Sally Field and Boniva: Great spokeswoman, misleading ad

In this installment of our Adwatch video series—our sixth—we turn to a commercial for Boniva (ibandronate), a drug for osteoporosis. The ad features beloved actress Sally Field, who looks refreshingly younger than her actual age. Sally’s psyched about Boniva and its super-convenient dosing schedule: You can take it just once a month, compared to once a week—or even daily—for most other drugs in its class, called bisphosphonates. So you have more time to do fun stuff, like play with your grandkids, and ostensibly stronger bones to do it with.

Few things are that simple, of course, especially when it comes to direct-to-consumer drug ads. Boniva’s convenient, sure. But as the Adwatch video explains, that convenience comes at a price—it can set you back about 10 times the cost of the similar drug alendronate (the generic version of Fosamax). No wonder Boniva’s backers, Roche and GlaxoSmithKline can afford to invest in a big-name celebrity to pitch it. Interestingly, studies don’t show that Boniva is any more effective than other bisphosphonates. So unless you absolutely can’t tolerate a weekly dosing schedule, it makes sense to try the generic first, even if it means you won’t take the same drug as Sally.

And that’s if you really need the drug in the first place. While there’s clear evidence that bisphosphonates reduce the risk of bone fractures among people with osteoporosis, there’s some concern in the medical community that more people will take the drugs than needed, due in part to osteopenia, a “pre-osteoporosis” diagnostic category for which the bisphosphonates’ worth is less clear. That means millions of postmenopausal women with reduced bone density—but not osteoporosis—could expose themselves to the drugs’ risks, including heartburn, jawbone damage, and vision-harming eye inflammation. While the latter two side effects are very rare, they certainly make Boniva seem less glamorous.

Finally, the use of celebrities in drug advertisements raises all sorts of questions, from the ethical (Do celebs really use the drugs they promote?) to the trivial (Who is Sally’s hair stylist?). This is the first commercial we’ve analyzed that has a famous spokesperson, and it adds a whole new layer to the analysis. Are there any other celebrity-fronted commercials, drug or otherwise, that make you squirm? We’d love to hear your thoughts via the Comments link below.

—Jamie Kopf Hirsh, associate editor

Watch our Boniva Adwatch video (above), read more about drug ads, and watch our Adwatch videos on Chantix, Cialis, Seasonique, Rozerem, and Requip.

Comments

[Omakaren]

I have stopped taking the bisphosphonate Boniva [I have also taken and stopped Fosamax in the past] because, even though those drugs are supposed to prevent brittle bones, more and more research is showing increased occurrence of unusual fractures [especially in the femur] and no reduction of fractures overall. These drugs prevent the body from getting rid of old bone [so increasing density, but now research shows also increasing brittleness] AND ALSO PREVENT PRODUCTION OF NEW BONE. We now believe taking Boniva for several years contributed to my friend's fractured femur [an unusual vertical fracture -- she did NOT fall]. Vivian Goldschmidt has written “The Bone Health Revolution” with a lot of documentation and research cited. Think of a dry, brittle dead branch and a green, flexible living branch. Bone is 60% mineralized collagen and 35% collagen matrix [flexible]. What are our bones without this 35% flexible collagen? Continuous old bone removal creates space for new bone. Stopping this normal process prevents new bone formation, leaving old, brittle, inflexible bone. These drugs are bone hardeners, not bone builders. What is really scary is that this is not a side-effect, such as nausea or difficulty swallowing. This is what these drugs DO. Potentially everyone who takes bisphosphonates will have denser but MORE brittle bones and increased aches and pains! Please do the research and stop! Karen

[ELAINE TRAYLOR]

BONIVA IS A BAD DRUG...SAME AS FOSAMAX....I AM SUFFERING WITH A FRACTURED JAW BONE INDUCED BY FOSAMAX....I HAVE A REALLY TRUE STORY TO TELL. I WILL BE ON PENICILLIN FOR THE REST OF MY LIFE. FOSAMAX IS STILL BEING PRESCRIBED AND SOLD...WHO COULD I TELL MY STORY TO?? PLEASE RESPOND

[Laurie]

Oh so, the author can decide who sees what comments - that's rich!

[Laurie]

Your negative comments about the use of celebrities to market products turn people off to the positive effects of the medicines being discussed. Boniva has help many people lead healthier lives. No one forces anyone to prescribe or use these medicines. If you don't like it, don't listen. Imagine where the world would be with out medicines to help us lead healthier, longer and more active lives.....

[md]

Drug companies should be ashamed of themselves for puting forth misleading ads, paying celebs big money, and making their drugs affordable to only the wealthiest. If they were truly altruistic in their efforts, they would spend less on advertising, and make drugs cheaper for patients. Healthcare costs are skyrocketing, and drug companies (and Sally Field) are getting richer. IF you believe in this drug so much, why not help subsidize the cost for those who need it?

[Lily]

cathie:
I don't have to know anything about drugs. That's what I pay my doctor to know. He's been educated in medicine and continues to learn from medical journals. He'll tell me what will mask my symptoms.

[cathie]

drug ads should absolutely be on tv, print ads, radio, etc - how else would we know anything at all about them? plus, remember freedom of speech? they have a right to advertise, & you have a right not to watch. people watch fiction dramas about medical conditions & think that have that disorder. should those shows all be pulled too? what about the fiction crime dramas? are they giving people murder ideas?
the ads for boniva do say it's for osteoporosis, not for saving yourself from breaking a bone from a bad fall when you already have strong AND dense bones! it's up to the doctors AND YOU to decide whether you need any medication, not up to the pharmaceutical companies! look at all the people on antidepressants - not because of the commercials, but because everyone thinks they need some kind of drug to get by. look at all the people who put their kids on meth, not because of the ads for concerta, ritalin, adderall, etc, but because everyone thinks most children have add/adhd.
almost all commercials are misleading! that's why they're ads, & that's why the phrases "buyer beware" & "buyer be aware" were coined in the first place!
people: take responsibility for ALL of your actions. don't blame them on the media!!

[Helen]

Really, watching television ads these days is just darned depressing, because my demographic is being relentlessly targeted. Apparently, we all have erectile dysfuntion, pee ourselves, and have osteoporosis. The unfortunate thing about ads for prescription drugs is that while they raise the topic of medical condtions that are treatable, they leave no indication that there is any other way to treat or deal with these conditions.
Erectile dysfunction is the canary in the coal mine, and often signals blocked circulation, including microcirculation which may have become permanently damaged. No amount of Viagra will fix circulatory problems, but diet may. (See Dr.Dean Ornish's research on reversing coronary heart disease with diet).
Women with bladder "leaking" and urgency problems may find improvement through balancing their hormones, and not necessarily by using prescription HRT, which of course is a longer process for which some physicians have neither preparation nor patience. Rx meds to deal with urinary problems like this act on the central nervous system, and not always in a good way.
Bone thining and osteoporosis are the result of complex functions of the body which are out of balance, and taking a pill to deal with that rather than, again, finding out what needs to be balanced, is a short-sighted and not always effective measure. I am about to embark on orthodontia at the age of 63, and one of the questions I was asked by the specialist was whether I was taking a bone hardening prescription, which would make repositioning my teeth with braces a very difficult proposition.
Physicians go from saying that our North American diet is completely adequate, to telling us to take more calcium and vitamin D when we finally run into problems, and if that doesn't work quickly enough, then we need a prescription with serious side effects.
If my mother in law had been able to take a prescription for her osteomalacia ten or fifteen years ago, (or even if she had been checked for bone density and advised to take a calcium/magnesium supplement long before that), she would have lived a longer, healthier life, free of pain. So I'm not saying that prescriptions to improve bone density are worthless, but rather that the issue needs to be dealt with life long, through patient education by informed physicians, at every stage of life, beginning with advice about keeping children active and well nourished (and of course breastfed as long as possible,which is a topic for another discussion).

[Gail]

Good going Jamie Hirsh! If you have people like 'A Pharma Ad Guy' complaining about your reporting, I know you are doing the work we are paying you to do. Thank you.

[Linda Shockley]

I, too, hate drug commercials. It's ironic that the FCC bans certain language in shows that could be watched by children, yet allow ads for erectal dysfunction. I'd hate to be the parent asked to explain that one to your 5-year-old! Also, most of the ads say "ask your doctor about..." well, if my doctor is any good, s/he has already talked to me about the drug if I need it. I've read that some doctors are wishing the FCC or FDA or whoever would re-impose the ban on drug ads. They spend a lot of their time explaining to patients why they don't need whatever drug they just saw advertised.

Another thing is, those ads all have so much information on the possible side effects that by the time the ad is ended, you wonder why anyone would go within 5 feet of the stuff. Kind of wastes the ad money in my opinion.

[TheManRetired]

I don't think any of the company's should be advertising their products to consumers as most do not know the side affects or if they are already taking the generic form of the pill, and why is it so hard to take a pill once a week and not so hard to take it once a month, if you have to have a pill to stay healthy or help you to stay healthy like I do then you make sure you take it and I take pills 5 times a day due to injury and it is not that hard to take a couple minutes and swallow a pill with a glass of water. I think all these commercials should be taken off the air.

[David]

In terms of celebrity commercials, LeBron James is a good pitchman but I don't see the sense of the State Farm ad where he's in a parking garage and his friend's car has been broken in to. LeBron gives his insurance agent's card to the friend, and the friend even calls in the commercial. Am I missing something? Isn't it a little too late to sign up with State Farm and get whatever its great coverage benefits might be after your car is trashed? If not, I have been taking the wrong approach to insurance shopping.

[Michael]

If anyone wants to know the truth about the type of ads Ms. Fields unfortunately endorses and the current state of the drug companies simply read Marcia Angell's book "The Truth About The Drug Companies" and John Abramson's book "Overdosed America". Doctor Abramson's book includes an excellent discussion of osteoporosis.

[Kevin V]

There is a trade off occurring within the medical realm. It is this: for-profit medicine leads to breakthrough treatments (beyond just big-pharma, there is a lot of profit with medical devices, etc.) Without for-profit medicine, we would not have the treatments or advances that we've seen in the last decade.

There is a delicate balancing act of risk vs. reward. For society, the risk is higher healthcare costs with a reward of better treatment. For a company, the risk is bankruptcy and litigation because of bad medicine and the reward is big profits.

Please don't blame companies for advertising their products. That is what they are there to do. If the drug is too expensive, then don't buy it! Whoever complains about the high cost of medical care, simply don't use the service. Think of it this way...if you only use the drugs and treatments from 15 years ago, then your medical costs would be much, much lower. Someone had to develop the tools and techniques, including regulatory hurdles and peer reviews, of every new procedure. Think about all the minimally invasive surgeries that can be done today. Not many would probably exist if not for a company taking that risk.

Try this on for size. Next time you or a family member has a medical emergency, tell the doctor that you only want treatments that were available 15 years ago. Those are the cheapest option. If you want to use the latest advances medicine has to offer, then pay for it.

[sharecropper]

I do realize that pharmaceutical ads encourage people to ask for certain drugs or become convinced that they have certain illnesses. However, they do educate consumers as to options for treatment and encourage them to ask questions of their doctors.

For instance, I never knew that restless leg syndrome was something treatable, and I had not asked my doctor about my symptoms because I thought I was not getting enough calcium or potassium and was having leg cramps. Once I saw the Requip ad, I realized that my symptoms might indicate something else and asked my doctor.

I also asked if I needed to take medication for my osteopenia, and my doctor said, NO. So, I don't, but I'm aware of what's out there because of pharmaceutical ads.

[Jan Hurd]

I agree with one of the other comments, that drugs should not be advertised to the general public on TV or in print. They are misleading in general and push drug-taking as the solution to all our problems. I think pharmaceuticals should be non-profit products just as I think all medical services should be non-profit.

[Howard W]

I think that direct to consumer advertisements of drugs provide many negative public benefits, such as higher drug prices and "driving" the public to make poor medication choices.

It clearly is part of a large private benefit, namely giant profits for investors and well paying jobs for marketers.

Is there any public benefit? I can't think of one. Why is direct to consumer advertisement of drugs allowed?

[Tamara]

I have a job for which I read medical journals all day. The numerous reports of osteonecrosis of the jaw are simply hair-raising. I certainly don't plan on ever taking biphosphonates.

[A Pharma Ad Guy]

As someone who worked on the direct to consumer launch of Boniva, I must disagree with your comments here. First of all, Sally Field is an actual Boniva patient. She has been on the brand for a few years. I will not even go into the convenience of once monthly dosing versus daily or weekly dosing. And snce when is it a crime to look younger than your age?

Many products use celebrities to sell their products, but for Rx pharmaceuticals we only use those who actually take the product. We are held to much higher ethical standards than non-Rx advertising. Every word, image and even our music is scrutinized by our clients legal, medical and regualtory teams and the FDA. We're not perfect, but our industry does a pretty darn good job of bringing fine products, and disease state awareness and educational programs to consumers. Many consumers discover illnesses because of our ads and are then able to go to the doctor for appropriate treatment.

Also keep in mind that if a consumer wants a generic drug all they have to do is ask their physician. We do not sell anything directly to consumers -- a prescription has to be written by the physician. We can only make people aware of our products and drive them to get appropriate treatment.

Jamie - maybe you should attend one of our 3 hour meetings with a pharmaceutical client legal, medical and regulatory team where we review and scrutinize every word and of our consumer marketing materials. I think you would have a much different opinion of our industry and realize that we are trying to be fair and honest to consumers, while at the same time offering them treatment options.

[Maxine Hoffman]

Forget the celebrities, drugs shouldn't be advertised on TV or radio. They mislead people into thinking they "need" something they are not qualified to make a judgement about.

[Barry Solin]

Boniva is not the only once a month drug. Actonel ( risedronate) is also available in a once a month dose. The biggest problem with having osteoporosis and not taking treatment for the problem is the possibility of a fall. Having a fracture is far more of a problem than the discomfort of taking the drug.

[Samuel]

T Turner:

Dennis Haysbert was doing the Allstate commercials before being on 24. Besides, I know his name from The Unit.

[Jim Reardon]

My mother had to take a similar pill once a week. It was, by far, the worst part of her week; the pills caused her pain and nausea and she had to sit upright like a zombie for an hour which was just uncomfortable.

Maybe the average consumer doesn't suffer as much, but if so, being able to avoid that 3 weeks out of 4 is worth $90. (In fact, I'm about to call her and ask if she's considered this option).

[Janice]

The one that bugs me is Alli with Wynonna Judd. If that's how you look on it, I'd definitely pass. She doesn't look too healthy (forty miles of bad road) to me.

[Jessica Gottlieb]

Giving Gidget a facelift does not make her an authority on drugs.

I'm not impressed by tv ads for drugs.

[richard levy]

It is very refreshing to see a young, honest reporter tell the TRUTH about misleading drug ads.

[Greg]

These people are just actors, being paid to play a part. Any special characteristics we ascribe to them are just in our imagination. Are we complaining that these celebrity ads are TOO effective? Shame on those advertisers and their agencies.

I think the relevant question for CU is, are these ads truthful and not misleading, despite who is hawking the wares.

[T Turner]

I don't like to see Sam Waterston pushing that investment group. That's the type of commercial that bothers me. Then we have the past 24 president (forgive my lack of memory for names) representing Allstate. These 2 actors especially are known for 1 role each. And the roles are as mostly honest, caring and trustworth men - father figures to anyone under 40. To have them representing these corporations just seems wrong. I lose respect for the actor when this happens. And my trust for the company goes right out the window.

[Lauren]

Just FYI...it is told by the reps who sell Boniva that Sally Field actually approached them to do the publicity after she was diagnosed.

[Laura]

Those Activia commericials with Jamie Lee Curtis certainly seem a bit misleading.