Is this crossing the line?

Is this crossing the line?

Recently AstraZeneca (NYSE; AZN) hired Phil McGraw — best known as “Dr. Phil” as spokesmen for Bydureon, the company’s once-weekly GLP-1. While “Dr.” Phil is not a medical doctor he has been living with Type 2 diabetes for the past 25 years. Although it is not unheard of for a company to hire a non-medical professional to promote a diabetes drug, keep in mind that Novo Nordisk (NYSE: NVO) did hire celebrity chef Paula Dean to promote Victoza, also a GLP-1, these hires do raise some ethical questions.

According to report published by Vox, “These campaigns create a blurriness between marketing and public health messages,” says Dartmouth physician-researcher Steven Woloshin. “People tend to view them with less skepticism, particularly when there is a trusted celebrity spokesperson.”

The story goes onto to state;

“AstraZeneca is sponsoring the Dr. Phil campaign. AstraZeneca makes a diabetes medication called Bydureon. Clearly, the drug maker doesn’t have an interest in giving the public objective information about all the different treatments available for diabetes — the kind of information that can help people make evidence-based choices about the harms, benefits, and trade-offs of various therapies.

A spokesperson told me that Dr. Phil was chosen for this campaign because he’s been “successfully using one of our medications, Bydureon, to manage his diabetes since 2012.”

The question is would a patient ask their physician about Bydureon because Dr. Phil has endorsed it? Another question is, do these celebrity drug endorsements cross the line? Does the fact that Dr. Phil is really not a medical doctor make his endorsement different? Anyone who has watched TV recently has likely seen the Xarelto ads which feature the famous golfer Arnold Palmer, the Miami Heat’s Chris Bosh, actor/comedian Kevin Nealon and racecar driver Brian Vickers. Yet these ads aren’t seen as crossing the line.

To make things even more complex consider that even without any endorsements or ads which drug a patient is prescribed is not always left up to the physician. As we have noted previously many physicians are handcuffed due to the patients’ healthcare coverage when it comes to prescribing diabetes therapies. Even though Bydureon may be the correct option for the patient their physician may be limited to using Trulicity, another once-weekly GLP-1 from Lilly (NYSE: LLY), based on formulary position. Yes, the doctor can prescribe Bydureon but this would likely result in the patient paying a higher co-payment based on the fact Bydureon does not have favorable formulary position.

The reality of the situation is that patients and their physicians are no longer in control of which therapies are used. Again as we have noted with regularity payors hold the keys to the kingdom.

Yet on the flip side of this issue is the fact that when it comes to diabetes therapies does it really matter which long-acting GLP-1 a patient is prescribed. Right now there are 3 once-weekly GLP-1’s on the market, Bydureon, Trulicity and Tanzeum from GlaxoSmithKline (NYSE: GSK). Yes, there are some minor differences between these three but basically all three do the same thing the same way. The reality is the biggest differences between these three is not how they perform rather it’s their delivery systems, simply put who has the most patient friendly pen.

Given this set of circumstances does any celebrity drug endorsement really matter. Back when Paula Dean was hired by Novo we didn’t question this choice because Ms. Dean was a celebrity, no our beef was the fact that Ms. Dean made her fortune by promoting recipes that weren’t diabetes friendly. Nor did it help much that Ms. Dean besides being a celebrity chef was also a racist. Still, Novo had every right to hire Ms. Dean much in the same way AstraZeneca has every right to hire Dr. Phil.

The harsh reality is in the real world which drugs are prescribed to treat a patient is complex puzzle involving many pieces. The old days when a physician had carte blanche are gone. The old days when payors did little more than reimburse any drug equally are gone, the lone exception being generics. The old days when patients did not have information available at the touch of a button or mouse click are also gone. The old days before health care reform came along and they weren’t plans with unreasonably high deductibles or co-payments are also gone.

We also live in a world filed with multiple options in each drug category, options which basically do the same thing the same way. This is why the diabetes drug market has transformed into a commodity market. Frankly by our way of thinking about the only thing these celebrity endorsements are good for is raising brand awareness, another confirmation that diabetes drugs are becoming a commodity. Yet, the fact is strong brand awareness or not the patient nor their physician is in control over which therapy options are prescribed.

To be completely candid we actually see a benefit from this endorsement and not for AstraZeneca. The fact is we now live in a celebrity obsessed culture, the fact that Donald Trump is about to become the Republican nominee for President proves this. While the Republican establishment may not like it the fact is the Donald used his celebrity with perfection.  Like him or not give the guy credit for knowing how to use his celebrity status.

The reality is there are millions of patients with Type 2 diabetes and millions more who have diabetes but don’t know it. It’s also true that Dr. Phil has a huge following and the fact the he is a Type 2 patient helps all patients with diabetes. Even though these patients may not be candidates for Bydureon knowing that Dr. Phil has had diabetes for 25 years and is now in control of his diabetes just might prompt his fans to do a little research. It just might be the catalyst these people need to have a discussion with their physician.

As Momma Kliff used to say; “Always look for the good that can come from what at first seems like a bad situation.”