Benadryl, ZzzQuil, and Wal-Dryl

One interesting example of OTC drug marketing I have noticed is the success of ZzzQuil. ZzzQuil comes in multiple forms including syrups and liquid-gel capsules, but the active ingredient is diphenhydramine HCl, more commonly known as Benadryl. ZzzQuil was released by Proctor & Gamble (P&G) in 2012 per this press release. ZzzQuil is marketed exclusively as a non habit-forming sleep-aid and P&G claims it is the best selling sleep-aid brand.

Diphenhydramine is a first-generation antihistamine. The drug reduces histamine levels throughout the body. As a first-generation antihistamine, the drug can cross the blood-brain barrier and affect the nervous system. Histamine regulates the allergic response in the body and is involved in promoting wakefulness in the CNS. The ability for diphenhydramine to cross the blood-brain barrier means that the drug reduces histamine levels in the brain, causing decreased alertness and the feeling of sleepiness. The newer antihistamines (second and third generation) have been reformulated to minimize CNS effects and do not cause drowsiness.

Diphenhydramine is hardly as new as ZzzQuil. It was discovered in 1946 by a former professor and became the first FDA approved antihistimine that year. So for over 70 years, the sleep-inducing properties of diphenhydramine have been known.

The marketing messaging is interesting because it is so segmented. The American consumer must be particularly fixated on the idea that a pill should treat a single condition. Benadryl and Wal-Dryl are marketed as allergy medications. ZzzQuil is marketed as being exclusively for sleep. I sincerely doubt that the average consumer is aware that these products are all really the same thing. The consumer probably doesn't even know what diphenhydramine is, but almost everyone recognizes Benadryl and ZzzQuil and knows what they are for. To me, this implies that medicine and pharmacy are seen as so complex by the average person (and they are very complex) that even reading the name of a chemical in a drug they are taking should only be left to doctors. Letting the marketing messaging of "Take this one to go to sleep and this other one to stop itching" is much less daunting than actually understanding what they are taking. In the context of OTC drugs, marketing distances the consumer from the underlying reality: these are all the same thing.

Companies like P&G have caught on to the value that consumers place in specificity of messaging through their branding. Benadryl, Wal-Dryl, and ZzzQuil all come in liquid cap forms and all of them have the same 25 mg dosage of diphenhydramine in every pill. The difference is that ZzzQuil costs 200% more per pill than Wal-Dryl on the Walgreens website. Consumers are clearly more willing to pay for something that promises them a restful night than stopping their itching. From P&G's perspective, this is free money to be had.

https://en.wikipedia.org/wiki/Diphenhydramine#cite_note-BC-63

https://en.wikipedia.org/wiki/Histamine

Food Glorious Food (blog #6)

Food. It fuels us. It helps build our bodies. Through it we often construct our identities and define our particular tribe; "I'm a vegan." "I follow a paleo diet." I'm lacto-ovan vegetarian." I'm lactose intolerant" and so on...
Once I was at a student appreciation party and dinner at a yoga studio in Austin, TX. I was a teacher at the studio and it was a great opportunity for students and staff to hang out and better get to know each other outside of class. Some of the food was catered by Whole Foods and a few students and teachers also brought various dishes, desserts  and beverages. It was a wonderfully eclectic buffet, much like Austin itself.
There was everything from teriyaki tofu, quinoa & pomegranate salad to dark chocolate & Himalayan sea salt caramel mousse, as well as many other gastronomically adventurous delights.
Suffice it to say that I had no trouble filling my plate. Someone, (who has earned a certain BBQ saint hood in my book) brought a brisket from Salt Lick BBQ. Words can not describe...
I greedily forked a few smokey slabs onto my plate. While doing so, a student saw me. She appeared to be somewhat shocked. She asked me, "Do you eat that?!!" I should have known. I felt like sheepishly pointing to my roasted organic golden beets and kale salad so that I could be somehow redeemed in her eyes. Also, the non-yogi rebel in me thought of playing tit for tat and mentioning her slice of tres leche cake, guava empanada and very large glass of Malbec and saying "And you eat and drink that?!!"
It's funny. Really it is! Neither of us were functioning rationally or had any right to question the other. Our opinions of each other weren't based on good science or an awareness of each other's metabolisms and personal tastes. We simply were in an environment and culture that seemed to encourage vegetarianism and discourage intake of sugar and dairy products. Neither of us had the training nor the expertise to be casting aspersions on each other's choices of food and drink. And hell, it was a party!!
All of this helps to point out how complex our relationship to food is. At times it seems almost impossible to pull apart the threads that construct our food choices. Personally I've tried going vegan, vegetarian, paleo, sugar-free, dairy-free and grain-free for selected stretches of time. Through that I think that I have found a diet that works best for me. It happens to include lean meats, fish and eggs while minimizing  sugar and refined carbohydrate intake. However, I love good pastries!! My mother and grandmother, in the hearty German tradition, were wonderful bakers. There are times I swear I'd sell my soul (if I believed that I had one; but we'll save that for another post)  For a pan of my mom's brownies or grandmother's apple strudel.
What does all of this say?
I think that we need to look at our collective evolutionary biology and see how important animal products were concerning the development of our brains and bodies and how equally important quick-to-burn foods like sugars and simple carbohydrates were to giving us the "rocket fuel" to either chase and capture prey or, avoid predation ourselves. What's changed is that those foods used to be scarce and hard to come by. Now, we can go to Teppanyaki Buffet and gorge ourselves on a regular basis if we choose. Poor old Neanderthal Man rarely got that chance.

Emergen-C vs Airborne vs Generic Multivitamin

I compared the ingredients of Emergen-C, Airborne, and Target's up&up brand women's multivitamin. Both Emergen-C and Airborne advertise illness prevention.

Emergen-C is a dietary supplement that boasts "1,000 mg of Vitamin C, other essential nutrients, antioxidants, and Electrolytes." A 30 pack goes for $9.99 at target, costing you $0.33/packet. Each dose is a little bag of powder that gives you a "Super Orange flavored Fizzy Drink with Natural Flavors."

Airborne is an "Immune support supplement" that contains a "BLAST of Vitamin C, plus 13 Vitamins, Minerals, and Herbs." It takes the form of little tablets that dissolve in water, giving you an effervescent, fruity drink. A 30-pack costs you $15.19 at target, so each tablet costs about $0.51.

Target Up&Up Women's Multivitamin advertises that it "supports bone, heart, and immune health. It also supports healthy skin, a healthy reproductive system, and energy metabolism." A pack of 300 costs $5.59, costing about $0.02/pill.

Main differences I found:
-Emergen-C and Airborne both contain 1,000mg of Vitamin C (which is 1,667% of our recommended daily value). There are no proven benefits to taking this much Vitamin C daily, as it is water soluble and will leave your body via your urine. There are actually some potential health consequences to taking over 1,000mg of vitamin c daily, such as interfering with other medications, *possibly* increasing risk of cataracts, and can possibly increase the risk of kidney stones in certain people. The Target Mulivitamin contains 60mg of Vitamin C, which is the recommended daily dose.

-Airborne, overall, was the most different from the other two. Airborne contains fewer vitamins overall and contains a "proprietary herbal blend" consisting of echinachia, ginger, and other fruit & flower ingredients. Airborne's claim to effectiveness is at least more unique than Emergen-C because it contains more unique ingredients that might actually help mitigate a cold.

-Emergen-C and Target Multivitamin had nearly the same ingredients and quantities. Other than Vitamin C, the target multivitamin had pretty much the same ingredients as Emergen-C and contained them in higher quantities. For example, Emergen-C contained 25% daily values of Thiamin, Riboflavin, Folic Acid, and Manganese, whereas the target multi contained 100% D.V. of all of those. The Target Muli-Vitamin literally contains all the same nutrients, usually in higher quantities, and costs significantly less money. One $5.59 package of target multis will last you almost an entire year, whereas you would need to spend $100 on the equivalent amount of Emergen-C.

Conclusions
Both Emergen-C and Airborne are tasty (or at least tastier than swallowing a big vitamin), and are sort of an "event." With a vitamin you just swallow it and it's over, making it seem less like you're actually "doing something" for your health or illness. Contrastingly, both Emergen-C and Airborne dissolve in water, giving you a fizzy drink that you drink in more time than you swallow a pill. In my opinion, these acts make individuals feel like they're "doing something" for their health and illness prevention. Additionally, Airborne and Emergen-C both have significant and sophisticated advertising presences. They both market as unmatched in what they do, as if no other options for ingesting vitamins and minerals exist. Emergen-C also uses rhetoric of "emergence", (like, Emerge Refreshed, Emerge Revitalized, Emerge Energized) implying that taking this supplement will change you almost instantly. In the case of a generic multivitamin, little to no advertising goes into it. Additionally, (hopefully) no one that takes a multivitamin expects to see immediate change. It's usually something people take every day to supplement their vitamin intake when their diet doesn't suffice. Most people with well-rounded diets do not need to take a multivitamin, so it really doesn't make sense to spend more than a small amount of money on them. However, if Emergen-C (and Airborne) can convince consumers that they will receive INSTANT health and IMMUNITY from illness, it makes sense that they're so popular!

Overall, Emergen-C seems like the biggest scam to me, as it is almost exactly the same as a generic multi vitamin. Airborne has more herbal ingredients, which may help in ways that haven't been studied or quantified by science. However, if you're looking for echinacea, ginger, and other natural ingredients, you're probably better off with tea, as it's cheaper, and doesn't contain all the sugar/flavoring of Airborne.

https://www.consumerlab.com/answers/is-it-possible-to-take-too-much-vitamin-c/too_much_vitamin_c/
https://www.consumerlab.com/answers/do-vitamin-c-supplements-help-prevent-cataracts/vitamin-C_cataracts/
https://www.drweil.com/vitamins-supplements-herbs/vitamins/overloading-on-vitamin-c/

Ibuprofen is my favorite drug!

For most of my life I had no idea what the difference was between major over the counter painkillers; my family used ibuprofen while I was growing up so that is what I have always used.  Now that I am older and do know some of the differences I gladly choose Ibuprofen over any of the other OTC painkillers. 

Ibuprofen falls under the category of  'non-steroidal anti-inflammatory drugs' (NSAIDs).  Advil is the generic brand name that sells the drug; it has been around since the 1950's.  After some quick research, I found that I could purchase Advil in a bottle of 300 count and 200 mg per at a whopping price of $14.42 on Amazon.  But what about some 'off' brands of the drug, they have to exist?

Basic Care brand Ibuprofen, one of my most reliable companions.  If there was ever a time I was too sore after sports practice or maybe I rolled an ankle for the 100th time, Basic Care brand Ibuprofen was there for me.  The active ingredient (Ibuprofen) is the same as Advil.  I found Basic Care brand Ibuprofen on Amazon in a bottle of 500 count and 200 mg per at a lovely price of $6.98.  So with this brand, I get more in a bottle, for half the cost! 

In my opinion, I have never noticed a difference between taking Advil and Basic Care Ibuprofen; I do know of sever people who swear by Advil firmly believing that it is better.  I often hear them say it taste better, which is true.  Most Advil is sugar coated to make the experience of taking drugs a little more pleasant.  I think if you have the drug in your mouth long enough to really notice the taste, you are doing it very wrong and the sugar coating is definitely not  worth twice the cost.  It is like Robin said, these people pay more so they have convinced themselves that it works better. 

Is it right that people pay twice the money for a product they can get cheaper with a different brand?  Yes it is right, it's the consumers money, they should be responsible for their purchase.  Access to the internet, and easy information regarding the subject is readily available.  It is a wonder that the generic brand is able to set their prices so high.  They were the first to use the drug, so they have that 'Name' that is associated with it.  Either way, I will stick with my Basic Care brand Ibuprofen. 

Claritin-

Claritin is a popular allergy medication. Its main ingredient is loratadine, which is an antihistamine (like the word hints, antihistamine inhibits histamines which halts allergy symptoms). Often times their commercials will have a person doing some sort of activity, but not enjoying one second of it. It is usually portrayed in a black and white filter. Then the person takes Claritin and suddenly colors become brighter, the mood becomes better, and the activity is enjoyable again. I remember back when I used to watch tv (now I’m on Netflix, screw commercials), it was extremely satisfying to watch all the bright colors that would come in the second half of the commercial after the actor had taken the medication.

When comparing Claritin to  CVS’s loratadine medication, we see a 45% price difference. Claritin is $1 a pill, while CVS’s medication is $0.62 a pill. Claritin is owned by the conglomerate, Bayer.

“Live Claritin Clear”

Ah that just sounds so perfect. It has a nice ring to it. I don’t want to be “CVS brand non-drowsy allergy relief clear”, so I guess I’m going to pay almost double the price. Note: Both medications have the same active ingredients.

Theory: Claritin is selling happiness not a clear nose and un-itchy eyes. Claritin’s commercials are just so pleasing  to watch. After the Claritin kicks in, everything is colorful, everyone is smiling, and life couldn’t get better. If you didn’t already know it was a Claritin commercial, one would notice that it is eerily similar to an antidepressant commercial. Coincidence? Obviously not. Most of Claritin’s commercials don’t even show the person experiencing the terrible symptoms of allergies; it is literally just someone having a terrible colorless day.

But what if a person says that the generic CVS allergy medication (with the same active ingredients) didn’t give them any relief? Are they just blaming their unhappiness and  despondent life on cheap medicine? I mean, probably.

Blog Post #5 Regan Bradley

Tylenol or acetaminophen?

In my naïve years as a teenager, I thought there was a difference. "Mom, I cannot take acetaminophen, I have to have Tylenol." To top off my stupidity I would pronounce it horribly wrong each time I attempted to say it. From a young age we learn of Tylenol due to the chewable tablets I assume we all took with a preference of cherry or grape. Grape for me. I really loved to taste and was pretty excited to be sick and get to take some yummy grape Tylenol. I knew the name well. It was branded to me and all children.

As we grew up and had to start swallowing the harder pills. Less flavorful and more expensive. But the metaphorically harder pills as well: the facts. The well-known brand I'd come to love for healing my fevers and pain was just socially created through a name. Acetaminophen is my true hero, not the concept provided by Tylenol including raising my spirits and being a part of everything I do as seen in a their common commercial (provided below). I was an adult now so I could better understand the aspects of branding and what medication contain.

From my field research, Extra Strength Pail Relief by CVS Health is $7.99 for 100 tablets 500 mg each and Tylenol Extra Strength $10.79 for 100 caplets 500 mg each. The children's medication also increase in price from the CVS Health Acetaminophen to Tylenol. There was a steady increase in price as the ages on the boxes increase for both brands. This is just a few examples from one store so of course this does not justify what I am saying but they are viable examples.

Acetaminophen is the key ingredient in Tylenol. It is a pain reliever as well as a fever reducer. It belongs to a class of drugs named analgesics and antipyretics which relieve pain and reduce fever respectively. Drug companies create a brand name that trademarks their medications for a certain period of time. After that time period, generic brand names can then sell that medicine under a different name. As we can see from my field work (the picture provided below) there is more than one pain reliever pill other than Tylenol. There is a bunch of "different" acetaminophen pills which are different simply through branding and packaging.

This is what marketing and capital have come to. Producers all sell the same thing but everything is priced differently due to branding and packages. This means that people who are unaware of these concepts will be paying more money than is necessary. I believe this is both a problem of the public and of producers. The public should be aware of these little scams and not partake in putting extra money where it doesn't need to go. Producers should not be using the ignorance of the American people to make more money off of things that should be easily accessible for a lower price. I believe the problem lies more on the side of the public. If we stop buying the more expensive drugs that are the same thing as generic drugs, the more expensive drugs will not be sold any more due to simple supply and demand economics. However there goes the jobs of people at Tylenol so what really is the right thing to do?

You Raised Her Spirits:

Infants' TYLENOL® - You Raised Her Spirits :30

Field Research:

Blog Post #5

While working at Walmart Pharmacy I think the most surprising thing to me is when customers come up to ask the differences between two products, most of the time they are the brand name product and then the generic. We explain to them that they are the exact same medication containing the same ingredients but they still decide to buy the brand name... IT NEVER MAKES ANY SENSE TO ME. Many have said that the brand works better, I think this has to do a lot with DTCA and the idea that a more expensive product will work better.

Where I wanted to go with this post though is the idea of different combo drugs such as Robins example of NyQuil and DayQuil. It has been a huge surprise to me how often people think they need to buy something along the lines of DayQuil when they aren't even experiencing all the symptoms that DayQuil is used to treat. A lot of people will bring DayQuil up to our window (keep in mind its is usually the brand name which costs about 9 dollars for a box of 16 liquicaps where the directions are to take 2 capsules every 4 hours not to exceed 4 doses in a day) and ask the Pharmacist if this will help with their congestion. Below are the main ingredients in DayQuil:

Active ingredients (in each LiquiCap)	Purpose
Acetaminophen 325 mg	Pain reliever/fever reducer
Dextromethorphan HBr 10 mg	Cough suppressant
Phenylephrine HCl 5 mg	Nasal decongestant

This is when the Pharmacist goes on to ask if they are experiencing a cough or fever, most of the time they say no. The pharmacist then goes on to explain to them that they do not need DayQuil because it has many other products in it they they don't need. They then recommend pseudoephedrine which is also a nasal decongestant that is sold behind the counter at pharmacies because it can be made into methamphetamine. They recommend pseudoephedrine because it lasts longer than phenylephrine. This product at Walmart can be bought for $5.98 ( generic Sudafed 30mg, it is a box of 48 tablets and the directions are 2 tablets every 4-6 hours and no more than 8 tablets in 24 hours). My point is, you would get a lot more bang for your buck buying a generic solo medication than a combo drug like DayQuil. We get so many customers that come up with the same situation but I can't imagine how many don't come up to ask and are wasting their money without even knowing it. 

Overall I think its very important to pay attention to what you are buying and the products that are in it. Do you need everything or would it benefit you to buy an individual generic product that will take care of the specific issue you are experiencing.