Playing the name game
Drug companies expend plenty of time, energy developing brands
By Tom Murphy
IBJ Reporter
The first erectile dysfunction drugs to make U.S. debuts also cornered the market on manliness. Pfizer Inc.'s Viagra evokes images of power and fluid motion, like mighty Niagara Falls, said branding consultant Anthony Shore.
Levitra, developed by Bayer Pharmaceuticals and GlaxoSmithKline Plc, also connotes power and, of course, levitation or elevation, Shore added.
The third entrant, Cialis, dared to be different. The name of that drug, developed by Indianapolis-based Eli Lilly and Co. and Bothell, Wash.-based ICOS Corp., tugs at the heartstrings.
"You have this very fluid, very soft-sounding word, Cialis," Shore said, noting how the name rolls off the tongue. "They're playing up ... the more emotional, heart-felt aspects erectile dysfunction drugs can address."
Shore's armchair analysis represents a small dose of the brainpower that can be burned during the branding process behind some of the biggest names in the drug market today.
Marketing gurus consider everything from soothing suffixes to syllable counts when they sit down to drum up a new drug name. The process, experts say, can take years to complete and cost nearly $1 million.
Despite all that time and energy, industry insiders are never certain they have a perfect name that will survive government approval.
How to name a drug
Drugs enter the market with a minimum of three names, said Amy Peak, director of drug information services at Butler University.
There's the chemical name scientists use. There's the generic name anyone can use. Then there's the brand name specific to the product produced by a particular company.
For example, the drug n-acetyl-p-aminophenol also can be called by its generic name, acetaminophen, or its brand name, Tylenol. Properties in the drug inspire its generic and chemical names, Peak said.
The brand name comes from any number of factors. Companies generally start thinking about branding their drug around the same time they start testing it on humans, said James Dettore, president and CEO of the Miami-based Brand Institute Inc., which has helped companies test 8,400 names over the last several years.
At Eli Lilly and Co., a team of five to 10 people will gather to devise some possibilities, said Bob Lee, associate general patent counsel for Lilly. A couple hundred names might surface in this initial phase. The group looks for a name with a positive attribute but no meaning.
Brainstormers also look for a name with three syllables or less, Dettore said. Three-syllable words provide flexibility and help avoid confusion with the longer generic names.
Namers also delve deeply into their ABCs by using individual letters to build images. Consumers associate the hard sounds produced by "x," "z" or "d" with power, Dettore said. "C" can be hard or soft, depending on which vowel follows it.
Research finds "l," "r" and "s" to be softer, more fluid letters, Shore said, noting that "v" and "z" also indicate speed.
He offered an example to prove his point: If consumers were given two potential drug names, say Cialis and Vialis, and asked to pick the one that sounded more comforting, they'd probably choose Cialis. The name Vialis more likely would come across as powerful or fast acting.
"That indicates to us that the individual sounds carry meaning," said Shore, the creative director of naming and writing at Landor Associates, a San Francisco-based brand consultant. "It's a field called sound symbolism."
This sound symbolism only works if the brand name actually means nothing, such as Cialis. Any actual definition would trump the sound symbolism, Shore said.
Aside from individual letters, companies also consider what the drug does or its list of ingredients when they look for a name. Premarin, for example, is a hormone replacement therapy made from a pregnant mare's urine, Peak said.
Prevacid comes from the phrase "prevent acid." Ambien, which wards off insomnia, consists of a.m. and bien, implying that if you sleep well at night you'll have a good morning, Peak noted.
Lilly derived the drug name Xigris from Tigris, the "river of life" that flows primarily through Iraq, Lee said. That fits nicely with the drug's use to treat sepsis, which involves circulatory breakdowns.
"You want to keep the river of blood flowing through the body; it's kind of the river of life," Lee said.
Lilly's Cymbalta offers a soothing suffix and conveys the image of balance, as in regaining balance in your life, said Dettore, who worked on that name with Lilly.
Pitfalls to avoid
Drug branding also comes with a long list of things to avoid. Companies steer clear of a name that describes too specifically what a drug does in case that changes during development, Lee said.
But they also avoid simple names such as "Lilly's Antidepressant." That wouldn't work because a company may market more than one antidepressant or a single drug could treat multiple ailments, said Michael D. Murray, a research scientist at the Regenstrief Institute for Health Care and a professor at the Purdue University School of Pharmacy.
Companies take these potential brands and spend months, sometimes years, checking the world for conflicts with other patents. They also test potential names to determine whether they look or sound too similar to other drug names.
They also want to avoid a dilemma such as the one Reebok ran into with a women's running shoe it labeled "Incubus." After the shoe hit the market, Reebok discovered that incubus is an obscure name for a demon that attacks women in their sleep, Shore said. The company had to pull the sneaker off shelves and retool its marketing approach.
Conflicts can crop up from any angle, as Lilly officials found out with Cialis. In 2001, they received letters of protest from people with the last name Cialis (pronounced SEAL-is), said Lilly spokeswoman Carole Copeland. She declined to say where these people live, but a Canadian newspaper has identified several residents of Great Britain.
By the time Lilly learned of the last name, the company already had filed for a trademark in 90 countries and registered Cialis (pronounced see-AL-us) in 50 others, Copeland said. There is no reliable way to check for surnames around the globe, she said. The company decided to continue.
"Of course, had we even chosen a new name, there was still no mechanism in place to ensure that would not be another person's surname," she said.
Once drug companies finish their research, they submit potential names to government agencies that perform a fresh round of checks.
Uncle Sam enters the picture
Companies register a possible brand name with the U.S. Patent and Trademark Office first, which gains the registrant right of first refusal on the name, Dettore said.
Sometimes, they register a name they like before they even develop the drug, Peak added. The Patent and Trademark Office then conducts another search for similarities with other names.
Then a company takes its drug brands to the U.S. Food and Drug Administration. There, Capt. Jerry Phillips and his team await.
Phillips, associate director of the FDA's Office of Drug Safety, oversees a staff that pores over every brand submitted to catch names that might be misleading or might look or sound too similar to a product already on the market.
The agency uses a computer to compare the potential brand name with 17,000 drugs marketed in the United States. An expert panel also examines all names submitted and designs some tests for confusion. Using a network of volunteer physicians, pharmacists and nurses, the panel simulates the prescription process with written and oral orders for the new drug along with orders for other known products.
They scan the handwritten orders into a portable document format and e-mail them to the volunteers. They leave the verbal messages on a recorder. Then the volunteers respond by describing how they would fill the orders.
The overriding concern here is patient safety, Phillips said. But the FDA also checks for any claims a company might slip into a name.
For instance, the hair growth treatment Rogaine originally was named Regain, Lee said. The FDA rejected that name because it implied that every consumer who uses it will regain hair.
Companies usually submit a couple of names for approval from the FDA, which rejects a third of the 300 names it reviews each year, Phillips said.
The end result
Drug companies can spend as much as $800,000 to survive this gauntlet. Developing the name costs $250,000 to $300,000, Dettore said. Securing all necessary trademarks and approvals might cost another half-million dollars.
Counting international registration, the whole process can take five or six years, he said.
Is the time and effort worth it? That can take awhile to figure out. Lee said he waits until about six months after the launch of a new drug before he becomes completely confident someone won't object to the name.
The wrong name can hurt business, as Reebok found out. However, the right name cannot make up for a lousy product, Shore said.
That reflects perhaps the one certainty in this entire process: Image is not everything.
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