Mylan Ad Frenzy Part II

[booandbrimom]

http://blog.onespotallergy.com/2012/05/misleading-and-dangerous-epipen-ad-campaign-launched-by-mylan-specialty-continues/comment-page-1/#comment-1008

The controversy IS very much like abstinence-only education. The "stay pure" (no may contains) message may not actually work, but we can feel good about Mylan promoting it.

All those Epi-Pen-less slacker parents need is more abstinence-only education! Right?

 

[CMdeux]

Well, I certainly have fewer issues with this ad than the TV spot.  I think it's a bit clever, actually.  It would be nice if it were so obvious.  Truly.  I'd prefer a flashing neon sign to indicate cross-contamination, myself.  <ahem>

Still...


it is doing mass-marketing promotion of the idea that an epipen is a complete "failsafe" and that life can proceed EXACTLY as it does for everyone else as long as you have on in hand.

This is probably an okay message in a specialty publication like Allergic Living, etc.  In those publications, the general public probably isn't who is reading in the first place.  It bothers me more in a mainstream, broad demographic target like in People.

The reason that it bothers me so much is that this is precisely the attitude that we've been fighting over-and-over-and-over again for over a decade... ignorance...  because the ads are telling others that what they WANTED to believe all along is true!  (Yay, right?)

The thing is, we're really NOT helicopter parents when we won't just "let {DD} carry one of those epipen things and be responsible for herself" in very high-risk environments/events, YK?

Even as an adult, I'm thinking that DD will have the common sense to use the buddy system at those kinds of events-- or avoid them entirely.  She seems to have more sense on this subject than most adults without food allergies do, but the problem is that "risk benefit analysis predicts that the risk here is too high to be worth it even with my EpiPen, but maybe next time!" doesn't fit into a cheery sound-bite or glossy two page ad.

It's just more "Well, just teach your kid what they can't eat, then..." but dressed up under the guise of selling autoinjectors.  I'm pretty sure that Mylan doesn't especially care whether or not this saves lives.  As long as this campaign sells autoinjectors, it's all good, YK?

[CMdeux]

While we're at it, then, why not a twin ad that has a vomiting child with reddened, teary eyes, looking miserably into the camera, with a tee shirt* that says "This isn't Viral-- Anaphylaxis in Progress."


If only it were so obvious.      


(Just saying.)  Because, see, that would also be educational in exactly the same way that this particular print ad is educational.  Yes?  Just a little less appealing.  But hey, it does nicely avoid the issues surrounding whether or not the cross-contamination Nazis or the slacker-livin-my-life parents are the crazy ones.

Because Barfy the wonder kid could belong to either one of them, right?


* late editorial change.  Needs to be written across the hiney of the pair of sweats.  That way the child's head can be in the toilet. 


Snark.  Yes.  This is me, being snarky.  Well, sort of.  I guess I do have some questions about why the birthday cake is "cute/clever" but MY idea isn't.   

[Mfamom]

the thing I don't like is how some people are "gurus" in the food allergy community and because "they approve" its all good/okay. 
I especially didn't like Nancy's message from annma.org
I appreciate that they are trying to get people to carry epi pens, but why not put out a complete message....avoidance, preparedness, etc.

[mattie's mom]

I have recently seen a tv ad from Dey that does have kids describing their ana symptoms with the voiceover saying that kids die from ana everyday and go to allergic living for a list of questions to see if your child may be at risk for ana and how to protect them.  The ad is running during prime time.  No menion of epis. 

[CMdeux]

Yes, I saw one of those quite a while back. 

I think that letting people know that HEY, "he just vomits for a few hours" is, um... fairly serious in terms of an allergic reaction  is a responsible and ethically correct tactic. 

People tend to underestimate severity in most allergic conditions-- asthma included.  So that kind of patient education (which avoids the entire lifestyle debate in the first place) is more appropriate, I think. 

Then again, Boo's point about it being impossible to "scare" people motivated is also worth bearing in mind.  At some point (and it isn't the same threshold, I suspect, for everyone) the subject is simply so unpleasant that they will not think about it instead of acting.  That may be an alternative explanation for the studies of behavioral leveraging that show that positive (and superficial) messages that make the action EASIER TO TAKE seem more effective than those that are more serious and factually seem more motivating (gory car crash pictures don't motivate people to wear seatbelts-- social pressure and widespread laws do).

So what best motivates people to carry epinephrine without out-and-out LYING about food allergy?  That's the real question.

[SilverLining]

This print ad doesn't bother me at all. 

And I'll add, everything I have seen objecting to it, seems to go back to onsepot.  Elizabeth seems to encourage knee jerk reactions.  It's why I chose to "unlike" her fb page.  I have nothing against her personally, and everyone I've heard who ordered products from her is a happy customer.  But, I don't usually agree with the comments made by people on her posts, which often seem to promote the knee-jerk.  This is just my own opinion.

[booandbrimom]

...everything I have seen objecting to it, seems to go back to onsepot.  Elizabeth seems to encourage knee jerk reactions. 

She's focused on making money. That means she has to pander. Since I've been blogging, I've been looking at all the "advocates" and "bloggers" who really run side businesses selling holders or bracelets or books. It's amazing how much money underlies our community.

And I feel terrible for Nancy from ANNMA. She gave an honest answer and those girls are gonna to hang her out to dry if she comes back. Charming advocacy!

[lakeswimr]

I think the print add is equally bad to the tv spot.  I think both send the wrong message.  i don't think it is the same as abstinence-only education.  People can have sex pretty darn safely with the use of some protection.  People can't eat who knows what cakes with the same safety.  One is a life or death issue, the other not so much. 

I still think it is an education issue.  The other FA parents in my district for the most part see pediatricians who give them less than complete info about FAs or they see an allergist who isn't very good and so isn't giving them enough info.  These are people who bothered to take their kids to a doctor for allergies and got less info than they needed.  We see people all the time on food allergy message boards who do not know when to epi, who were not given a written emergency plan, who weren't told how to read labels (esp if they deal with non-top 8 but even for top 8), who weren't told basic things and so they don't know these things.  I have a great allergist but even he didn't have time to tell me everything and I had to learn some things the very hard way as a result. 

I know there are parents who don't take proper care of their kids across the board but they are not the majority of parents.  I have seen some shocking things from some parents but even if they are 30% of parents they are not 80% of parents or 90% or whatever that statistic was about people who don't carry epis.  Parents who otherwise are involved, caring parents, I think those people WOULD carry epis if only they had access to the right information and doctors who knew what they were taking about. We still have the majority of ER staff not knowing to give the epi, monitor for at least 4 hours and send the person home with an epi script and these are people telling parents to give benadryl and that the reaction wasn't that bad, etc.  And these people go home believing this.  I have seen this happen to people in my family and to my friends and read countless stories of this and the 2 studies by FAAN back this up. 

We have a vaccination rate of close to 100% in this country.  We have the majority of parents taking their kids to well visits with the pediatrician, for hair cuts, for new clothes, for dental appointments.  This type of parent who does these things would carry the epi, IMO if they knew to do so.  They would not feed bakery cakes if they knew the risk.

I can't count how many people have posted that they used to do all these risky things (have kid eat non-nut varieties of ice cream, bakery cakes, not mention FA to wait staff and restaurants, etc) until they realized it wasn't safe because *no one told them otherwise*.  I remember when DS was small I let him eat baked goods friends made who told me they were allergy-free.  I wouldn't do that now unless it was from someone with very similar allergies and comfort zone.  I also let DS have a bakery cookie once! i wouldn't do that, either.  He had big anaphylaxis at a restaurant because I didn't understand what we were dealing with.  And I was trying to get this info very hard. 

So, I don't know.  For parents who aren't going to take good care of their kids anyway I'm not sure these adds are going to do the trick but they are going to damage others so I don't like these adds and I do not agree that they are going to help the 90% and hurt the 10%. I don't think those numbers are accurate. 

[booandbrimom]

I think the print add is equally bad to the tv spot.  I think both send the wrong message.  i don't think it is the same as abstinence-only education.  People can have sex pretty darn safely with the use of some protection.  People can't eat who knows what cakes with the same safety.  One is a life or death issue, the other not so much. 

I didn't mean that the situations were 100% equivalent. I meant that the advocacy approach is equivalent. Those who believe in abstinence-only education, whether for sex or food allergies, are completely unwilling to consider any other type of education because it trips their moral bells, even if that education might work better.

IMO, this part of our community is just so incensed at these other mothers that we really don't want them having Epi-Pens. They're cheaters! They make us look bad! We hate them! Their kids deserve what they get!

(Whew...time for more coffee.)

[SilverLining]

  i don't think it is the same as abstinence-only education

This isn't an ad by an advocacy group....it's from a for profit business.  They are advertising their product.

If we could absolutely 100% always always alwyas completely avoid our allergens we would not need their product.  But we cannot do that.  Accidents happen, and so we carry our epi-pens with us.

This print ad (to me) shows it more in that light.  maybe there is nobody in the entire world that you trust to cook anything for your child.  (I'm not judging or criticizing...just commenting.)  But, there is someone I trust.  She makes dinners and baked goods and I eat them.  She often calls me to verify what brand of an ingredient is safe.  But, what if.....Brand X used to be safe but no longer is and no warning is added?  She might use that Brand and contaminate the birthday cake she bakes.  Accidental cross contamination....and I'm a very careful person.....but it could still happen.

[twinturbo]

My concern is self-centered: I want an agnostic approach to epinephrine auto-injector delivery systems, one that leaves market entry open to newcomers with hopefully improved delivery systems and unique form factors that provide better drug stability for longer shelf life or excursions, ease of carry for people who must carry multiple doses for multiple persons or any other improvement/development I haven't covered.

In that regard I have an interest in Dey's ability to report to share owners, i.e., stock owners (of which I was probably one years ago), so that Dey is around to make branded EpiPens - which I currently prefer for the kids. I also have a vested interest in others doing as well so that I have reliable auto injector choices in epinephrine delivery.

The problem is that they're doing it wrong, like incompetently wrong. Yes, while it is theoretically true that any company can internally position a product as anything (hey, it's theory) Dey has chosen an ad campaign that concentrates on repositioning the therapeutic role of epinephrine in allergic disease management rather than their patented drug delivery system. Their brand strength is military grade technology, years on the market, proven reliability, word of mouth evangelism, and increasingly the use of EpiPen to stand in for "epinephrine auto injector" probably because it's a good name EpiPen. Easy to write, say, conveys what it is efficiently. Why this is noticeably absent I can only guess they don't want to acknowledge competitors like Shionogi.

The next issue is that it is a prescription only control usable only by the patient it was prescribed to. If Dey is not hitting the medical side HARD then they are even more incompetent than I currently believe. If the doctors don't believe in prescribing multiple EpiPens for good coverage at home, at school then what exactly do they hope to accomplish by going directly to patients who were told they don't need it. I'd say the bottleneck resides more in the doctors than the patients.

As for the blogs, Facebook groups, etc., no comment. I don't follow them. I do know that E-cue just settled with Pfizer (was it?) and I think cleared their last FDA hurdle. With our needs and our insurance I go through about 20 epinephrine auto injectors a year. Already I've started to mix up what I carry from all Dey EpiPens to include some Twinject. Part of this is form factor, Twinject is smaller even in two doses, and has an opaque carry case to block light. When the card hits the market I'm sure either myself or DH will start carrying one of those as well.

[booandbrimom]

Dey has chosen an ad campaign that concentrates on repositioning the therapeutic role of epinephrine in allergic disease management rather than their patented drug delivery system.

...

The next issue is that it is a prescription only control usable only by the patient it was prescribed to.

I don't think they see it that way. Their press release after the first brew-ha-ha was very informative. They said  90% of allergic people do not carry epinephrine. We could quibble with the accuracy of that statistic...but since they do it for a living, I'm gonna assume they're right and the vast majority of allergic people do not.

Would you rather try to keep 90% of a 10% market with new competitors on the horizon, or convert even 15% of an unpenetrated new 90% market?

P.S. And I don't think they're going to put their energies into open-use legislation. That WOULD look self-serving and the advocacy groups (the real ones with money and lobbyists) are moving that along nicely.

[twinturbo]

What I think about Dey's campaign in action is a statement on the therapeutic role of epinephrine was as a lifestyle drug (again not why their auto injector is better than a competitor) if we're talking about the commercial that was pulled.

What I think about their Dey's numbers is looking at gaining new (white, English speaking, suburban moms?) American customers rather than looking at which segments of their market use EpiPen brand auto injectors and how many which would drive total sales. It's a suicidal move to sacrifice your core heavy users... unless you think they have no choice. I read that they were also going for a larger market presence in Europe, how it's unfolding I haven't seen so I can't compare it to the US.

What I think is ethically challenging and self-serving, if we're going to go there shortly, is the Dey-FAAN corporate partnership which is essentially a marketing outlet. Sorry, ain't nuthin' should be happening "behind the scenes". The last thing I either need or have time for is to resurrect the beaten dead horse of FAAN good FAAN bad so I'm leaving it at that.

My choice in action from here on would be to talk less about Dey in particular to become more agnostic towards auto injectors, examine delivery system choices in pro/con format of Adrenaclick, Twinject, EpiPen and follow E-cue's entry. Maybe look closer at licensed generics.
Considering the same heavy users and believers of epinephrine auto injectors also employ social media that could be a powerful force in change.

[lakeswimr]

I certainly can't related to thinking anyone doesn't deserve epis because they are cheaters and have  hard time imagining anyone thinking that way. 

I just think this is a false dualism.  We don't have to either have factually accurate, positive message adds that encourage proper actions across the board (avoidance and carrying epi pens) or adds that say, 'well, you are going to eat that bakery cake so carry epi pens'.  We can have another type of message that doesn't go for either.  I think the ones I have seen recently where they show people who have some symptoms and encourage people to take the test and talk to their doctor about whether or not they might need and epi pen, the one with the mother sending her child off to school on the bus and saying something like, 'thank goodness for epi pen' are very good ads and don't involve either issue.

I agree with whoever said they don't think epi pen companies are the ones who should be doing advocacy work.  They also shouldn't undo advocacy work as they have with these adds. 

I think the print add is equally bad to the tv spot.  I think both send the wrong message.  i don't think it is the same as abstinence-only education.  People can have sex pretty darn safely with the use of some protection.  People can't eat who knows what cakes with the same safety.  One is a life or death issue, the other not so much. 

I didn't mean that the situations were 100% equivalent. I meant that the advocacy approach is equivalent. Those who believe in abstinence-only education, whether for sex or food allergies, are completely unwilling to consider any other type of education because it trips their moral bells, even if that education might work better.

IMO, this part of our community is just so incensed at these other mothers that we really don't want them having Epi-Pens. They're cheaters! They make us look bad! We hate them! Their kids deserve what they get!

(Whew...time for more coffee.)