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For Some, GSK's new diet drug is A Lie not Ally 4-18-08
Since GlaxoSmithKline's (GSK) high profile launch of alli last summer, the
first FDA approved diet drug sold over the counter, the only figures that have
flattened are sales.
Two million starter packages sold in the first few weeks at $49.99 for 60 pills
and $69.99 for 120 thanks to a $150 million populist rollout that included
displays in Targets, Wal-Marts and warehouse clubs.
But that revenue growth "will be down a notch" in 2008 Jean-Pierre Garnier,
GSK's outgoing CEO cautioned financial analysts, "because you won't have as much
growth coming out of alli, although we have some."
Of course all diet products generate dropouts who don't like the results they're
getting or the dietary restrictions.
And GSK admits alli results are slow and close to placebo.
But not all diet products feature the "oily bowels" and "anal leakage" that made
alli an instant success on the comic circuit.
Because the active ingredient in alli, Orlistat, blocks the body's absorption of
fat and ushers it out the bowels, sometimes before a person is ready or warned,
GSK originally cautioned users to bring backup underwear with them or wear dark
colors.
Users could even exchange "accident support group" tips on alli's online message
board.
"You lost a couple of pounds, and you're on a date with that special girl,"
riffed Jay Leno, and then find yourself saying, "Excuse me while I change my
pants."
"With Allies Like This, Who Needs Enemas?" asked Prescription Access Litigation.
"Maybe it should come with a coupon for Depends," quipped Philadelphia-area
pharmacist Maria Taylor.
"The Diarrhea Diet" and "Sh-t Yourself Thin" spoofed bloggers.
GSK said the dreaded "treatment effects" which occur when users exceed 15 grams
of fat a day--a fast-food hamburger has 30--could teach people to avoid fatty
foods through aversion therapy, like Antabuse does with alcohol. (One specialist
even suggested users shouldn't get so upset about a little bowel incontinence.)
But critics said if eating right is doing the heavy lifting, why do you need
alli to begin with.
And Dr. Sidney M. Wolfe, director of Public Citizen's Heath Research Group
observed that "alli doesn't block carbohydrates" which for many overweight
people is the real problem.
Even though Orlistat has been available as the prescription drug Xenical,
manufactured by Roche, since 1998, not everyone thinks it's safe.
Roche's own study raises questions about pre-cancerous colon polyps says Public
Citizen. And questions about a higher incidence of breast cancer in early
clinical trials actually delayed FDA review of the drug.
Nor has the prescription version of Orlistat been successful--falling in sales
from $135 million in 2002 to just $93 million in 2007 which some say led to
GSK's last ditch recasting of it as an over the counter medication.
Of course it is no secret that GSK is hurting.
Since the New England Journal of Medicine outed its top selling diabetes drug,
Avandia, in 2007 for raising the risk of heart attack by 43 percent and the FDA
subsequently mandated a black box warning, the drug giant has lost $1
billion--not to mention its reputation and Wall Street luster because of the
apparent subterfuge.
"When you lose the most profitable of your line, it has a disproportionate
effect on the cost of goods and the gross margin," conceded Garnier to reporters
reviewing last year's bleak performance.
GSK no doubt thought it could churn alli--whose lower case "a" may have been
unconsciously to disassociate it with Avandia--like a bad movie or IPO. After
all, even Merck's Vioxx made money after the law suits were paid.
But you can't blame GSK for the public's willingness to accept anal leakage and
an eating disorder as the price of being thin.
"Don't we consider people that are using drugs to induce diarrhea as suffering
from Bulimia, and in need of medical and psychological help?" asks a blogger
writing about alli. "Maybe someone should consider repackaging Ipecac into pill
form, and marketing it as the newest diet plan."
Especially because the traditional American tool kit of consumerism, impatience,
control and overkill doesn't work with obesity--as failed fat surgeries and
liposuctions testify.
And you can’t treat overeating with a different kind of overeating.
In 1998, Frito Lay introduced a brand new potato chip made with a fat that was
chemically processed to make it indigestible.
WOW potato chips boasted that they had no fat calories because the recently
approved sucrose polyester, Olestra, passed right out of the body. Quickly.
But two years after its introduction, Wow's sales tanked. Not only did it not
make people thin, they didn't like its "treatment effects." They weren't the
kind of "wow" people were looking for.