Health Inc.

As Drug Marketers Embrace Social Media, FDA Mulls New Rules

Would you look for prescription drug advice on Facebook?

Apparently quite a few people do, and the Food and Drug Administration is starting to take notice. The agency has sent its first warning letter about Facebook to drugmaker Novartis for the way it's been using the popular social networking site to promote a cancer drug.

But Novartis isn't alone. Drug companies have embraced social networking, and industry critics say the FDA is responding too slowly.

Novartis's sin, the FDA says, was the misuse of a widget. Specifically, on the website for the leukemia drug Tasigna, the company had one of those "Share" widgets — you click on it to promote the drug to your Facebook friends.

The problem, says the FDA's Marci Kiester, is the widget doesn't share enough information. "If they're presenting efficacy claims, then there should be a balanced presentation of risks that is reasonably comparable to those benefits," she says.

That's FDA-speak for the fact that the widget didn't give people information about the downside of the drug, used to treat certain kinds of leukemia. It doesn't include the litany of side-effects and warnings that you'd see on a drug ad on TV.

Novartis wouldn't give NPR an interview, but it has taken down the "share" widget, for now. The company still wants to promote its drugs through social media. In an email, Novartis tells NPR, "we will continue to have active discussions with regulatory authorities on the appropriate ways to use online and social channels."

Jeff Chester runs the Center for Digital Democracy, a group that's been trying to stiffen the FDA's spine on this issue. He says the agency has a lot of catching up to do, when it comes to drug companies' use of the social-media.

"Marketers are deliberately creating campaigns, and use what they call 'digital buzz' techniques" to get their message out, he says.

The approaches go way beyond Facebook widgets. Some drugmakers have set up support-group websites for certain diseases. Take a look at ShareYourPain.com for people with chronic pain from cancer.  Make sure you scroll all the way to the bottom, where the small type reveals that site is sponsored drugmaker Cephalon.

Then there's YouTube, where a funny video series for the impotence drug Levitra has been making the rounds.

Jeff Chester says the drug company marketers are counting on you to forward the funny video.  And, he says, that's the idea behind all these techniques.

"The key to viral, peer-to-peer marketing is to in fact send a message to your friends, that I like this drug," he says.  "It's not Novartis sending you this widget.  I'm sending you this information.  I've endorsed it."

Viral marketing may be okay for selling sneakers, Chester says, when it's used to promote prescription drugs, he believes it can be dangerous.

Drug companies see it a little differently. Yes, they say, there are risks. But they also say social media can empower patients. At an FDA hearing last year, Jeff Francer, of the trade group PhRMA, asked regulators to facilitate drug makers' responsible use of social media.

The FDA is thinking about it.  A big issue is the "one-click" question — is it enough for widgets and other online devices to make a drug's "downside" information available one click away?  The FDA says it may have the first rules on that by the end of the year.

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