Lesson 1: A couple Swedes came up with the first commercial test for measurement of IgE – a “RAST”. Then, a Texan and a New Jersey doc improved it and made it clinically relevant – and called it a Modified RAST. The Swedes started losing their shirts, not to mention their national pride. Testing was automated in the 90s by both Hycor and Pharmacia, and both companies came up with their own EIA tests (not “RAST”). Pharmacia fixed their automation problem, but not their sensitivity problem, because EIA has never been more sensitive than Modified RAST.
Lesson 2: Most companies guard their brand names jealously. “RAST” and “ImmunoCAP” are Pharmacia brand names. But Pharmacia came up with a creative marketing solution and a study to distance themselves from their original RAST, while at the same time lumping everyone else under that name: ImmunoCAP (an EIA test) was an improvement on Pharmacia’s own original “RAST” test (which lacked sensitivity), but it wasn’t an improvement on Hycor’s Modified RAST (which always had superior sensitivity). The marketing solution to Pharmacia’s problem was to distance themselves from their own “RAST” brand name, while emphasizing their “ImmunoCAP” brand name, and then label (“libel”) all their competitors’ tests as “RAST”, regardless of whether they are modified-RAST, new RIA, or EIA technologies. Of course, only the original Pharmacia RAST performed poorly, but Pharmacia did not let facts interfere with marketing, and they have been able to thoroughly confuse physicians about the performance characteristics of RIA, EIA, and more recently, advanced chemiluminescent technology. With more creative marketing, including giving away instruments at a convention in the late 90s, Pharmacia managed to increase their US market share, especially by promoting testing to primary care physicians. Since 2000, Pharmacia has been confusing physicians with a Williams et al. study that didn’t evaluate LabCorp’s current RIA test, or Hycor’s EIA test, and was cited as having “critical scientific and statistical flaws.”