The Advertising column in today's Wall St. Journal has an interesting note on some recent Merck ads for their COX-2 inhibitor, Vioxx. What they've done is break their TV ads up into pieces. Why would you do that? Well, the FDA rules are that if you mention a drug and what it's good for in the same ad, you also have to list the possible bad side effects - the sort of thing that's in the package insert. And since every drug has side effects, that's a real problem for an advertising agency - finding something to do on screen while the voice-over announcer drones on quickly about flatulence, night sweats, and other appealing topics.

Roche tried this about a year ago (see below,) and Merck seems to be using nearly the same strategy. One ad shows Dorothy Hamill skating, while she talks about how sometimes she has arthritis pain in the morning - followed by an announcer saying that you should ask about new medicines that could help, and giving a phone number for Merck. The other ad has Dorothy Hamill skating, and mentions a medicine from Merck called Vioxx - with another Merck phone number to call. The drug and its intended therapeutic use never get mentioned in the same ad.

Roche got into trouble with this little innovation. They were advertising Xenical (orlistat,) which in my book is a pretty tough sell under the best of circumstances. In case you don't know the mechanism, that drug inhibits pancreatic lipase, the enzyme that's secreted into the gut to break down fat. It would inhibit most any other lipase it got ahold of, for that matter, but it doesn't make it out of the gut, so pancreatic lipase it is. No triglyceride breakdown, not much fatty acid absorption into the body, not much fat from the diet. What could be easier?

Well, that fat has to go somewhere. And in the GI tract, if it's not absorbed, there's only one place for it to go, and the consequences can be most unpleasant. Believe me, taking a pancreatic lipase inhibitor and then pigging out on a bucket of fried chicken will bring on a really unforgettable experience. I will go into no more details, in the interest of maintaining this blog's dignified facade, but will refer you to this page of side effects. Note that none of these are terms that you'd want to mention in your TV commercials if you could posibly help it, especially not ones that run during the dinner hour.

So Roche broke up their ads. One ad mentioned the word "Xenical" and the other ad mentioned weight loss. Otherwise, the two ads were extremely similar - same images, same announcer, colors, fonts. And Roche arranged to have them shown back-to-back (or nearly so) in case anyone missed the point. The FDA sure didn't, and prevailed on them to stop. Merck, on the other hand, seems to be making sure that their ads don't get run back-to-back. The FDA is apparently thinking about whether these are really separate ads, or just an attempt to get around the advertising rules.

I can save them the trouble: of course this is an attempt to get around the rules. Whether these rules should exist in their current form (or exist at all) can be debated; I get e-mail from people who say "ban 'em all" and I get some that say "let 'em all loose." But they exist right now, and there's no arguing about that. And if the FDA lets these through, they should prepare for this to become the standard advertising method for the whole industry.