Drugs 101: What’s in a (Brand) Name?

I recently read an impassioned plea from a doctor for health care professionals to stop referring to drug by their brand name. The brand name, he argued, was basically just an advertisement for the drug.

This got me to thinking, how do drugs get their names anyway?

The answer is marketers, researchers, doctors, focus groups, the FDA and about $2 million. Really.

When a Drug is Born

When a pharmaceutical company first develops a compound they wish to test for possible release, it is assigned a code specific to the company so only those with the decoder ring (others in the company) know what they’re talking about. This code is registered in the company’s chemical information system along with its formal chemical name. The chemical name conforms to a worldwide standard as governed by the International Union of Pure and Applied Chemistry.

When a Drug Grows Up

If the drug survives development, it is given a name (we think of it as a generic name) loosely based on the drug’s chemical formula. Two other US agencies do this: The United States Pharmacopeial Convention and its United States Adopted Name (USAN) Council. This name is listed in the USAN Catalog (often referred to as the “Orange Book”) which contains all known drugs.

At this time the company can also assign a (trademarked) drug brand name.

Processes vary in different countries.

Sample Drug Product Naming Cycle

• Drug company Merck created a drug and assigned it the code MK-421.
• Formal name registered: (S)-1-[N-(1-ethoxycarbonyl)-3-phenylpropyl)-L-alanyl]-L-proline
• Generic name assigned: enalapril
• Brand name given by Merck: Vasotec

(In case you’re wondering, enalapril is an angiotensin converting enzyme (ACE) inhibitor, used to treat high blood pressure and some kinds of heart failure.)

How the Heck Does a Drug Go From Enalapril to Vasotec?

So glad you asked, because this is where it gets interesting. Naming a drug is like naming every other product in the world: it’s about marketing.

Marketers, psychologists and researchers have determined the letters and sounds to which people will respond best. “X,” “Y,” and “Z” have been found particularly powerful (as in Paxil, Effexor, Celexa, Lexapro, Luvox, Zoloft, Prozac and a zillion others).

“X” is seen all over the place as in:

• X (short for the drug ecstasy)
• X-Box
• X-Factor
• The X-Files
• The Matrix

“X,” is associated with science fiction, tech and drugs.

And while you may not believe people are so easily manipulated, you would be wrong. From a New York Times article:

“James L. Dettore, president of the Brand Institute . . . has tested 8,400 drug names in the last seven years . . . said the letters X, Z, C and D, according to what he called ''phonologics,'' subliminally indicate that a drug is powerful. ''The harder the tonality of the name, the more efficacious the product in the mind of the physician and the end user.''.”

The human brain makes subconscious links all over the place; marketers are just really good at exploiting them. Fascinatingly, X and Z are thought to be so powerful that brand names are registered before drugs even exist for them. (Obviously, I should have named my blog Bipolar-X.)

Drug Brand Names Are Chosen with You in Mind

There are many factors taken into account when choosing a drug name. Dettore says he tests up to 15 names for each drug. He looks at:

• Copyrights in 40 countries
• Ensuring the brand is not offensive / misleading in other languages
• Focus groups who talk about their feelings about the drug name
• Doctors writing of the drug names to see if pharmacies could confuse the name with another drug

Dettore then submits two names to the FDA. The FDA routinely rejects about one third of applications for a series of reasons like sound-alike drugs and drug names that seem to make promises about the drug.

Drug companies might spend $2 million determining the name, market placement and packaging that will appeal to you, the consumer. All without you knowing it.

Next time I’ll talk about why doctors should and should not stop referring to drugs by their brand name.

Molecular image of fluoxetine, provided by Wikipedia.

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You can find Natasha Tracy on Facebook or @Natasha_Tracy on Twitter.