Ironwood confronts gout stigma in new Duzallo ads
Ironwood Pharmaceuticals launched its latest consumer advertising campaign last week, this time for its newly approved gout drug Duzallo (allopurinol/lesinurad). The campaign, called 'I'm no angel,' notes that diet is one of, but not the biggest, contributing factor to the disease. Ads feature five gout characters, four men and one woman, that are depicted with halos of high-purine foods.
Sharon DeBacco, VP of product promotion at Ironwood Pharmaceuticals and an industry veteran, admits it took a few tries to get this campaign right.
"In most pharma ads, and we found this with most conditions, that patients generally want to see themselves as the 'aspirational me.' So we generally cast people who are five years younger and ten pounds lighter," she said.
"But this is the first time I've actually had a product where this would work to our disadvantage. And we actually had a few campaigns that had more aspirational looking guys — because we didn't want them to look in the mirror and see that guy with less self-control — but we found that patients pushed it away. So we intentionally found men that looked exactly like the people that we dealt with," DeBacco said in an interview with BioPharma Dive.
Prior to her work with the Cambridge-based biotech, DeBacco played a key role in developing the 'Purple Pill' campaign that became synonymous with AstraZeneca's acid reflux drug Nexium (esomeprazole magnesium). She also worked on campaigns for Crestor (rosuvastatin) and Prilosec (omeprazole).
She acknowledges her experience with these products and later Ironwood's own irritable bowel syndrome drug Linzess (linaclotide) did not quite prepare her for work on Duzallo.
The drug is the latest Ironwood product to gain approval, securing an OK from the Food and Drug Administration in August for the treatment of hyperuricemia associated with gout after treatment with allopurinol alone proves ineffective. The condition is characterized by increased uric acid levels in the blood — patients generally overproduce uric acid, but many also have the problem of under-excreting the acid as well. Ironwood believes Duzallo is uniquely designed to address both of these issues.
The drug was launched in the fourth quarter, but Ironwood is just now rolling out the direct-to-consumer campaign. The company is only targeting limited test markets currently, said DeBacco, in order to see how it resonates with patients. The company believes its gout franchise — which also includes the single-agent Zurampic (lesinurad) — could eventually bring in peak sales of $300 million or more.
It's not your fault
Most patients who have gout are embarrassed by the disease, and reluctant to seek treatment, said DeBacco.
In fact, when Ironwood started conducting market research, the biotech found that of 1,000 patients surveyed, 50% don't tell their doctor about their gout flares and even a third of these patients don't reveal their condition to family. The company's research also revealed people with uncontrolled gout miss an average of 6.3 days of work per year due to flares.
There are approximately eight million patients with gout in the U.S. About four million gout sufferers have their symptoms under control by using the standard-of-care allopurinol, but at least two million patients fit into the category of uncontrolled and could benefit from Duzallo, said DeBacco.
Part of the problem is the lore of the disease. It was famously associated with Britain's gluttonous king, Henry VIII, and in turn linked with overindulgence and alcohol consumption.
"The cultural stigma around gout — which you always hear about being the King's disease, the disease of overindulgence, the disease of lack of control — I never realized how deep that runs and how much it affects gout sufferers. These patients carry around a tremendous amount of guilt because of this stigma," she said.
Ironwood hired Hill Holiday advertising agency to make the campaign and found it had to take a different approach to getting the message out there.
"These patients are not telling their doctor because they don't want to be blamed for their lack of control," said DeBacco. "Our challenge with our consumer campaign is to get patients to understand that it isn't their fault. Because they are not going to do anything when they believe it is their fault," she added, noting Ironwood had trouble even finding patients to test campaigns on because most patients are not looking for new medications online.
"Until we show them, with an authentic tone, a campaign that really demonstrates that we understand what they are going through, they are probably are not going to be listening to us. They're not really open and looking for new medication because they believe it's all on them," DeBacco said.
- BioPharma Dive How DTC got things moving for Linzess
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