This year marks the 90th anniversary of a signal moment in advertising history, the first time a problem was turned into a social stigma so that a company could sell a product to fix it.
One fine day in 1922, Gerard B. Lambert of Lambert Pharmacal in St. Louis was shown an article in a British medical journal that used the word “halitosis” to describe bad breath. His father had helped invent a product called Listerine, which dentists used as an antiseptic and which Lambert Pharmacal marketed for a whole range of uses, from treating gonorrhea to cleaning floors. Lambert started an advertising company that turned “halitosis” into a national epidemic for which Listerine was the cure.
Today, mouthwash is a $689 million-a-year business.
Lambert’s legacy is all around us today. Got weeds in your lawn? Got oily hair? Got a dirty car? Feel the shame, buy the product, erase the shame. It was genius.
And when you combine Lambert’s legacy with the awesome power of the prescription drug industry to create demand for drugs, $689 million a year is nothing.
You may have heard a radio commercial for a prescription medication called Nuvigil, targeted at people with “shift work disorder,” a medical condition about which I was blissfully unaware.
Sure, I understand that people who work overnight shifts can have trouble adjusting their sleep schedules. What I didn’t understand was that this was a “disorder,” a medically recognized condition having to do with interrupted “circadian rhythms.”
When you get a problem classified as a “disorder,” insurance companies sometimes will pay for treatment. This is important when you’re trying to sell a drug for $18 per tablet.
In 1998, a company called Cephalon began marketing Provigil, the trade name for a French-developed drug called modafinil. It is a stimulant that keeps you awake like amphetamines without all the frantic behavior and with far less potential for addiction and abuse.
At first it was marketed for narcolepsy, a fairly rare sleep disorder. Then medical science decided that excessive sleepiness at work could be classified as a medical condition called shift work disorder. A new market was opened for Provigil. Long-haul truckers and students figured out some off-label uses for it, as did the U.S. military during its incursions into Iraq and Afghanistan.
Provigil was very profitable for Cephalon, one reason why the Israeli pharmaceutical firm Teva last year bought the firm for $6.8 billion. But, sadly, all drugs eventually go off patent, and the exclusive rights to produce modafinal expired this year. Now customers can get it for as little as $1.20 a tablet. And the price will go nowhere but down.
Hence the radio commercials for Nuvigil. Rather than lose its sleepy cash cow, Cephalon created Nuvigil, what it says is a better, longer-lasting drug for excessive sleepiness because of shift work disorder. Whether Nuvigil is merely a tweak of Provigil or an entirely new drug is a matter of some dispute. More important for Cephalon, however, is that Nuvigil has patent protection for another 11 years.
Nuvigil, and, for that matter, Provigil, can keep you awake for two or three days under the right conditions. But out on the frontiers of science, out where the white crowned sparrow flies, they’re thinking that staying awake for a week or more might be possible.
Your United States Department of Defense has an outfit called the Defense Advanced Research Projects Agency. DARPA knows there might be times when it would be useful for soldiers and pilots to stay awake and alert for long stretches of time. Why can’t a G.I. be more like a white crowned sparrow, which stays awake for two weeks when it migrates?
It’s the kind of question that keeps you up at night.
