Why Have Drug Names Become So Weird? A Retrospective Analysis of the Orthographic Distinctiveness of Proprietary and Generic Names Across Four Decades of FDA Approvals
- 1Northwestern University
Abstract
BackgroundRegulatory pressure to avoid confusingly similar drug names appears to have pushed manufacturers to coin more distinctive proprietary names, but no one has quantitatively analyzed this trend.
ObjectiveTo determine whether proprietary drug names became more orthographically distinctive (unusual in spelling) over time.
MethodsWe examined 1,321 US Food and Drug Administration (FDA) new molecular entity (NME) names (1985-2024), 2,769 FDA Orange Book trade names (1982-2026), 177,337 US pharmaceutical trademarks (1980-2026), and 1,273 generic names (1982-2025). Compared to prior names (including those already marketed) and ordinary English, we scored each names character trigram (three-letter sequence) surprisal (statistical unexpectedness) and its edit-distance similarity to the closest existing names. Linear regression tested time trends, controlling for name length.
ResultsMean NME trigram surprisal rose in every decade between the 1980s and 2020s, from 7.21 to 8.50 nats (natural-logarithm units, higher meaning less predictable), an 18% increase (b = 0.038, p < .001, R{superscript 2} = 0.34). Half of 2020s names (7% in the 1980s) contained a letter sequence found in no common English word (e.g., Jesduvroq, Omvoh). Nearest-neighbor similarity fell after the early 1990s. Trademark data showed the same trend (b = 0.016, p < .001). Generic names showed a weaker trend (b = 0.011, R{superscript 2} = 0.063).
ConclusionsOver four decades, drug names became more orthographically distinctive, consistent with namespace crowding, deliberate efforts to avoid confusing names, and branding strategy. Because unfamiliar letter sequences can introduce other error pathways, increased distinctiveness does not necessarily imply improved safety.
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BibTeX
@misc{lambert2026have,
title = {{Why Have Drug Names Become So Weird? A Retrospective Analysis of the Orthographic Distinctiveness of Proprietary and Generic Names Across Four Decades of FDA Approvals}},
author = {B. L. Lambert},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.15.26365645},
url = {https://www.medrxiv.org/content/10.64898/2026.10.15.26365645v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Why Have Drug Names Become So Weird? A Retrospective Analysis of the Orthographic Distinctiveness of Proprietary and Generic Names Across Four Decades of FDA Approvals
AU - B. L. Lambert
PY - 2026
DA - 2026/10/15
PB - medRxiv
DO - 10.64898/2026.10.15.26365645
UR - https://www.medrxiv.org/content/10.64898/2026.10.15.26365645v1
AB - BackgroundRegulatory pressure to avoid confusingly similar drug names appears to have pushed manufacturers to coin more distinctive proprietary names, but no one has quantitatively analyzed this trend. ObjectiveTo determine whether proprietary drug names became more orthographically distinctive (unusual in spelling) over time. MethodsWe examined 1,321 US Food and Drug Administration (FDA) new molecular entity (NME) names (1985-2024), 2,769 FDA Orange Book trade names (1982-2026), 177,337 US pharmaceutical trademarks (1980-2026), and 1,273 generic names (1982-2025). Compared to prior names (including those already marketed) and ordinary English, we scored each names character trigram (three-letter sequence) surprisal (statistical unexpectedness) and its edit-distance similarity to the closest existing names. Linear regression tested time trends, controlling for name length. ResultsMean NME trigram surprisal rose in every decade between the 1980s and 2020s, from 7.21 to 8.50 nats (natural-logarithm units, higher meaning less predictable), an 18% increase (b = 0.038, p < .001, R{superscript 2} = 0.34). Half of 2020s names (7% in the 1980s) contained a letter sequence found in no common English word (e.g., Jesduvroq, Omvoh). Nearest-neighbor similarity fell after the early 1990s. Trademark data showed the same trend (b = 0.016, p < .001). Generic names showed a weaker trend (b = 0.011, R{superscript 2} = 0.063). ConclusionsOver four decades, drug names became more orthographically distinctive, consistent with namespace crowding, deliberate efforts to avoid confusing names, and branding strategy. Because unfamiliar letter sequences can introduce other error pathways, increased distinctiveness does not necessarily imply improved safety.
ER -