By Joe Broadmeadow
Somewhere in America, in a glass-walled conference room with a kombucha tap and a whiteboard nobody has fully erased since 2019, a group of highly paid professionals is sitting around a table trying to decide what to call a pill.
This is a real job.
There are firms that do nothing else. They hold meetings. They run focus groups. They charge sums that would fund a small police department for a year, and at the end of the process they hand a pharmaceutical company a word sounding like a Scrabble bag fell down a flight of stairs.
Consider the evidence.
Xeljanz. Rinvoq. Skyrizi. Qulipta. Vraylar. Otezla. Kerendia. These are not medications. These are the names of minor moons in a science-fiction series, or the villains a starship captain negotiates with before the phasers come out.
“Captain, the Skyrizi fleet is hailing us.” “On screen.”
I spent twenty years as an investigator, and I recognize a pattern when I see one. The pattern here is the letter X. Also Z. Also Q, preferably without the U God and the English language intended to follow it. A drug-naming committee regards the letter Q the way a cop regards a confession: pure gold and rarely left alone.
I have tried to reconstruct how these meetings go. I imagine it is something like this.
“We need a name saying healing.”
“Healix?”
“Taken. And too obvious. It sounds like it might work.”
“What about Healyx? With a Y?”
“Better. Now add a Z.”
“Where?”
“Doesn’t matter. Everywhere. Put one in the middle. Make it silent.”
“Zhealyx.”
“Now we’re getting somewhere. Run it through legal.”
To be fair to the naming wizards, they work under constraints most of us never consider.
The name can’t sound like any other drug, because a pharmacist squinting at a doctor’s handwriting might hand you a blood thinner when you wanted something for toenail fungus.
It can’t mean anything rude in Portuguese, Tagalog, or Finnish. It can’t make promises the company’s lawyers would have to defend in court. And it has to be trademarkable, which means it cannot resemble anything being sold at Ikea.
The result is a word engineered to be remembered and impossible to pronounce. You hear it on television forty times a night and still can’t say it at the pharmacy counter. “I’m here to pick up my… Jard… Jar-DEE… the one with the people dancing in the kitchen.”
Which brings me to the commercials.
No one in the modern world is happier than the people in a prescription drug ad. They kayak. They hold grandchildren aloft in slow motion. They laugh at salads. A woman in a sun hat walks through a farmers’ market while an unseen narrator, speaking at the pace of an auctioneer being chased, explains the product may cause dizziness, nausea, unusual dreams, sudden urges to gamble, swelling of the face, tongue, or throat, and in rare cases, death.
Then everyone goes back to kayaking.
My favorite line in the whole genre is “Do not take Zhealyx if you are allergic to Zhealyx.” Thank you. I had planned to take it anyway, out of spite.
The side-effect list often runs longer than the list of things the drug treats, which raises an interesting question of evidence. If a medication for mild itching carries a warning about “thoughts of harming yourself,” I would want to know how many people in the clinical trial were itching that badly.
There is a science to this madness, allegedly.
Certain letters suggest speed, strength, or cutting-edge technology. The X is aggressive and modern. The Z suggests calm. The Q is exotic. Vowels are soft and comforting, which is why a name like Eliquis flows gently off the tongue, like a Renaissance saint who guards the circulatory system.
That is my theory, anyway. Somewhere there is a hidden room where the Order of Saint Eliquis meets with Brother Xarelto and the Venerable Farxiga, and they chant softly in a language only insurance billing departments understand.
There’s a certain genius in it.
Most of us will never meet the men and women who name these pills, but they have accomplished something writers only dream of: they have invented words millions of people repeat every day without the faintest idea what they mean.
I have written many books. Not one of my made-up words has ever been printed on a bottle in a Walgreens.
Still, I’d like to propose a reform. Name the drugs for what they do, in plain English. A sleeping pill called Finally. A cholesterol drug called Put Down the Bacon. An antidepressant called It Gets Better, With Side Effects. And a pill for erectile dysfunction called, simply, Up Yours.
Cue the Fifth Dimension, “Up, Up, and away in my beautiful balloon…” Ask your doctor if Up Yours is right for you.
Until then, I’ll keep watching the kayakers, trying to sound out the names like a man reading an eye chart in a foreign country. And if my doctor ever hands me a prescription for something called Qzyrvanta, I’ll take it.
Right after I ask what it’s for.
Author’s note: I wonder if Ikea trains people to move up to the big leagues of naming drugs?
Any actual medication name is the trademark of its respective company. Who the hell would steal them anyway?
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