Harvard Health Ad Watch: Can an arthritis drug help you become a morning person? – Harvard Health Blog

It might be obvious, but drug ads are not meant to educate you on the best way to treat any illness you may have. Their main goal is to sell a product, as explained in a previous blog post on direct-to-consumer drug advertising. And the newer drugs tend to be the most expensive, although some are not much better than the older drugs.

So, the ads you see for drugs usually don’t promote the newest and the biggest, but rather the newest and the most expensive. And these advertisements vary widely in the amount of specific and useful information included and the information left out. A recent announcement for Xeljanz (tofacitinib) is a good example.

The announcement: a focus on the morning

A woman is awakened by her son, who is carrying a toy dinosaur. She gives him breakfast, he straps his dinosaur backpack and they happily go out together. We see them arriving by school bus with their classmates to a museum’s dinosaur exhibit.

The first word you hear in this ad is the tagline: “Mornings are made for better than rheumatoid arthritis.” I think we can all agree that this is true. But why is this a selling point?

Well, a prominent feature of rheumatoid arthritis (RA) is morning stiffness. People with rheumatoid arthritis are usually much worse in the morning, struggling with an hour or more of stiffness before their joints relax. And in that commercial, you just saw the main character, a mom who presumably has RA, jump out of bed, full of energy, ready for the day.

The standard sequence for a pharmaceutical ad

This particular announcement follows a familiar sequence of

  • describing the approved use of the drug (“for adults with moderate to severe rheumatoid arthritis when methotrexate has not helped enough”)
  • noting the benefits of the treatment (“… may help relieve joint pain, swelling, stiffness and help stop other joint damage”)
  • quickly listing possible side effects similar to those of most of the newer and more effective treatments for rheumatoid arthritis, including “serious and sometimes fatal infections” (due to reduced ability to repel them) and allergic reactions. The risks of blood clots and tears in the stomach and intestines are more specific to Xeljanz.

Weird phrases are heard often in direct-to-consumer marketing and seem intended to deflect blame for the drug: According to the ad, cancers, including lymphoma, “have happened.” It might make you wonder if these cancers “happened” just while people were taking the drug, or were they really due to the drug? The ad leaves that question unanswered.

Unspoken messages

Even as the journey to the dinosaur museum begins, words appear on the screen to sing the praises of this drug:

  • “Not an injection or an infusion.” This is important because many of the other newer and more effective rheumatoid arthritis medications cannot be taken in pill form. For many people, the fact that Xeljanz is a pill is a major plus.
  • It “… can be taken with or without methotrexate.” Some rheumatoid arthritis medications are only recommended when taken with methotrexate, a common initial treatment. This is not true for Xeljanz.
  • “The recommended dose of Xeljanz for rheumatoid arthritis is 5 mg twice a day or 11 mg once a day.” It is important to state this dose in the advertisement, as higher doses of Xeljanz are sometimes prescribed (for example, for patients with ulcerative colitis), and higher doses may lead to a higher risk of side effects. .

The great finish

Students pose in front of dinosaur skeletons while mom takes pictures. The voiceover returns to the morning theme: “Don’t let another morning go by without asking your doctor about the pill prescribed for RA over seven years ago.” This last part is there to remind us that while Xeljanz is a relatively new drug, it is not all new. The longer the history, the less likely it is that new side effects will be discovered.

The bottom line

This ad is absolutely right about rheumatoid arthritis:

  • Symptoms are usually worse in the morning.
  • The mom – either an accompanying parent or a teacher – is active and has normal-looking joints, which rightly suggests that good disease control is possible.
  • It is important to take a medicine that not only reduces the symptoms, but also protects the joints from damage.
  • Although methotrexate is often the first choice for treating rheumatoid arthritis, it does not work well for everyone.

But, like in most advertisements, some facts are not mentioned. For example, Xeljanz is expensive (in the range of $ 4,900 / month, although insurance coverage and discounts vary). In addition, there are over a dozen other very effective treatments, some of which may be even more effective and less expensive for you.

So the next time an advertisement for a drug interrupts what you are watching or reading, keep in mind that while the advertisement may be accurate, it may not be complete. As they say in the ads, if you think this product might be right for you, ask your doctor. But a word to the wise: the answer may be “it is not”. If your doctor thinks a medicine is right for you, chances are he or she has already prescribed it.

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Jothi Venkat

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