As Seen on TV, an occasional column, brings you the inside story behind TV drug ads.
n a spot that has aired on TV more than 12,000 times, a blind woman embraces her daughter at the threshold of her elegant home.
But the ad’s primary target audience can’t see it. They’re completely blind.
Vanda Pharmaceuticals has bought more than $29 million worth of air time in the past two years for a TV ad blitz aimed at raising awareness of a rare sleep disorder for which Vanda makes the only approved drug.
The ad campaign ranks in the top-50 most expensive TV promotions for prescription drugs over the past two years, according to the media research firm iSpot.tv. It’s part of a surge in ads meant to raise awareness of conditions that affect small patient populations — and the pricey drugs that treat them.
(The iSpot data reflect the list price of TV ad space, and don’t account for any discounts Washington D.C.-based Vanda may have negotiated. )
Vanda’s drug, sold as Hetlioz, costs $148,000 a year, 76 percent more than when it was first introduced in 2014, according to the research firm Truven Health Analytics. Fewer than 1,000 patients in the United States take the drug, which is aimed at completely blind people with the disorder.
So why did Vanda turn to the TV airwaves?
Non-24 sleep-wake disorder, often called “non-24,” is a circadian rhythm disorder in which the body clock is out of sync with the 24-hour cycle of night and day. It’s believed to affect tens of thousands of the more than 100,000 people in the US who are completely blind (and therefore unable to perceive the light changes that would normally regulate their sleep patterns), as well as a small number of people who can see. People with the disorder suffer from drowsiness that may cause them to miss work and school.
The disorder hasn’t gotten much scholarly attention: the phrase “non-24” turns up in just 177 citations in PubMed, the database of biomedical literature. By contrast, a search for insomnia gets 18,000 hits.
And Vanda raised eyebrows for the way it interpreted its study results when it was seeking regulatory approval for Hetlioz. The company changed the design of a late-stage study just one month before it reported results, deciding to focus on a new measure of success (adapting the circadian rhythm) that hadn’t been used before in a sleep drug study.
The company’s now starting or planning new studies in hopes of getting the drug approved to treat jet lag, a rare genetic disorder that affects development, and non-24 in blind children. Doctors can also prescribe the drug off-label, though it’s not clear how many such prescriptions have been written.
Jim Kelly, Vanda’s chief financial officer, said the idea to run TV ads came from focus groups with blind people.
Produced by the agency Merkley+Partners, the Vanda ad featuring the blind woman at home never mentions Hetlioz. A male narrator urges the audience to talk to a doctor about symptoms and provides a phone number and website run by Vanda offering resources about the disorder. “Don’t let non-24 get in the way of your pursuit of happiness,” the woman implores her audience in the ad’s closing moments.
Vanda spent the most on CBS, Fox News, and CNN. The top shows for its ads: celebrity news programs The Insider and Entertainment Tonight, and the game show Family Feud, according to iSpot.
Vanda is also running a second TV ad, which has aired much less frequently, featuring several blind people walking confidently or spending time with family as they tell their stories. “Non-24 is real,” one man says.
Together, the two spots have aired more than 16,000 times, including more than 4,000 times on prime time, since the spring of 2014, according to iSpot. One-seventh of the spots have aired between the hours of 11 p.m. and 6 a.m, fitting for a disorder that keeps people up overnight.
The company is also running an ongoing radio ad campaign.
Many blind people listen to TV shows and movies with the help of special technology that narrates action on the screen for them. But the tech isn’t used for TV ads, including Vanda’s. That leaves blind people to rely on sighted family and friends in the room, if they’re available, to narrate what’s going on on-screen.
Vanda didn’t answer questions about whom the ad campaign is targeting. But the retiring Executive Director of the American Foundation for the Blind, Carl Augusto, said there’s real value in raising awareness of the disorder among blind people’s family, friends, and employers. Augusto, who’s completely blind himself, said he thinks the campaign depicts blind people in a way that’s tactful and empowering. (The foundation receives funding from Vanda.)
Did it work?
The company sure thinks so. On an earnings call with investors on Wednesday, Vanda CEO Dr. Mihael Polymeropoulos cited contact with patients prompted by the ad campaign as “the main driver” of new demand for Hetlioz.
The drug has netted the company more than $73 million in revenue.
This story was updated to include information from Vanda’s May 4 quarterly earnings call.