The use of the letter y in pharmaceutical brand names has been steadily increasing over the last two decades. In the five-year period from 2000-2004, the letter y was included in approximately 12% of FDA approved novel drug brand names. From 2013 to 2017, that number doubled to approximately 24%. And from 2018 to 2022, 33% included the letter y. What gives? Are drug name developers simply infatuated with this letter? Or are there more pragmatic reasons for this letter’s invasion of the pharmaceutical lexicon?
In the English language, the letter y is a wonderfully versatile letter. It is both a consonant (e.g., yes, lawyer, beyond) and a vowel (e.g., gym, sky, baby). And, depending on the word, it is pronounced in an atypical myriad of ways. In the context of pharmaceutical brand names, some brands use the letter as a consonant, as in Yupelri, Libtayo, and Danyelza; and a plethora of names take advantage of the various ways in which the letter can be pronounced as a vowel, as in Ajovy, Oxbryta, Rybelsus.
But just because incorporating the letter y into pharmaceutical neologisms is a unique way to achieve the desired phonetic result, does not mean that other, more common vowels wouldn’t better achieve the intended sound. And the letter y is certainly not without pronunciation challenges and inconsistencies across global languages. So, novelty aside, why y? The answer lies in the biggest challenge namers face when developing pharmaceutical brand names: regulatory approval.
Pharmaceutical brand names require government approval before the name can be marketed. Just like the drug itself requires approval (after going through a series of clinical trials to establish the product’s safety and efficacy), the name too needs to be proven safe. The drug name cannot sound like or look like another drug name. If it does and the name is misinterpreted, the wrong medicine can be dispensed, which can be dangerous or even deadly.
Part of the FDA’s (and other global regulatory agencies’) methodology is to assess handwritten and computer-entered prescriptions. If a reviewer misinterprets the drug name on the prescription, that’s a medication error, and that drug name might get rejected. This is often referred to as an orthographic assessment (look-alike analysis). Part of the job of a pharmaceutical neologist is to craft names that do not look like other drug names. Because handwriting varies greatly from one doctor/prescriber to the next, name reviewers look to letter characteristics in addition to trying to interpret the specific letters/name that is written.
The use of upstroke and downstroke letters can significantly differentiate names from a visual standpoint. Upstroke letters move upward when written (b,d,f,h,k,l,t), and downstroke letters move downward (g,j,p,q,y). When looking at the entire alphabet, you can see how these letters are distinguished from no-stroke letters (abcdefghijklmnopqrstuvwxyz).
Of all vowels, y is the only one that offers orthographic distinctiveness. Using y in place of an e or an i, for example, may improve the safety of a proposed name, giving that name candidate a potential higher likelihood of approval. And when you string upstroke/downstroke characters together, e.g., Zykadia, Entyvio, Hyqvia, Bylvay, and Skyla, your chances for approval may be even greater.
So the next time you see a new drug name that includes the letter y, you’ll know why.
By: Scott Piergrossi
