Z-Pack: Pfizer Can’t Assume That Science Will Trump A Scare Story

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This week, the U.S. Food and Drug Administration (FDA) issued a warning that Pfizer’s popular Z-pack antibiotic (also known as Zithromax or Zmax) may cause sudden death in some patients with preexisting heart conditions.
 
Z-packs are prescribed nearly 60 million times a year and are often requested by name by patients who understand just how powerful and effective they are in treating bacterial infections. Any suggestion that such a popular and effective medication might have adverse side effects is therefore newsworthy – and high-profile media from the Today Show to World News Tonight ran wild with the story.
 
It is important to note, however, that newsworthy items are not necessarily true. The possibility that Z-packs might cause irregular heartbeats in a small number of patients makes for a great scare story. But it does not mean that the vast majority of people who take the pills have anything at all to worry about.
 
As is often the case, the context is buried deep under the sensationalism. The FDA warning shows correlation -- that a statistically significant, although apparently still rather small, number of patients who took the drug suffered the potentially serious side effect. But that is not the same as demonstrating actual causation through the rigorous and replicated scientific testing that would prove how the drug might actually cause the side effect.
 
Moreover, the side effect referred to in this latest round of scare stories turns out to be not all that new. It may, in fact, be something doctors have known about and taken into consideration all along. Even before the FDA issued its warning physicians probably did not prescribe Z-Packs to patients with heart problems
 
All that said, Pfizer needs to be careful not to assume that the scientific facts alone – no matter how well they are presented – will effectively address the brand risk. Winning the scientific battle is a necessary defensive move. But the war will be decided emotionally.
 
When the public hears the words “sudden death” leading the nightly newscasts, no amount of scientific evidence will entirely eliminate their anxiety. Instead, the public needs to be reminded of why Z-Packs are so popular in the first place. Why taking them is worth whatever slight risk might be involved.
 
Pfizer needs to aggressively communicate the benefits of its antibiotic in order to ensure that they outweigh the apparently very slight risk to a very small percentage of the patient population. This is especially true in the online and social media space, where wild rumors and exaggerations about the latest medical scare are the rule rather than the exception.
 
It is a rock solid principle of risk communication that most people perceive a risk as less serious if it is associated with a clear benefit. As such, this is truly a situation in which the best defense is a good offense.
 
David Bartlett is a Senior Vice President at LEVICK and a contributing author to LEVICK Daily.