Quick, which one is a character in a novel and which is the name of a drug to treat shingles?
I’ll tell you in a minute. Or... “in a MYNIT™.”
This week my Dumb and Dumber column has been taken over by lots of Xs, Ys and Zs.
The names of recent pharmaceuticals make my head hurt. Maybe I need an Advil, a quaint little name which makes no sense (Ad-Ville? Is that where commercials go to live? #DadJoke). At least I can pronounce it.
I started thinking about drug names after the FDA sent me a press release saying Byooviz has been approved to treat macular degeneration.
Do you pronounce it BYE-oh-viz or Bee-YOO-viz? Bring Your Own Oviz?
What does it mean? I get the “viz” part — for “vision”— but “byoo” makes me think BOO-YAH!
I asked Byooviz developer Biogen to explain the name. Here’s their response:
“Biogen developed the brand name BYOOVIZ™ in accordance with the U.S. Food and Drug Administration (FDA)’s guidance entitled ‘Best Practices in Developing Proprietary Names for Human Prescription Drug Products.’”
The FDA guide is 42 pages long and you’ll need to be medicated to get through it, but I liked this part: “Generally, as a best practice, proprietary names should be pronounceable as a word because proprietary names are used by health care professionals when prescribing, ordering, transcribing, dispensing, and administering drugs, and when counseling patients on their medications.”
Which still doesn’t tell me how to pronounce BYOOVIZ™, but I did learn how to make the ™ symbol on a Mac. Press Option and 2 at the same time. ™™™
But drug names are in a class by themselves. My favorite is AcipHex, for acid reflux. It’s pronounced “ass-effects.”
Amazingly, creating these names is its own industry — MABTHERA™! KEYTRUDA™! TALTZ™! — and my colleagues at CNBC have talked about it before:
One reason for all the crazy names is that the number of new drugs is exploding, making it more difficult to come up with something unique. “Drug names use the letter Q three times as often as words in the English language,” says CNBC reporter Meg Tirrell. “For Xs, it’s 16 times as much. Zs take the cake at more than 18 times the frequency you’d find them in English words.”
The FDA has approved 39 new drugs so far this year, with names like Exkivity, Bylvay, Jemperli, and Rezurock.
Four of the 39 on the list include a Q, while six have Xs, eight have Zs, 13 have Ys, and 20 have Ks.
One drug, Nexviazyme, would earn you 34 Scrabble points if proper names were allowed.
“HOW DO THEY COME UP WITH THAT NAME?”
I reached out to several large pharmaceutical companies and the FDA hoping they could explain the naming process. (Is Kevzara named after Kevin?) They either declined to participate, couldn’t meet my deadline, or did not reply at all.
Pfizer, however, has an explainer on its website. First, the company says a proprietary brand name is an opportunity to make a drug stand out in a crowded marketplace.
This is different from picking a generic name for the same medication. The generic name is what the drug will be called regardless of who makes it. Acetaminophen is a generic name, while Tylenol is the brand name owned by Johnson & Johnson. Generic names have a lot of rules. For example, the prefix has to have two syllables, and the suffix tells you what class of medication it is.
Pfizer says when it comes to brand names, though, there are fewer rules. Companies want these proprietary names to communicate what the drug can accomplish without making any actual claims.
“They can range from abstract ideas, tonality, strong sound or gentle sound,” writes Pfizer’s Michael Quinlan. “You hear a word and it brings something positive to mind, or a nice association that isn’t a claim.”
Vigor + Niagara = Viagra.
“I’ve watched commercials and I go, ‘How do they come up with that name?’” says Jeff Abraham, CEO of Absorption Pharmaceuticals. Their main product is Promescent, an over-the-counter treatment for premature ejaculation. Since Promescent does not need a prescription, there are almost no rules about creating a name. You mostly have to make sure the name hasn’t already been taken so you can trademark™ it.
Pfizer says it can spend two to three years picking a brand name, starting from a list of about 200 candidates created by an outside firm. The company tosses away names on the list that it doesn’t like and then begins researching the remaining candidates to weed out any that 1) step on someone else’s trademark, or 2) could be confused with another drug already on the market.
Avoiding confusion is critical, says Jeff Abraham, or doctors could accidentally prescribe the wrong drug because it has a similar spelling. “Can you imagine, ‘Oh, I want this, but I got this [other drug] instead.’” He says that’s one reason prescription brand names have so many weird letters.
Names also have to translate well. Pfizer says you wouldn’t want a name that means something awful or inappropriate in another language. Finally, the company does market research to see which names generate the most positive response. The best remaining name at the end of this whole process is sent to the FDA for approval.
In comparison, Jeff Abraham says it was ridiculously easy to come up with Promescent.
“I wish I could say there was much more involved in this and we spent a fortune on it and there was a think tank.”
Instead, Promescent was thought up by its developer, urologist Ron Gilbert. It didn’t cost a dime beyond the trademark search.
“Promescent is actually combining ‘prolonged tumescence,’” says Jeff. “Tumescence is the medical name for an erection.” He said it also makes people think of “promise” or “pro.”
(I should mention that I’ve been following the story of Jeff’s company for years. It’s pretty unbelievable. Dr. Gilbert was murdered in a case of mistaken identity, then Jeff built up the company to create a legacy for the doctor’s family, and now he’s fighting a major household goods company in court alleging theft of trade secrets… it’s really something.)
But after everything the company has been through, naming the product Promescent was the easiest and best decision. Jeff says some people over the years have suggested he change the name to something more literally descriptive. Rival products carry names like Uber Numb and Horny Goat Weed. He says Ron Gilbert always wanted a name that appealed to doctors. Promescent “was a little more elegant,” Jeff says, adding, “It wasn’t something that sounded like a bunch of guys cooked up the name.”
There is one name already on the market, though, that Jeff would love to have. “If we ever come out with an [erectile dysfunction] medication, I am going to call the makers of Boniva, and I want that name,” he jokes. “Why does someone choose Viagra if Boniva was available, because that would have been a great one.”
BUT WAIT, WHAT ABOUT ZOSTAVAX V. ZARATHUSTRA?
To answer the question at the top of this column, Zostavax is the shingles medication, Zarathustra is a character in a novel by philosopher Friedrich Nietzche (and “Thus Spoke Zarathustra,” by Strauss, is the amazing theme of “2001: A Space Odyssey”).
But you should’ve figured that out. Zostavax has both a Z and an X.
Your favorite drug name? Let me know in the comments.
DISCLAIMER (to be read very quickly): Side effects of this column may include fatigue, boredom and nausea. Do not take this column while operating a heavy laptop. Consult your physician if you’re reading this column while reading other columns at the same time. Only read this column while drinking alcohol unless pregnant, in which case consume chocolate ice cream instead. Erections lasting more than four hours should be celebrated.