Cymbalta marketing by the back door

This is a re-post.

I’m going to keep bringing this little story to everyone’s attention as I’m still waiting for a reply from those involved who have suddenly gone very quiet on the matter.

I wrote a post recently to bring everyone up to speed about a discussion that had been going buried deep in Seroxat Secrets on the comments section of an older post (if you follow…?)

I’d just like to focus on one point of detail that might help people to understand why I think the way that I do. In another related post, I wrote about a specific booklet that had been produced to support National Depression Week 2005. This campaign was themed ‘Pulling Together’ and was described by the Charity (Depression Alliance) like this: “The 2005 campaign highlights one of the most remarkable and positive aspects of the condition – how people pull together to defeat the illness.”

All well and good. My point – one which I feel I have demonstrated in great detail – is that I think that the booklet had very little to do with ‘Pulling Together’ as described by Depression Alliance and rather more to do with “increasing awareness of the established link between depression and somatic symptoms such as general aches and pains, and to improve recognition among journalists of general aches and pains in depression.”

You can read my critique and see what you think – I was however firmly put in my place by a comment from Jim Thomson, who used to be the CEO of Depression Alliance:

“I apologise for not addressing your point about “Pulling Together” and have just spent time re-reading it (in fact I’m not even sure if i was still with DA when it was published, but I may have been.) I have also been reading your critique of it, which is conspiracy theory of the first water. I doubt I can convince you of this, but I can assure you that the research was undertaken for very different reasons than those you assume.

For some time, many of us working in mental health, had become concerned at how depression was being viewed within the DOH. You might not know that the illness was not even included in the GP GMS contract – effectively dis-incentivising GPs from diagnosing it. You most certainly won’t know that in a recent re-shuffle, there wasn’t even a Minister with responsibility for mental health until I telephoned the DOH and told them than it might be an idea to correct the ommission before I contacted the media. It seems that they “forgot” about mental health.

This de-construction of depression looked to us to be very deliberate. The illness was not (and is still not) classed as an SMI (serious and enduring mental illness – which is where all the DOH funding goes.) This is convenient because if GPs actually diagnosed all of the undiagnosed depression in this country, the NHS would be in worse shape than it already is. The reason GPs don’t diagnose early, is that they often don’t realise that patients are presenting with the physical symptoms of depression.

Again this backdrop, a piece of research was planned, to try to underline that somatic symptoms are (or can be) very much a part of the illness. That was the strategy – it had nothing to do with Cymbalta. You can take my word for that or not – it is immaterial to me because, whether or not it satisfies your concerns, it is the truth. If you want to ake it further, then take the matter up with the ABPI – and before you counter that the ABPI is an industry body, I would remind you that they have suspended, I believe, at least three of their big pharma members in the past year, for the sort of activity you imply.”

As per Jim’s description of the research brief, I’m still a bit hazy as to where the ‘Pulling Together’ concept fits in – you know …”highlights one of the most remarkable and positive aspects of the condition – how people pull together to defeat the illness.”

Also Jim states “That was the strategy – it had nothing to do with Cymbalta. You can take my word for that or not…” In which case I think maybe Jim ought to read this, from the Healthcare PR agency Packer Forbes:

“National Depression Week for Eli Lilly’s/Boehringer Ingelheim’s Cymbalta

National Depression Week is held annually by Depression Alliance, the leading UK charity for people with depression. The 2005 campaign, Pulling Together, which highlighted how people pull together to defeat the illness, was co-sponsored by Lilly and Boehringer Ingelheim.

The aims of the campaign were to achieve increased awareness amongst healthcare professionals and patients of the established link between depression and somatic symptoms such as general aches and pains, and to improve recognition among journalists of general aches and pains in depression.”

Packer Forbes clearly link national Depression Week directly with Cymbalta and clearly state the aims of the campaign.

Packer Forbes worked with Depression Alliance on the research and the campaign for Pulling Together. Packer Forbes also worked for Eli Lilly & Boehringer Ingelheim on the UK launch and marketing of Cymbalta.

Jim may or may not have been CEO of Depression Alliance when this document was actually published, but clearly he was CEO when the booklet (and entire campaign) was being written, designed and approved for production.

So the question remains – why?

Why was the aim to increase awareness of the established link between depression and somatic symptoms such as general aches and pains, and to improve recognition among journalists of general aches and pains in depression?

Maybe – just maybe – because Eli Lilly & Boehringer Ingelheim had Cymbalta to launch and sell in the UK – the first antidepressant/painkiller combo?

Maybe? – or is all this just a conspiracy theory of the first water [sic]

9 Responses to “Cymbalta marketing by the back door”

  1. You are a putz Says:

    The reason is because nearly 70% of patients present to their GP’s with back ache, neck ache, inability to sleep as the first signs of depression….these patients are put on a myriad of sleep aids and run through a battery of tests to find nothing physically wrong with them.

    But the clock is ticking.

    Research, by those outside of pharma (see Steven Stahl), has shown that patients have about twelve weeks to hit some level of response to an antidepressant or they risk huge increases in relapse rates and greater risks of future depressive episodes. By helping GP’s get a better understanding of how to identify these patients earlier, they have a better chance of turning a life long battle with depression into a one and done scenario.

    I know that doesn;t fit your “anti-pharma” agenda, but it is the truth. Research “kindling effect of depression”, “BDNF (brainderived neurotrophic factor)” and the studies of Del gado (also non-pharma funded) and you will find your answers.

    Lastly, when was the last time you attacked any other company in health care for trying to make a profit after investing $800 million to bring a product to market? When was the last time you boycotted a pharmacy for marking up a product? do you know how much your local pharmacy gets when you fill a script? It is making alot of money yet you all think it has only to do with the pharma company.

    Please educate yourself a bit more.

  2. admin Says:

    Scary stat there, ‘You are a Putz’

    Even more scary if you believe it!

    Please read my post properly and try to understand what I’m talking about…

    And, as I’ve asked before, will you tell me if Cymbalta is approved as a painkiller for aches and pains associated with depression?

  3. Matthew Holford Says:

    That’s a great deal of money, isn’t it? US(?)D800mm? I’m not sure that minimum spend is one of the criterion assessed, when licensing drugs, however. I’m also puzzled by the twelve weeks’ lead time. Were you aware that NLP has been used (on the NHS, in the UK) to treat mild depression. The impact is usually pretty much instantaneous (20 minutes). Perhaps it’s all about expectation management.

    Matt

  4. You are a putz Says:

    Cymbalta is approved as an antidepressant proven towork on somatic symptoms such as backache, etc and as an analgesic for the treatment of diabetic peripheral neuropathic pain. Now indicated for the management of Generalized Anxiety Disorder. 3 indications….multpile studies….FDA approved.

  5. truthman30 Says:

    Cymbalta is approved as an antidepressant proven towork on somatic symptoms such as backache, etc and as an analgesic for the treatment of diabetic peripheral neuropathic pain. Now indicated for the management of Generalized Anxiety Disorder. 3 indications….multpile studies….FDA approved.

    Hey Mr Putz… You are a drug pusher ..
    How do you sleep at night?…
    Do you take Cymbalta yourself?…

  6. admin Says:

    Oi Putz – stop rewriting Cymbalta’s approval – go check the Lilly’s press release…

    “Cymbalta is approved in the United States for the treatment of major depressive disorder, the management of diabetic peripheral neuropathic pain and now the treatment of generalized anxiety disorder, all in adults. Cymbalta is not approved for use in pediatric patients.”

    No mention of somatic symptoms such as aches and pains associated with depression, is there?

    That’s because there’s no approval. THAT was the whole point of my post… how can Lilly sell Cymbalta on the back of “Depression Hurts?” – there is no connection.

    It’s marketing.

  7. seroxat secrets… Pharma TV - drug marketing or patient information? - 4 « Says:

    […] no 5905/1990/4817, 19 Feb 1991).” Just don’t start me off on Depression Alliance – see here, here, here and […]

  8. Brian1234 Says:

    I think the Cymbalta commercial is great and about time. Many of us with depression have physical issues. I find the commercial educational to both depressed people and the general public. I really don’t care a whole lot about off label use of meds as many meds are prescribed for off label uses. If Lilly wants to promote Cymbalta as a treatment for the physical pains of depression I think it’s great as for many of us who are depressed proper treatment of our depression diminishes our physical issues. I know when I am depressed I have many physical symptoms. If Lilly can market better than the makers of Effexor then so be it, it’s called business and competition.

  9. admin Says:

    Well, that’s certainly one point of view Brian…

    I can’t agree with at you at all though- but whatever floats your boat.

    Just wait until you try and stop your meds…

    Good luck


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