Key Topic 4: Maintaining high standards
In addition to all of the requirements for claims that we have considered in the other key topics, you must always keep in mind the need for high standards in all promotional activities. This means looking at general suitability, avoiding causing offence, and making sure that promotion is in ‘good taste’. In addition promotion must not be disparaging to the medical profession or to competitor products.
This is a very subjective area and is often a matter of judgment. It is therefore wise to look at relevant case law to get a good idea of what is not considered acceptable. Here are some examples to consider.
Consider these examples
Offending imagery
This is a famous painting by Delacroix showing Liberty ‘leading the people’ in the French revolution of 1830. It was used to advertise taxotere for breast cancer. Do you think this is acceptable?
Generally use of imagery of naked or partially naked people or sexual imagery to attract attention is not considered acceptable. However use of this image in the context of taxotere was considered acceptable by the UK Authority.
Cetraben advert
Consider the following imagery, which your marketing colleagues tell you they would like to use to advertise a cream for the relief of eczema. The concept is one of improved self-confidence because the eczema has been treated successfully.
Would you approve this?
A similar concept was used to advertise Cetraben, an emollient used for symptomatic relief of eczema and the advert was the subject of a complaint in the UK. The advert featured the back view of a young woman walking down a city street. The wind appeared to have lifted her short turquoise skirt to reveal red and white polka dot underwear. The photograph showed her looking over her left shoulder and gasping. The headline read: ‘Confidence to live life their way’ followed beneath by ‘However that might be’.
The company stated that the Cetraben campaign was developed specifically to show the potential negative effects of eczema on people’s lives and demonstrate the positive impact that successful treatment could have in allowing patients to continue with normal activity and improve their self-confidence – hence the headline ‘Confidence to live life their way’.
The UK Authority considered that the suggestive manner in which the young woman’s underwear was exposed was for the purpose of attracting attention to the advertisement, rather than to show the impact of the treatment on a patient’s confidence. The Panel considered that the material did not recognize the special nature of medicines and the professional standing of the audience to which it was directed and was likely to cause offence.
Format
Your marketing colleagues present this image as a concept for a promotional mailer to you. The mailer will celebrate an important anniversary for a product and will contain some information about important clinical trial data generated over the years etc.
The format of the mailer is to be a ‘celebratory’ box which when opened will release some confetti as shown in the picture (there is a mechanism to spray the confetti upon opening the box)
Would you approve this mailer in terms of its format?
In the past there have been successful complaints about ‘extremes of format’ like this. Although this could be considered ‘just a bit of fun’ it may prove very irritating for a customer to be showered with confetti just before a clinic! It’s a matter of judgment but this would be unlikely to be considered ‘suitable’ in the event of a complaint.
Disparaging
Consider the following slide which is part of a slide set for ticagrelor to be used by sales representatives:
Which of the following statements do you agree with?
- This is an unfair comparison
- This is approvable as it is
- This is potentially disparaging to prasugrel
- More information is needed on this slide before it can be approved
- This slide is potentially misleading
Ruling
There is a claim for superiority over prasugrel in terms of platelet inhibition – however there is no information on the slide as to what level of inhibition is considered clinically relevant inhibition. In fact both products inhibit platelets to a level adequate to provide clinically relevant inhibition. It could be argued that without showing this information and highlighting this fact, this slide misleadingly implies clinical superiority of ticagrelor over prasugrel and therefore also potentially disparages prasugrel.