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Tuesday
2 November, 2021
top stories
1. Introducing Marketing Rx and why pharma marketing matters. Pay attention biotechs, it’s not just for Big Pharma anymore
2. Q&A: Moderna’s chief brand officer on navigating the Covid-19 spotlight and charting the biotech brand’s future
3. Migraine marketing wars? AbbVie, Biohaven, Eli Lilly, Amgen lead push for attention in newly competitive space
4. Novo Nordisk bets big on obesity: Can marketing help it succeed in the notoriously tough therapy area?
5. Marketing Rx roundup: J&J boosts health equity goals in 6-city challenge; Allergan Aesthetics kicks off breast cancer efforts
6. Looking to win back investor confidence, BioMarin preps for its ‘largest launch’
7. Endo taps bent veggie in first Xiaflex brand campaign for Peyronie's disease curved erection condition
8. Is that drug ad for me? People pay more attention to pharma DTC for familiar conditions, study finds
9. Bausch Health’s Salix pilots study to shine light on chronic liver disease and push back on stereotypes
10. Novartis in hot water again over alleged kickbacks, revealing new DoJ probe related to Entresto
11. Teva appeals to court to keep 'incredibly damaging' Hollywood parody videos under wraps in New York opioid case
Beth Bulik
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Welcome to the first issue of Endpoints Marketing Rx. We’ll be dropping into your inbox every Tuesday afternoon with executive interviews, trends, features and news from the pharma marketing and drug commercialization world. Sign up here for weekly delivery, and feel free drop a line with news, tips or ideas to bbulik@endpointsnews.com.

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Beth Bulik
Senior Editor, Endpoints News
@BethSBulik
1
by Beth Snyder Bulik

Wel­come to End­points Mar­ket­ing Rx, the new week­ly about phar­ma mar­ket­ing, ad­ver­tis­ing and drug com­mer­cial­iza­tion.

The newslet­ter launch begs an old ques­tion though: what is phar­ma mar­ket­ing and why does it mat­ter?

To some peo­ple, phar­ma mar­ket­ing is the ex­clu­sive play­ground of Big Phar­ma com­pa­nies try­ing to one-up each oth­er on main­stream TV with celebri­ty spokes­peo­ple and big ad bud­gets. Oth­ers look at the up-and-com­ing hip op­po­site end of the spec­trum where new brands with shoe­string bud­gets get cre­ative on so­cial me­dia chan­nels with pa­tient in­flu­encers and PR plays.

The an­swer is yes. Phar­ma mar­ket­ing is big-bud­get TV. Al­though it’s been a few years since a phar­ma com­pa­ny ad­ver­tised on the $5.5 mil­lion for 30-sec­ond Su­per Bowl show­case, phar­ma brands spend more than $6 bil­lion every year on na­tion­al TV ad­ver­tis­ing.

Phar­ma mar­ket­ing is al­so small bud­get so­cial me­dia tar­get­ing, word-of-mouth pub­lic re­la­tion push­es and lo­cal city-to-city events to get a drug no­ticed or raise aware­ness of what may be a rare or lit­tle-known con­di­tion.

It's al­so health­care provider mar­ket­ing with sales reps and com­mu­ni­ca­tions that speak di­rect­ly to physi­cians — which at around $30 bil­lion ac­tu­al­ly dwarfs con­sumer spend­ing.

Yet there re­mains a stig­ma in the in­dus­try that ad­ver­tis­ing, or even overt­ly mar­ket­ing, a ther­a­py is un­seem­ly. The pre­vail­ing at­ti­tude bor­rows the mantra of a well-known mag­i­cal base­ball movie: “If you build it, they will come.”

No, they won’t.

Even in rare dis­ease where a treat­ment may have a built-in au­di­ence, if the pa­tients and fam­i­lies nev­er hear about it, it won’t suc­ceed.

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Kate Cronin, Moderna's first chief brand officer
2
by Beth Snyder Bulik

It’s prob­a­bly not an ex­ag­ger­a­tion to say that all eyes in the mar­ket­ing world are on Kate Cronin. Maybe not specif­i­cal­ly on Cronin by name, but most def­i­nite­ly on the Mod­er­na brand she is shep­herd­ing as the biotech’s first chief brand of­fi­cer.

An Ogilvy ad­ver­tis­ing agency vet­er­an where she was most re­cent­ly CEO of Ogilvy Health, Cronin has craft­ed strate­gies and cam­paigns for many Big Phar­ma brands. But Mod­er­na is dif­fer­ent. The biotech is not on­ly a new­com­er to the pub­lic per­cep­tion stage but al­so joins with what may be one of the most high-pro­file prod­uct de­buts in his­to­ry. Mod­er­na’s COVID-19 vac­cine — its one and on­ly com­mer­cial prod­uct to date and still un­der emer­gency ap­proval — has pro­pelled the com­pa­ny in­to the white-hot spot­light of con­sumer opin­ion and sky­rock­et­ed it up the charts of in­vestor es­ti­ma­tion.

In fact, Mod­er­na’s cur­rent es­ti­mat­ed $140 bil­lion mar­ket val­u­a­tion puts it in the con­sumer mega-brand ter­ri­to­ry of Star­bucks, Volk­swa­gen and Amer­i­can Ex­press. Its clos­est bio­phar­ma com­par­i­son, BioN­Tech, has sim­i­lar mR­NA sci­ence and a COVID-19 vac­cine de­but as well, but BioN­Tech ben­e­fits from the mar­ket­ing, man­u­fac­tur­ing and dis­tri­b­u­tion prowess of 50/50 part­ner Pfiz­er.

So how is Cronin build­ing a brand with the whole in­dus­try watch­ing, while con­tin­u­ing to help to save the world from a dead­ly virus and still get home in time for the oc­ca­sion­al fam­i­ly din­ner?

Cronin, now just a few months in­to the role, brings a broad port­fo­lio of mar­ket­ing ex­pe­ri­ence, wis­dom from men­tors in­clud­ing ad in­dus­try lu­mi­nary Shelly Lazarus, and a reen­er­gized pur­pose and af­fa­ble sense of hu­mor.

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3
by Beth Snyder Bulik

For a long time, mi­graine suf­fer­ers were stuck with the same old med­i­cines and ad­vice. Try some trip­tans, change your di­et, maybe even see if a nar­cot­ic might help — but no ma­jor drug ad­vances to pre­vent or stop de­bil­i­tat­ing mi­graine episodes in al­most 30 years.

Fast for­ward to 2021. With sev­en new drug ap­provals in the past three years, the once-mori­bund mi­graine mar­ket is sud­den­ly com­pet­i­tive. That’s good news for pa­tients be­cause the new meds from Ab­b­Vie, Bio­haven, Eli Lil­ly, Am­gen, Te­va and Lund­beck of­fer a va­ri­ety of de­liv­ery meth­ods and few­er side ef­fects.

How­ev­er, for the phar­ma com­pa­ny that makes the drugs, the in­creased com­pe­ti­tion cre­at­ed a new chal­lenge — how to make their brands stand out in the now-crowd­ed field?

Wel­come to the mi­graine mar­ket­ing wars. Mi­graine drug brands are an­gling for at­ten­tion and mar­ket share by craft­ing mar­ket­ing and ad­ver­tis­ing strate­gies to make sure con­sumers and physi­cians know who they are — and why they’re bet­ter than the oth­ers.

The com­pe­ti­tion is es­pe­cial­ly ap­par­ent in ad­ver­tis­ing spend­ing over the past years. Na­tion­al TV com­mer­cial spend­ing in the mi­graine cat­e­go­ry, for in­stance, went from $32 mil­lion in 2018 to $150 mil­lion in 2019 to al­most $230 mil­lion in 2020, ac­cord­ing to da­ta from re­al-time TV ad track­er iS­pot.tv.

Dig­i­tal ad spend­ing is on the rise, too, as mi­graine mar­keters look to reach a typ­i­cal­ly younger pa­tient tar­get au­di­ence that spends much more time with dig­i­tal me­dia than tra­di­tion­al TV. Dig­i­tal ad bud­gets among the sev­en new­er meds col­lec­tive­ly topped $25 mil­lion in 2021 so far this year, a 20% bump com­pared with the same time pe­ri­od last year, ac­cord­ing to da­ta pro­vid­ed by ad spend­ing an­a­lyst firm Path­mat­ics.

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Queen Latifah (Novo Nordisk)
4
by Beth Snyder Bulik

Queen Lat­i­fah is done. With weight jokes, judgy peo­ple, self-hate and a com­plic­it me­dia. No­vo Nordisk’s newest face — and body — for an­ti-obe­si­ty aware­ness lays out the strug­gles in a se­ries of video vi­gnettes that nev­er even men­tion the word obe­si­ty.

The un­brand­ed work aims to change the nar­ra­tive around obe­si­ty, fram­ing it as a man­age­able health con­di­tion in­stead of a char­ac­ter flaw. The new cam­paign de­buts as No­vo Nordisk has be­gun rolling out We­govy, the glucagon-like pep­tide (GLP-1) drug semaglu­tide to treat obe­si­ty. If the gener­ic name sounds fa­mil­iar, that’s be­cause We­govy is the same med as Novo's type 2 di­a­betes Ozem­pic but at a high­er dose. Di­rect-to-con­sumer brand ads are in the works for next year.

In one of the aware­ness sketch­es, Queen Lat­i­fah meets up with a friend for lunch while an ob­nox­ious laugh track blares in the back­ground. A wait­ress looks up and down at her “big-boned” friend as she or­ders, and again when the friend makes jokes about cab­bage soup. Fi­nal­ly, Queen Lat­i­fah says “Enough … The amount of times I’ve yoyo’d with my weight and hat­ed my body and just gave up? I can’t even count them. But this is big­ger than us, and our DNA is part of it.”

The up­shot? It’s not your fault. Ge­net­ics, bi­ol­o­gy, hor­mones and en­vi­ron­ment play key roles. Obe­si­ty is, as the cam­paign is ti­tled, “Big­ger than me.”

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5
by Beth Snyder Bulik

John­son & John­son is look­ing for big ideas from small en­tre­pre­neurs. Spurred by the pan­dem­ic health in­equities and on­go­ing racial in­jus­tice in lo­cal com­mu­ni­ties, J&J is run­ning a new in­no­va­tion chal­lenge in six hard-hit cities. And there will be lots of win­ners. With $1 mil­lion to dis­trib­ute, awards won’t top more than $75,000 each, Seema Ku­mar, J&J’s VP of in­no­va­tion, glob­al health and pol­i­cy com­mu­ni­ca­tions told End­points Mar­ket­ing Rx. Not be­cause J&J is be­ing stingy, but be­cause it wants to fund as many ef­forts as pos­si­ble of course, but al­so be­cause it doesn’t want to over­whelm the small en­tre­pre­neurs and com­mu­ni­ty or­ga­niz­ers it’s hop­ing to ap­ply.

With just ten days left un­til the Nov. 12 sub­mis­sion dead­line, J&J has al­ready re­ceived 110 en­tries but an­tic­i­pates more. As a J&J spokes­woman not­ed in J&J’s long-stand­ing Quick­fire in­no­va­tion chal­lenges, peo­ple tend to work long and hard on the ap­pli­ca­tion un­til the last minute with about half of the en­tries sub­mit­ted with­in the last 48 hours.

“Peo­ple al­ways knew health in­equities ex­ist­ed, but COVID brought it to light and made it un­avoid­able to see,” Ku­mar said re­fer­ring to the dis­parate neg­a­tive out­comes in many com­mu­ni­ties of col­or. “In six cities last year, the gap was just gi­nor­mous. And we want­ed to do some­thing about it.”

Ap­pli­cants are in­vit­ed to sub­mit so­lu­tions in pre­ven­tion and treat­ment of ill­ness, in­creas­ing eq­ui­table ac­cess to health­care, grow­ing di­ver­si­ty in sci­ence, and cre­at­ing more trust­ed com­mu­ni­ty-based care.

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Jean-Jacques Bienaimé (BioMarin via Youtube)
6
by Beth Snyder Bulik

Bio­Marin is ready to launch the first drug to treat achon­dropla­sia, the most com­mon form of dwarfism, in Vox­zo­go – it just needs an FDA green­light.

The US com­mer­cial team is plan­ning for Vox­zo­go’s launch at the end of the year with an “ex­pe­ri­enced” sales force al­ready in place, Bio­Marin ex­ecs told an­a­lysts in its quar­ter­ly call this week. The bio­phar­ma is al­so work­ing with the FDA on late-stage la­bel­ing and post-mar­ket­ing re­quire­ments.

That’s as­sum­ing FDA ap­proval next month of course. Vox­zo­go’s FDA dead­line date in Nov. 20.

Con­cur­rent with the US prep plans, Vox­zo­go is al­ready rolling out in Eu­rope af­ter a late Au­gust EMA ap­proval. So far, sales there have “ex­ceed­ed ex­pec­ta­tion,” Bio­Marin chair­man and CEO Jean-Jacques Bi­en­aimé said.

Al­though Bio­Marin record­ed a small num­ber of sales ($100,000) from the first pa­tients in France un­der treat­ment by third quar­ter’s end, more pa­tients have start­ed re­cent­ly in France and ship­ments are now out to Ger­many and Switzer­land for new pa­tients there, it said.

In the US, Bio­Marin is en­cour­aged by “ear­ly in­di­ca­tors of prod­uct de­mand,” Bi­en­aimé said, not­ing the ap­proval would “set the stage for sig­nif­i­cant rev­enue growth start­ing in 2022.”

An­a­lysts agreed, not­ing a Vox­zo­go nod would go a long way in restor­ing in­vestor con­fi­dence in Bio­Marin af­ter last year's shock­ing FDA push­back on its as­sumed shoo-in Roc­ta­vian, a he­mo­phil­ia A gene ther­a­py.

Cowen an­a­lysts said in a note that “Vox­zo­go's US ap­proval fol­lowed by a sol­id launch will be­gin to change opin­ions,” and pre­dict­ed in­vestor op­ti­mism will con­tin­ue to build around that through the sec­ond half of 2022.

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A bent carrot takes center stage in Endo's first brand ads for Xiaflex to treat Peyronie's disease (Endo International)
7
by Beth Snyder Bulik

En­do's last trip to the gro­cery store en­list­ed a va­ri­ety of pro­duce to raise aware­ness about curved erec­tions in Pey­ronie’s dis­ease. Now in its first brand­ed cam­paign for Xi­aflex, En­do set­tles on just one veg­etable — a car­rot.

The bright or­ange vi­su­al is meant to be sim­ple and strik­ing, con­tin­u­ing to re­mind men they’re not alone, but al­so dodg­ing stri­dent net­work cen­sors and in­tro­duc­ing the brand name for the first time, En­do's ex­ec­u­tive di­rec­tor of men’s health mar­ket­ing Justin Mat­tice said.

“Taste and tone is ab­solute­ly crit­i­cal,” he said. “We’re talk­ing about a con­di­tion that is a curved pe­nis. It needs to be  fac­tu­al­ized, med­ical and it can’t be fun­ny. And it needs to be ap­pro­pri­ate for TV — an ex­treme­ly dif­fi­cult task.”

En­do laid the ground­work for the Xi­aflex ad with its 2019 un­brand­ed “Learn about PD” cam­paign se­ries of ads us­ing crooked pro­duce to con­vey its mes­sage. Men looked at bent cu­cum­bers, ba­nanas and pep­pers, while a voiceover not­ed that “guys come in all shapes and sizes.” The nar­ra­tor goes on to sug­gest a painful or new bump may be a rea­son to talk to a doc­tor.

En­do’s Pey­ronie’s dis­ease aware­ness ads date back to 2017, with ef­forts to des­tig­ma­tize and open up con­ver­sa­tions. Mat­tice likened the work to Pfiz­er's Vi­a­gra and Eli Lil­ly's Cialis mar­ket­ing that changed the “dark and scary” term “im­po­tence'' in­to the more friend­ly med­ical term “erec­tile dys­func­tion” or just ED. En­do wants to change Pey­ronie’s dis­ease un­fa­mil­iar­i­ty and po­ten­tial fear to eas­i­er-to-un­der­stand erec­tile cur­va­ture or sim­ply a lump, bump or curve, Mat­tice said.

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8
by Beth Snyder Bulik

Drug ads on TV are al­ways telling peo­ple to “ask your doc­tor.” But guess what? Al­most one in five ac­tu­al­ly do bring up a drug they’ve seen in ad­ver­tis­ing dur­ing a med­ical vis­it while one in 10 say they even ask di­rect­ly for the pre­scrip­tion.

That’s ac­cord­ing to a new Deep­In­tent study field­ed as a fol­low-up to an ini­tial deep dive in­to per­cep­tions around phar­ma di­rect-to-con­sumer mar­ket­ing in March. Back then re­searchers at the dig­i­tal health­care mar­ket­ing plat­form found, not sur­pris­ing­ly, peo­ple were see­ing more DTC ad­ver­tis­ing thanks to in­creas­es in dig­i­tal con­sump­tion dur­ing the pan­dem­ic.

A lot more in fact. Phar­ma and health­care com­pa­nies’ dig­i­tal ad spend­ing jumped to more than $9.5 bil­lion in 2020, eMar­keter re­ports, and pre­dicts an­oth­er big jump by the end of this year to $11.3 bil­lion, an in­crease of 18%.

Yet at the same time, peo­ple al­so re­port­ed feel­ing less in­formed than ever. While 75% agreed that be­ing in­formed about phar­ma treat­ment op­tions could save lives, more than 30% said they didn’t know enough in­for­ma­tion be­fore they talked to their doc­tors.

One of the goals of Deep­In­tent’s sec­ond study was to fig­ure out what peo­ple are find­ing on­line when they look up a drug and how phar­ma com­pa­nies can bet­ter con­nect the dots be­tween con­sumers and physi­cians.

The num­ber one ap­peal of a drug ad was rel­e­vance. More than half (51%) of the more than 1,200 con­sumers sur­veyed paid more at­ten­tion to drug ads that dis­cuss a health con­di­tion they have, and an­oth­er 33% pay at­ten­tion to ads that talk about a loved one's con­di­tion. A small­er 15% point­ed to good con­tent as a rea­son they paid at­ten­tion to the ad.

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9
by Beth Snyder Bulik

Oc­to­ber is both breast can­cer aware­ness and liv­er dis­ease aware­ness month. While there’s no doubt which con­di­tion draws more at­ten­tion dur­ing the month, Sal­ix wants to change that.

Sal­ix, Bausch Health’s gas­troen­terol­o­gy arm, pi­lot­ed its first chron­ic liv­er dis­ease re­port and physi­cian sur­vey with re­sults out this week aimed at rais­ing aware­ness and dis­pelling stereo­types.

While 4.5 mil­lion peo­ple have chron­ic liv­er dis­ease or cir­rho­sis – which is even more than 3.8 mil­lion women di­ag­nosed with breast can­cer – the re­search found chron­ic liv­er dis­ease “has not re­ceived the at­ten­tion or lev­el of ef­fort need­ed for ad­e­quate pre­ven­tion, di­ag­no­sis, and stan­dard­iza­tion of its man­age­ment.”

Among doc­tors sur­veyed, 38% weren’t aware of na­tion­al guide­lines to treat chron­ic liv­er dis­ease even as 20% of them point­ed to big in­creas­es in dis­ease sever­i­ty and hos­pi­tal­iza­tions among their pa­tients over the past year.

The pan­dem­ic made the al­ready grow­ing liv­er dis­ease prob­lem worse – al­though like­ly more for lack of care rea­sons than the much-dis­cussed al­co­hol use in­creas­es wide­ly dis­cussed in the me­dia. Al­co­hol and drug-re­lat­ed caus­es do make up about one-third of cas­es, but the rest of chron­ic liv­er dis­ease falls in­to two non-al­co­hol re­lat­ed cat­e­gories, non­al­co­holic fat­ty liv­er (NAFL) or non­al­co­holic steato­hep­ati­tis (NASH), along with he­pati­tis, oth­er vi­ral and ge­net­ic con­nec­tions.

Jump­ing to an al­co­hol con­nec­tion is one of the myths Sal­ix wants to push back on with the study and on­go­ing ad­vo­ca­cy work. Doc­tors in its sur­vey blamed al­co­hol and recre­ation­al drug use as the top two de­ter­mi­nants for pa­tient out­come de­spite agree­ing the ma­jor­i­ty of their liv­er pa­tients were not al­co­hol re­lat­ed.

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Vas Narasimhan, Novartis CEO (Jason Alden/Bloomberg via Getty Images)
10
by Max Gelman

No­var­tis’ En­tresto has proven a block­buster drug since its ap­proval in 2015, net­ting $924 mil­lion in sales this past quar­ter alone, rep­re­sent­ing a 46% gain from last year’s pe­ri­od. But the US gov­ern­ment is call­ing the com­pa­ny’s sales prac­tices in­to ques­tion, de­mand­ing in­fo dat­ing back years in a new­ly re­vealed probe.

The De­part­ment of Jus­tice is seek­ing doc­u­ments as far back as 2016 re­lat­ed to the mar­ket­ing, pric­ing and pay­ments to doc­tors for En­tresto, No­var­tis re­vealed in its third quar­ter reg­u­la­to­ry fil­ing. Per the bio­phar­ma’s ac­count, DoJ ini­ti­at­ed the probe — known for­mal­ly as a Civ­il In­ves­tiga­tive De­mand — this past Sep­tem­ber.

A spokesper­son for DoJ de­clined to com­ment.

It’s not yet clear whether this process will lead to for­mal lit­i­ga­tion against the com­pa­ny. No­var­tis said in its up­date, tucked away in a small note on page 36, that it’s cur­rent­ly eval­u­at­ing the re­quest.

This isn’t the first time No­var­tis has found it­self in hot wa­ter over its mar­ket­ing prac­tices. Just last year, the Swiss bio­phar­ma paid $678 mil­lion to set­tle a law­suit al­leg­ing it paid hun­dreds of mil­lions of dol­lars in kick­backs to es­sen­tial­ly bribe doc­tors to pre­scribe its med­ica­tions. The civ­il suit, filed in 2011 by a whistle­blow­er and joined by DoJ two years lat­er, claimed No­var­tis paid for lav­ish din­ners, so-called speak­ing fees and ex­pen­sive al­co­hol to per­suade clin­i­cians.

In some of the more os­ten­ta­tious kick­backs out­lined in that DoJ com­plaint, No­var­tis paid for a $3,250 per per­son din­ner at a Dal­las sushi restau­rant, at least sev­en trips to Hoot­ers and fish­ing trips off the Alas­ka and Flori­da coasts. No­var­tis had de­scribed such events as “speak­er pro­grams,” though DoJ said the drugs were hard­ly men­tioned, if at all.

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11
by Beth Snyder Bulik

Te­va is dou­bling down to pre­vent “par­o­dy” mar­ket­ing videos from en­ter­ing the court­room in its New York opi­oid tri­al. The 15-year-old Cephalon videos con­nect­ed to the launch of fen­tanyl drug Fen­to­ra — la­beled with Hol­ly­wood ti­tles such as “Austin Pow­ers” and “A Few Good Men” — are ir­rel­e­vant and in­flam­ma­to­ry, Te­va is ar­gu­ing.

Its mo­tion last week is the lat­est in a se­ries of Te­va ef­forts to keep the videos un­der wraps, re­port­ed first by Law360.

Te­va asked the court in the Oct. 15 fil­ing to de­ny the state’s re­quest for the videos, dis­miss­ing them as “par­o­dy videos” and “jokes” and ar­gu­ing that the state is im­prop­er­ly try­ing to in­sert the po­ten­tial­ly prej­u­di­cial videos at the last minute. Te­va claimed the state has had the films for years and tried — and failed — to in­tro­duce them un­der cross-ex­am­i­na­tion of an ex­pert wit­ness.

In an ear­li­er let­ter sent di­rect­ly to New York State Supreme Court Jus­tice Jer­ry Gar­gui­lo, Te­va ar­gued that the court it­self la­beled the videos “in­cred­i­bly prej­u­di­cial” and “in­cred­i­bly dam­ag­ing.” Te­va says the in­tro­duc­tion of the video cre­ates a "grave risk of a ju­ry ver­dict based on a neg­a­tive re­ac­tion to ir­rel­e­vant videos rather than ac­tu­al ev­i­dence," Law360 re­port­ed.

Still, Jus­tice Gar­gui­lo may yet al­low the videos. Law 360 re­port­ed the judge said dur­ing the tri­al last week, "I dis­agree with de­fen­dants that they're too prej­u­di­cial — you pro­duce them, you've got to live with them, pe­ri­od.”

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