If you’re like most people, you never heard of the prescription drug Humira until 2013. That’s when Abbott Laboratories spun off AbbVie, to aggressively market the rheumatoid arthritis (RA) drug which went on to become the top selling drug by 2019.
Humira marketing is a case study in how drug makers promote expensive, dangerous and often unnecessary prescription drugs risking public safety and at taxpayer expense.
Before creating AbbVie, Abbott had already lobbied Congress successfully to get Humira covered by Medicare and seeded seniors with “free samples” to create “demand.” Today Humira costs $2,984 per one syringe, pricing which the U.S. Congress is investigating. The cost of the Medicare-reimbursed Humira has been raised 27 times since the drug’s launch.
AbbVie then created a “nurse ambassador” program according to the Milwaukee Journal Sentinel in which registered nurses were paid to go to the homes of people taking Humira to assure compliance and downplay risks. At least 179,000 patients were reached through the nurse program according to a Journal source and doctors allegedly received kickbacks from the program.
Meanwhile the television airwaves in the United States were saturated. Humira is arguably the most advertised prescription drug on TV and even increased its presence during the COVID-19 pandemic as more locked-down people watched TV. According to Fierce Pharma, AbbVie spent $52.9 million advertising Humira in April, 2020, double the ad budget of its next closest competitors which were also high.
According to the Journal Sentinel, between 2013 and 2017, AbbVie also greased the palm of the American Academy of Dermatology to the tune of $2 million in grants and donations. Another marketing tactic is indication creep – the successful addition of new indications like uveitis, hidradenitis suppurativa, plaque psoriasis, juvenile idiopathic arthritis and ankylosing spondylitis to Humira once its RA indication was FDA approved.
Humira drug safety risks
Even before the creation of AbbVie, Humira was linked to serious and sometimes lethal side effects. In 2008, the Associated Press reported 240 people had contracted the fungal infection histoplasmosis from Humira and similar drugs – and that 20 percent died.
Current Humira prescribing information reads, “Lymphoma and other malignancies, some fatal, have been reported in children and adolescent patients treated with TNF blockers, including HUMIRA. Postmarketing cases of hepatosplenic T-cell lymphoma (HSTCL), a rare type of T-cell lymphoma, have been reported in patients treated with TNF blockers, including HUMIRA. These cases have had a very aggressive disease course and have been fatal.”
Last year the Milwaukee Journal Sentinel reported that, “Humira was linked to 169,000 reported serious adverse events and 13,000 reports of deaths.”
More drug safety risks and hypochondria
Many have observed that raising “awareness” of a disease – whether RA or ankylosing spondylitis – increases self-diagnosis and drug sales, even hypochondria. The proof is that “unbranded” disease awareness advertising (that mentions neither the medication being sold or the sponsor) constitutes a big part of drug maker budgets. The “sale” occurs when the disease is searched online revealing symptom quizzes and even “scripts” to recite during the suggested doctor visit. (Yes, patients are doing drug reps’ work for free.)
For example, AbbVie “Face Your Back Pain” campaign has tried to sell its ankylosing spondylitis drugs through convincing people they have “AS.”*
Currently, AbbVie is selling “EPI,” short for exocrine pancreatic insufficiency. Despite the COVID-19 pandemic, wildfires, hurricanes, mass shootings, lead in water systems, oil spills, earthquakes and floods, the ads would have us believe the real risk people face today is EPI – a disease so obscure that few of the doctors with whom I work have ever encountered it.
“My number two does not look like a number two. I don’t know what to call it,” began an old AbbVie radio ad for EPI with the payoff line, “Don’t Keep a Lid on It.” Currently, AbbVie’s radio ads sport a man and woman suggestively asking in unison “Could I have EPI?” and telling listeners to get more specific with their doctors. Creon, the drug AbbVie is selling for EPI, contains animal derived pancreatic enzymes and sells for several hundred dollars. Like Humira, the risks listed on its prescribing information are alarming.
Money over safety
In the countries where direct-to-consumer drug advertising exists, many say it has not improved public health but promoted unsafe drugs and hypochondria. Moreover, since drug makers are major funders of news media, the huge ad revenues may explain why unsafe drugs and unethical marketing is very underreported.
*Drug makers have discovered that reducing a disease to a nickname of letters-whether ED, RA, RLS, Low T, AS or GERD – helps sell product.
Martha Rosenberg is a freelance journalist and the author of the highly acclaimed “Born With A Junk Food Deficiency: How Flaks, Quacks and Hacks Pimp The Public Health,” published by Prometheus Books. Check her Facebook page.