A “Arte” de Nomear Medicações

… According to brandirectory.com, Roche is considered more valuable than other popular brands such as Rolex®, Hilton® and Victoria’s Secret®. Trademarks are a large component of what makes a brand like Roche so valuable and one of the reasons why companies pay up to an estimated $500,000 for branding services when releasing a new drug.

(DALY e EMERY, 2019.)

Se em épocas passadas o processo para se chegar ao nome-fantasia (ou comercial) de medicações era menos complicado e o mercado menos competitivo, nos dias atuais a complexidade aumentou enormemente. Muitas empresas recorrem a serviços especializados para esse fim.

Por exemplo, em 1899 a Bayer® lançou o ácido acetilsalicílico (ou ácido 2-acetoxibenzóico, conforme nomenclatura oficial da IUPAC) sob o nome de Aspirina®. O nome-fantasia foi montado da seguinte maneira:

a-, do radical acetil;
spir-, em referência às plantas do gênero Spiraea, fontes naturais do ácido salicílico; e
ina, sufixo formador de nomes de substâncias químicas

Algum tempo depois, a Eli-Lilly® lançou a fluoxetina em 1986 sob o nome de Prozac®, “montado” por David Wood (fundador da Wood Worldwide, posteriormente vendida para a Interbrand Health®). Em How Prozac brought depression out of the dark, a empresa diz a respeito do processo que levou ao nome:

When Prozac (fluoxetine) launched in 1987, it was a sensation, representing new beginnings and opportunities for those suffering from depression. We realized that in order for it to succeed, we would have to tackle depression head-on, and destigmatize the condition by raising social consciousness. We created the name, Prozac, by intentionally distancing the name from everything typically associated with anti-depressants – strong chemicals, side effects, and mood swings. The easy and accessible language provided patients a platform to talk comfortably and openly about their condition.

By crafting a drug name patients could talk to their doctor about, the launch of Prozac marked a huge change in medicine and the treatment of mental health. And unveiled one of the most successful drugs of all time.

(Do portfólio da Interbrand Health®.)

A propósito, a fluoxetina atende pelo nome da IUPAC de…

N-metil-3-fenil-3-[4-(trifluorometil)fenoxi]propan-1-amina.

Pelos nomes da IUPAC serem frequentemente longos e complicados, para fins médicos e farmacêuticos prefere-se o uso de nomes não-proprietários (ou genéricos). A OMS compilou as normas de uso de prefixos, sub-raízes e sufixos para os vários medicamentos existentes sob a entrada INN Stems. Novas medicações passam por uma análise quanto à observância das normas de nomenclatura e diferenciação em relação a outras já existentes pelo Programa de INNs da OMS e pelo USAN Council.

Algumas das normas para criação dos prefixos:

It must avoid certain letters.
The generic drug name is created using the Roman alphabet, and the goal is to create a name that can be communicated globally. Because the letters Y, H, K, J, and W aren’t used in certain languages that use the Roman alphabet, they aren’t used in the creation of the prefix of the name.
It can’t be considered marketing.
Using the company’s name within the drug’s name must be avoided. Also, it’s important to stay away from superlatives or laudatory terms (best, new, fastest, strongest) that could be considered promotional.
It avoids medical terminology.
You don’t want to imply that a drug is intended only for one particular function, because in time, if it is also helpful for another purpose, the name could be reductive. (…)

(Do site da Pfizer.)

Quanto aos nomes comerciais:

… Naming fuel includes thesauri and Google, of course, but also cowboy dictionaries, surfer dictionaries, encyclopedias of gems and minerals, Sanskrit rhyming dictionaries, and the big book of sports metaphors, to name just a few sources.

The goal of the naming team is to represent the drug — a complicated formulation that confers various primary and secondary benefits — with a single word that communicates a core aspect of those benefits. Take an inhaled asthma drug as an example. The creative teams may focus on the simple yet rich idea of air, and draw inspiration from any number of sources.

Working with the idea of air, a copywriter could spend hours poring over numerous aeronautical tomes including a dictionary of flight, “Jane’s All the World’s Aircraft,” a book of aviator slang, and the 1938 edition of “The Glossary of Meteorological Terms.”

Naming experts also turn to sound symbolism. Again, working with the idea of air, a linguist might develop names that rely on sounds made with the letters “b” and “p,” which are vocalized with bursts or puffs of air through the lips. (…)

(PILE, 2017.)

Frequentemente as empresas começam com milhares de diferentes nomes, progressivamente “eliminados” até se chegar a uma dezena de nomes finalistas. Escolhem-se um ou dois nomes para submissão às várias agências (FDA, USAN Council nos EUA; EMA na União Europeia), com outros mantidos em contingência caso necessários.

Trademark screening and clearance.
A team of attorneys scrutinizes each name to make sure that name is truly unique. “All companies developing drug brands have to be diligent that it’s not getting too close to other companies brand names, or generic names for that matter,” says Quinlan [Michael Quinlan, trademark development senior manager in Customer Analytics & Insights group].
Linguistic checks.
Does the drug name translate ok? The goal is to have a product that is appealing on a global scale, so it’s important to make sure it sounds and reads okay, regardless of the language or dialect. “We want to make sure the brand name is checked in major world languages to make sure the name in its entirety does not mean or imply a word or phrase that would be inappropriate or embarrassing,” says Quinlan.
Safety checks for interpretation during the prescription process.
Safety is the major focus in naming drugs. If one medication name is confused with another, the mistake could have serious consequences. (…) When drugs have an unexpected letter — such as the Q in Pristiq or the X in Xeljanz — it may have been chosen to make the name look more distinguishable.
Market research.
The team will survey others, including health care professionals, to gauge how they respond to the different names, inquiring about areas such as safety as well as general likeability of the way the word looks, sounds and how memorable it is.

(Do site da Pfizer.)

E:

“The FDA’s Division of Medication Error Prevention and Analysis is responsible for proprietary name review prior to approval,” explained Lyndsay Meyer, a spokeswoman for the agency, noting that this division can “require the company to select another name, for safety reasons, as part of the approval process.”

(…)

For instance, the use of certain word “stems” are officially protected by the International Nonproprietary Names program. Word stems are groups of letters, usually just two — “os,” for instance, or “aj” — that cannot appear within brand names, explains Teck [Arlene Teck, diretora criativa da Ixxéo Healthcare], as it might cause confusion with a generic name.

The FDA also rejects names that seem too fanciful or overstate a drug’s effectiveness and puts the kibosh on names that might stigmatize a patient (or condition).

“If you are wanting to do metaphors that are life-affirming, and you want to think of things like trees or flowers or something strong like metal, you cannot do that, because it might suggest an ingredient,” Teck noted.

Even once a product is commercially launched, the FDA retains the authority to request a name change. In fact, the agency may request a name change if doctors report confusion and medical errors even after a drug can be found on the shelf at your local pharmacy.(…)

For example, FDA examiners are known to look at handwritten samples of a drug name and listen as a variety of people (each with different accents) pronounce the name. They also check for illegal stems, similarity to the names of discontinued products, and common medical or coined abbreviations tucked within the name. Meanwhile, examiners analyze for possible promotional claims and references to active or inert ingredients within the sound of the proposed name.

(SCUTTI,2016.)

Mesmo depois do lançamento, entretanto, o trabalho não termina:

Even once a product is commercially launched, the FDA retains the authority to request a name change. In fact, the agency may request a name change if doctors report confusion and medical errors even after a drug can be found on the shelf at your local pharmacy.

(Idem.)

E esse trabalho todo vale a pena? Sim, pois o laboratório farmacêutico continua na posse do nome comercial mesmo após a expiração das patentes.

Nota:

Os posts Nomenclatura dos Anticorpos Monoclonais (e Relação de Alguns Deles Utilizados na Neurologia) de 13/07/2020 e Nomenclatura das Terapias Gênicas de 17/01/2021 citam exemplos das normas da INN respectivamente para anticorpos monoclonais e para terapias gênicas.

Bibliografia:

Daly, T.J.; Emery, A. Branding pharmaceuticals: drug naming and non-traditional trademarks. World Trademark Review. 17/07/2019. Acessado em agosto de 2021.
Pile, M. The creative science of coining drug names. STAT. 08/02/2017. Acessado em agosto de 2021.
Scutti, S. ‘Creation engineering’: The art and science of naming drugs. CNN Health. Última atualização em 25/11/2016. Acessado em agosto de 2021.
Aspirin. Wikipedia. Acessado em agosto de 2021.
Ever Wonder How Drugs Are Named? Read On. Pfizer. Acessado em agosto de 2021.
Fluoxetin. Wikipedia. Acessado em agosto de 2021.
Interbrand Health. Portfólio acessado em agosto de 2021.
Part 2: What’s in a Brand Name? How Drugs Get Their Names. Pfizer. Acessado em agosto de 2021.

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