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In medicine, we often take for granted that drugs and devices that will be forthcoming will change or improve our patient well-being. There is some expectation that if companies are investing millions of dollars to develop new products, they will do so intelligently and market effectively approved new products. Recent articles have spotlighted the marginal efficacy of drugs such as libido enhancers, but there are several drugs in our own field that may not be terribly effective.

Nevertheless, I see huge dollars spent on ads that are poorly designed, with graphs that are misleading and taglines that are ridiculous. I suspect that many of these ads were developed in rooms with dermatologists (“ad boards”) and numerous company representatives present, where the agenda (and the conclusions) were fully determined in advance by a committee or ad agency. The ad board’s only function was to rubberstamp the consensus of the advertising agency and management of the drug company.

I have seen commercials designed by an agency that received a few talking points about a new drug and then produced the requisite images of people having fun while using the drug, rather than honestly portraying the lives of patients who suffer from the condition. Side effects are glossed over in hushed tones, with background music and quick dialogue, while the benefits are exaggerated. Most patients would much rather have a realistic appraisal of the likelihood of success that might come from taking the drug. A million images of beach/lake/mountain trips won’t make up for an overpriced, mediocre drug treatment with significant side-effects. But focusing on the disease and its treatment would not be good entertainment—and sales of the drug depend on entertaining ads.

Another scenario is often seen in conferences and ad boards where huge amounts are spent by companies to present or explain away flawed data. Recently, I was at an ad board for a drug that is clearly a ‘me-too’ drug developed by a pharma company for a common condition. My guess is that it won’t fare very well on the market, because it has appeared too late and is not significantly different enough to capture the attention of dermatologists, despite heavy promotion by a well-oiled sales force.

It was clear at the ad board that just about every dermatologist present was trying to tell the company that promoting the drug was a poor idea and it would not be a huge success. Concurrently, the company had other alternatives to pursue with the FDA that were riskier but had better possibilities for long-term success. Not-so-surprisingly, the ad board ended with the ‘me-too’ conclusion and the ‘thought’ of exploring new uses in the future, whenever that happened. The dermatology participants left with the realization that the conference was designed to only provide one conclusion for the company’s promotion of the me-too drug.

The scenarios discussed here are very concerning for our specialty and the realization that stock prices for the companies in question may be briefly elevated, followed by a descent into the doldrums, is the most likely outcome. My hope is that companies will realize that a sound future will come only with investment in better trials, promotion of novel ideas, responsible advertising and effective consumer education. Our future and those of our friends in product development are intertwined, and the patients we all serve depend on us finding ways to effectively serve them.

—Joel Schlessinger MD, FAAD
Chief Cosmetic Surgery Editor

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