Xalkori? Zelboraf? Yondelis? Why New Drug Names Are So Strange

Health and medicine explained.
Aug. 22 2013 2:46 PM

With a Name Like Xalkori ...

New drug names aren’t just bizarre—they’re dangerous.

Xanax
Who says palindromes that begin with X aren't common?

Photo By BSIP/UIG Via Getty Images

What would Don Draper make of Xalkori? Pfizer’s lung cancer drug, released in 2011, has a name that would make an old-school ad wizard scratch his Brylcreemed head.

It begins with one of the least commonly used letters of the alphabet. It’s impossible, at first glance, to know how to pronounce it correctly. It looks like it could be the name of one of the creatures from the Star Wars cantina.

In any other industry, calling your product Xalkori would be the business blunder of the century. But this isn’t any other industry; this is pharma.

“Xalkori is not just a crazy name,” says R. John Fidelino, who, as director of creative at the firm InterbrandHealth, helped bring the word into existence.

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Interbrand is an international marketing consultancy responsible for some of the most strikingly odd words to enter the lexicon in recent years. In addition to Xalkori, Interbrand created Zelboraf, Yondelis, and Horizant. It also helped invent Prozac and Viagra—words that initially seemed bizarre but are now instantly recognizable.

Fidelino walked me through the thought process that leads him and colleagues to a name like Xalkori. Their objectives are twofold: First, Fidelino needs to come up with a name that can be trademarked. (It also helps if the name doesn’t have a negative connotation in any foreign languages.)

His second goal, both more important and more difficult, is to come up with a name that can win approval from the Food and Drug Administration and its counterpart the European Medicines Agency.

The FDA has veto power over the monikers attached to all brand-name prescription drugs sold in the United States. (Generic drug names, which are often even more bizarre than their brand-name counterparts, go through a different and much more complicated approval process.)

When considering a brand name for approval, FDA reviewers run tests to see how likely it is that a proposed name could be mistaken for an already existing drug with a similar-sounding or similar-looking name. They do handwriting tests to catch names that might look alike when scribbled out on a prescription pad. They also reject any names that could be seen as a boast about the drug’s power or efficacy, which is why you won’t see any drugs named Cholesterol Busters, or Angina-B-Gone. (Too bad. I’d love to see a commercial for that one.)

The development of a brand name can take up to five years, Fidelino says, and the FDA usually doesn’t issue its final ruling until 90 days before a drug is scheduled to go to market. “So if you got it wrong, you better have a backup,” he says. “It can be a very expensive process of throwing things at the wall if you don’t think strategically about it.”

When concocting the name for Xalkori, Fidelino and his team wanted something that conveyed how the drug works. It’s one of the first treatments for a rare form of lung cancer that affects nonsmokers, shrinking tumors by blocking a receptor on the ALK gene, which can cause cancer if it malfunctions.

“With Xalkori, we went straight to the science,” Fidelino says.

His team took the gene’s letters—ALK—and added an X in front to signify that this drug targets that gene. Because Xalkori is a specialty drug designed to treat a very rare, very grave disease—not the kind of drug you’d see an advertisement for on TV—Fidelino says it made sense to give it a science-focused name that probably only doctors and scientists would understand.

“When you start to think of it this way,” he says, Xalkori “is actually a language that is uniquely speaking to the physician community.”

“If a brand name is really good, it can do a lot of heavy lifting up front,” says William Leben, an emeritus professor of linguistics at Stanford. “It can arouse our curiosity, or make a long-awaited promise, or change our minds about things, or just make a spectacle of itself.”

Many of the names of drugs now on the market would seem, at first glance, to be aiming for that last category: Zosyn, Ziac, Qnasl, Xeljanz, Isentress, et al., ad infinitum.

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