CAROLINE O’DWYER, marketing manager, Johnson & Johnson.MSD, replies:

The purpose of the man featured within the Zocor Heart-Pro advertising is to represent someone who may benefit from being recommended an over-the-counter statin. Such individuals are appropriate for a recommendation if they have a 10–15 per cent (or one in 10 to one in seven) risk of a heart attack in the next 10 years, and can be identified by assessing their age and the presence of specific risk factors for heart disease. These criteria are clearly stated within the advertising text. The advertising also directs individuals to discuss their risk status and eligibility for Zocor Heart-Pro with their pharmacist as a key next step.

The headline of the advertisement makes it clear that this individual is 45 years old. Age is the major driver for cardiovascular risk: men from the age of 45 years and women from the age of 55 years have steeply increasing risk in the remaining decades of life. This “baseline” risk is 10–15 per cent for the male population over 55 years. However, for younger men, ie, those 45 years and over, a further risk factor is required before the risk would fall into this category. Although it is obvious from the visual that this individual does not qualify as a result of being overweight, it is entirely possible that he may qualify as a result of having a family history of early heart disease, or alternatively that he is a smoker (current or has given up within the past five years).

If an individual aged 45 presents without other risk factors for CHD, then it is appropriate that a pharmacist alert the individual to the fact that their risk level is not high enough to justify treatment with Zocor Heart-Pro, and encourage the individual to continue with their healthy heart lifestyle. Rather than find the pharmacist “unfeeling” or “unprofessional monsters”, it is more likely that the customer would be relieved to hear this advice.

In summary we believe our national press advertising campaign is a responsible and measured attempt to increase awareness of CHD risk among the population most likely to benefit from reducing that risk. This population is clearly defined within the text of the advertisement, and readers are directed to check with a pharmacist to ensure that the product is right for them. It is also important to note that all of our advertising material has been approved by the Medicines and Healthcare products Regulatory Agency as being in line with the summary of product characteristics for Zocor Heart-Pro. Furthermore the advertising material has also been fully reviewed by the Proprietary Association of Great Britain for compliance with the self-medication industry’s codes of practice for over-the-counter medicines.