Our series on the online reputations of the top 10 DTC-spending brands in Q1 2012 continues with the smoking cessation drug Chantix and the pre-filled insulin delivery device Novolog FlexPen. As always, if you need a refresher course on the study’s methodology or terminology click here, or feel free to take another look at Cymbalta, Lipitor, Cialis and Abilify or Celebrex and Humira. This month, we take a look at drugs on the opposite ends of the negative sentiment index.


chantix cropped

Chantix has one of the most negative sentiment indexes at -27.6. Extreme psychological side effects contribute to negative sentiment as does withdrawal symptoms. Chantix also seems have a weak Sales to Spend index of 6.6, meaning that the brand’s spend in advertising does not yield a strong return in sales.

Main Issues Contributing to Negative Sentiment

• Patients report extreme thoughts of suicide, psychotic episodes and depression along with other side effects including stomach upset, vivid dreams and nightmares, nausea, rashes, hallucinations, forgetfulness, dizziness, reduced libido, heart palpitations and increased blood pressure. Reports started in 2006 and continue to today.

• Some patients report feeling euphoric and have developed obsessions.

• Patients with severe side effects found withdrawal from Chantix almost harder than quitting smoking.

• Bipolar and patients suffering from depression are still prescribed Chantix even if they are actively on medications. These patients report exacerbated symptoms.

Main Issues Contributing to Positive Sentiment

• Patients report success in quitting smoking and have remained without smoking months and even years later. Many had tried other types of cessation aids and only Chantix worked for them. This includes patients who have smoked for decades.

• Even the most successful patients believe that you have to want to quit smoking for Chantix to work.

• Some patients report that their cravings stop almost immediately and some even “forgot” to smoke.

Main Area of Risk

• Side effects including suicidal thoughts, aggression, severe withdrawal and others coupled with the current lawsuits.


Novolog FlexPen

novolog Flexpen cropped

Novolog FlexPen has one of the least negative sentiment indexes but sentiment does still remain negative. As a delivery device, patients express their experiences about the device, the drug and the delivery of the drug through the device. Patients do report problems with the dosing, clogging, varied performance from Pen to Pen, and waste; these issues contribute to sentiment. Novolog FlexPen also has a weaker Sales to Spend index of 8.6 than other brands including those spending less in advertising.

Main Issues Contributing to Negative Sentiment

• Some patients give up the pen for pumps and feel that the pump is more convenient.

• Some of those report that they experienced more hypoglycemic episodes with the pen than other delivery methods.

• Patients have issues with the device including persistent problems with blocked needles, difficulty using the pen, wasting insulin, concern about the amount of insulin being delivered when needle gets clogged, do not reach “zero” with a single push to the button, the air shot wastes some insulin, and the needle dribbles coming out of the arm.

• Patients with mental health problems can struggle with both treatment and getting assistance with diabetes related issues including how to use their FlexPen.

• Many patients feel that their FlexPen does not dose well under three units so they also use other delivery.

• Waste is a consistent issue with all insulin discussions as is the comparison of costs of pen vs. vial and syringe. Patients who use more insulin seem to see less waste with the FlexPen and seem to have switched to a pen for that reason.

• Some patients find a pre-filled syringe to be less conspicuous than the FlexPen because of the coloring and size of the pen.

• Some patients report that the FlexPen varies in performance and that they do not get the same results with each use. They question both the performance of the drug as well as the device.

Main Issues Contributing to Positive Sentiment

• Patients find the FlexPen easy to travel with even with ever changing TSA regulations and easier than vial and syringe for travel to work.

• The FlexPen seems sturdier than the Levemir pen according to many patients which allows it to last all 28 days in good working condition.

• The FlexPen is a good introduction to insulin for those just moving from pills. Many wish they would have transitioned earlier.

• Most patients find the FlexPen to be painless. Many consider it easy to use and convenient.

Main Area of Risk

• Concerns about waste, costs, conspicuousness of a brightly colored Pen, and uncertainty that patients are getting the same dose and responses pose adherence issues for the brand.

Next month we conclude the series as we dig into the reputations of Nasonex and Lyrica.


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