Phil Hammond's funny old ward

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Here it comes: "Can I have the ones with the compact case, please?"

Patients arriving for a consultation convinced they already know precisely which brand of drug is best for them is nothing new. But being asked to prescribe something on the basis of fancy packaging comes as a first.

The drug in question, Kliofem, is a hormone replacement therapy. It's bright yellow and comes with an optional and rather snazzy vanity tablet holder, plus details of a free information video. The tablet holder was the product of extensive market research which unearthed the surprising - at least to a non-menopausal male GP - discovery that a substantial proportion of menopausal women find the idea of taking HRT stigmatising. They worry about leaving it around the house (lest the odd-job person spot it).

As an averagely ignorant male GP, I never guessed women would be vain enough about their HRT to want to hide it. Teresa Gorman must shoulder a lot of the blame for shouting the wonders of her HRT habit from the Commons rooftops. Most post-menopausal women are apparently a tad more reserved. The compacts are going like hot cakes.

Drug companies put as much effort into the marketing of their products as the product itself. The colour, name, shape, dosage, regimen and gift- wrapping are meticulously researched to maximise the placebo effect. The human condition is such that anxiety responds best to green pills, depression to yellow and pain to red. A silly name adds to the aura, especially if it begins with "Z", and the route of delivery is equally important. If you've just taken something large and oblong the French way, you'd be a fool to admit it didn't work. Likewise if you shell out nearly pounds 6 on a prescription.

Novo Nordisk, the makers of Kliofem, couldn't tell me what the best colour for HRT is. They've opted for yellow, not just to elevate the mood but also to make it harder for copycats to emulate - when a drug's patent runs out, "me-too" companies then churn out the stuff as cheaply as possible, which invariably means small white tablets. Patients, however, are loyal. It's virtually impossible to get them to change from the long yellow ones to the small white ones. The name Kliofem is probably a touch too guttural to have much of a placebo effect in Britain but the "K" is a concession to the company's Scandinavian roots. And it's a big improvement on their other HRT product, "Vagifem".

Propelling the name into the media is vital. Health journalists are bombarded with press releases, which, if they arrive close to copy date, have a curious habit of ending up in print, only slightly altered. The courting of doctors is much more bizarre, with wave after wave of silly full-page adverts in the medical press. In the cut-throat world of HRT marketing, Kliofem's calling card is ... a hair dryer. Evorel goes for a suffragette chained to the railings. Premique backs a dancing saxophonist. Estring, perhaps unwisely, opts for a pink, gaping oyster. All these images are painstakingly researched to ensure maximum impact (eg "Did you remember the pink oyster more than the blue?" "Do you prefer the saxophonist dancing or squatting?")

What of the product itself? The fact that there are more ads for HRT in doctors' magazines than for any other treatment declares its importance. Women already outlast men by an average of three years, and are now opting to top up their ovaries not just for the feel-good factor, but for preventative benefits to heart and bones. Unfortunately - unless you own a drug company - these benefits accrue only if you've been popping the pills (or foam or gel or whatever) for 10 years or so. Until recently, that meant having periods into your sixties and beyond. Newer "bleed-free" products are now flooding the market. At three times the price of older brands, they can afford a few gimmicks.

I'm not immune to patient pressure and I'm not a fundholder either, so the woman received her compact case, along with my patronising little spiel about HRT: "It's not a panacea and it won't bring you fame, wealth or a husband who doesn't snore."

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