Marketing: Celebrity selling
Authors: R. Moynihan
Journal: BMJ (2002)

By spreading the word about osteoporosis, Camilla Parker Bowles, companion to Prince Charles, is inadvertently raising awareness about the latest trend in global drug promotion

Working round the clock from her home office in New Jersey, Amy Doner Schachtel is at the cutting edge of medical research—she helps drug companies find celebrities to help expand markets for new medicines. 

Chatting on the phone one night last week, Ms Doner Schachtel explained how she worked with big pharmaceutical companies to locate high profile personalities to talk about low profile diseases. The research she does for the companies and their public relations firms was not promoting drugs, she stressed, but raising awareness. “The trend is growing dramatically,” she said.

Thanks to this experienced public relations agent and her company, Premier Entertainment, the American public learnt about irritable bowel syndrome from the star of the sitcom Frasier, Kelsey Grammer, and his wife, who has the condition. They appeared publicly on behalf of a foundation for gut disorders. The celebrity awareness-raising campaign was funded by GlaxoSmithKline, makers of the irritable bowel syndrome drug Lotronex (alosetron hydrochloride). Around the same time, that drug was withdrawn from the market after reports of serious side effects, including deaths.

In 1999 Ms Doner Schachtel lined up film and television star Cybill Shepherd to talk about the menopause and a big-selling supplement for symptom relief. As luck would have it, Cybill was taking the supplement with “tremendous results,” said Ms Doner Schachtel. That gig was funded directly by the manufacturer, an Australian company called Novogen.

Both of the celebrity campaigns were a huge success in the enormous US healthcare market. The Frasier pair made the Today Show and Cybill made Oprah Winfrey.

While Camilla Parker Bowles's recent appearances talking about osteoporosis have been somewhat more modest, her comments on the bone condition have nevertheless attracted media attention. Unlike the television stars she is not being paid by a drug or supplement company, but rather is advocating on behalf of a charity she helps to run: the National Osteoporosis Society.

However, her awareness-raising activities do appear somehow to be synchronised with a much larger global campaign being underwritten by the world's biggest pharmaceutical companies.

Motivated by her own family's health problems, Mrs Parker Bowles became a patron of Britain's Bath-based National Osteoporosis Society in 1997, and president in 2001. But it was not until last month that she made her first major speech on the subject. 

The location was Lisbon. The setting was the Roundtable of International Women Leaders. The commercial sponsor for the meeting was Lilly, the manufacturer of a new osteoporosis drug called Evista (raloxifene).

On 11 May, at the Lisbon meeting, Mrs Parker Bowles described how her mother and grandmother “both tragically died as a result of this crippling disease.” She explained that, as a result of her mother's death, “I became determined to find some way of helping people with osteoporosis from experiencing the same fate and general disregard that she encountered.”

Her message for health authorities was clear: “There are not enough DXA scanners, not enough staff to monitor them; not enough physios or special nurses, or money to help fund the vital research . . . We must emphasise the importance of spending more money on early diagnosis.”

Importantly, Mrs Parker Bowles also signed a “call to action” urging governments across the globe to “make the diagnosis and treatment of osteoporosis prior to the first fracture a priority for public health.” The “call to action” is based on a report released previously by the International Osteoporosis Foundation—a kind of global umbrella for national groups. On the final pages of that report, a few lines of fine print acknowledged the sponsors, who provided “unrestricted educational grants to enable us to produce the report.” There are eight sponsors and they are all global pharmaceutical companies. Lilly is the “Gold Sponsor.”

Intuitively early diagnosis and prevention make perfect sense, but the debate within the medical literature about osteoporosis is far more complicated than these simple messages reveal. While it is not at all clear from the publicity material and the media stories, there is a genuine scientific controversy about the role of bone mineral density scanning in predicting a person's future risk of fracture. There are also complex cost-effectiveness arguments about the value of extending subsidised tests and treatments to the millions of relatively healthy women who have not had a fracture.

One of the other high profile people at the Lilly-supported Roundtable of International Women Leaders was the former governor of Texas, Ann Richards. Just days after that Lisbon meeting Ms Richards appeared on CNN's Larry King show, talking about the star-studded roundtable on osteoporosis and strongly endorsing the value of a good diet and plenty of exercise. She also revealed she was taking a medication. According to the transcript, she told Larry it was “Evista. It works for me.” Her assistant later confirmed that Ann Richards worked for Lilly from time to time.

Back in New Jersey, Amy Doner Schachtel is explaining the changing role of celebrities in raising awareness about diseases. “Companies originally wanted the biggest names, the biggest stars. Now it is finding the celebrity with the right fit—someone who has genuine connections, through suffering the condition themselves or having a family member or friend with the condition,” she said.

The woman who organised the Lisbon meeting, where Camilla Parker Bowles made her first big public speech, was Mary Anderson, from the International Osteoporosis Foundation. She confirmed that Lilly paid the airfares and accommodation of Ann Richards and some of the other high profile guests, but that Mrs Parker Bowles paid her own way. Asked about the influence of drug company sponsorship in raising awareness about osteoporosis, she said that individual brands were most certainly not promoted. “The International Osteoporosis Foundation doesn't want to have anything to do with product endorsement. The more proven medications for people the better. The more the merrier.”