As spending on consumer drug advertising skyrockets, experts advise ‘healthy skepticism’

January 24, 2019

If you spend any time watching television, you are bound to see “real people” who appear to be healthy and happy bicycling down the road, hugging a grandchild, walking on the beach, or working in the garden. They mention the consonant-heavy name of a pharmaceutical drug you could use. “Ask your doctor, “an announcer suggests, after spouting the product’s benefits—and speed-talking her way through a scary list of side effects.

And it’s not just one ad; it’s several per prime-time show: A recently televised sporting event, for example, featured one ad for a drug to help you fall asleep, followed by another to keep you awake, according to an editorial in JAMA  that was written by Howard Bauchner, M.D., and Phil B. Fontanarosa, M.D., (who are, respectively, the editor and executive editor of the Journal of the American Medical Association).

Indeed, according to a Dartmouth College study, over a 20-year period, from 1997 through 2016, drug marketing increased dramatically—from $17.7 billion to $29.9 billion; while regulation did not.

“Because the goal of medical marketing is to shape our perceptions of the benefits and harms of drugs, treatments, and even of diseases, themselves, it can have a very significant impact on healthcare and can even hamper efforts to control unsustainable healthcare spending,” says Dartmouth Institute Professor for Health Policy and Clinical Practice Steven Woloshin, MD, who co-authored the paper with his wife and longtime research partner, the late Professor Lisa Schwartz, MD. (Dr. Schwartz passed away in November 2018).

In their review of spending, Schwartz and Woloshin found that the most rapid increase was in direct-to-consumer (DTC) advertising, which increased from $2.1 billion (11.9% of total spending) in 1997 to $9.6 billion (32% of total spending) in 2016. 

Over the same time period, the total amount consumers spent out-of-pocket on their prescription medication also skyrocketed to $328.6 billion from $116.5 billion (after industry rebates and discounts), the study found.

Why the explosion in drug ads over the past 20 years? The study notes that in 1997 the Food and Drug Administration began allowing drugs ads to mention side effects with voice-overs, instead of scrolling through a visual list on the screen, which takes more time. Shorter ads can allow for more ads, says Dr. Woloshin.

Another possible explanation is that at the same time that drug companies are spending more on drug ads directed at consumers, they’re also spending more marketing the new drugs to physicians, says Adriane Fugh-Berman, M.D., an associate professor in the department of Family Medicine at Georgetown University who has studied drug advertising. That can increase “irrational prescribing and overuse of medication,” Dr. Fugh-Berman recently told Consumer Reports.

Perhaps the most important reason for the increase: “The ads work,” Woloshin says. “They increase patient requests and prescriptions for advertised drugs, even when there are lower-cost alternatives.”

Indeed, Consumer Reports notes, numerous studies suggest that drug ads increase healthcare costs by promoting higher-cost medications when lower-cost, older ones might work as well.

In recent years, the consumer-oriented news outlet reports, many TV drug ads have focused on expensive drugs used to treat relatively uncommon, and hard to treat, conditions, such as rheumatoid arthritis, psoriasis, rare cancers, and seizures, according to figures from Kantar Media for the year ending in October 2018.

What’s an inundated consumer to do? The magazine warns, those sorts of pricey meds may not be covered by your insurance, especially if you get insurance through your employer. A 2017 survey of employers by the Pharmacy Benefits Management Institute found that when it came to high-cost medications, most of the insurers required a person to try other medications first, required a person to obtain approval from the insurer for expensive medications before filling a prescription, or limited the amount of the drug a person could obtain. Fully 75% of employer plans simply did not cover certain drugs, including high-cost drugs, according to the survey.

There are alternatives, Consumer Reports advises: For complicated medical conditions, which may necessitate higher-cost medications, work with your physician and insurance plan to find covered treatments. Also check NeedyMeds for the drug you’re being prescribed to see what Patient Assistance Programs, manufacturer coupons, or other discounts might be available.

Research contact: steven.woloshin@dartmouth.edu

Starbucks Delivers expands to more U.S. cities, powered by Uber Eats

January 23, 2019

After a successful pilot test in Miami, on January 22, Starbucks announced the expansion of its delivery service to another six cities nationwide.

The rollout, in partnership with Uber Eats, began on Tuesday in San Francisco—and the company says that it “remains on track to bring Starbucks Delivers to nearly one-quarter of [our] U.S. company-operated stores, “ with planned expansion to select stores in Boston, Chicago, Los Angeles, New York and Washington, D.C., in the coming weeks.

According to the Seattle-based coffee chain, the Miami test, also powered by Uber Eats, saw “strong demand, including repeat business throughout the day and positive feedback from customers.”

What’s more, Starbucks Delivers will launch a new pilot later this month in London—its first in Europe, also powered by Uber Eats—following other overseas delivery initiatives in China, Japan, Hong Kong, Singapore, Indonesia, Vietnam, Mexico, Columbia, and Chile.

The company plans on tapping into a global $95 billion online food delivery market. partnership Starbucks will leverage Uber’s expertise as one of the fastest-growing meal delivery services in the United States—reaching Uber’s current customers, as well as offering the existing Starbucks clientele a new method for including the chain’s beverages in their daily routines.

“We know we have untapped customer demand for Starbucks Delivers in the United States and, starting today, we’re expanding our best-in-class experience to our customers both in and out of our stores,” said Roz Brewer, group president and chief operating officer for Starbucks. “We’re building on key learnings from past delivery pilots and by integrating our ordering technology directly with Uber Eats, we’ve unlocked the ability to bring Starbucks to customers for those times when they’re not able to come to us.”

Customers will be able to access Starbucks Delivers through the Uber Eats mobile app, available on iOS and Android devices. With approximately 95% of core menu items available directly from the Starbucks menu, customers will be able to customize their orders just as they would when ordering on Starbucks mobile apps. Delivery orders will come with an initial $2.49 booking fee.

“At Uber Eats, we’re always looking for new ways to offer people the widest selection of food they love. That’s why we’re so excited to deliver Starbucks fans their favorite food and beverages in a way that’s as easy as requesting a ride,” said Jason Droege, VP and head of UberEverything. “Be it breakfast delivered straight to the soccer field or afternoon lattés to the office, we know this partnership will delight our customers.”

Starbucks Delivers represents the next evolution of the company’s approach to delivery and expanding its digital relationships with customers. In addition to the pilot in Miami and a pilot in the Empire State Building, Starbucks previously tested delivery in Seattle in 2015 for members of the company’s Starbucks Rewards loyalty program.

Starbucks Delivers was first announced in August 2018 in China through a partnership with Alibaba and on-demand food delivery service Ele.me. By the end of 2018, delivery services had expanded to 2,000 stores across 30 cities in China, while also being introduced to select stores in Tokyo and Miami.

Research contact: #starbucksdelivery

Richard Branson says new cruise line will treat guests like ‘rock stars’

January 22, 2019

You don’t necessarily want to “rock and roll” on a cruise ship. (Think roiling waves and sea sickness.) But Sir Richard Branson—heretofore best-known for Virgin Records, Virgin Atlantic airlines, Virgin Hotels, and Virgin Galactic space tours—has come up with an experience he thinks consumers, literally, will go for.

Virgin Voyages, the latest Branson brand, will begin operations in 2020, with the first of its four ships on order from master builder Fincantieri—the Scarlet Lady. The cruise will set off from Miami to a Caribbean destination, hosting more than 2,770 guests (whom the company calls “Sailors”) and 1,160 crew members.

The Scarlet Lady will be “adult-by-design,” Branson says—”a sanctuary at sea for the 18+ traveler.” The new company is throwing out traditional clichés on luxury and formalities, and instead bringing what it calls Rebellious Luxe to life at sea; with RockStar Suites created by Tom Dixon’s Design Research Studio “as the pinnacle of that experience.”

The top two suites aboard the ship—dubbed the Massive Suites—will boast their very own guitar-clad music rooms, views of the ocean from every corner, hot tubs, hammocks—and runway outdoor dining tables.

“Virgin has always avoided stuffy formalities and brought a lot of excitement and a bit of rebelliousness to our customer experiences,” says Branson. “With these glamorous suites, Virgin Voyages is bringing rock and roll to the high seas and spoiling our Sailors like the rockstars [sic] they are.”

“We have combined brilliant design and Virgin Voyages’ epic Sailor experience vision to create a completely new version of luxury—Rebellious Luxe, which is at the intersection of luxury and a rebellious attitude that makes everything we do different, indulgent and meaningfully relevant to our Sailors. Whether they want to sleep all day, praise the sun with yoga at dusk or party all night, our RockStar Suite Sailors can live out their fantasies aboard the Scarlet Lady,” says Tom McAlpin, CEO of Virgin Voyages.

RockStar Suites Sailors “will live their best lives,” attended to by the RockStar Services Crew, from time of booking, to sail away, and throughout their voyage, Virgin Voyages claims. There will be backstage access for RockStar Suites Sailors at every corner, with early access to onboard entertainment, restaurants, Shore Things (a private transfer to and from the ship in Miami), and an exclusive express VIP pathway to the ship during embarkation.

What’s more, RockStar Suites Sailors will have their very own wardrobe team to help unpack and repack; complimentary pressing service; and nightly express swimsuit drying service—“because no rockstar should ever have a wet bottom.”

All RockStar Suites Sailors will have access to Richard’s Rooftop, their very own private members club—a secluded place for them to bask under the sun or have a drink under the stars.

From now through January 31, Virgin Voyages fans can enter for the change to win the opportunity to Party Like a rockstar, Virgin Voyages’ style, at their next #ShipTease event in New York City on Valentine’s Day. Those interested in the sweepstakes should visit www.virginvoyages.com to enter.

Research contact: @VirginVoyages

Beer here?

January 21, 2019

What will fans drink at baseball games next summer? Something tells us that fraternity boys are still buying kegs—but overall, Americans are increasingly laying off the booze; especially, the beer.

In response to the growing trend toward nonalcoholic drinks, the world’s biggest brewers and liquor companies are innovating beyond their traditional inventory and rolling out teas, energy drinks, and nonalcoholic spirits, The Wall Street Journal reports.

According to the Journal, new data show that U.S. alcohol volumes dropped 0.8% last year, slightly up from the 0.7% decline in 2017. Beer got hit the hardest, with volumes down 1.5% in 2018, compared with a 1.1% decline in 2017. Growth in wine and spirits slowed, as well, according to data compiled for the news outlet by drinks market analyst IWSR.

The fall in alcohol volumes reflects “a growing trend toward mindful drinking or complete abstinence, particularly among the Millennial cohort,” Brandy Rand, president of IWSR’s U.S. Region told the newspaper. Wine grew by 0.4%, down from 1% the year before; while spirits climbed 1.9%, compared with 2.2% in 2017. IWSR’s figures are based on products shipped.

And speaking of Millennials, could alcohol (and weed) vaping be a factor? While The Wall Street Journal doesn’t cover this game-changer in its report, the vaping industry is now a multi-billion dollar business, with teens and Millennials among the fastest-growing groups of users.  According to recent research by the FDA, over 1.3 million youths are vaping. 2017 saw the largest spike of any substance use in the United States in the past 50 years. E-cigarettes are now at epidemic level of use in the United States.  

In response to the changing marketplace and the growing disinterest in alcoholic drinks, producers are beginning to diversify:  Molson Coors Brewinghas turned to kombucha, Budweiser brewer Anheuser-Busch InBev  sells a spiked coconut water, and Smirnoff maker Diageo wants teetotalers to start mixing cocktails with a pricey, alcohol-free gin alternative, says the Journal.

IWSR forecasts low- and no-alcohol products in the U.S.—still a small slice of the market—to grow 32.1% between 2018 and 2022, triple the category’s growth over the past five years.

Industry executives say drinkers are increasingly concerned about health and that younger generations socialize differently from their parents, drinking less.

“Twenty years ago we didn’t have coffee shops open late, and pubs and bars open for coffee,” Ben Branson, CEO of nonalcoholic distilled spirit maker Seedlip (which is part owned by Diageo) told the news outlet. “People are favoring experiences over ‘let’s go drink on a night out.’”

AB InBev last year created a new global position, head of nonalcoholic beverages, to lead its efforts to diversify. Nonalcoholic drinks—including energy drinks and nonalcoholic beers—already make up more than 10% of the Bud brewer’s volumes. In 2017, it acquired San Francisco-based Hiball, a producer of organic energy drinks.

What’s more, says the Journal, AB InBev recently began selling Budweiser Prohibition brew—a nonalcoholic version of its flagship beer—in Columbus and Detroit. Nonalcoholic beer volumes nationwide. are expected to climb 9.3% over the next five years, according to research firm Euromonitor.

The beer company also has stepped up its efforts to woo consumers defecting to wine and cocktails. Its craft-style breweries in Oregon, California and New York have served as incubators for new, boozy versions of coconut water, matcha tea and agua fresca, a Mexican fruit-juice drink. And the brewer plans to later this month launch a spiked seltzer brand, Bon & Viv, which it will advertise alongside its beers at the Super Bowl.

“People are looking for something that tastes good but also allows them to live well,” Chelsea Phillips, head of marketing for AB InBev’s Beyond Beer division in the U.S., said in an interview with the Journal.

Research contact: saabira.chaudhuri@wsj.com

Closer to a cure: United Neuroscience tests Alzheimer’s vaccine

January 18, 2019

Today, 5.7 million Americans are living with Alzheimer’s—and, every 65 seconds, someone in the United States develops the disease, according to the Alzheimer’s Association.

For the past 20 years, biotech companies have been striving to tackle Alzheimer’s—with little success.  However now, Bloomberg reports, a four-year old Dublin-based biotech team—comprising leaders in neurology, vaccines, drug development, and disruptive ideas—believes it may be on to something.

To be clear, the news outlet says, United Neuroscience hasn’t solved Alzheimer’s yet, nor has it claimed to. But previously unreported results from a small, recent United clinical trial find that 96% of patients responded, without serious side effects, to the Alzheimer’s vaccine the company calls UB-311. The researchers describe the drug as “a novel synthetic peptide vaccine targeting beta amyloid [the main component of the amyloid plaques found in the brains of Alzheimer patients] in the treatment of Alzheimer’s.”

The patients demonstrated improved brain function and showed a reduction in the protein plaque gumming up their neurons, the company’s report says.

“The positive results show that we can safely raise and maintain [anti-beta amyloid] antibody titers in a predictable and sustained manner,” said Peter Powchik, EVP of Research and Development at UNS, in a company release.

“High response rates, reproducibility of response, and generation of antibodies directed to relevant toxic protein species are key elements of an effective therapeutic vaccine for neurodegenerative conditions. The UNS platform is proving that it can deliver on these requirements,” Powchik claimed.

Indeed, Bloomberg explains, United’s vaccine stimulates the patient’s own immune system to attack amyloid, which some researchers believe to be the leading cause. The vaccine’s job is to slow the proteins’ clumping and, if possible, reverse some damage and restore brain function.

United’s clinical trial, a Phase II study completed last year, tested the vaccine with a group of 42 patients who had mild cognitive impairment and appeared to be in the early stages of Alzheimer’s.

One set of patients was in the control group and received a placebo; while two other groups received three shots of the vaccine and then boosters either every three or six months over the course of a 18 months.

Although the small number of patients prevents United from drawing any major statistical conclusions, the company has been encouraged enough to move ahead with development of the vaccine, possibly with a larger partner, according to CEO Mel Mei Hu.

For now, United says it’s focused on raising capital to fund a more conclusive UB-311 study and to keep refining its widening range of vaccines. The 35-person company is gearing up to start trials of UB-312, aimed at Parkinson’s disease, and a second Alzheimer’s vaccine meant to combat tau [a protein that causes tangles in the brain].

“They have taken thoughtful initial steps with this very promising technology,” Eric Reiman, a leading Alzheimer’s researcher and an adviser to United Neuroscience, told Bloomberg. “But this is still the beginning of the beginning.”

Research contact: @UNSTechBio

Netflix hikes prices on subscription plans

January 15, 2019

As the old saying goes, “You pays your money and you takes your choice”—and that’s certainly true for Netflix.

The Los Gatos, California-based streaming video service has just raised prices for all of its subscription plans—a move that will enable the company to continue its aggressive spending on content in the face of stepped-up competition from rivals, according to a report by The Wall Street Journal.

Netflix will increase the price of its most popular plan by 18%—to $13 a month from $11. That plan allows users to stream from two screens at the same time. The most basic plan, which allows a single stream in standard definition, will go up one dollar, or 13%, to $9 a month.

“We change pricing from time to time as we continue investing in great entertainment and improving the overall Netflix experience for the benefit of our members,” a Netflix spokesperson told the Journal.

The new rates will go into effect immediately for new customers and be applied to the accounts of existing customers in the next few months, according to a person familiar with the plans.

Netflix last raised prices in October 2017, when the standard plan increased $1, to $11 a month; and the premium plan went up $2,  to $14.

The increase in monthly subscriber fees comes as Netflix continues to spend heavily to woo talent to its streaming service. Already, it has cut long-term deals costing hundreds of millions of dollars with powerful Hollywood producers—among them, Shonda Rhimes and Ryan Murphy.

Indeed, the Journal reports, industry analysts expect Netflix this year will spend $12 billion on licensing and creating content, more than double what it spent just two years ago.

Research contact: joe.flint@wsj.com

From fantastical to familiar: Elon Musk portends new products—and Metaculus takes heed

January 15, 2019

Elon Musk is visionary and a pioneer. He is known for making bold predictions—and then, for going on to invent, design, and produce exactly what he has portended. In doing so, since 2002, he has become either the founder or co-founder of a slew of futuristic companies, from Neuralink to SpaceX to Tesla.

Hence, when Musk anticipates or forecasts a new development, most of us sit up and take notice—and if we are even smarter, we take notes.

For example, back in April 2017, Musk said that, by 2021, his brain-computer interface company Neuralink would release a viable product for treating brain injuries. Two years before that, he predicted that the electronic vehicle manufacturer Tesla would eventually grow as big as Apple—a company that was then worth $700 billion.

Now, to help us all keep track of one of one of his biggest claims, a website called Metaculus—built by a community dedicated to generating accurate predictions about future real-world events by aggregating the collective wisdom, insight, and intelligence of its participants—has created an interactive timeline that tracks all of Musk’s predictions for the future.

According to the website Futurism, among the predictions already filed away by the Metaculus team: Musk’s hunch that we all live in a simulation; his conjecture that there’s a 70% likelihood that he’ll move to Mars; and his prophesy that SpaceX will shuttle a million colonists to Mars by 2120.

In the site’s new Musk timeline, Metaculus also includes predictions that are relevant to Musk’s companies. For instance, only 17% of Metaculus voters agree that we live in a simulation. And unfortunately for Musk, the community that thinks there’s only a 7% chance that Tesla will become the world’s largest car manufacturer by 2035.

So far, Futurism reports, the Metaculus community has been correct nine times and incorrect three times about predictions related to Musk; and the validity of another 13 predictions has yet to be determined.

The community voted that there was only a 3% chance that Musk would be sanctioned for tweeting about taking Tesla private, while his tweet actually prompted two federal investigations. The Metaculus community also incorrectly guessed that SpaceX would land a Falcon 9 rocket on a barge by March 2016 and that Tesla would not be profitable in Q3 of 2018.

However, the community was right on the nose when it found a 9% probability that Elon Musk’s boy-sized submarines would prove useful in that whole cave rescue debacle.

Overall, Musk is more optimistic about the future of technology than the Metaculus community. For instance, Musk thinks there will one million Martian colonists by 2120. Metaculus voters say there’s just a 43% chance that humans will sustain any sort of “off-world presence” by 2100.

But you have got to dream it, before you do it, right? And with his boundless imagination and worldwide following, we would bet on Musk to help us live the dream.

Research contact: @DanRobitzski

Lightning or fireworks? Ford EU develops ‘noise-cancelling kennel’ for scaredy dogs and cats

January 14, 2019

Thousands of dog lovers (and cat lovers) worldwide are clamoring for a new Ford prototype developed by the automotive company’s European engineers—although it is not available commercially and will never be taken on the road.

While “thunder jackets” and “thunder shirts” already are bestsellers—calming canine  and feline anxiety during electrical storms and other high-volume events, including fireworks celebrations—those who have been granted access to Ford’s experimental “noise-cancelling kennel” say that it would beat everything else on the market.

And pet owners are willing to pay for the new teepee-like chamber, even though it is not in production. Among the thousands of emails that Ford Europe has received is a typical one from Milla29, who begged, “Make the prototype available for potential customers? I am sure that there are thousands—if not more—people willing to buy this, even if it is just a prototype.”

According to Ford Europe’s blog page, n estimated 45% of dogs in the UK show signs of fear when they hear fireworks—causing distress to owners and their families too.

Graeme Hall, “The Dogfather”, a UK-based dog trainer who has helped 5,000 pets and their owners with behavioral problems, comments, “Many animals find fireworks scary—and compared to people, dogs can hear things that are four times further away, and across a much wider range of frequencies. Preparing in advance of firework displays is the key—and part of that is to identify a place where our pets feel safe and happy.”

The idea was inspired by the noise-cancelling technology that Ford has  introduced in its newest Edge SUV—ensuring a quieter journeys for drivers and passengers. When microphones pick up high levels of noise from the engine or transmission, this is counteracted using opposing sound waves from the car’s audio system.

The prototype kennel uses the same technology. Once microphones inside the prototype kennel detect the sound of the fireworks, a built-in audio system emits opposing frequencies that, in effect, cancel out the noise completely—or at least reduce it significantly. High-density cork, ideal for sound proofing was an integral part of the design.

Lyn West, brand content manager, Marketing Communications, Ford Europe, explained, “We wondered how the technologies we use in our cars could help people in other situations. Making sure dogs and their owners could enjoy a stress-free New Year’s Eve seemed like the perfect application for our Active Noise Control system, and we have a few more ideas in progress as to how our everyday lives might benefit from a little Ford know-how.”

The automaker promises that its new  noise-cancelling kennel is the first in a series of initiatives—called Interventions—that apply automotive know-how to help solve everyday problems.

Research contact: @FordEU

A brush with greatness? 1 million people have joined this ‘no-frills’ electric toothbrush startup

January 11, 2019

Step away from the sink. It turns out that most of us stubbornly persist in brushing our teeth the wrong way—without the optimal instruments.

In fact, according to Simon Enever, an industrial engineer who designed the new Quip system along with his friend Bill May, “Years of toothbrush ‘innovation’ [have] barely improved the humble toothbrush and, instead, [have] only served to overshadow the far more damaging, habitual problems that still persist.

“Brushing too hard, not brushing long enough, not brushing twice a day, not replacing your brush, and not going to the dentist are issues that are ignored–yet have far greater impact on oral health than a ‘Bluetooth Ultra Sonic’ toothbrush alone could ever have,” he says, “We set out to address that.”

The two designers spent a year gathering insights from dentists. Enever says he was shocked to learn that the average person brushes his or her teeth for only one minute instead of the recommended two; and that most people wait around nine months to change their worn out electric toothbrush heads, rather than the dentist recommended three months.

Now, CNN Business reports, Quip has 1 million customers to whom it delivers dental education, a streamlined routine, automated upkeep, and $5 rewards for dental visits.

And the price is right. The starter kit costs $25 for a plastic model and $40 for a metal version. For a $5 fee, subscribers are sent a new brush head every three months

For $65 a year, a customer can purchase a prepaid plan that covers a starter set—electric toothbrush, multi-use cover/mount, and a larger toothpaste—and then continue to receive a fresh brush head, an AAA battery, and a large toothpaste every three months.

According to CNN, the battery-operated Quip uses sonic vibrations (where the motor vibrates the bristles back and forth) instead of rotations, providing “a higher level of cleaning.”

Each brushing is automatically programmed to last two-minutes and consists of 30-second intervals so that users can cover each zone in the mouth. Quip is meant to be portable and has a holder that can be attached to the wall with a suction cup.

The first shipment went out in November 2015 and the rest is history.

Research contact: @quip