What Can Abbott and Costello Teach Us About the Naming of Drugs?

The naming of drugs is a serious business, but comparing it to a famous comedy routine can make us both laugh and reflect on the impact of names.

If a patient tells a hospital he is taking one drug because he confuses it with another, or if a tired health professional makes a similar mistake, that can have life-threatening consequences. The naming of biosimilars and of interchangeable biosimilars has also generated discussion because some have asked that the biosimilar and the original biologic have the same name while the Food and Drug Administration wants them to have the same name as their active ingredient with each carrying an additional randomly selected four-letter suffix—see my article here.

My Bloomberg BNA colleague Anandashankar Mazumdar has written a series of articles—see one here—on a copyright dispute over Abbott and Costello’s classic comedy routine “Who’s on First?” about the names of baseball players.

Abbott: Strange as it may seem, they give ballplayers nowadays very peculiar names.

Costello: Funny names?

Abbott: Nicknames, nicknames. Now, on the St. Louis team we have Who's on first, What's on second, I Don't Know is on third—

Costello: You know the fellows' names?

Abbott: Yes.

Costello: Well, then who's playing first?

Abbott: Yes.

Costello: I mean the fellow's name on first base.

Abbott: Who.

Costello: The guy on first base.

Abbott: Who is on first.

Costello: Well, what are you askin' me for?

For some reason, maybe because of the stories about the lawsuit concerning the duo’s routine, it made me think about how it would apply to the issue of the naming of drugs and biologics.

Abbott: We have a whole lot of prescription medicines on our team and so there’s lot of names, some of which sound a little alike, like Allegra, Viagra, Arista, Arixtra, Benzepril, Benadryl, Cidex, Cedax, Leukeran, Alkeran, Amicar, Omacor, Prozac, Prograf—

Costello: So Allegra is the fellow on second base.

Abbott: Viagra is the guy on second base.

Costello: I thought Viagra was on first.

Abbott: He’s on third.

Costello: I’m not askin’ who’s on third.

Abbott: Asedin’s in left field, he just joined the team.

Costello: Boy, I got a migraine! I could use some Topamax.

Abbott: He’s our shortstop! Unless you mean Toprol-XL, and she’s pitching.

Another version could be for biologics and their biosimilars.

Abbott: The only players on our team are biologics and biosimilars: there’s filgrastim, filgrastim-sndz, infliximab, infliximab-dyyb, infliximab-abda, etanercept, etanercept-szzs, adalimumab, adalimumab-atto.

The Food and Drug administration is working to prevent and eliminate look-alike/sound-alike medication names, but they still cause medication errors. The Institute for Safe Medication Practices has developed a list of medication pairs that have been involved in medication errors.

As new types of medications are developed, the issue of naming takes on increasing importance.

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