Diet drug update: “But the other kids get to do it”

A major diet drug company admitted that their intense direct-to-consumer advertising campaign was to generate consumer awareness and played a key role in their sales. Without DTC, their predicted sales would fall.

Australian regulators with the National Drugs and Poisons Schedule Committee have disallowed Xenical to be marketed directly to the public, finding that its marketing was improperly influencing people, notably young girls, not appropriate for the drug. The Committee “decided that, on balance, there was insufficient public health benefit associated with allowing direct-to-consumer advertising” of Xenical, according to The Australian News.

Two months into its campaign, the Therapeutic Goods Advertising Council ordered Xenical advertisements off the air after receiving complaints it was targeting teen girls. The ads were played during Australian Idol, which reaches about 320,000 viewers under the age of 16 and Pharmacists began reporting that smaller and younger girls were asking for the pills by name. While later dismissing that claim, the Council did find that the pharmaceutical company, Roche, had breached the code prohibiting “inappropriate or excessive usage.”

As reported in the Sydney Morning Herald, Roche managing director, Fred Nadjarian, said that because of the decision, predicted sales would inevitably fall as consumer awareness dropped off. Annual Xenical sales in Australia were reported as $95 million. This admission sharply contrasts with the industry’s justification for DTC advertising has having lifesaving educational value, as discussed here. But as researchers have noted, only 25% of drug ads to consumers actually provide helpful educational information about a medical condition.

Worldwide sales of Xenical are $500 million a year, mostly outside the United States, and this could be about serious money if other countries follow Australia’s lead.

Nadjarian’s response to the Committee’s decision was to claim it would give free rein to “hocus pocus” alternative products. In reference to a leading alternative weight loss product, he said: “We won’t be able to advertise yet products with dubious ingredients largely based on green tea extract, eye of newt, wing of bat and guinea pig tails can.”

David Henry, professor of Clinical Pharmacology at the University of Newcastle, however, noted that the Committee’s decision had only corrected an unusual decision allowing that class of medications to even be advertised. He commented on the inappropriateness of the Roche response, saying: “There are problems with complementary medicines that need to be dealt with ... but that’s not an argument for allowing a scheduling loophole which should never have existed in the first place.”

Roche’s DTC advertising campaign in the United States was launched in 1999 and was described in its press release as being one of the largest in the history of the pharmaceutical industry. The company recently told the FDA that its over-the-counter version of Xenical could bring in annual sales in the U.S. of $1.5 to $3.9 Billion.

But the surge among Australians turning to diet drugs has already sparked international concerns and warnings about the dangers associated with diet pills and other extreme weight loss measures. The UN’s International Narcotics Control Board released a report this week finding the countries with the highest per capita prescription diet pill usage are Brazil, Argentina, South Korea, the United States and Singapore. “Anorectics are being used indiscriminately to feed the slimming obsession that affects some societies,” said INCB President Philip Emafo. Diet pill usage in Brazil is a stunning 40% higher than in the U.S.

And those numbers are in addition to disconcerting numbers resorting to over-the-counter diet pills. This week, researchers at the U.S. Centers for Disease Control and Prevention published a study [not yet available online] in the Journal of the American Dietetic Association. It found that more than one in seven American adults have used dietary supplements in efforts to lose weight. According to the study, 74% said they have used a supplement containing a stimulant, such as ephedra, caffeine and/or bitter orange. Those ingredients are in such products as Xenadrine, which the FTC cited in January for deceptive marketing.