As Seen on TV, an occasional column, brings you the inside story behind TV drug ads.

Biogen’s twice-a-day pill for multiple sclerosis was a smash hit out of the gate in 2013, with one of the most successful drug launches in US history, even at a price of nearly $55,000 a year. But by late last year, sales growth had slowed.

So the biotech company went big with its first TV ad blitz for the teal pill, sold as Tecfidera. It has bought nearly $39 million worth of TV airtime over the past seven months, vaulting Tecfidera into the top 20 most advertised drugs on US television for that period, according to the media research firm iSpot.tv.

Many of the other most-advertised drugs target common conditions like erectile dysfunction and type 2 diabetes, which affect tens of millions of patients in the US. But Tecfidera — developed from a chemical once used to prevent mold from growing in sofas — has a small market: It’s aimed at several hundred thousand patients in the US with relapsing MS. Those patients are disproportionately female and white and they have two other options for oral MS therapies.

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How did Biogen try to sell them on its drug?

The pitch

The 60-second ad, produced by the agency CDMiConnect, features a white woman moving quickly through an array of activities; her clothes change in a flash as she shifts between hiking, diving into a swimming pool, and strolling with a man at a carnival. “Imagine what you could do with fewer relapses,” the female narrator says.

It’s aired more than 3,800 times, including more than 700 times on prime-time, since October. Biogen devoted the biggest chunk of its TV ad budget to the big networks — CBS, ABC, and NBC. But the commercial has also gotten plenty of screen time on the Game Show Network and Hallmark Channel. Biogen has put special focus into buying spots on the celebrity news show Entertainment Tonight, the sitcom The Big Bang Theory, and the morning news show Good Morning America, according to iSpot.

(The iSpot data reflect the list price of TV ad space, and don’t take into account any discounts companies may have negotiated.)

The reaction

Some patient advocates slammed the ad for what they called an unrealistic portrayal of living with MS. The condition can vary dramatically, but many patients experience chronic, severe fatigue and numbness, even when they’re not in a state of relapse.

“It just makes me cringe. I want to throw something at the TV,” said Laura Kolaczkowski, an Ohio resident who has MS.

“What did it take her to get ready to go to the fair? What did it take her to swim that lap across the pool and then hoist herself out of the pool? How do you walk through the woods when you have numbness in your feet? How long did it take her to pick herself up off the ground after she fell because she was out traipsing in the woods?” said Kolaczkowski, who has also criticized the ad on her blog.

Other patients, though, said they were pleased to see an ad raising awareness of the condition.

Biogen spokeswoman Nicole Pacheco said the company “knew that the ad would not appeal to everyone, but patient feedback indicated that this commercial was relatable, likeable, believable, and positive.”

Did it work?

It can be tough to measure the direct impact of a drug ad. What we do know is that, in the first six months the ad was on the airwaves, Biogen’s US revenue from Tecfidera increased by 3.6 percent over the previous six-month period. That’s important because Tecfidera, which has brought in $8.3 billion in worldwide sales, is Biogen’s single biggest source of revenue.

But there is one red flag for Biogen: Fewer prescriptions are being filled for the drug.

The number of Tecfidera prescriptions filled in the US, including refills and renewals, dropped 3.2 percent in the first six months the ad aired, compared to the previous six months, according to data from IMS Health, a market research firm. (It’s not unusual for revenue to rise even as prescription numbers drop, since the drug’s price may go up or discounts may be eliminated.)

Biogen CEO George Scangos told investors on an earnings call last week that the company believes the TV ad raised patient awareness. But he wasn’t ready to say whether the ad boosted prescriptions until the data from this spring comes in.

Biogen is planning to stop running the TV ads in the middle of this year, though it will continue a print and online ad campaign that began long before the TV blitz. Look for Biogen to issue a final verdict on the ad’s effectiveness on its next earnings call this summer.

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