Strategy Developed to Get Latinos ‘to Take the Risk’

WASHINGTON —  In trying to promote sales of the diabetes drug Rezulin, Warner-Lambert Co. representatives in 1998 explored ideas on how to get doctors who treat Latinos “to take the risk” of prescribing the drug.

Latinos are an outsized chunk of the 15 million Americans with adult-onset diabetes and are twice as likely as non-Latino whites to have the disease, according to the American Diabetes Assn.

In January 1998, the company convened “focus groups” among Spanish-speaking doctors in Miami, whose patients were predominantly Latino. A summary of the sessions, distributed to Warner-Lambert’s top marketing executives, described “differences between Hispanic and American patients,” including:

* “These physicians describe the Hispanic patient as less informed and educated about medicines/health than the American patient.”

* “Some physicians describe the Latino patient as less disciplined than the American patient. They are less likely to comply with treatment and come back for follow-up visits.”

* “The Hispanic patient relies on word-of-mouth and is very likely to ask for a medicine simply because a family member, friend or neighbor said it is good.”

* “Several physicians mentioned that the Hispanic patient is easy to intimidate because they are afraid of having to go on insulin.”

Asked about the research summary, Robert J. Fauteux, a spokesman for Pfizer, which acquired Warner-Lambert two years ago, said it reflected “the genuine challenges of controlling diabetes in these patients.”

“It is widely recognized, of course, that regional, cultural and ethnic factors all influence the different ways in which various populations perceive and address health-care issues,” Fauteux said.

“In our multicultural society, the differences in the incidence and treatment of diabetes are a case in point.”

The research summary also reported that while the doctors treating Latinos voiced unease about the safety of Rezulin, they found the side effects of a competing diabetes drug, Glucophage, to be “minimal.... Rezulin was thought to have more negative side effects.”

Moreover, the summary said that “many physicians noted that Glucophage has been helpful in taking patients off of insulin.” (Warner-Lambert executives had first carved a niche for Rezulin among FDA regulators and endocrinologists by claiming that their drug was effective in controlling the blood-sugar levels of adult-onset diabetics who were taking insulin.)

The Warner-Lambert summary, dated March 31, 1998, concluded:

“It is clear that in the Miami area, a more aggressive approach to promoting Rezulin needs to be undertaken in the Hispanic community. The physicians are far behind on the learning curve and until they know more, will be very unlikely to take the risk of prescribing Rezulin.”