– April 10, 2018

The era of blockbuster prescription drugs has given us indelible brand names like Prozac and Viagra, but in the past few years things have gotten truly bizarre. The list of new drugs approved by the FDA in 2017 includes Bevyxxa, Mepsevii, Kymriah, and Zejula. I’ve cherry-picked my favorites, but I challenge you to find a single name on the lengthy list that’s easy to remember, let alone pronounce. It’s difficult to ask your doctor about Gocovri or Qtern when the name lacks precedent in English or any other language.

These names emerge from the perfect storm that can only be created when complex government regulation, big corporations, and high-priced consultants come together. Regulation often starts with a well-meaning attempt to solve a real problem, in this case the large number of deaths that result from errors in prescribing, dispensing, and taking prescription drugs. It’s easy to understand why the FDA wants drug names to be novel: naming a new drug Brozac would lead to obvious mistakes.

But how does the FDA ensure new drugs’ names are novel? It checks each syllable, or “stem,” of the proposed name against a database of existing names. It looks at handwritten samples and listens to people with various accents pronounce the name. And this is after drug companies have already gotten chemical and generic names that comply with rules from the International Union of Pure and Applied Chemistry and the United States Adopted Name Council.

Pharmaceutical companies spend millions every year on “brand engineering” firms, consultants that navigate the labyrinth of regulations and develop names that remain novel as new drugs are approved in record numbers. The letters q, x, and z come up in new drug names 3, 16, and 19 times more frequently, respectively, than in the English language. In an attempt to prevent situations in which names sound confusingly similar, the FDA has created a system in which patients and doctors must remember names like Vyxeos, Mavyret, and Haegarda. What could possibly go wrong?

The unintended consequences of regulating drug names don’t stop with the names themselves. Regulators often create complex sets of rules in part to check the power of large corporations but end up providing incentives for those companies to get even larger. Big companies have the resources to anticipate and get around regulatory hurdles while smaller companies struggle to comply. Companies sink millions of dollars more into the already-expensive R&D process that leads to high drug prices.

Government regulations are often attempts to protect people from direct harm, but they risk distorting the market in ways that indirectly harm people more than they help. The scrutiny under which the FDA places new drug names is a well-intentioned attempt to protect people from taking the wrong drug. But in practice the rules lead to bizarre drug names that may result in more human error, and while contributing to higher drug prices and larger firms.

Max Gulker

Max Gulker

Max Gulker is an economist and writer who joined AIER in 2015. His research focuses on two main areas: policy and technology. On the policy side, Gulker looks at how issues like poverty and access to education can be addressed with voluntary, decentralized approaches that don’t interfere with free markets. On technology, Gulker is interested in emerging fields like blockchain and cryptocurrencies, competitive issues raised by tech giants such as Facebook and Google, and the sharing economy. Gulker frequently appears at conferences, on podcasts, and on television. Gulker holds a PhD in economics from Stanford University and a BA in economics from the University of Michigan. Prior to AIER, Max spent time in the private sector, consulting with large technology and financial firms on antitrust and other litigation. Follow @maxgAIER.

Get notified of new articles from Max Gulker and AIER.