Lamisil: Salesmanship Over Science

<"">Lamisil, a drug used to treat toenail fungus, has been linked to 16 cases of liver failure, including 11 deaths. Yet despite this risk, Lamisil is a big seller for Novartis. According to a report on, critics of Lamisil contend that its success is more the result of salesmanship rather than science.

Though it can be painful and ugly, toenail fungus is not a life-threatening condition. Yet as the article makes clear, some Lamisil side effects can be. In 2001, the Food & Drug Administration

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(FDA) issued a health alert regarding Lamisil after it had been associated with liver damage that could include liver failure, transplantation, and death. Doctors were advised to obtain nail specimens prior to prescribing Lamisil to avoid unnecessary risk.

According to, Lamisil is Novartis’ fourth biggest selling drug. Though it costs $850 dollars for a three month course of treatment, Lamisil has been taken by more than $10 million people. That’s a lot of money to spend on a minor medical condition.

Lamisil sales have been spurred by a clever ad campaign that features a character named “Digger the Dermatophyte”. Digger was seen in TV commercials attacking victims’ toenails. According to, Novartis may have spent as much as $236 million on the Lamisil campaign.

It was apparently money well spent. By 2004, Lamisil sales had jumped 19 percent, to $1.2 billion worldwide. But the Digger ads are not without controversy. According to, regulators cited the first phase of the campaign for overstating the drug’s benefits.

According to, Lamisil is an example of how drug marketing can be used to create demand for an expensive – and possibly risky – medication that treats a relatively minor ailment. Meanwhile, while drug companies spend big to market drugs like Lamisil, research on drugs to treat truly serious conditions goes underserved.

Drug companies like Novartis insist they do not spend money on marketing at the expense of research. But the numbers reported by contradict those claims. The top ten drug makers spend about $42 billion on research annually, an amount that equals about 14 percent of their yearly marketing budget, said. And of the money they spend every year on research, more than $9 billion goes to clinical trials of drugs that are already approved or may soon be. According to, more often than not, such “research” is an attempt to find novel marketing angles for an existing drug.

The ad campaigns generated by this research can create a demand for a disease that’s not even there, said. Such research helped create for drugs now known to be dangerous, such as the now-withdrawn painkillers Vioxx and Bextra. As one expert told, “Unfortunately, people saw the ads and started demanding the drugs from their doctors.”

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