Pfizer Lipitor journal advertisement found misleading for exaggerating urgency to prescribe

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Key facts

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Case number	AUTH/2093/1/08
Case reference	AUTH/2093/1/08 (Code of Practice Review August 2008)
Complainant	General practitioner
Respondent/company	Pfizer Limited
Product(s)	Lipitor (atorvastatin)
Material/channel	Journal advertisement (ref LIP2933e)
Key issue	Advertisement found misleading for exaggerating urgency to prescribe using an emergency fireman analogy; lacked reference to “high-risk” patients and was incompatible with SPC context.
Dates (received/completed if stated)	Complaint received 31 January 2008; Case completed 15 May 2008
Appeal	Pfizer appealed Panel rulings on Clauses 7.2 and 7.10; appeal unsuccessful and rulings upheld.
Code year	Not stated
Breaches/clauses	Breaches of Clauses 7.2 and 7.10; no breach of Clause 3.2
Sanctions	No explicit additional sanctions stated beyond the required undertaking/corrective actions described in the report

Reviewed by Dr Anzal Qurbain (FFPM) — ABPI Final Signatory

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A general practitioner complained about a Lipitor (atorvastatin) journal advertisement (ref LIP2933e) issued by Pfizer Limited.
The advertisement showed a photograph of a fireman with text including: “I need to act quickly… You don’t often get a second chance… For a few minutes…” and the product strapline “My life. Your decision”.
The complainant alleged the imagery and wording suggested Lipitor was for acute management of cardiovascular events (eg myocardial infarction) rather than chronic cholesterol management, and created an impression of an emergency/therapeutic crisis.
The complainant also raised concern that the ad’s implied urgency could be seen as inconsistent with SPC advice such as liver function tests before initiation and dose adjustment intervals.
The Authority asked Pfizer to respond in relation to Clauses 3.2, 7.2 and 7.10 of the Code.
Pfizer said the ad aimed to position Lipitor as a cholesterol-lowering agent for patients at high cardiovascular risk and argued the analogy was creative but not misleading.

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The Panel accepted there can be urgency in lowering cholesterol in very high-risk patients, but ruled the advertisement implied an immediate urgency similar to a fireman in an emergency, which it did not accept.
The Panel ruled the advertisement was misleading as alleged and found breaches of Clauses 7.2 and 7.10.
The Panel did not rule a breach of Clause 3.2 (it did not consider the ad promoted an unlicensed indication/acute rescue treatment).
Pfizer appealed the breaches of Clauses 7.2 and 7.10.
The Appeal Board noted the advertisement contained no reference to high-risk patients and appeared relevant to all patients with hypercholesterolaemia.
The Appeal Board considered the advertisement exaggerated urgency to prescribe in a way incompatible with the Lipitor SPC and upheld breaches of Clauses 7.2 and 7.10; the appeal was unsuccessful.

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