I was interviewed by Beth Snyder Bulik, Senior Editor at EndpointsNews for this piece about drug names.
Prescription drug names often spark speculation, debates and sometimes derision, but they also stir curiosity.
That’s maybe never been more evident than during the Covid-19 pandemic, when vaccine names were dissected everywhere from Zoom water-cooler chats to late night TV talk show monologues.
When it comes to vaccines, what’s in a drug name is typically more obvious than in other drug names. Syllable clues, like endings with “-vax” or even just the strategic use of the letters “v” and “x,” clearly at least hint at what the meds do.
Still, good drug names are generally harder than ever to come by. While the upside for pharma marketers is widespread notice and kudos for the good ones that do make it through – such as AbbVie’s recent Vuity for the age-related vision problem presbyopia or Moderna’s Spikevax Covid vaccine that sparked late-night show high fives – the downside is a public disdain for the seemingly syllabic nonsense.
So where have all the good drug names gone? And what is a “good” drug name anyway?
Of course, good names didn’t “go” anywhere – however, thanks to a proliferation of new drug discoveries, trademark filings and a finite set of letters and syllable combinations, experts are simply running out of possibilities. While not all drug names are created equal, most drug names follow the basic principles of good naming and go through the same rigorous process to get to the goal line.
“Coming up with new names in pharma that are appropriate and available is just so hard. What you see happening now is that many new drug names are like alphabet soup – because they’re just the only things that are available,” said Laurel Sutton, a linguist and co-founder of naming agency Catchword who also serves as the president of American Name Society.
Twenty years ago there was a lot more emphasis on developing meaningful names – in part because it was much more possible, she said. That’s one of the reasons why Sutton, whose agency came up with the Vuity name for AbbVie’s Allergan eye care med, doesn’t take on much pharma drug naming work anymore.
“Things have really changed over time and I think pharma companies are just kind of grateful to get a name that’s legally available – whether or not it makes sense or is pronounceable or even spellable,” she said. “You see all these weird letter combinations and spelling conventions and it’s just simply built around availability.”
She’s not alone in the industry and a longing for the good old days. Many naming experts fondly recall when names like Lunesta or Sonata that evoke quietness and sleep imagery with soft “s” sounds and “a” endings made it through to FDA approval.
The naming process today is essentially the same. Pharma companies almost always hire an outside naming agency with the skills and staff to run hundreds of potential names through safety, drug attribute, copyright and other checks. And there’s also still a lot riding on what will end up as literally one candidate – the FDA will review only one proposed name at a time, while the European comparable agency EMA will review two.
Naming experts haven’t given up though. Everyone is still striving for names that mean something.
Drug naming falls into three general categories: descriptive, associative and empty vessel. Even though that last category – empty vessel, also called blank canvas names – seems to indicate the name doesn’t mean anything, marketing can and typically does change that.
Take the blockbuster antidepressant Prozac. It’s a classic blank canvas name that didn’t mean anything, but Eli Lilly crafted physician and consumer marketing around a med that helped define the modern-day depression drug category.
When it comes to the other two categories of naming, either going for descriptive names or ones that evoke emotion, it often depends on the condition or health category when trying to build purposeful associations into the name.
“You do see trends with letter combinations in different conditions or therapeutic areas like R-E-N could convey renal or O-N-C embedded in a name for oncology,” Daniel Plaisance, managing director at Brandsymbol, said. “There are ways to build that type of messaging with just three letters, although with regulatory agencies you have to be careful in regards to how overtly you communicate.”
That means no “-cure” syllables would likely pass FDA muster, but also no syllables that strike a too-similar tone to any already approved drug – no matter if they’re in distinctly different categories. Takeda and Lundbeck found that out a few years ago after the launch of their depression medicine Brintellix. Pharmacy reports soon surfaced with an alarming number of mix-ups between the blood thinner med Brilinta and the depression med Brintellix. The FDA raised a flag on the problem in 2015 and a year later, the Takeda and Lundbeck voluntarily agreed to rename Brintellix as Trintellix.
Certain therapeutic areas such as respiratory, oncology and cardiovascular have been more conducive to syllable naming conventions that add meaning.
“The naming strategy, whether it’s around an attribute or benefit, an indication of a therapy area, a mechanism of action, a blank canvas or a non-proprietary, those are all explored in the process,” Scott Piergrossi, Brand Institute’s president of operations and communication, said. “But in each therapy area, some of those strategies carry greater weight during the creative process.”
Oncology, for example, often uses descriptive mechanism of action syllables in naming. Amgen’s Lumakras KRAS inhibitor, Deciphera’s Qinlock kinase inhibitor, or Bristol Myers Squibb’s Opdivo with “pdi” in the middle to evoke PD-1. Experts agreed the MOA naming convention is more popular in oncology because physicians who would pick up on the connections are typically the target audience.
In another descriptive name example, Emilie Tolley, content manager at Brandsymbol, talked about her agency’s naming of an ovarian cancer imaging drug, Cytalux from On Target Laboratories.
“We talked to our client about it through the process, but especially in the upfront workshop in trying to gauge what they’re really looking for and what’s the best course and strategy. Cytalux lighting up and targeting cells is extremely descriptive,” she said.
The other drug name category of associative or suggestive words are typically easier to get approved because they’re not overtly saying what the drug does.
Associative names then attempt to suggest or draw associations between what the drug does and the condition, for example. Take GKS’s Flovent or Breo in the respiratory category that suggest air flow and breathing, or Spark Therapeutic’s Luxturna for retinal dystrophy in the eye disease category with “lux” evoking light or illumination.
Mike Pile, Uppercase Branding president and creative director, pointed out a subcategory of associative naming called sound symbolism which more simply uses letters and combined letters to evoke a tone.
“If you have a product that you want to communicate soft, comfort or caring which can be important in healthcare, you would use soft sonorous sounds for example ‘s’ or a soft ‘c’ which can deliver very subtly elements of caring and comfort,” he said.
The sleeping drug or sedative category, for instance, with brands like Lunesta and Sonata as mentioned but also Ambien, are oft-cited as good examples of the softer sounding or relaxation-conveying brand names.
Piergrossi described Brand Institute’s creative process beginnings and how names initially start to fall into descriptive, associative or blank canvas buckets.
“We have a creative exercise where we talk about metaphors associated with the product, maybe a symphony or a race car, for instance,” he said. “Sometimes we coin directly from those words and sometimes they’re more of a tonality-based exercise. You never know what will come out of the creative process and what is a coinable or actionable concept – or what is more just a direction that we need to use.”
Just as in oncology, vaccines are another therapy area where syllables and letters can carry weight. With the latest round of Covid-19 vaccine names, for instance, the syllable “vax” that lets people know exactly what they’re getting has been widely adopted.
The Covid-19 vaccines following the “vax” inclusion are led by Moderna’s already FDA-approved Spikevax. Some of the other names, still only approved outside the US, also incorporate the common syllable including AstraZeneca’s Vaxzevria, Novavax’s Nuvaxovid and Serum Institutes’ re-produced Novavax shot Covovax.
Across vaccines more broadly, the syllable inclusion of “-vax” or even just the letters “x” or “v” are popular mainstays. On the CDC’s list of more than 50 approved vaccines, 22 include an “x” and 19 include a “v.” Some have both, for instance, cholera vaccine Vaxchora from drugmaker PaxVax.
More broadly among vaccine makers, GlaxoSmithKline stands out for its signature naming convention across its portfolio with the use of an “-rix” ending.
From Shingrix for shingles, Infanrix for DTaP, Havrix for hepatitis A, Fluarix for influenza, Twinrix for hep A and V combined, Boostrix for tetanus to its most recent first-ever malaria vaccine Mosquirix, many of GSK’s vaccines seem to recall the underlying vaccine category with the distinctive “-ix.”
However, it’s not actually a vaccine reminder, but instead named after a GSK R&D site, a GSK spokesperson said. The long-time vaccine ending is named after GSK’s site in Rixensart, Belgium.
Influenza vaccines prove an exception to the “-vax” and x-ending names in vaccines. In the flu case, it’s the front-end “flu-” syllable that brands have adopted. Eight of the nine FDA-approved influenza vaccines begin with “Flu” – such as Fluad, Flublok, FluMist and Fluzone – while the lone Afluria from Seqirus even still uses “flu” in the middle of its brand name.
While most parents would be hard pressed to name the measles, mumps and rubella shot most commonly called the MMR vaccine for infants, Merck embraced the vernacular with its officially named M-M-R II vaccine.
Still, for all of the apparent naming conventions, vaccines may be the only prescription drug category where a brand name isn’t necessary. Johnson & Johnson still hasn’t picked a name for its viral vector Covid-19 vaccine, for instance. And people still generally know if they got the Moderna or Pfizer vaccine, but almost never refer to themselves as Spikevax or Comirnaty customers.
Those last two vaccine names, in fact, have spurred another public naming discussion. How do you end up with Comirnaty and Spikevax polar-opposite brand names for Covid-19 vaccines? Especially since both were named by Brand Institute.
Piergrossi explained that although the process is standard, each individual brand name development process takes different turns at different steps. That means sometimes ending with category cousin-feeling names, but at other times ending up with night and day differences.
In the end, while drug naming consultants’ strategic pressure testing, marketing dynamics, alphabet constraints and even the pharma company’s preference play important roles, the always-hovering consideration is coming up with a name that will get approved.
As Pile said, “Eighty percent of the work that drives the development of a name is the nuts and bolts and prosaic work of ensuring that it jumps through the numerous hoops and clears the high hurdles of the FDA because it absolutely has to meet certain criteria and avoid other criteria.”