Point and counter point as JAMA tackles the question: Are cancer-related DTC ads beneficial?


Are cancer drug DTC ads valuable, or "prone to cause harm?" In dueling articles, the Journal of the American Medical Association (JAMA) recently tackled their public pros and cons.

Two Boston oncologists coauthored the article against cancer DTC ads after mailing surveys to breast and blood cancer patients to gauge awareness of those ads. Their findings? Eighty-six percent of 348 in the sample size were aware of cancer-related drug ads--and 11% of those patients said seeing the ads made them less confident in their doctors' judgment.

The way they see it, though DTC ads might encourage dialogue between patients and physicians, it's "difficult to conceive" that an oncologist wouldn't discuss the potential uses of an advertised drug--like Bristol-Myers Squibb's ($BMY) immuno-oncology med Opdivo--with patients in the first place.

And that makes DTC advertising "not only a potential source of patient misconceptions about efficacy and toxic effects, but also unnecessary," they wrote. "Such confusion requires oncologists to spend valuable patient face time correcting misconceptions rather than counseling about the formidable clinical challenges ahead.”

But a Harvard-degreed master of public health professor at the University of Miami noted the criticism of DTC ads had a counterpoint. “What has drawn little attention is the degree to which direct-to-consumer drug advertising encourages the adoption of healthy behaviors, fosters a new sense of patient empowerment, and emphasizes personal responsibility for individual health,” he said.

He called the “preoccupation” with banning DTC--a move for which the AMA voted in favor at its annual meeting last fall--“unfortunate,” and he instead suggested more stringent monitoring and regulations to improve effectiveness as possible solutions.

“The positive effects of DTCA must be balanced against supposed negative effects of DTCA, such as rising prices. If DTCA leads to earlier diagnosis and treatment, particularly among populations who face many obstacles to obtaining access to health information, DTCA’s benefits will outweigh its costs,” the article said.

Bristol-Myers Squibb has come under fire recently for its aggressive advertising of Opdivo in light of its announcement that the immunotherapy drug failed in clinical trials when used as a frontline treatment. A recent New York Times op-ed--penned by a man whose wife died of lung cancer last year after failing to respond to the therapy--labeled Opdivo TV advertising "misleading and exploitive," stirring up a debate of more than 360 comments.

As "In the Pipeline" columnist and pharma chemist Derek Lowe sees it, more similar stories--and anger about too-hopeful cancer drug marketing--are likely on the way as better treatments continue to come to market.

"Immuno-oncology, in its various forms, has pulled some people practically out of the grave by current treatment standards, and we’re going to see more of that in the years to come. But we’re also going to see people who aren’t helped by it, not yet, and losing them will be harder than ever," he said.

- read JAMA articles for and against cancer DTC
- see NYT op-ed
- get more from In the Pipeline

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