. Well being Advert Watch: A feel-good message a couple of diabetes drug – . Well being Weblog

This 60-second commercial for Trulicity, a drug for diabetes, is one of the most feel-good drug commercials I've seen. The narrator never uses the fear tactic of so many other ads, listing the horrific things that could happen if you don't do the treatment. Instead, music, pictures, and spoken words deliver powerful, encouraging messages from start to finish, aimed at helping your body do what it is supposed to do despite diabetes.

There's a lot of good information here, but as with most direct-to-consumer health marketing, some is missing. Let's go through it, shall we?

Three actors, three positive messages

The ad opens to uplifting music and testimony from three people with type 2 diabetes (although all actors are as indicated in the text at the bottom of the screen). A woman stands in front of the camera to explain

"My body is really powerful."

So far, so good! Then says a man wearing a hard hat and holding blueprints on a construction site

"I have the power to lower my blood sugar and A1C."

More good news! Incidentally, it refers to hemoglobin A1C (HbA1C), a molecule in the circulatory system that has served as the standard test for average blood sugar for the past two to three months. A normal or near-normal HbA1C indicates good diabetes control, while higher scores indicate increased blood sugar and poorer diabetes control.

We then meet a third woman in scrubs who works in the physiotherapy department of a hospital. she says

"… because I can still make my own insulin and Trulicity activates my body to release it as it should."

That sounds good too, doesn't it? Presented this way, Trulicity appears to be more natural as it promotes the release of your body's insulin rather than relying on injected insulin.

What is Trulicity anyway?

A voice over tells us that Trulicity is not insulin, but is taken once a week and works from the first dose. Tiny print notes the common name (dulaglutide) and the fact that it is an injection, "to improve blood sugar in adults with type 2 diabetes when used with diet and exercise." Then we hear who shouldn't take Trulicity, a list of children, people with type 1 diabetes, and pregnant women. Possible side effects such as nausea, low blood sugar, stomach problems, and allergic reactions are described (see full list here). The FDA requires this in all direct mail.

While the camera pans to the sun shining through the leaves and a band is playing in the background, we see the physiotherapist again having a picnic with her family – after she has transformed from scrubs into normal clothes. We hear a few more warnings about side effects and the risk of lowering blood sugar too much if Trulicity is taken with other diabetes medications.

The woman stands in a beautiful park, stands in front of the camera and says

"I have it in me to lower my A1C."

Finally, the voiceover makes the usual suggestion

"Ask your doctor about Trulicity."

What this ad does right

The description of dulaglutide as a non-insulin drug that stimulates the release of insulin is accurate. The text and spoken information about the drug, including who should and should not take it and possible side effects, reflect FDA-approved prescribing information. And the unspoken message that people with diabetes can be active, working, and social individuals is also true (and may be underestimated).

What's missing from this ad?

It is easy to overlook some important information that is only contained in the text. It only appears for a few seconds, and some of the print is pretty small – they don't call it fine print for nothing! For example, you could easily overlook the fact that Trulicity is only available through injection. Similarly, you might overlook the text that explains that Trulicity is not a first choice for treating type 2 diabetes and that diet and exercise are important in treating this condition.

Other missing information include

• the importance and relevance of HbA1C
• whether Trulicity reduces complications of diabetes such as kidney disease, nerve damage, or visual impairment, or improves quality of life or longevity; In fact, there is some evidence that it may reduce cardiovascular complications and the death of those at high risk
• whether Trulicity is better than other treatments for diabetes, including other injectable treatments that work in a similar way, oral medications, or insulin
• Trulicity's high cost: “list price” is nearly $ 10,000 / year, although health insurance or utility programs can cut costs out of pocket.

Another potentially misleading feature of the ad is the selection of actors. Obesity is a major risk factor for type 2 diabetes. However, two of the three actors portraying patients, including the physical therapist who performs multiple times, appear to be close to normal weight. The third one seems to be only slightly overweight.

The final result

Advertising can contain a lot of useful information, but it can also be misleading. While there are regulations about what can and cannot be included in prescription drug ads like Trulicity, these regulations do not require advertising to paint the full picture.

If you or a loved one has type 2 diabetes, there are better ways to find out about treatment options than through a medication display. Yes, speak to your doctor. However, don't limit your conversation to something you heard or read in a feel-good drug commercial.

Follow me on Twitter @RobShmerling