ASA Adjudication on Ferring Pharmaceuticals Ltd

Ad

A moving internet banner ad on the British Medical Journal "Learning" website showed a young boy looking miserable next to the headline "WHO'S A STINKY, STUPID, BABY BEDWETTER?" The next frame showed the young boy smiling next to text which stated "MELT AWAY THE MISERY OF BEDWETTING WITH DESMOMELT". Text in the final frame stated "Desmomelts 120mcg and 240mcg oral lyophilisate desmopressin (as acetate)".

Issue

The complainant, a doctor, objected that the ad was offensive and demeaning to patients who suffered from this condition.

CAP Code (Edition 11)

Response

Ferring Pharmaceuticals Ltd (Ferring) did not believe the ad was offensive or demeaning to patients. They said it used shock tactics to highlight an under-recognised and under-treated condition and was directed at healthcare professionals only, either on medical professional websites or in journals.

Ferring said the impact that bedwetting could have on a child too often went unrecognised.  In many cases children and parents seeking treatment were told by their GP that they did not require treatment and would grow out of wetting the bed.  They said, whilst most children did indeed stop bedwetting it was impossible to tell when it may resolve; it could be weeks, months or years from the initial consultation, if the condition resolved at all.

Ferring said many studies had confirmed the distress that bedwetting could cause in children, including low self-esteem, anxiety and depression, which if it persisted, might increase the likelihood of psychiatric and/or psychological dysfunction. They sent references for those studies. They said children would try to hide their condition from their peers for fear of teasing and bullying and as a result could avoid socialisation, which could restrict social development and cause isolation. Ferring said the expression in the ad reflected the type of language and teasing that enuretic (bedwetting) children feared, and which could lead to a decline in a childs self-esteem. They said those fears were well recognised with regards to bedwetting and sent a video clip featuring the patient support group ERIC (Education & Resources for Improving Childhood Continence) in support of that.  

Ferring said the ad campaign had not been chosen lightly. They said they had held an advisory board with acknowledged UK experts in the field of paediatrics and nocturnal enuresis, including clinicians, continence nurses and the patient group, ERIC. In addition, a separate focus group of GPs was undertaken.  They said the consensus of these meetings strongly supported the use of a hard hitting advert that would make people stop and think about the condition and the effect it could have. They sent examples of the feedback they had received.

Ferring said the BMJ (British Medical Journal) Learning website, where the ad was seen by the complainant, was intended for healthcare professionals only, and was predominantly accessed by GPs, GP trainees, hospital doctors, medical students and practice nurses.

The BMJ said the ad was marketed to medical professionals. They said it had appeared on the BMJ Learning site, which was a closed access site, with only the home page open to unregistered users. They said the service was not marketed to patients or the public, was not intended for their use, and was written in professional medical language. They said the site was not search engine optimised for generic terms so they believed the proportion of non-medically qualified people finding or accessing BMJ Learning would be very small.

The BMJ believed the ad demonstrated the taunts that a bed-wetting schoolboy might experience from his peers, which the advertised drug would release him from. They said the ad fitted into a long tradition of showing the "before" state in a patient.

Assessment

Not upheld

The ASA understood the BMJ front page could be accessed online by anyone and that it contained a link to the BMJ Learning site. We understood that the ad appeared on the front page of the BMJ Learning site, which was open to unregistered users. However, we accepted that the ad was aimed at medical professionals and that the BMJ Learning Site was designed for and aimed at that audience.

Whilst we acknowledged that the headline "WHO'S A STINKY, STUPID, BABY BEDWETTER?" could be shocking, we considered that it was intended to elicit sympathy for the child depicted, by referring to the taunts they might receive from others. We understood the ad was intended to highlight the product to medical professionals as a potential prescription product which could help alleviate bedwetting. Whilst we accepted the ad might be distressing to some readers who saw it, we concluded it was unlikely to cause serious or widespread offence in the professional medical contexts in which it was presented.

We investigated the ad under CAP Code 5.1 (Decency: offence) but did not find it in breach.

Action

No further action required.

Adjudication of the ASA Council (Non-broadcast)