Abbott Uses Fear To Promote Sleeping Pills In India

Abbott Uses Fear To Promote Sleeping Pills In India

July 11th, 2011 // 12:37 pm @ jmpickett

To promote its Zolfresh sleeping pill in India, Abbott Laboratories has embarked on an advertising campaign that is being harshly criticized for using unproven data and old-fashioned fear in the guise of educating consumers about insomnia. Moreover, critics say the ads may prompt some people to buy potentially harmful pills that are not really needed, Reuters writes in an interesting expose.

To wit, a newspaper ad featuring an attractive Bollywood actress warns that “Hard Work Never Kills. Lack of Sleep Can.” The message then says that “Research shows that sleeping less than 6 hours at night leads to (a) 48 percent increase in developing or dying from heart disease.” But the research cited only demonstrates an association, not a link between insomnia and heart problems. And Francesco Cappuccio, whose research Abbott cites, did not respond to Reuters for comment.

“They are implying that taking sleeping pills may help you live longer, whereas the data shows that taking sleeping pills is associated with increased mortality,” Daniel Kripke, a psychiatrist at the University of California, San Diego, tells Reuters. “The use of sleeping pills, including zolpidem (the chemical name), is associated with higher mortality, and there are 18 studies that show that.”

Adds Ana Krieger, who directs the Center for Sleep Medicine at Weill Cornell Medical Center in New York: “They can’t make any claims about the cause. We don’t know if people who sleep four to five hours are environmentally stressed because they work multiple jobs, and then get anxiety and insomnia, or because they are sicker to begin with…It’s really an extrapolation, which can be kind of dangerous because there are side effects for any medication that we give to people.”

There is another issue: the ad includes a link to a website showing a picture of Zolfresh, despite the fact that direct-to-consumer advertising is illegal in India. “This is so dramatic and ridiculous,” Adriane Fugh-Berman of Georgetown University in Washington, D.C., who runs PharmedOut, a think tank that studies pharma influence on physicians. “It is really advertising, but it is disguised as education. Industry calls it disease awareness, those of us who are public health advocates call it disease-mongering – making people believe that they are sick when they are normal.”

The ad points to lower standards in emerging markets where oversight is poor. “You already feel like you are in the Wild West,” former FDA attorney Ben England, who runs the FDAImports consulting firm, tells Reuters. “There is not likely to be anybody who is going to take them to task. If there is nobody paying that much attention to what people are saying about the product, then they’ll push the envelope and say things they would not have gotten away with here.”

A pack of the generic sells for only a couple of dollars in India, but profits can be large if a small fraction of the population buys Zolfresh, Reuters notes. “There is a lot of public resistance to treating insomnia, because they don’t think it is such an important condition,” Ram Bala, a marketing expert at the Indian School of Business in Hyderabad, who has consulted for Johnson & Johnson and AstraZeneca, tells Reuters. “If you bombard them with enough information about insomnia, maybe they may at some point decide, ‘Hey, you know what, there are so many people telling me that insomnia is important, maybe I should go to the doctor and check it out.’”

And the Abbott ad encourages readers to see a doctor if they check just one of 10 statements, including “I feel sleepy during the day” and “I have a feeling that my sleep is unrefreshing.” As Reuters notes, a report by the McKinsey consulting firm about India says: “The acceptability of modern medicine and newer therapies will increase due to aggressive market creation by players. Investments in increasing patient awareness and education will impact diagnosis and treatment levels…In addition, patients will show greater propensity to self-medicate.”

Meanwhile, Reuters also points out that sleeping pills are known to cause some unusual side effects, such as sleepwalking, and impairing memory and driving skills. A Merck sales rep claims a pill caused him to go sleepdriving. According to the FDA, sleeping pills may also cause sleepcooking.

For its part, Abbott would discuss its marketing with Reuters and declined to comment on the claims made in its ad. “Abbott and other health care companies support disease awareness education programs for health conditions where there is an unmet need and where awareness about these conditions is low,” an Abbott spokesman wrote Reuters. He did maintain ads “commonly incorporate education on lifestyle factors such as diet, stress and exercise,” although Reuters noted that info was not in the Zolfresh ad. The drugmaker also insists local regulations are followed where ads run.