When Bad Things Happen
Problems that are remembered become genericized: it's a horrible word, but the phenomenon is even nastier. Here is a real-life
story—the brand involved is dead so it doesn't matter. Almost 20 years ago, a scare started about fragments of glass being
found in baby diapers. The brand involved had about a 27 percent share of the UK market—well behind Pampers, with about 50
percent. We told the manufacturers to forget the Tylenol model: instead, get nurses or pediatricians to talk about checking
diapers in general, but make company spokespeople inaccessible and never show or mention the brand. When all else failed,
present one of the Finnish diaper research scientists who spoke only in polysyllables and did that with an impenetrable accent—be
sure to label him as a representative of the parent company not of the brand, we said.
After ten days of recalls, headlines, live TV news reports, threats of lawsuits, a torrent of demands for compensation and
endless weeping mothers, it passed (by the way, there probably never was any glass). A few journalists were frustrated by
the mumbling Finns and wrote the odd snide piece. A year later, we got a leading polling company to measure who remembered
the incident. Unsurprisingly, the parents of toddlers remembered it well but about 80 percent thought it had happened to Pampers.
When I slipped a disc, the orthopedic surgeon behaved the same way: giving me a prescription for naproxen, he warned me that
NSAIDs are linked to an increased risk of MIs and strokes and suggested that I take high doses of codeine instead. For once,
I nodded politely (and then went off to buy a COX 2 inhibitor—it really is linked to the increased risk but it is far less
likely to make you bleed to death from a stomach ulcer than an NSAID—as a gym-going, hill-walking vegan addicted to omeprazole,
I thought it was a sound trade-off). Johnson & Johnson were right to react as they did to the product poisoning, but only
because Tylenol was the market leader. If you're not, keep your head down and spend money to make sure that you don't have
to put it above the parapet.
Generally speaking, customers only differentiate in a few chronic diseases where they have a particularly close relationship
with the pharma company; others never do. In the US in the age of DTC, I have never seen any research to show that consumers
can differentiate between big companies even when the consumer has heart disease, osteoporosis or diabetes (of course, there
is lots of research that I haven't seen so it may exist although I would be amazed if the beneficiary had not used it in a
detail piece by now. There is some ad testing that, I believe, shows that putting any corporate name in a prescription medicine
ad reduces audience favorability). Patients who have used a medicine recently linked to serious adverse events know who made
it: people who have taken Avandia will know GSK and some of those who took Vioxx will know Merck—especially those who are
suing. However, if you survey people with diabetes who have not taken Avandia, I would be amazed if you could find a significant
difference in reputation between GSK and, say, Novo Nordisk.
There are exceptions. For example, most influential doctors (those who can influence policy or academic thinking) differentiate
between vaccine and pharma companies—even though all the major vaccine producers are owned by major pharmaceutical companies
and carry the same brands. They think that vaccine companies are more scientific and more ethical. Or, in another example,
companies with a big OTC presence are usually better recognized by consumers and are more trusted, but in qualitative research,
this is not a particularly firm or well-grounded belief. There is, though, limited evidence linking these, or any other, exceptions
to the bottom line.