May/June 1999 Vol 17 No 5/6 ISSN 1321-571X
Boehringer Ingelheim promotes Atrovent (ipratropium bromide)
in Russia as first
line for chronic bronchitis.
A request from Russia
On 9 December 1998 we received the
following e-mail from Russia:
Dear Peter,
In Russia long time Boehringer Ingelheim advertise Atrovent (ipratropium
bromide) using the chess board image and question: 'Chronic bronchitis:
your first step? e2-e4 Atrovent'.
I think that it is not correct advertisement, Atrovent is not the agent of
first choice for the initial treatment of all types of chronic bronchitis.
Is it good target for MALAM action?
vasya
Vasiliy Vlassov Dr. Med. Sci., Professor
Saratov State Medical University
A copy of the
advertisement for Atrovent in Russia appears below.
Pharmaceutical marketing in Russia
In 1997 the
Russian pharmaceutical market was one of the fastest growing markets in the
world and reached US$ 3.5 billion. That
was 25% more than the previous year.<1>
This rapid growth rate may reflect increased use of promotion to doctors who are not accustomed to it.
In August
1998 the Russian economy crashed.
Responses from drug companies have varied. For example:
“Eli
Lilly have continued to distribute life saving pharmaceuticals, such as
insulin, despite non-payments from distributors.”
but
“Smith
Kline Beecham increased it budget for advertising and promotion of its
products, increased prices, and declared no intention to withdraw from Russia.” <1>
Boehringer Ingelheim
According to
Boehringer Ingelheim’s web site the company ranks among the top 20 pharmaceutical companies in the world. It reported revenues
exceeding DM 8.75 billion in 1998.
Boehringer
Ingelheim’s “Vision statement on Value” is interesting regardless of whether or
not the company’s staff take it seriously:
“Value
will be our competitive advantage, our customers demand more for less.
Our
customers are objective, professional and analytical. They have a balanced view
of purchasing. The value of our customers' demands is changing and will
continue to change. We need to anticipate the value our customers will place on
our products and services now and in the future. We will only be able to exceed
our customers' expectations by being closer to them. We have to share their
values, aspirations and problems. We need to understand how they use our
products, how we can make our products more efficient and effective, and how
our products answer the needs of our customers. The closer we all are to our
customers, the easier it will be. We have to remove the barriers between them
and us and between ourselves. We have to be one group with a shared objective.”
1. Undated
Advertisement. Scrip Industry Alert. The Russian Pharmaceutical Market: What
next? London, Scrip Reports 1999
Dr Heribert
Johann
Chairman of
the Board
Boehringer
Ingelheim GmbH
Binger Strasse 173
D-55216 Ingelheim am Rhein
GERMANY
re: the promotion of Atrovent (ipratropium bromide)
Professor
Vasily Vlassov of the
Saratov State Medical University, Russia, has
asked MaLAM <1> to write to you about an advertisement for Atrovent
(ipratropium bromide) published in his country. The advertisement uses the image of a chess game and some small
but very active dancers and asserts:
“Chronic
bronchitis:
your first step?
e2-e4
Atrovent”
We understand from
Professor Vlassov that Russian doctors are likely to take away from that
advertisement the message that Atrovent alone is always the best choice for the
initial treatment of all types of chronic bronchitis. We are also concerned that the image of tiny dancers in the
advertisement may lead to an association (perhaps subconsciously) between
Atrovent and dramatic improvement so that patients gain the capacity for
vigorous physical activity. The
advertisement fails to provide any safety information. Consequently the advertisement could lead
doctors to believe that Atrovent may be used by all types of patients without
any safety concerns.
Question
1: Are those the messages that your
company intends to send?
Question
2: What is your best evidence to
support those messages that are intended?
Question
3: What steps will be taken to ensure
that unintended messages are not sent in the future?
Comparison of those
messages with initial conclusions based on the expert opinion available to
MaLAM, summarised below, raises some questions. This letter is intended to give you the opportunity to express
your point of view so that we can assess whether or not your promotion of
Atrovent assists appropriate therapy.
We hope that you will either provide evidence to support your
advertisement or reconsider the way you promote Atrovent. We are
optimistic that dialogue can lead to improvements in drug promotion to the
benefit of the public, health professionals and your company in accord with
your company’s “Vision statement on Value”.<2>