Merck Promotes Cervical Cancer Shot by Publicizing Viral Cause

By Angela Zimm and Justin Blum

May 26 (Bloomberg) -- Maria Shriver, the former television anchorwoman and California's First Lady, wears bead bracelets to show the connection between a female cancer and its cause. Stars from the TV shows ``7th Heaven'' and ``Law and Order'' help drum up awareness about the virus-cancer link.

The celebrities are helping Merck & Co. convey the link between cervical cancer and its origins, a virus with a two- word, eight-syllable name. Aside from the 14,000 women diagnosed with the cancer each year in the U.S., most Americans will learn about the viral cause from a publicity campaign paid for by Merck.

Company ads and educational events by patient groups Merck is funding are paving the way for a vaccine against the infection even though the Whitehouse Station, New Jersey-based drugmaker can't legally advertise to the public until U.S. regulators approve the product, probably next month.

The campaign, including ads on TV, is unusual as drugmakers rarely promote treatments they can't yet sell, said Thomas Lom of the advertising firm Saatchi & Saatchi in New York.

``Merck must be fairly optimistic that this is going to fly,'' said Lom, president of the U.S. health-care division at the firm, which isn't working with Merck.

The U.S. Food and Drug Administration is due to decide by June 8 whether to allow Merck to market the vaccine, called Gardasil, to girls and women ages 9 to 26. A group of agency advisers unanimously backed Gardasil on May 18, and the agency generally follows the recommendations of its advisory panels.

The vaccine would be the first to prevent infection with the cancer-causing human papillomavirus, or HPV, one of the most common sexually transmitted viruses in the world. Sales might reach $3 billion a year, according to Tony Butler, an analyst with New York-based Lehman Brothers.

Link Little Known

About 20 million people in the U.S. are infected with the virus, according to the Atlanta-based U.S. Centers for Disease Control and Prevention. As recently as 18 months ago, Merck's research showed that fewer than 20 percent of American women knew that HPV causes cervical cancer, company spokeswoman Kelley Dougherty said.

Worldwide, about 510,000 women are diagnosed with cervical cancer each year. Developing countries account for about 80 percent of cases because of the lack of access to the Pap smear test that detects the cancer.

Richard Haupt, executive director of medical affairs in Merck's vaccine division, said in a May 11 interview that the company has ``invested in public affairs and consumer education more than we've done for any vaccine in the past.''

Ad Spending

In the first quarter this year, Merck spent $107.3 million on all its advertising, including $841,000 for Internet ads on the human papillomavirus, according to TNS Media Intelligence, which provides research on ad spending. In April, Merck bought 295 TV advertising spots for its campaign, followed by 788 this month, according to TNS.

``It seems to be a sensible strategy,'' said Jon Paul LeCroy, an analyst with Natexis Bleichroeder in New York. ``How well it will work for a vaccine is hard to say.''

Drugmakers spent $4.8 billion last year on advertising in the U.S., including ``disease awareness'' pitches that focus on alerting the public about an illness. Usually, the company paying for the ads has an FDA-approved treatment it is selling.

Merck's ``Tell Someone'' television ads on HPV depict women, including mothers with arms around their daughters, expressing surprise at the viral link to cervical cancer.

`I Was Stunned'

``I was stunned at how many people have HPV. I was stunned. Millions? That's insane,'' says a woman in one of the commercials, her eyes getting big and eyebrows raised. Another woman says, ``You can have HPV and not even know it.'' Merck's logo flashes briefly on the screen, with no mention that there's a product on the way.

Gary Ruskin, executive director of Commercial Alert, a consumer group based in Portland, Oregon, that is critical of drug company advertising, said Merck's promotional Web site on the viral connection to cervical cancer is ``deceptive and dishonest.''

``Merck doesn't tell you why the site exists, which is to sell Gardasil,'' Ruskin said.

Dougherty, the Merck spokeswoman, said the campaign isn't about Gardasil.

``This campaign is part of a broad and longstanding Merck public health commitment to encourage education about the disease,'' Dougherty said in an e-mail.

The company began raising awareness with doctors as long as a year ago about the cause of cervical cancer and the potential for a vaccine.

The Campaign

Then, in September, two organizations began a consumer- oriented campaign funded by Merck. They enlisted TV actresses including Beverley Mitchell of the series ``7th Heaven'' and Elisabeth Rohm from ``Law and Order.'' The stars appeared at events as part of a project called ``Make the Connection.''

The campaign was run by the nonprofit groups Cancer Research and Prevention Foundation and Step Up Women's Network and included selling kits for show-your-support bracelets made of beads. The foundation, based in Alexandria, Virginia, was started by a woman whose father died of cancer. The organization provides funding for scientists and runs public-education campaigns about ways to reduce cancer risk.

The Step Up group, based in Los Angeles, is a social organization that focuses in part on health issues and touts ``supporters'' including actress Annette Bening and musician Sheryl Crow. The group's Web page on the campaign features a photo of Shriver, the wife of Republican Governor Arnold Schwarzenegger, wearing the bracelets at a California Governor's Conference on Women and Families.


Earlier this year, Merck successfully headed off opposition to Gardasil from conservative groups by meeting with representatives from organizations such as the Family Research Council. Leaders of abstinence organizations say they support the vaccine and would only oppose efforts to make the shot mandatory.

The Family Research Council, a Washington-based group that advocates positions such as abstinence from sex before marriage, also met with representatives from London-based drugmaker GlaxoSmithKline Plc, which is developing a rival vaccine. The product, called Cervarix, does not prevent genital warts as does Merck's Gardasil.

Merck's advertising might also benefit Glaxo, analyst LeCroy said. Glaxo filed for European Union approval last March and plans to apply for U.S. clearance by the end of this year.

``The first drug to the market does all the legwork,'' LeCroy said.

Public Health Support

Georges Benjamin, executive director of the Washington- based American Public Health Association, said he supports Merck's advertising strategy because it's educational.

``I've seen the ads on TV and I'm fine with the fact they are investing in educating the public and would like to see more of the pharmaceutical industry do more of that without pushing a product,'' Benjamin said in a May 19 interview.

Pfizer Inc., the maker of the Zoloft depression drug, has run its ``Why Live With Depression'' campaign without mentioning the product. The promotions featured actress Lorraine Bracco, known for her role as psychiatrist Jennifer Melfi on the television series ``The Sopranos.''

Merck says it plans to continue its educational campaigns if it wins regulatory approval.

To contact the reporters on this story: Angela Zimm in Boston at; Justin Blum in Washington at at