GP complaint upheld: Meda Dymista ad claim “drug of choice” ruled misleading (AUTH/2710/4/14)

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Key facts

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Case number	AUTH/2710/4/14
Parties	General practitioner v Meda Pharmaceuticals Ltd
Product	Dymista (fluticasone propionate/azelastine hydrochloride) nasal spray
Material	Advertisement (ref UK/DYM/13/0022(2)a)
Channel	GP (publication), 28 April 2014
Main claim at issue	“can be considered the drug of choice for the treatment of AR”
Indication context	Relief of symptoms of moderate to severe seasonal and perennial AR if monotherapy with either intranasal antihistamine or glucocorticoid was not considered sufficient
Complainant’s concern	Claim implied first-line “drug of choice” despite second-/third-line positioning
Applicable Code year	2012
Breach clauses	7.2, 7.4, 7.10
Sanctions	Undertaking received; Additional sanctions: Not stated
Complaint received	30 April 2014
Case completed	30 June 2014
Appeal	No appeal

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

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A general practitioner complained about a Meda Pharmaceuticals Ltd advertisement for Dymista (fluticasone/azelastine nasal spray) published in GP on 28 April 2014.
The ad prominently stated Dymista “can be considered the drug of choice for the treatment of AR [allergic rhinitis]”, with “drug of choice” in larger/bolder font.
The claim was presented as a quotation and referenced to Leung et al (2012) (an “Editors’ Choice” commentary on Carr et al (2012)).
Dymista’s indication (moderate to severe seasonal and perennial AR, if monotherapy with either intranasal antihistamine or glucocorticoid was not considered sufficient) appeared in smaller print; prescribing information was along the lower edge.
Meda argued the claim was supported by published data and that materials had been pre-vetted by the MHRA, and that the full indication was included to qualify positioning.

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The Panel ruled the “drug of choice” claim gave a misleading impression of Dymista’s place in therapy.
The Panel considered the claim implied Dymista should be first-line and that no other medicine could/should be chosen first.
The smaller-print indication did not negate the overall impression created by the prominent headline claim.
Breaches were ruled under Clauses 7.2, 7.4 and 7.10 (Code year 2012).
No appeal was recorded.

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