December 4, 2023

This week, the world simultaneously got yet another weight-loss drug and a reason to wonder why pharmaceuticals have the names they have. Zepbound is the name that multibillion-dollar pharmaceutical company Eli Lilly has chosen to brand its newly FDA-approved obesity-fighting injection. Zepbound?

“It sounds like if we had a word for your jeans being too tight. ‘Ugh, i’m zepbound by these jeans!’ ” observed one person on X. Others likened it to a ’70s cover band, a character from The Hitchhiker’s Guide to the Galaxy, and an “off-brand bus line.”

Who stuck us all on the Zepbound Express? To answer that, I reached out to a few people involved in creating and vetting drug names. Naming teams typically get brought in two or three years before the anticipated launch of a drug if Phase 2 trials are making a pharmaceutical company feel optimistic. The process, it turns out, is a bit different depending on whether it’s the brand-name version of the drug—like Lipitor—or the generic version, like atorvastatin. And ultimately, the same active ingredient can receive multiple names. The newly branded Zepbound, which will now be prescribed for weight loss, has been available as Mounjaro, a diabetes medication, since 2022. Both had to get approved by the U.S. Food and Drug Administration’s Office of Prescription Drug Promotion, which is focused, among other things, on making sure that drug names aren’t excessively promotional.

Super- and ultra- are off limits, for example, Dr. Peter Rheinstein, who has long been involved in drug naming, explained to me. Decades ago, as an official at the FDA, he rejected the name Regaine for the drug we now know as Rogaine since there was no evidence, at the time, that people regained their hair.

Tirzepatide, the generic name for the active ingredient in Zepbound and the likely inspiration for the Zep part, had to meet the criteria of a different group: the United States Adopted Names Council. (Rheinstein is the chair.) This group makes sure that generic drugs abide by specific naming requirements. Some rules have to do with chemical structure. Others have to do with letters. (And again, these apply only to generic drugs.)

“You can’t use ph, you have to use f, for whatever reason, and the letter k is off limits,” lamented Nancy Globus, the vice president of regulatory and medication safety for Addison Whitney, a branding firm that has named many drugs. Neither can you use sta- at the beginning, “because it might suggest some sort of chemical compound,” Jenna Wise, the associate creative director for verbal design at Addison Whitney, told me. Globus and Wise were part of the team that named Wegovy and Ozempic, Zepbound and Mounjaro’s primary competitors. Globus and Wise talked to me in a joint video interview this week about the process of creating a brand-name drug name. (No offense to Eli Lilly. I would gladly have spoken to the people who came up with Zepbound, which I personally think sounds like an intergalactic pogo stick. But they were out until next week, according to a spokesperson for Eli Lilly.)

This interview has been edited and condensed for clarity.

Heather Tal Murphy: So, what does a pharma company first tell you about a drug they want you to name?

Jenna Wise: It’s very technical: Here’s the science; here’s what we hope it does. We want the name to communicate this message. In the case of something like Ozempic [which she helped name about seven years ago], they might come to us and say, This needs to say achievement or victory, and help us explore names that evoke that sense. So for Ozempic, it does have that kind of Olympic-achievement message kind of automatically built in.

So then how do you come up with the name? 

Wise: It is a lot of individual brainstorming on the part of the team. We might be researching—you know, if a team wants something like victory or achievement, we’re thinking about not just the literal word achieve or goal or victory. We’re thinking about, What are some symbols of those things? And it’s just a matter of putting these letters together and creating this word that doesn’t really say anything.

So it can’t be an existing word. What are other rules for brand-name drugs?

Nancy Globus: Drug naming is different from naming or branding any other consumer product, like a soda or a car, because the names need to be reviewed and approved by regulatory bodies like the FDA. And they have the purview to be able to reject a name based on whether or not they think that name is promotional. And so you can’t name your drug Superdrug. They can also reject a name because it is too close to another name—those two names could get confused and the patient could get the wrong drug. Xanax and Zantac have existed on the market together for a really long time, and there have been many instances where confusion has occurred due to the names being too similar. We also have to take into consideration trademark restraints. We also take a look at linguistics to make sure that we’re not saying a bad word in Italian or wherever.

Wise: It can’t look too much like another drug [either], and by looking, that includes in the doctor’s handwriting.

So you guys come up with a name, and then what happens? 

Wise: Unfortunately, we do not live in a Mad Men world when it comes to pharma naming. I wish that we could just show three names. Sometimes we’re presenting 200 names to a client over the course of several months. And then we have to take that list of names and see what survives other testing, such as marketing evaluations. Every step along the way, it’s almost like Survivor—names are getting voted off the island.

“Every step along the way, it’s almost like Survivor—names are getting voted off the island.”

How do you know when you’ve found the right name?

Wise: I think the client is expecting the brand name to just magically jump off the page. But that just is not the reality of it. Like Skyrizi, for example, for psoriatic arthritis. That was one that the client team was looking at, and it was just that kind of, like, middle-of-the-road feeling. But then, by the end of the process, the more they hear the name, the more it’s like, These resilient survivors, reaching the end. They get so excited about the name. Now other people that we work with are like, “We want the next Skyrizi.”

How long does it take to get through the FDA approvals? 

Usually three to six months. And then it’s still not public knowledge until the entire product gets approved.

And is there one name for either of you that makes you jealous? Like, you know, in my world of journalism, there are certain stories by colleagues that are like, That’s the best story ever. I wish I’d written that. Is there a name for either of you that you hear it and you’re like, I wish I came up with that?

Globus: Speaking about this whole diabetes and weight-loss category, one that was not ours that I happen to think is a really strong name is, um, Victoza. [Editor’s note: Victoza is a diabetes treatment that has not been approved for weight loss, but some doctors have started prescribing it for that purpose. The FDA has given the drug a black box warning for thyroid cancer risk.]

That does sound like victory. I’m surprised that it got through. 

Globus: So, you know, there’s—there’s definitely some envelope-pushing that goes on. I happen to think that is a really strong name. I wish that one were ours.

Wise: One that I love is Jardiance. [Editor’s note: Jardiance is another diabetes drug.] But when Jardiance came out, I was like, I just think it’s so beautiful because it’s like, you get the radiance, you get dance. Um, the French word for garden—jardin—is in there, so it’s very colorful and there’s just so much beautiful, elegant energy to it.

I’m here to make you feel better about it by telling you it sounds like Giardia (as in the parasite that causes stomach problems.) Giardia is not a fun connotation.

Wise: No, it is not at all.

How much do you get paid for naming? 

Wise: I mean, it’s very much an investment. We would have to ask our team if we could say a range for you.

I’m just curious if it costs the pharma company tens of thousands of dollars or millions of dollars. 

Globus: There are always variables. Not millions. It’s in the five-to-six-figures range.

Do you think you could be replaced by A.I.?

Wise: I am not worried. Right now I use A.I. kind of as another team member who just happens to know everything. There is more of a human element at every stage of the naming process than I think most people realize. It would be difficult to be wholly replaced, at least this early in the A.I. game.


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