Pioneers on Pinterest

I have been keeping track of pharmaceutical employees who have personal accounts on Twitter for over a year (see "More Pharma Social Media Pioneers Recognized"). There are currently 105 people on the list (find it here).

I do this for several reasons:

1. to see if the people who "talk the talk" of pharma social media actually "walk the walk" (only 40% of pharma people who have taken my Social Marketing Readiness Self-Assessment personally use social media "frequently; fill out the assessment here and see more results),


2. to keep track of how these pioneers are using social media, and


3. to help me communicate with them (it's often impossible to reach them via email or by phone).

A majority of these pioneers have LinkedIn accounts for professional use and probably many also have Facebook pages. While I also keep track of pharma pioneer LinkedIn pages, I generally do not bother to peer into their personal lives that they may chronicle on personal Facebook pages.

Recently, I've been interested in Pinterest for my own use and started searching for pharma companies who have Pinterest accounts (see "Should Pharma Ponder Pinterest? Novo Nordisk Is!" and "Pharma Pinterest Update: Bayer US Pins, Novo Nordisk Depins!"). Yesterday, however, I received an email notice from Pinterest that Craig DeLarge, Director, Healthcare Professional Relationship Marketing at Novo Nordisk, who liked my pin "Charlie Kimball, Novo Nordisk, and Me Make Up. http://bit.ly/kjIAH." (This link is to the blog post in which that pin/image appears.)

Craig has a very interesting Pinterest page (here) that includes the following "boards" (ie, categories of images):

• Places I've Been
• Brands I Love (Live)!
• Health
• Wisdom
• eMarketing
• Social Media
• Politics

Craig likes some of the brands I like, including BMW, Movado (watches), and Apple ("Apple MacBook Air My latest tech crush"). Novo Nordisk, of course, is also on his list of brands that he likes and obviously lives by.

I was also interested in what Craig pinned on his "Politics" board, especially this one about Mitt Romney:

Source: a3.sphotos.ak.fbcdn.net via Craig on Pinterest

I've learned a lot about Craig DeLarge in a very short time via the images he has posted to his [emphasis]personal[end emphasis] Pinterest page. While Facebook also now is very visually focused, it takes me longer on Facebook to discover a person's true beliefs and interests than it does on Pinterest. As they say, an image is worth a thousand words.

I searched Pinterest for other pharma people social media pioneers on my list, but found only 2 others: Kevin Nalty, Consumer Product Director, Psychiatry, Janssen, and Brad Pendergraph, Manager, Consumer Digital & Social Engagement at Novartis (recently or soon to be laid off). These people -- and Craig -- are among the most followed pharma people on Twitter, so it makes sense that they would lead the way on Pinterest.

I look forward to finding more pharma people/social media pioneers on Pinterest. In fact, I think I will start a new board on my Pinterest page dedicated to "repins" from pharma people (I already have one for repins from pharma companies).

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!

Pharma Pinterest Update: Bayer US Pins, Novo Nordisk Depins!

Two things occurred after I posted about Pinterest use by the pharmaceutical industry (here):

1. Bayer US started pinning (here)  and 
2. Novo Nordisk "depinned" (deleted) everything on its Pinterest boards (here).

"Bayer has joined up-and-coming social network Pinterest and is using it to share images and information about its activities in the US" (Hat Tip to PMLive: "Bayer starts using Pinterest").

Bayer snapped up the Pinterest username "bayerus" ("bayer" is being used by an individual named "Courtney Bayer"). It currently has three Pinterest boards: (1) Bayer's Business, (2) Sustainability, and (3) Innovation. Twenty-eight items (including at least one video!) are posted to these boards.

Bayer has pinned a couple of product images, including this one for Bayer Aspirin (shown on the left; click on it for an enlarged view).

As you can see, visitors are able to add comments to these pins. Always the "spoiler," I added a comment that was a truthful concern of mine, but one that points out a possible "adverse event."

Aspirin, of course, is an over-the-counter drug not regulated by the FDA like Rx drugs are regulated. Therefore, Bayer does not have to worry about reporting this adverse event to the FDA. But will it allow the comment to stand and/or make a reply? I'll let you know.

I have also "repinned" this image to my Pinterest "Pins from Pharmaceutical Companies" board (here). I notice that my comment does not carry over to the "repinned" image, so I added a comment about the comment I made over on the Bayer US Pinterest site.

I have found no way to edit or otherwise manage comments on Pinterest. It appears that the only option is to delete the pin and then repin it without the comments. This inability to moderate comments may be Pinterest's Archilles heel as far as pharma is concerned. But as of this date, pharma's presence on Pinterest is virtually unnoticed except for me and a few other pharma social media followers!

P.S. As I mentioned, Bayer included at least one video as a pin. I didn't know you could do this. Kudos to Bayer for taking advantage of that capability!

UPDATE: Bayer responded to my comment today (4/9/2012) - about 4 days after I submitted my comment. Their response was:

"It is important that you speak with your doctor before you begin a daily aspirin regimen, only your doctor can determine if you are an appropriate candidate for aspirin therapy. Please contact us at 800-331-4536 (M-F 9:00AM -5:00PM Eastern Standard Time) we would like to learn more about your use of Bayer Aspirin."

At least Bayer responded rather than deleting the pin as I suggested was an option (see above).

It's still early in the game for Pinterest as a viable social media site. However, Pinterest is now the 3rd most popular social networking site behind Facebook and Twitter (see here).

I think pharma needs to provide support to patients through every channel at its disposal, including social media. When Bayer, for example, suggested I call their phone number (M-F 9:00AM -5:00PM Eastern Standard Time) in response to the comment I made on their Pinterest site, I was surprised they didn't just continue the conversation on Pinterest since that was the channel I used to open the conversation and thus clearly my preferred channel.

Should Pharma Ponder Pinterest? Novo Nordisk Is!

This is an image from the Pinterest Social Media Board of my friend Jay Byrant:

Source: tech.fortune.cnn.com via Jay on Pinterest

Looks like he "pinned" that image from a CNNMoney Technology Blog post (here), which asks "Is Pinterest the next Facebook?"

I don't know if Pinterest is the next Facebook or not, but if it is, Pharma marketers are likely to stay away from it at least until they figure out how it works.

While pharma ponders Pinterest, others are using pharmaceutical company names as their Pinterest usernames and URLs. Džesika Fizor, for example, staked a claim to http://pinterest.com/Pfizer/. Fizor's boards include "juicing," "homie," "belly goodness," and "things i like that are clothes."

Boards are categories into which users of Pinterest arrange pictures that they upload from their computers or steal, er, I mean PIN from other sites or from other Pinterest users ("repinning").

Here are some other "pharma" Pinterest usernames that have been claimed:

• http://pinterest.com/Roche/ - Rochelle Pickering (has "Foodie food stuff" board)
• http://pinterest.com/GSK/ - Gautam Sivakumar (claims to be "Doctor | Technologist")
• http://pinterest.com/Novartis/ - Avi Hollis (blank page)
• http://pinterest.com/EliLilly/- Kathleen Hargett (board with most pins: "yummy yummy food")
• http://pinterest.com/JNJ/ - just "Jen"
• http://pinterest.com/Merck/ - Carolyn Merck (blank page) 
• http://pinterest.com/Abbott/ - Bruce Abbott (looks like a happy newly-wed)
• http://pinterest.com/Boehringer/ - Alyssa Boehringer (not sure she is related to the Boehringers who own Boehringer Ingelheim)
• http://pinterest.com/Bayer/ - Courtney Bayer (could be a newborn baby)

These Pinterest pages are still available. I suggest the brand companies hurry up and claim them:

• http://pinterest.com/Sanofi/
• http://pinterest.com/AstraZeneca/
• http://pinterest.com/Allergan/
• http://pinterest.com/BI/
• http://pinterest.com/BoehringerIngelheim/
• http://pinterest.com/Amgen/

Novo Nordisk is on Pinterest!
Meanwhile, Novo Nordisk has a legitimate Pinterest page (http://pinterest.com/NovoNordisk/)! Novo actually has 11 "pins" posted to several "boards": 4 pins in "Patients," 1 pin in "About Novo Nordisk," and 6 pins in "World Diabetes Day." Two other boards -- "Health Care Professionals" and "Careers" -- are empty.

I "repinned" the image from  the "About Novo Nordisk" board to a new board I created on my Pinterest site titled "Pins from Pharma Companies" (here). I was also able to "like" that image (pin) and post it to my Facebook wall as well:

Of course, I also attached a comment to the original pin on Novo's Pinterest site. My comment: "Nice image! I posted it to my Facebook wall."

I wonder if the Novo Nordisk Pinterest site is legitimate (seems so) and if their legal/regulatory people know about it (maybe not). I know that comments submitted to pharma Facebook pages have been the industry's Archille's heel (see "Janssen to Shut Down Psoriasis 360 FaceBook Page Due to Lack of Commitment"). I wonder if the same will be true of Pinterest?

My Pinterest page is here: http://pinterest.com/pharmaguy/

P.S. Novo Nordisk confirmed via Twitter that the Pinterest page is legitimate. But I wonder why the Facebook button on the page links to the page of someone called "Kasper Kofod" (here)?

Who is Kasper Kofod (seen on the left)? He may be a Novo Nordisk employee -- he is friended by Craig DeLarge who definitely works for Novo here in the U.S.

P.P.S. I just learned from LinkedIn that Kasper Kofod is Social Media Manager at Novo Nordisk in Denmark (see his profile here). He is @kofod on Twitter.

It's strange that Kasper would use his personal Facebook page as a link on Novo's Pinterest site.

P.P.P.S. I posted this to Twitter and heard back from Kasper who informed me that the link to his personal FB page was inadvertent. By the time you read this it will probably be fixed. Any way, it allowed me to make a new friend and get a glimpse of who is behind the social media curtain at Novo Nordisk :-)

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 :-)

Funny or Die Spoof: "Paula's Victoza Injected Sneaky Snacks!"

"All of my desserts are injected with Victoza to lower my blood sugar and keep me immortal," says "Paula Deen" in the spoof YouTube "Paula Deen's Diabetes Ad" posted by Funny or Die (see video here).

Next: Saturday Night Live!

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"

Taking the "Cool" Way Out of Having Rx Product Convos on Social Media

I have criticized pharma companies for mentioning Rx brand product names via social media. Mostly because they forget to include fair balance or don't educate the public (see, for example, "Novo Nordisk's Branded (Levemir) Tweet is Sleazy Twitter Spam!").

That doesn't mean, however, that I don't believe there is a way for pharma to engage in branded product discussions via social media such as Twitter and Facebook (see, for example, "Breaking the 140-character Limit of Twitter Opens the Door to FDA-Compliant Branded Tweets").

It appears that most pharma companies have decided not to engage in these kinds of discussions and are implying that FDA regulations prevent them from doing so.

Take for example a discussion about Paula Deen on the Novo Nordisk Facebook wall (here) . Amidst the criticisms and defenses of Novo was this statement by "Tanya", a representative of Novo Nordisk:

"Hi Darcy, I had to remove your post becuase (sic) you mention a product name, which we are not allowed to have on our page - even if you post it yourself. Can you repost without mentioning the product name? Sorry! -- Tanya"

Unfortunately, I can't see what product was mentioned because the post was deleted. Duh! However, it was probably Victoza -- the diabetes product that pays for the endorsement by Paula Deen.

I infer from Tanya's statement that there is some FDA law or regulation against mentioning product names on the Novo FB page. In fact, there is no such law or regulation. And in other "social media" contexts -- such as my BlogTalkRadio show -- Ambre Morley, Associate Director, Product Communications, Novo Nordisk, didn't seem to have any problem mentioning the product name. In fact, she didn't point out the possible side effects (fair balance). I'm not sure if she broke the law there or not (you can read a summary of that discussion here; use code '1111nvd' to get it free; or listen to the podcast here).

Are pharmaceutical companies missing an opportunity to educate people about their products by "handling" posts as Novo did in the above example?

Some people actually think this policy of removing posts that mention products is a good thing. Idil Cakim, for example, said "the Novo Nordisk community manager 'played it cool' by only reminding the fans of the FDA guidelines" (see "Novo Nordisk Handles Paula Deen Reactions on Facebook").

I should have put a "sic" next to "FDA guidelines" because there are NONE! Tanya only reminded people what Novo Nordisk's POLICY is. [To be more clear, Tanya SHOULD have said "it is our policy not to mention product names."] I guess Idil -- one of "the world's best social media thinkers" featured on socialmediatoday.com -- also inferred from Tanya's statement that there was a LAW or guidelines.

There are, in fact, some new FDA guidelines for dealing with certain branded communications on social media (see "Review of The Social Media Guidelines Nobody Expected!"). These guidelines only apply to "off-label" discussions on social media sites. I don't know if these guidelines were applicable in this case.

Tanya may have "played it cool," but she missed an opportunity to really inform her FB visitors about Victoza, assuming that was the product mentioned in the deleted post.

But without more encompassing FDA social media guidelines, every pharma company will just continue to take the easy "cool" way out and censor any mention of product names on its social media sites.

P.S. Dear Novo Nordisk: Sorry that I seem to be focusing on you these past couple of weeks! But you ARE in the news a lot these days. I'm not sure it's helping or hurting the sales of Victoza because you don't mention the drug much in public statements about Paula Deen or on your Facebook page. That's fine. Just so you know. I'm not picking on you exclusively. I've gone on posting binges against Pfizer, Boehringer-Ingelheim, and practically every other pharma company. So, please don't take it personally.

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.

Three Companies Compete for Diabetes Market Share Using Recipes Rather Than Product Efficacy

Whose recipes will reign supreme?!

My Twitter friend, @serious_skeptic, who has Type 1 diabetes, just tweeted: "why the hell would anyone want a recipe from a DRUG company anyway???" during a conversation we were having about celebrity chef Paula Deen and her new relationship with Novo Nordisk (read this for the background).

From reading comments made by other people with diabetes on influential blogs such as DiabetesMine, I get the impression that most do not think Paula Deen was a smart choice as a pharma-paid diabetes treatment spokesperson. Of course, most of these people may come from the "hoity-toity" northeast and LA region of the country that is, according to Novo Mordisk, not representative of the majority.

"and what is this b.s. NYC/LA bias to which Novo refers? I don't live in either & Deen still disgusts me," says @serious_skeptic.

Getting back to the original question about drug company recipes... Novo's deal with Deen propels the company into crowded territory. At least two or three other major pharmaceutical companies tout "diabetes-friendly" recipes, including Merck, which markets Januvia, and Bristol-Myers Squibb/Astrazeneca, which together market Onglyza. With Novo (which markets Victoza), those were the top three Google search results on "diabetes certified recipe" (at least the top 3 PAID results; it's hard to tell these days what are paid and unpaid search results when using Google!):

What these drugs have in common is that they treat type 2 diabetes, NOT type 1. Instead of competing on the effectiveness of their treatments, these companies are competing based on which one offers the best diets. Novo just trumped the competition on that score by signing on a celebrity chef, which none of the others has done at this point.

The emphasis that these drug companies place on DIET rather than efficacy indicates to me that without the diet, these drugs simply would not work very well or work equally well.

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.

Citizen Petition Filed by Pharma Likely to Delay Indefinitely the Issuance of FDA Social Media Guidance

Allergan, Eli Lilly, Johnson & Johnson, Novartis, Pfizer, Novo, and Sanofi-Aventis filed a "citizen petition" with the FDA yesterday, urging the agency to "establish comprehensive, clear and binding regulations [my emphasis] to guide the industry" in communicating off-label drug information to physicians and payers. You can find the petition here.

Greg Kuetreman, writing about this petition in a post to Lilly's corporate blog (LillyPAD), said "we’re not asking for a change in the regulations -- just clarifications that will help us communicate in a better way." But this is not what the petition says. As I quoted above, the petition is asking for "comprehensive, clear and binding regulations."

In addition to specifically asking for regulations, rather than non-binding guidelines, there are a few other interesting points to make about this "petition" that are relevant to whether or not FDA will be able to issue social media guidance this year (or ever):

The petition asks for regulations regarding manufacturers responses to "unsolicited requests" from physicians for off-label information.

The word "Internet" and the phrase "social media" do not appear in the petition.

"Patients" and "consumers" also are NOT mentioned.

I find these points to be interesting because I recently reported that the FDA 2011 guidance calendar includes guidance for "Responding to Unsolicited Requests for Prescription Drug and Medical Device Information, Including Those Encountered on the Internet" (see "FDA Drops Social Media from Its 2011 Guidance Agenda"). Whether or not such guidance would satisfy the 7 pharma petitioners with regard to "unsolicited" requests is open to debate.

According to the FDA (see here), a citizen's petition is a way to "influence the way FDA does business... change or cancel a regulation, or to take other action." The agency receives about 200 petitions yearly. "Ultimately, FDA management decides whether to grant a petition. But first, agency staffers evaluate it, a process that may take several weeks to more than a year, depending on the issue's complexity. After FDA grants or denies the petition, the agency will notify the petitioner directly. If not satisfied, the petitioner can take the matter to court."

Since this petition specifically addresses the unsolicited request issue for which FDA planned to issue guidance (see "First FDA Social Media Guidance to Address Responding to 'Unsolicited Requests' for Off-label Information"), that guidance will have to be delayed possibly more than a year while the agency reviews the petition.

If the petitioners are not satisfied with how the FDA responds to the petition, they are likely to "take the matter to court" further hamstringing the FDA efforts to issue social media guidance. The number one pharma company and one of the petitioners is already on record opposing any social media guidance on first amendment grounds (see "Pfizer Asks for New FDA Regulations, Not Guidance, for Social Media").

Last week, at the Pharma Virtual Sales & Marketing Summit, I asked Craig Delarge, Director of Healthcare Professional Relationship Marketing at Novo Nordisk, when he thought FDA would issue social media guidance for the industry. His personal opinion was "not in the foreseeable future." That comment surprised me at the time, but now I understand why he said it.

P.S. STRANGE COINCIDENCE?
Pharma's Citizen Petition was filed on the SAME day (July 5) that DDMAC Director, Tom Abrams, said that "publishing social media guidelines for industry is the division's 'highest priority,' and that the document will be 'published as soon as it's vetted.'" Abram's comments were made at the Drug Information Association’s in Chicago (see here).

Lilly's Greg Kuetreman attempted to answer the question "Why Now?" in his blog statement, saying "Because there continues to be some confusion about what companies can - and cannot - say to health care professionals, payers, and patients about new scientific information." Considering that there's ALWAYS been this confusion, Kuetreman's statement fails to answer the question. I think the answer is that pharma anticipated imminent release SM guidelines by the FDA and wanted to delay that release by filing a Citizen Petition.

[This post originally appeared in Pharma Marketing Blog. 

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