Astroturfing
The practice of masking the sponsors of a message or organization (e.g., political, advertising, religious or public relations) to make it appear as though it originates from and is supported by grassroots participant(s).
Earlier this week celebrity Kim Kardashian stirred the hornets next via her Instagram account by posting a photo of herself clutching a bottle of morning sickness pills. The pills, Diclegis, (known as Diclectin in Canada) are manufactured by Duchesnay Inc, a pharmaceutical company based in Canada. Duchesnay also have a HQ in the US.
I became interested in this, not so much because Kardashian was promoting a pharmaceutical product but more so because Danny Martel, who is a market analyst for Duchesnay, challenged me on Twitter with a series of tweets telling me to 'educate myself' (Back Story)
Well, throw a dog a bone...
During the past 48 hours or so I have been 'educating myself' and have found something quite interesting.
Duchesnay's American website have a list of "Expectant Mother Resources". Let's just take a look at some of them.
American Pregnancy Association, a national health organization committed to promoting reproductive and pregnancy wellness through education, support, advocacy, and community awareness.
One of their sponsors/supporters is, it appears, Duchesnay, as you can see from the list of "Education Supporters" (Fig 1) it appears that Duchesnay and the American Pregnancy Association prefer the logo of the brand rather than the company. (second logo in pic)
Fig 1
BabyZone (Now called 'Babble) - The website is broken into categories and is associated with Disney. No information of any sponsoring or funding but an interesting post appears in the 'Pregnancy' section of the website. The post, entitled, "The Only Drug You Should Take for Morning Sickness -- And It Isn't Zofran", was written by Aela Mass. Aela writes...
"But that doesn’t mean you have to suffer from severe morning sickness; there is a drug approved by the FDA to take so you don’t have to spend your days hugging the toilet bowl.
"Diclegis.
"As the article states, Diclegis is not only approved for use during pregnancy, but it is also the only drug that has been “studied in hundreds of thousands of pregnant women and is a pregnancy category A drug there is now a safer option for women” suffering from morning sickness."Her article invoked quite a response from people who were suggesting that Zofran worked for them. Zofran is, incidentally, the subject of a birth defect lawsuit in the US. Diclegis, under a different brand name and manufacturer, has also been the subject of a birth defect lawsuit.
It's difficult to say if BabyZone (Now called 'Babble) have associations with Diclegis manufacturer, Duchesnay, and I'm not insinuating that they do. The article, however, does smack of pharmaceutical tactics in as much that it highlights one drug that is unsafe whilst bigging up another drug that is apparently safe. GlaxoSmithKline did pretty much the same thing with Paxil. When promoting it to doctors via their reps they would often highlight how bad Prozac was and how good Paxil was. They did this via reps and strategically placed news articles similar to the one above.
"My child is deformed. I took no other medicine. My husband and I have no genetic history of any problems."
Everyday Health, whose portfolio includes websites, mobile applications and social media assets, designed to provide consumers and healthcare professionals with access to the most trusted health and wellness content tailored to meet their daily needs.
I'm including Everyday Health for the simple reason that they allow reviews of drugs on their website. The reviews for Duchesnay's Diclegis are quite telling. In all there are four consumer reviews averaging 1.5 out of 5. One in particular is quite revealing (Fig 2)
Fig 2
MorningSicknessUSA.com, is a website that, at first glance, looks like a resource for morning sickness. That is until you scroll down to the bottom and read the small print. (Fig 3)
Fig 3
What to Expect, is a website filled with the latest in pregnancy and parenting information and news.
There is no evidence of funding from Duchesnay on this website but I'm including them as they include a post about Diclegis that says, "The good news is that there's now an FDA-approved drug called Diclegis that can treat the symptoms of NVP, or Nausea and Vomiting in Pregnancy. Your doctor will likely prescribe you to take two tablets daily at bedtime. If your symptoms persist, your doctor may then up your dose to a maximum of four tablets daily."
The article credits no particular author and I'm not suggesting that this is a case of product placement. Only in litigation do we ever get to see evidence that points to ghostwritten or product placement articles funded by pharmaceutical companies.
MotherToBaby.org (formally known as Organization of Teratology Information Specialists)
They have a section on Diclegis entitled, Non-Profit Answers Questions About New Drug Aimed At Treating Nausea And Vomiting In Pregnancy.
Experts at MotherToBaby, the counseling service branch of the non-profit Organization of Teratology Information Specialists (OTIS), said NVP affects nearly 80% of pregnant women, usually in their first trimester. A smaller proportion of women develop hyperemesis gravidarum, a much more severe form of NVP. A pregnant woman who develops hyperemesis gravidarum, may potentially deliver a smaller baby. “Babies who are born at a lower birth weight can be predisposed to other complications,” explained Robert Felix, a senior teratogen information specialist for MotherToBaby’s California affiliate at the University of California, San Diego. “Diclegis might help to possibly curb that result.”
They even have a Toll number - Those with questions about Diclegis or other medications during pregnancy and breastfeeding are encouraged to call MotherToBaby experts toll-FREE at 866-626-6847 or by visiting MotherToBaby.org.
As a non-profit private corporation, OTIS’ MotherToBaby service receives funding from a number of different sources including, amongst many other pharmaceutical companies, Duchesnay. (Source)
Moving away from Duchesnay's own website reveals more collaborations.
The Star Canada, revealed in April this year that Duchesnay, has a financial relationship with Sick Kids’ Motherisk program and the Society of Obstetricians and Gynaecologists of Canada.
The Star writes...
"In the latest Sick Kids Foundation annual report, Duchesnay is included on a list of donors that gave between $1 million and $5 million between April 1, 1993, and March 31, 2014."
Today sees the Sick Kids: Motherisk website proudly boast the following (Fig 4)
Fig 4
Meantime, the Society of Obstetricians and Gynaecologists of Canada told The Star...
"...the society’s relationship with its sponsors as “unbiased,” and stressed that all of these relationships “are bound by strict policies to mitigate conflict of interest and adhere to all (Canadian Medical Association) guidelines."
Just last month Duchesnay was one of the sponsors at the American College of Nurse-Midwives 58th Annual Meeting & Exhibition. A Breakfast Symposium, sponsored by Duchesnay USA, was presented on June 1 where Nausea and Vomiting in Pregnancy was discussed. The two speakers were Elaine Mielcarski and Andre Lalonde, MD.
Mielcarski is a a gynecologic nurse practitioner and a licensed midwife, whilst Lalonde was, or still is executive vice president of the Society of Obstetricians and Gynaecologists of Canada. Make of that what you will.
It seems Duchesnay may have shot themselves in the feet when hiring Kim Kardashian to promote their morning sickness pill. Kardashian, for one reason or another, isn't really liked by many people - I can't really comment as I really don't know enough about her other than she seems to be famous for knowing the famous.I don't think there would have been such a backlash had they have hired someone with a wider appeal, say Jane Fonda or Shania Twain for example. Maybe Duchesnay did approach other celebrities but were turned down or maybe they approached Kardashian because she is currently pregnant. (Fig 5) I'd really like to know if Kardashian actually uses Diclegis or just endorses it. Given the controversy of the compounds that make up Diclegis, I do hope that Kardashian has a healthy baby.
Fig 5
So, I've educated myself thanks to the request of someone who works for, or is associated with Duchesnay.
Call it bittersweet irony, if you will.
Bob Fiddaman.
Back Stories
Kim Kardashian on the Pharma Payroll
When Pharma Use the Defence of the FDA
Diclectin and the Redacted Adverse Events
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