Ads disguised as news: A drug company's stealth marketing campaign exposed

It's rare to get a glimpse behind the curtain of pharmaceutical marketing.

And it raises questions about when particular symptoms needto be treated with prescription drugs.

It started whenCBC learnedabout a stealth marketing campaign involving a drug company, a well-known Canadian comedian, a doctor and a public relations firm.

"Cathy Jones ofThis Hour Has 22 Minutesis on a mission to get women to start talking about female sexual health after menopause and particularly, their vaginas," wrote PR companyGCI Group in a press release, offering to arrange an interview.

But nowhere did it saythis "mission" was initiated and sponsored by NovoNordiskCanada Inc., which makes a vaginal hormone pill. Nor did GCI's release specify that Jones was paid to give media interviews about vaginal atrophy.

When CBCasked if there was a drug company involved,the PR firm said yes, NovoNordisk, but that was to be kept secret.

"No parties including GCI want any mention of the drug or drug company," CBC was told. "It's an unbranded campaign."

In other words, it's marketing that looks like any other lifestyle article in news. This is what it looks like on theGlobe and Mail'swebsite. There was originallyno mention of NovoNordisksponsoring the campaign.

When CBC contacted the Globe's reporter, she said she wasn't aware that Jones was being paid. The paper later published an article acknowledging that the connection to the drug company was mentioned during their interview.

We were intrigued by what thecampaignrevealed about pharmaceutical marketing and the questions it raised.

'Highly misleading'

For instance, is itOK for a drug company, behind a curtain, to generate news about a condition and thenencourage women to see their doctor?

"No, it is not OK," says Dr.JerilynnPrior, who runs the University of British Columbia's Centre for Menstrual Cycle and Ovulation Research.

"It is misrepresenting the marketing purpose behind it. It's misrepresenting as helping women, but its purpose is making money."

SergioSismondo, a philosophy professor at Queen's University, says it's"highly misleading and that's an ethical implication in and of itself."

"And then there are the issues of what are these people to do?Are they going to see their doctors about something they might not have chosen to see them about before? Or whether they think they have a larger problem than they thought they had before?"

Novo Nordisk also hired Dr. Vivien Brown, assistant professor of family and community medicine at the University of Toronto, to accompany Jones on the media interviews. Brown has published research sponsored by Novo Nordisk. CBC's request to interview Brown was declined.

The headline in the Globe and Mail upset Cathy Jonesbecause it read: "What it's like to have vaginal atrophy."She says she doesn't actually have the condition.

"I've never been diagnosed with vaginal atrophy myself," she said, although she uses NovaNordisk'sVagifemmedication.

After she complained about the headline, the Globe changed the online version to read: "What it's like to talk about vaginal atrophy."

"That's my focus," Jones said. "My focus is that I agreed to be part of a campaign where I promote that women should talk to their doctors and doctors should talk to their patients because I feel passionate about vaginal health."

Power to shape information

Sismondo studies the way the pharmaceutical industry shapes medical opinion and says this is a rare public example of something thathappens all the time.

"The companies have a lot of power to shape the sorts of medical information that doctors see, and thenmeanwhile, when Cathy Jones and Dr.VivienBrown are talking to the media, they can shape the way patients can see their symptoms too," he said.

"And if they can bring these two things together neatly, seamlessly, using the same terms, then that will really increase prescriptions."

Health Canada has rules about how drug companies are allowed to advertise to consumers.

NovoNordisktold CBC News in a statement: "In Canada, pharmaceutical companies are permitted to provide factual, fair, balanced and non-promotional information to the public on health and diseases."

Under the rules, it's considered ahelp seekingannouncementand the drug company is not allowed to mention itsname or the name of a drug.

'Igniting the VA Dialogue'

It's not the first time GCI Group has worked with NovoNordiskto get "vaginal atrophy" in the news.

It ran a campaign in 2012 that tried to get people to call the condition by the initials "VA." It declared the efforta successon itswebsitebecause it was "the first time in Canadian media history, the acronym "VA" was mentioned in mainstream news channels."

The campaign, called "Igniting the VA Dialogue,"even won a Silver Leaf Award of Merit from the International Association of Business Communicators.

It is misrepresenting the marketing purpose behind it. It's misrepresenting as helping women, but its purpose is making money.- Dr.JerilynnPrior

ForSismondo, unbranded campaigns can beone piece of a drug company'slarger effortto control what scientific data is generated about a condition, what information is given to doctors and then how consumers think about their health.

"A lot of the medical literature is ghostwritten,"Sismondosaid. "The company does the research, does the analysis, does the statistics and then hands it over, perhaps a pre-written article, to a medical researcher to serve as the author."

Doctors for hire

He also studies the way doctors are used to influence the medical opinions of their peers.

"Pharmaceutical companies will hire researchers, prominent doctors, to go and give talks to other doctors," he said. "In a sense, giving talks about the science, but at the same time, giving talks the way the company wants the science to be understood."

• Doctors who cozy up to drug firms get a wake-up call
• Expert worried about how little public knows about prescription drugs

In the case of vaginal atrophy, what's the evidence that post-menopausal women need to worry about their vaginal health? A close look at the scientific literature fails to produce a clear answer.

Most of the data have been generated throughonline surveys and questionnaires, by researchers who work for, or are funded by, drug companies makingvaginal hormone products.

Dr.JerilynnPrior says most women don't experience vaginal dryness.

"It's usually attributed to a drop in estrogen, but that's a misunderstanding about how the vagina works," she said. "If you're sexually active, and you're interested, the vagina secretes kind of a film that makes the sex painless and smooth."

"It is certainly not a disease."

Expect to hear more about vaginal health in the coming months. A series of new vaginal atrophy drugs are in the pipeline, and industry analysts believe it's a big untapped market.