Sunday 4 September 2011

A headache for Nurofen Plus and the lessons from the Tylenol crisis

Allegations of contamination or tampering are an emergency for a pharmaceutical company.

The core element of every reputation is trust, and the trust bar is set very high indeed by consumers when buying or being dispensed drugs in the pharmacy.

The most famous example of this was the Tylenol crisis in the United States in 1982.  Tylenol was the most successful over the counter medication, with over 100 million users.  It was discovered that someone had placed capsules in boxes contaminated with deadly cyanide.  Seven people in Chicago were reported to have died after purchasing tampered boxes and taking the medication.  How the company dealt with the crisis has become one of the most famous example of crisis management.  It could have finished the company which made Tylenol, Johnson & Johnson.

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Now it's been reported that 5 boxes of Nurofen Plus in the UK made by Reckitt Benckiser contain prescription only anti-psychotic or epilepsy medication.  If it is sabotage, it's not yet clear why someone is doing this.  No-one appears to have been harmed by this, and doctors say the risk is low.


When I began my career in Britain's National Health Service, a study of a new pain-killing wonder-drug was being carried out on the medical wards.   The drug Ibuprofen was so successful in patients with the severe pain of chronic arthritis that some physicians were calling for the study to be curtailed and the drug to be licensed without further delay.   It both relieves pain and is anti-inflammatory. The drug became commercially known as Nurofen and is now available over the counter.  We take ibuprofen for granted but it is a remarkable and useful drug - and very safe.

It's important to know that Nurofen is marketed as Nurofen, Nurofen Extra (which is simply higher dose ibuprofen) and Nurofen Plus which is a capsule mixed with Codeine to deal with strong pain, for example after a dental procedure like an extraction. (Nurofen Plus is not available in countries which prohibit the import of medicines containing codeine).  The present recall only affects Nurofen Plus.

In a major operation, all packs of Nurofen Plus have been recalled from pharmacies and consumers are being asked to bring any packs they have to their local pharmacy.

A product recall is highly expensive for a company.  In this case the company ordered an immediate product recall.   It was the right thing to do.  No consumer will buy medication they think may cause them harm.  The huge expense of a product recall is necessary for public safety, but also to protect the brand's long-term reputation.  In this case the recall has knocked the story off the news agenda.

The recall is a reminder of the lessons learned in the Tylenol crisis in the early eighties.   Andrew Gilman  was one of the team who worked to restore the reputation of Johnson & Johnson after the crisis.

It is such a powerful crisis lesson that he returns to it again and again, including in his blog.

When a company is faced with a possible contamination problem, what are the crisis rules:

1. First of all, consumer safety always comes first, last and always - as Reckitt Benckiser have demonstrated by their actions.

2. Secondly, take control, or someone else will.

3. Go beyond what you are legally required to do.

4. Spend money and effort getting information out there quickly. Don't hide from the media.  The Andrew Gilman lesson: transparency and clarity.

5. Contact people affected.  Care about them.  Not just for PR.

6. When the problem is resolved tell consumers what you've learned and how you will prevent a recurrence (In the Tylenol case, investment in new tamper-proof designs).

The cost of all this might nearly break the company.  But the sentence for companies who fail to respond is oblivion.

Consumers judge your company not on what happens to you, but how you respond to it.





(Posted from London)