The makers of medical products are finding subtle and sophisticated new ways to target kids — a demographic that can bring them hefty profits now, and could grow up to be loyal, even more lucrative, adult customers.

Drug and device companies have been trying to reach kids for decades, but a STAT examination has found that these efforts are taking new forms. Medical companies are bankrolling classroom lesson plans and comic books, hosting events with costumed characters, and promoting smartphone apps. It’s all aimed at teaching children and teens about certain health conditions — conditions for which there just happen to be treatments marketed by the companies sponsoring the outreach.

Companies frame their efforts as a service to kids. But they also bring benefits to the company: Children might ask their parents for a certain medicine just as they would a cereal brand. And kids are valuable customers. The percentage of American children and teens taking prescription drugs has stayed fairly steady over the past two decades, but insurance companies are forking over more money for their pills.

advertisement

Some of the initiatives are raising alarm among critics who say they’re indistinguishable from marketing.

“Health information should come from experts, not from people who are trying to make money,” said pediatrician Dr. Victor Strasburger, who has studied the effects of media on children and teens. “Drug companies obviously have a conflict of interest when it comes to what they’re going to say.”

advertisement

Some doctors and educators, however, say these initiatives play an important role. High-quality educational materials developed or funded by a drug company, for instance, can be “wonderful timesavers” and “very useful tools,” particularly for a time-strapped health teacher, according to Jeanie Alter, who sits on the board of the American School Health Association.

Here are some of the ways kids are interacting, directly or indirectly, with medical companies.

Your Pfizer-sponsored homework is due on Monday

The worksheets prompt high schoolers to report on recent meningitis outbreaks on college campuses, or answer a true-false quiz about the bacterial disease. At the bottom of every page: “Check with your doctor about getting vaccinated,” beside a small Pfizer logo. They’re sponsored by the drug maker, which markets one of two vaccines protecting against meningitis B. (Sally Beatty, a Pfizer spokesperson, said the company works “with a wide range of healthcare providers and health authorities to raise awareness of the disease” and the new availability of vaccines.)

The over-the-counter acne product brand Clearasil, owned by the consumer goods giant Reckitt Benckiser, has sponsored handouts on puberty for seventh- and eighth-grade girls and boys. And another older set of worksheets, which instruct grade-schoolers to color and unscramble the names of body parts, have small images of Neosporin and Band-Aids at the bottom of each page. The sponsor? The health care giant Johnson & Johnson, the maker of those products.

It’s not clear how widely used these lesson plans are in classrooms: Young Minds Inspired, the marketing agency that works with corporate sponsors to develop these and many other lesson plans, didn’t respond to questions about feedback it’s received from health teachers.

Alter, who works with K-12 teachers on public health and prevention issues in her role at Indiana University Bloomington, said the realm of corporate-sponsored educational materials can be “tricky to maneuver.” Her advice to health teachers: assess whether the corporate sponsor’s objectives are educational. And be wary of materials overtly trying to sell a particular product.

A scene from “What’s up with Josh?”, a comic book about ADHD developed by Medikidz and sponsored by Shire. STAT

This comic book brought to you by Shire

The superheroes have names like “Skinderella” and “Gastro.” They hail from a planet shaped like the human body. And they’re the stars of a series of several dozen comic books aimed at explaining medical conditions like ADHD, type 1 diabetes, and growth hormone deficiency.

The books are produced by a company called Medikidz, which uses doctors to write and peer-review each edition. More than 3.5 million of the books have been distributed globally. Drug companies (as well as other organizations) often sponsor editions; the sponsor’s logo sometimes appears on the back cover.

Sponsors contribute funding and input on storylines. But Adam Schaeffer, a spokesperson for Medikidz, said that all the company’s content is “free of conflict of interest” and that there is never any mention of a specific medication.

In practice, the final product tends to be pretty nuanced. Take ADHD, a condition for which many in the medical community worry that kids are overmedicated. An ADHD-themed comic book — sponsored by Shire, which markets several ADHD drugs — does extol the potential benefits of medication, but it also talks about side effects and advocates therapy and counseling.

An online comic sponsored by Horizon Pharma, which makes several urea cycle disorder medications, is also fairly measured: A superhero explains that medication for the condition is available in powder, tablet, or liquid form, but that “the doctors will keep a close eye on you to make sure your treatment is working.” (Geoffrey Curtis, a spokesman for Horizon, said the company saw the sponsorship as “an innovative, fun approach to educating children” and has received an “extremely positive” response.)

A Saturday on the DePuy Synthes campus

Companies that make medical products aren’t just reaching kids where they are — they also sometimes draw kids to them.

For instance, on a Saturday earlier this spring, DePuy Synthes, a unit of Johnson & Johnson that markets products used in scoliosis procedures, hosted about a dozen teenagers with scoliosis at its sprawling corporate campus south of Boston. The agenda: A day of educational conversations about the spinal condition — and sandwiches and chicken fingers for lunch.

Costumed Medikidz superheroes entertained younger siblings while young scoliosis patients and their parents learned about resources and listened to expert panelists. Hannah Koval, a friendly 14-year-old who has scoliosis, talked about her experiences and demonstrated some breathing exercises she does.

“It’s nice to be there where there are other people who’ve gone through the same things you have,” she said as she left the day’s event with her dad, Paul, with a Medikidz comic book in her bag.

A selection of Medikidz comic books. STAT

Direct-to-teenager advertising

Pharma companies aren’t widely targeting children with drug ads. But a STAT review of ads for over-the-counter acne medicines show that their makers aren’t shy about explicitly targeting teens — particularly during prom season.

And that’s caught the attention of the FDA, enough so that the agency launched a study to understand how teens perceive risks and benefits from ads for acne and ADHD drugs. The agency is now analyzing the results and plans to announce what it learns, according to FDA spokeswoman Sarah Peddicord.

Newsletters Sign up for Pharmalot Your daily update on the drug industry. Please enter a valid email address. Privacy Policy Leave this field empty if you're human:

Then there are the many ads aimed at adults that get seen by kids anyway. Drug industry group PhRMA tells its members that ads “containing content that may be inappropriate for children should be placed in programs or publications that are reasonably expected to draw an audience of approximately 90 percent adults.”

That doesn’t always happen. A 2013 study found that children viewed TV ads for erectile dysfunction drugs Viagra, Cialis, and Levitra an estimated 30 billion times between 2006 and 2010.

‘Siri, launch the Sanofi app’

Kids spend increasing amounts of time on their phones — so it’s only natural that companies marketing medical products would find ways to reach them at their fingertips.

In March, the over-the-counter skin care brand OXY (owned by the Mentholatum Company) launched a smartphone app promoting a “28 day challenge” to help kids clear up their acne in time for prom. Users can get coupons, set up daily alerts reminding them to use OXY products, and snap photos of their faces before and after the challenge. (“We want to make sure students know that OXY has an effective regimen to get clear skin in time for such a BIG day,” an OXY executive said in a press release announcing the promotion.)

There are smartphone apps for more serious conditions, too. Drug maker Sanofi has released games aimed at kids with type 1 diabetes, a condition for which it markets treatments. There’s “Monster Manor,” which turns blood glucose monitoring into a game set in a creepy mansion, and “Mission T1D,” which gives players tips about managing their condition as they navigate through a school.

Video games sponsored by the makers of medical products might sound distinctly of the iPhone age, but in fact they have a long history: In 1983, Johnson & Johnson put out a oral hygiene-themed video game called “Tooth Protectors.”