Friday, October 12, 2012

Did Pharma Online Ad Spending Increase 50% in First Half of 2012?

"Entertainment, automotive, pharmaceutical and healthcare were the fastest growing vertical sectors for online advertising in the first half of the year, according to a new report from the Interactive Advertising Bureau" (IAB) reports ClickZ (here). The report (get it here) utilizes data and information reported directly to PwC by companies generating online / mobile advertising revenues, and publicly available corporate data. The following figure shows the online ad formats tracked and how much was spent on each in the first half of 2012 compared to the first half of 2011. Overall online ad spending was $17.0 billion in the first hlaf of 2012 compared to $14.9 billion in the first half of 2011 (a 14% increase).


Search accounted for 48% of the online ad spend and display-related advertising accounted for 33% (Display-related advertising includes Display/Banner Ads, Rich Media, Digital Video, and Sponsorship).

Here's the data comparing the total online ad spending by major industry category:



Online ad spending by "Pharma & Healthcare" increased by 50% (from 4% of the total to 6% of the total). Keep in mind that not all of this is specifically spending by the Rx drug industry because the category includes "pharmaceutical products, facilities, services, researchers, and biological products. Also comprises establishments providing healthcare and social assistance for individuals as well as personal care, toiletries, and cosmetic products."

6% of $17.0 billion is $1.02 billion. That could pan out to be more than $2 billion for the entire year -- again, not all of that will be spent by the Rx drug industry.

eMarketer has predicted that online ad spending by the health industry in 2012 will be $1.58 billion (see "Bogus Predictions of Pharma Industry Online Ad Spending"), which is significantly different than the IAB guesstimate 0f $2.04 billion based on the data for the first 6 months.

Why the difference? It could be that eMarketer is measuring something different. However, its 2011 number of $1.28 billion is virtually the same as what IAB said the healthcare industry spent online in 2011 (4% of $31.7 billion equals $1.27 billion).

$1.58 billion, $2.04 billion -- whatever. Pharma's share of that ad spend is probably 50% or $0.8 to $1.0 billion. Taking out the 48% attributed to search, we get $0.38 to $0.48 billion spent on other types of online advertising. This compares to about $4 billion pharma spends on all direct-to-consumer (DTC) advertising -- a number that does not include the online spending of any sort. In other words, online ad spending by pharma is still insignificant compared to offline ad spending.

Tuesday, October 9, 2012

It's Official: Doctors Prescribe Adderall to Help Kids Get Higher Grades at School

Dr. Michael Anderson, a pediatrician for many poor families in Cherokee County, north of Atlanta, routinely prescribes Adderall to kids who get poor grades in school. To do that, he first must commit fraud: submit a false diagnosis of attention deficit/hyperactivity disorder (ADHD) to Medicaid and/or private insurer.

The doctor admitted his fraudulent activity in a story published in today's New York Times (here). “I don’t have a whole lot of choice,” said Dr. Anderson. “We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.”

He does this believing in his heart of hearts that ADHD is “made up.” His excuse? To prescribe the pills to treat what he considers the children’s true ill — poor academic performance in inadequate schools.
Dr. Anderson’s instinct, he said, is that of a “social justice thinker” who is “evening the scales a little bit.” He said that the children he sees with academic problems are essentially “mismatched with their environment” — square pegs chafing the round holes of public education. Because their families can rarely afford behavior-based therapies like tutoring and family counseling, he said, medication becomes the most reliable and pragmatic way to redirect the student toward success.
This is wrong on so many levels. For one thing, who made Dr. Anderson and other physicians who feel the same way judge and jury regarding what school is "adequate" or "inadequate"?

That, of course is not the main problem, which is prescribing a dangerous, additive drug to children who have no real medical need. This is clearly a case where a drug's benefit does not justify the risks that the patients are subject to. "Reported side effects of the drugs have included growth suppression, increased blood pressure and, in rare cases, psychotic episodes," says the NY Times.

Not mentioned by the Times is the dangers of addiction. ABC News recently ran a story documenting this problem: Dangers of Adderall Addiction Among Moms (see here or view the embedded video below).



If moms can become addicted to Adderall, their children can also become addicted. When they can no longer get Adderall, they will try other drugs easily available from physicians or on the street (see, for example,

This is so egregious that I must ask if Dr. Anderson has received payments from Shire Pharmaceuticals, which sells Adderall XR (the extended release version of Adderall, which Shire sold to Teva Pharmaceuticals). Unfortunately, Shire does not publicly disclose such payments. According to its compliance Web site (here), Shire only reports spending on HCPs (healthcare providers) to a "limited number of states as required by the individual state laws."

Related posts:

Monday, October 8, 2012

Psychiatry "Suicide" by Pharma

British psychiatrist and "Big Pharma gadfly" David Healy argued that his profession is “committing professional suicide” by failing to address its dangerously close relationship with the pharmaceutical industry. He made his argument speaking at an annual meeting of the American Psychiatric Association during a "well-attended session on conflicts of interest" according to this article.

Dr. Paul Appelbaum, a past president of the APA and director of Columbia’s Division of Law, Ethics and Psychiatry cited a study that showed "only 34% psychiatrists believe that receiving food or gifts affects their own prescribing patterns, 53% believe that it influences that of their colleagues... Research shows that this type of thinking — 'Everyone else is prone to biases and social factors, but not me'” — is common and confounds attempts to address conflicts.'At least some of our colleagues are wrong,' Appelbaum said drily of the study."

Healy offered some advice for how his profession can put some distance between it and the pharmaceutical industry.“The key issue in the short term is access to data. We have to insist on that,” he said. “We let industry come to our meetings and let them talk in our programs. I don’t think it’s huge problem that they get paid. The big problem is that if you ask for data, they can’t give it to you. That’s not science, that’s marketing masquerading as science.”

Daniel Carlat, M.D., director of the Pew Prescription Project, organized the session. Carlat once characterized pharma-sponsored Continuing Medical education (CME) as "a new twist on that well-known instrument of corruption, money laundering." Listen to the following podcast interview of Dr. Carlat on that issue:

Listen to internet radio with Pharmaguy on Blog Talk Radio

Friday, October 5, 2012

Who Has Actually Played BI's SYRUM Game? The Silence is Deafening!

During today's #hcsmeu chat session (see archive here) I asked "Truthfully - has any of my EU colleagues actually played SYRUM?"

There's been a lot of hype about Syrum previous to its launch by Boehringer Ingelheim (BI) in the EU (see here), but I've heard nothing post launch from anyone who has actually spent time playing the "game" (I'm told that it's not a form of "gamification").

"Who's the EU 'pharmaguy' who will take on this task and report back?", I asked.

Turns out that one person (Maria Öst, Sweden, aka @mariaatomaca) admitted she signed on to a beta account, but she didn't actually play the game. By signing on, Maria gave Syrum (and BI) permission to "post on [her] behalf" and "read [her] checkins" even if she does not play the game (see here).

According to @fision (Kai Gait, UK) Syrum opens "lots of potential opportunity in the future by accessing the interest graph of players" -- even if they don't actually play the game ("If a user doesn’t ‘disconnect’ the game, they [BI] still have access to data in theory," said @fision).

Felix Jackson (@felixjackson, UK, founder of medDigital) actually has played the game and said "I ... enjoyed it! I liked the way it showed me drug development." I thank Felix for taking the time to give me a live tour of the Syrum via Skype during which I saw a few peculiar things such as a masked avatar that looked like an Al Qaeda terrorist! I guess it was supposed to be a surgical mask. I've worked in a lab and I never saw anyone wear a mask. Maybe drug development labs are different.

One of the features of the game is that you can see friends on Facebook who have also signed on to play the game. You can "recruit" these friends to be members of your drug development team or you can collaborate with them. Unfortunately, none of Felix's FB friends -- including BI's John Pugh -- were able to collaborate with Felix because they didn't have any molecules under development (ie, they currently are not playing the game).

Meanwhile, Helen Harrison (@harrassedmom) alerted me to this "walk through" on YouTube:



By the time you read this, one or two other people I know on Twitter may tell me that they also have played Syrum. These people, however, are mostly like me -- not representative of Syrum's target audience, which is the general public. We won't know very much about how many of those people have signed on to play, how long they have played, etc., unless BI shares that information with us. That make take another 3 years -- I'll wait :-)

Wednesday, October 3, 2012

Shane Victorino: Adult ADHD Poster Boy

Adult ADHD (attention deficit/hyperactivity disorder) is the "next big thing" for pharma companies like Shire, which markets Vyvanse for the treatment of ADHD in adults. So says the author of a Salon article titled "Big Pharma’s newest invention: Adult ADHD."
“Immature adult market continues to offer greatest commercial potential,” read a 2008 press release to the pharmaceutical industry from the market research agency Datamonitor: “Estimated to be twice the size of the pediatric ADHD population, the highly prevalent, yet largely untapped, adult ADHD population continues to represent an attractive niche to target.”
So who might consider themselves part of this “untapped” market?

Well, former Philadelphia Phillies center fielder Shane Victorino for one. The "Flyin' Hawaiian" is now an adult ADHD celebrity spokesperson appearing in magazine ads like the one shown below and in video testimonials like the one you can find on ShanesStory.com.


If you talk to people in the know, Victorino is an ideal adult ADHD "poster boy." I've heard that Victorino was a mile-a-minute talker and often people around him wished he'd shut up. In a Shire-sponsored YouTube video, Victorino himself admits "always interrupting" his teammates and having problems focusing.

Interestingly, Victorino doesn't mention Vyvanse. It's unclear, therefore, if he benefited from Shire's drug, which entered the market in 2007, about 8 years into Victorino's major league career and about the time that Victorino became a starting player for the Phillies.

So it's unclear if Vyvanse -- or any other medication -- helped Victorino play ball as well as he did for the Phillies. Some have speculated, however, that his constant talking and interruption of teammates was one reason why the Phillies traded him. Could the trade be part of a devious Phillies plot to insert a disruption agent within the ranks of a rival team?

I'm just kidding, of course. Like many Phillies fans, I like Victorino and wish hime the best.

Unlike some other pharma-paid celebrities, Victorino is not promoting a brand of drug, but promoting awareness of a medical condition. Some people -- like the Salon article author -- claim that ADHD awareness marketing is a form of "disease mongering," which causes more people to be diagnosed with the condition than is necessary. But that's a whole other issue that I don't have time to get into now. You can read about disease mongering here.