While in a hospital outpatient waiting area last week I was forced to watch “The View” on one of the ubiquitous overhead flat screen TVs that seem to be everywhere these days. Whoopi Goldberg was talking about the “ultimate gift” a mother could give a pregnancy-challenged daughter — implanting her daughter’s embryo in her uterus and delivering her child — when she was rudely interrupted by the new Amitiza DTC ad.

For those of you who haven’t heard, Amitiza is an anti-constipation drug being marketed by Takeda, the folks that bring you Rozerem and Actos. If you believe what you read on Cafe Pharma, Amitiza, which was developed by Sucampo Pharmaceuticals, Inc. — a drug company I never head of — is Takeda’s #2 selling product (I assume Actos is #1 because Rozerem sure as hell isn’t).

I can believe that Amitiza is Takeda’s #2 drug. There’s been a void in the woman’s constipation/Irritable Bowel Syndrome (IBS) market since Novartis withdrew Zelnorm (see “Novartis suspends US marketing and sales of Zelnorm” and other articles here).

The ad could not have been better placed within the show — interrupting Whoopi speaking to women about difficult pregnancies! Constipation is frequently associated with pregnancy.

Of course, Takeda does not want to limit the market for Amitiza just to pregnant women. Therefore, it is engaged in a bit of “disease mongering” on the Amitiza web site, to whit:

“Chronic Constipation touches the lives of up to 28% of adults in America. Both men and women suffer from it, but the condition is two to three times more common in women.”

What exactly “touches upon” means is anybody’s guess. Nevertheless, the 28% figure is dutifully repeated in media stories (see, for example, “Amitiza DTC seeks to move constipation sufferers“).

In fact, the media go even further and cite these numbers given to reporters by Takeda: “Constipation affects 42 million American adults, and 12 million could be characterized as suffering from chronic idiopathic constipation, the condition for which Amitiza is indicated…”

Let me whip out my trusty Microsoft desktop calculator and do some math.

How many US adults are “touched upon” by “chronic constipation?” There are about 220 million US adults over the age of 20. 28% of that equals about 62 million people. Clearly, that’s a much greater number than 42 million adults that are said to suffer from simple “constipation” and much greater than the 12 million sufferers of “chronic idiopathic constipation,” which is a form of constipation having an unknown cause. The latter is the “official” FDA approved indication for Amitiza. All the other numbers about simple constipation and “touched upon” seem to have been thrown in to confuse us into thinking that this drug is indicated for a much larger population than the FDA gives it marketing approval for.

Back to the TV ad.

I was struck by how utterly boring the Amitiza TV ad was. This is definitely NOT the kind of ad Abelson Taylor (AT) — the agency responsible for the Rozerem campaign — would have done (for an idea of the print ad that AT WOULD have done, see this post).

The ad focuses on women, women’s shoes, and women on the move — by which I mean walking out of the house! The rest was totally unforgettable.

The Amitiza web site is no less boring!


If Amitiza is currently the only Rx out there for chronic constipation (and soon to be approved for IBS as well) and if it is indeed Takeda’s #2 drug (in sales as well as indication), then the DTC campaign does not have to be creative (ie, expensive) and “break through the clutter.” It merely has to inform the target audience that Amitiza is out there and you can get it!

Given the simplicity of the TV, print, and Web ads, the ROI for the Amitiza campaign must be astronomical!


Meanwhile, Zelnorm has been cleared to return to the market under limited conditions. Too bad. I was looking forward to that day when Takeda would have to rethink its campaign and compete with a new Zelnorm campaign.

I envisioned Takeda turning to AT, its top gun ad agency to break through the clutter.

Here’s my concept for the new Amitiza campaign. Forget women’s shoes and walking out the house! Bring in the critters! Of course, you can’t use beavers or bees or moths. So, I propose “Stippy Stool” pictured on the left.