Healthy Skepticism Library item: 16159

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Walker R.
Eyelash of the Beholder
The New York Times 2009 Jul 31
http://www.nytimes.com/2009/08/02/magazine/02fob-consumed-t.html?_r=1

Full text:

A great deal of advertising is about problems and inadequacies, the tangible and intangible shortcomings in your life that could be neatly resolved with a satisfying purchase. This may be most true in the case of advertising for prescription products, the subtext of which is always what might ail you: trouble sleeping, trouble having sex, troubles of the body and the mind that you might “ask your doctor” about, soon.

If you’ve heard of eyelash hypotrichosis, for instance, you probably heard about it from an ad for Latisse, which of course is a prescription product that is meant to solve the problem of eyelash hypotrichosis. In the spot, Brooke Shields describes the problem as “inadequate or not enough lashes.” She evidently had this problem herself, because she tells us that she has been using Latisse, which caused the growth of more, thicker lashes. Ask a doctor, she suggests – adding that you can visit the Latisse Web site to find one. It’s applied daily with a special applicator and costs about $120 a month.

Latisse is a recent offering from Allergan, the company best known for Botox, its physician-administered cosmetic-injection product. Like Botox (and like a number of other prescription drugs, including Viagra), Latisse came about indirectly. During clinical testing of a glaucoma medication called Lumigan, Allergan’s researchers noted a side effect: eyelash growth. Recognizing the market potential for such a thing, the company conducted a new safety-and-efficacy study, this time making the former side effect the main focus, explained Robert Grant, the president of Allergan Medical, the company’s aesthetic-products division. In December, the Food and Drug Administration gave Allergan clearance for this new use. By May, Latisse ads were on the air, and in its first three months on the market, the product totaled about $12 million in sales. That’s nothing compared with Botox, which has annual sales that exceed half a billion dollars for cosmetic use,but it does suggest that there is a bigger market for eyelash-hypotrichosis relief than you might have guessed before Latisse’s promotional campaign began.

That campaign, it should be noted, avoids the explicit you’ve-got-a-problem tone of typical pharmaceutical marketing. In fact, it has a rather glamorous feel. “Grow longer, fuller and darker lashes!” the voice-over in the Shields ad gushes over a chipper club beat. We zero in on the actress’s baby blues. It’s all as upbeat as any cosmetics ad. The company has even added a cause-marketing pitch with donations to the Make-a-Wish Foundation.

When it sinks in that this is something you need a doctor to obtain, it’s oddly reassuring. Inadequate eyelashes aren’t simply a matter of looks; they’re a problem serious enough that the F.D.A. itself had to be brought in to sign off on a treatment, right? Clearly the logic I’ve just suggested is wrongheaded: the Food and Drug Administration doesn’t offer opinions about what needs treating; it evaluates drugs containing certain ingredients that require approval.But we don’t always evaluate sales pitches with perfect logic. (Well, you do, I’m sure, but you probably know somebody who doesn’t.) And in any case, Allergan isn’t making a disease-related claim about Latisse but rather positioning it, like Botox, as part of what the company calls a “science of rejuvenation.”

John Mack, who publishes the e-newsletter Pharma Marketing News, notes that some critics of contemporary medicine complain of disease mongering – the conversion of what used to be routine dissatisfactions of life into medical conditions, often treatable with drugs. But he agrees that Latisse, like Botox, makes no pretense of addressing a medical condition, just a cosmetic one. What he wonders about are consumers who hear “F.D.A. approved” as meaning “completely safe.” The ad mentions potential side effects like itching and redness and that if Latisse comes into regular contact with the eye there is “potential for increased brown iris pigmentation, which is likely permanent.” The latter had Mack somewhat jokingly fretting on his blog about whether Shields’s baby blues might turn brown. His real point: “Many people don’t read the side effects.”

Hypotrichosis aside, then, Latisse isn’t disease mongering. But is it inadequacy mongering? Defining eyelash adequacy is largely subjective. And if Brooke Shields – who, after all, is basically great-looking for a living – didn’t have adequate eyelashes, who does? Grant says that this is a matter for a patient and a doctor to discuss. He also notes that mascara is a billion-dollar business in the United States.

“Let’s just put it this way,” he says. “There is a very large demand for eyelash enhancement. Eyelashes are a very important part of a woman’s beauty regimen.” Any given individual’s eyelashes may not look inadequate to other people, he allows, but that person still “may feel they are inadequate.” And that, perhaps, is all it takes.