Friday, February 29, 2008

The Rower Mis-Impresses? - Pfizer Ends its Lipitor Advertising Campaign

We posted last week about misleading aspects of the Pfizer Inc US television advertising campaign for Lipitor (atorvastatin), some of which were recently discovered by NY Times reporter Stephanie Saul. The ads centered on Dr Robert Jarvik. They touted him as a physician with great expertise about the heart. However, although Dr Jarvik does have an MD, he never was an intern or resident, never got a medical license, and never practiced medicine. Dr Jarvik's career is that of an inventor and biomedical engineer. Furthermore, the ads gave the impression that Dr Jarvik is tremendously fit, showing him jogging and apparently rowing a racing scull. However, a body double, not Dr Jarvik, was rowing the boat.

This week, Pfizer cancelled the advertising campaign. As reported again in the NY Times by Ms Saul, "Under criticism that its ads are misleading, Pfizer said Monday it would cancel a long-running advertising campaign using the artificial heart pioneer Dr. Robert Jarvik as a spokesman for its cholesterol drug Lipitor."

Meanwhile, further information came out suggesting that the campaign was even more misleading than previously thought. The ads originally touted Dr Jarvik as the inventor of the artificial heart. However, this is actually in dispute. Ms Saul also reported that

at least one former colleague of Dr. Jarvik’s ... contends that he was not the actual inventor of the artificial heart, as stated in the ads.

In a letter to Pfizer in August 2006, three former colleagues of Dr. Jarvik’s at the University of Utah complained that the ads erroneously identified Dr. Jarvik as 'inventor of the artificial heart.' That distinction, they said, should go to Dr. Jarvik’s mentor, Dr. Willem J. Kolff, and his associate, Dr. Tetsuzo Akutsu.

Pfizer subsequently changed its ads to identify Dr. Jarvik as the inventor of the 'Jarvik artificial heart,' but Dr. Jarvik’s former colleagues, members of a large team that worked on the heart, were not entirely satisfied, according to Dr. Donald B. Olsen, a veterinarian who worked on the heart and is president of the Utah Artificial Heart Institute.


In addition, the ads present Dr Jarvik as someone who actually takes Lipitor. However, Dr Jarvik really is not a long-term user of Lipitor. A NY Times editorial stated "that Dr. Jarvik only started taking Lipitor about a month after he started touting its virtues under a contract that would pay him a minimum of $1.35 million over two years."

Pfizer's decision to stop the advertisements drew praise from some US Congressmen who are now investigating direct to consumer (DTC) drug advertising. Bart Stupak (D - Michigan) said, "I commend Pfizer for doing the right thing and pulling the Lipitor ads featuring Dr Jarvik. When consumers see and hear a doctor endorsing a medication, they expect the doctor is a credible individual with requisite knowledge of the drug."

I agree that it is good that this particular advertising campaign has stopped. However, it is not clear whether the leadership of Pfizer, or of any pharmaceutical company has learned anything from this case. Here is how Pfizer explained its actions (again, per the NY Times article by Ms Saul),

'The way in which we presented Dr. Jarvik in these ads has, unfortunately, led to mis-impressions and distractions from our primary goal of encouraging patient and physician dialogue on the leading cause of death in the world — cardiovascular disease,' Pfizer’s president of worldwide pharmaceutical operations, Ian Read, said in a statement. 'We regret this. Going forward, we commit to ensuring there is greater clarity in our advertising regarding the presentation of spokespeople.'


First, note that Mr Read's pledge of clarity seems limited only to "the presentation of spokespeople." Second, and more importantly, note that Mr Read, and through him, Pfizer really never admitted any fault, particularly not for fielding an advertising campaign that had multiple misleading elements. Instead, he seemed to spread the blame among television viewers and print media readers, that is, those who developed "mis-impressions and distractions." Note that Mr Read did not even admit that the advertisements were meant to market Lipitor. Instead, he portrayed them as an educational exercise meant to encourage "patient and physician dialogue."

It may be that it is hard for Pfizer leadership to move on from a two-year plus advertising campaign orchestrated by the Kaplan Thaler Group ((a unit of the Publicis Groupe) that cost more than $258 million since the beginning of 2006 (again per the Times article).

In my humble opinion, though, this inability to admit any fallibility on the part of Pfizer leadership underscores a central problem affecting the leadership of many health care organizations. Much current business thinking seems to support the concept of the infallibility and omniscience of "imperial CEOs," presumably partly to justify their pay so enormous it could not be due to mere mortal men and women. The infallible, by definition, do not make mistakes. So many organizations seem unable to admit mistakes, much less worse misconduct, by their leaders. Of course, inability to admit mistakes makes it likely that even worse mistakes will be made in the future.

The NY Times editorial called this case "a telling reminder that consumers, besieged by drug promotion ads on television and in print media, need to take what they see, hear and read with a very large grain of skepticism." It also suggested "drug companies would be wise to find pitchmen who have the credentials - and the athletic skill - to back up their claims, without having to rely on stunt doubles."

I say, as long as drug companies continue to be lead by "imperial CEOs," and hence by people insulated from criticism and immune to self-doubt, their emphasis on marketing ahead of science will continue. Furthermore, as long as drug company marketers are convinced that they are providing education, they will continue to make misleading pitches, no matter who the pitchmen are.

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