Skimpy risk info on cancer drug websites may give patients false hope: Study

Cancer drug websites load up on numbers about treatment benefits, but skimp on details about their risks, an FDA-commissioned study found. It’s the latest analysis to identify weaknesses in drugmakers’ cancer drug advertising and promotions.

After analyzing 65 sites for branded cancer meds, researchers from the agency’s Office of Prescription Drug Promotion and RTI International found that almost all of them cited specific numbers on their effectiveness and side effects--not surprising, given the fact that regulations require disclosure of both.

But the amount of info on each was far from equal. And websites were more likely than print ads to cite relative numbers on benefits versus risks, the researchers said, which could lead consumers and doctors to “overestimate the benefits of a drug.”

Critics--and sometimes government investigators--have come down on drugmakers for overstating benefits and downplaying risks. That’s not exactly the case here; the researchers aren’t suggesting that pharma companies are exaggerating or hiding information. But the disparity flagged in this study echoes previous research--and poses potential problems when patients’ expectations meet reality.

For instance, in 2013, academic researchers surveyed doctors in three countries about information they received from pharma sales reps. Most of the doctors said they heard little to no information about side effects during sales calls, and serious risks were mentioned only 6% of the time. For 59% of rep visits, salespeople failed to offer any information about side effects or contraindications to a drug’s use.

As for the pitfalls of off-balance discussions, look no further than a recent dust-up about cancer drug advertising. In a New York Times op-ed, the husband of a woman who died of cancer took aim at Bristol-Myers Squibb’s Opdivo commercials. The drug didn’t help the author’s wife, and he called the brand’s advertising “misleading and exploitive” for its hopeful message.

The fact is that cancer drugs, even those as effective as Opdivo has proven to be, don’t work for everyone, and though advertising does tend to include response numbers, the overall impression they create is favorable. Otherwise they wouldn’t be ads. But obviously, drugmakers run the risk of a backlash--and the new study suggests that some numerical tweaks could help avoid that.

For cancer drug websites oriented toward consumers, 38.5% included quantitative information about the drugs’ full complement of benefits, but only 3.1% offered a numerical rundown on all the risks.

For doctors, the split was even more dramatic: More than 86% of professional sites included quantitative data on the range of benefits, while just 6.2% offered similar information about the full list of risks.

The disparity is significant--and worrisome--the researchers said. Studies show that “adding quantitative information about drug benefits and risks” helps consumers understand both better.

If consumers and doctors “overestimate the benefits of a drug,” as the researchers suggest, that could backfire on drugmakers. And DTC ads, as now used, already are problematic, some doctors say.

DTC ads are "not only a potential source of patient misconceptions about efficacy and toxic effects, but also unnecessary," two Boston oncologists wrote in a recent point-counterpoint about consumer advertising, published in the Journal of the American Medical Association. "Such confusion requires oncologists to spend valuable patient face time correcting misconceptions rather than counseling about the formidable clinical challenges ahead.”

Other doctors aren’t so sure; they see the criticism of such advertising as overblown. “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,” a public health expert wrote in the counter to the above article.

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.

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