Correspondence
Cal Ripken, Jr., and Prinivil
N Engl J Med 1998; 339:2024-2025December 31, 1998
- Article
To the Editor:
It is no secret that product endorsements provide a lucrative supplement to the day jobs of celebrities and athletes. Sports great Michael Jordan is the perfect example of this, making $47 million last year in endorsements alone.1 Another sports hero, Cal Ripken, Jr., made $6.5 million in product endorsements last year.1 As a resident of Baltimore, I see the baseball great's face on everything from roller-coaster rides to milk cartons. But imagine my surprise when I opened up not Sports Illustrated but the Journal and saw a picture of Cal Ripken, Jr., in a Prinivil (lisinopril) baseball cap instead of his usual black and orange Orioles cap.
I was disappointed to find that pharmaceutical companies are now using celebrities to sell their products. Celebrity endorsements work because everyday people think that they can be like these superstars if they don the same kind of shoes that celebrities wear or use similar products. Indeed, we all “want to be like Mike.” I take issue with the Prinivil advertisement, however, for this reason: Cal Ripken, Jr., does not have hypertension. The concept of a celebrity's endorsing a product for a medical condition he does not have or for a drug whose benefits and side effects he will never experience is, in my opinion, unethical. As a physician and patient advocate I find myself offended on behalf of my patients with hypertension. Furthermore, I am personally offended that Merck thinks that the use of such a ploy will influence physicians' choices in drug therapy.
I realize the Journal needs to pay its bills and that pharmaceutical advertising provides a considerable source of income. However, we readers need to be careful in how we allow ourselves to be targeted by advertising schemes. In this instance I believe Merck has crossed the line. The government recently put Joe Camel out of a job by abolishing unethical tobacco advertising. As physicians we should adopt a similar tactic toward unethical pharmaceutical advertising. There are plenty of other products that are more appropriate choices for endorsement by celebrities.
1 ReferencesBrian K. Jefferson, M.D.
Johns Hopkins Hospital, Baltimore, MD 21205Author/Editor Response
A spokesperson for Merck replies:
To the Editor: In 1996 Merck launched an advertising campaign for the antihypertensive agent Prinivil (lisinopril) featuring Cal Ripken, Jr. The campaign was titled “On the job. Every day. Prinivil: Hard at work against hypertension.” The advertisements have changed slightly since then and have been appearing in medical journals for the past two years. Mr. Ripken appears in advertisements directed at health care professionals only, and it is clearly noted in the advertisements that Mr. Ripken does not have hypertension and is not being treated with Prinivil.
Regarding the question of why we chose to feature this baseball star in an advertisement for Prinivil, the answer is simple: Cal Ripken, Jr., is not an ordinary baseball star. As the holder of baseball's record for consecutive games played, Mr. Ripken embodies the same hard-at-work ethic that we associate with Prinivil, an angiotensin-converting–enzyme inhibitor indicated for the treatment of hypertension. Prinivil is also indicated for the management of heart failure in patients who do not have an adequate response to treatment with diuretics and digitalis and to improve the survival of patients who are hemodynamically stable within 24 hours after a heart attack in association with standard treatments, such as thrombolytic agents, aspirin, and beta-blockers.
The aim of the advertising campaign has never been to urge consumers to “be like Cal,” and physicians' responses to the campaign are tested periodically. Their reactions have been highly positive, because it is understood that Mr. Ripken is espousing a work ethic that our company and physicians alike can support. Despite the availability of effective antihypertensive therapy, there is recent evidence that the use of such therapy is slackening rather than increasing.1 Our advertising campaign reinforces the need for continuous, effective treatment.
Our company continues to be very pleased with this campaign and with our association with Mr. Ripken.
1 ReferencesLouis M. Sherwood, M.D.
Merck & Co., West Point, PA 19486-00041
Julius S . Current trends in the treatment of hypertension: a mixed picture. Am J Hypertens 1997;10:300S-305S
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Author/Editor Response
The editors reply:
We shared some of Dr. Jefferson's concerns, but after some discussion we decided to run the advertisement in question. In general, our policy is to accept advertisements for drugs approved by the Food and Drug Administration as long as they are not in bad taste. The concern about this advertisement may be moot, because Ripken ended his streak of consecutive games on September 21, 1998.
Jerome P. Kassirer, M.D.
Marcia Angell, M.D.
