Direct to consumer advertising on the part of pharmaceutical companies has gotten a lot of negative press, and with good reason, several studies have supported. That's because such advertising frequently stimulates people to demand specific medications from their healthcare providers, who often simply write the prescription rather than engage in a prolonged discussion about why or why not it is appropriate. Now such advertising on the part of cancer treatment centers may also take it on the chin, with a study Rick and I discuss on PodMed this week in Annals of Internal Medicine. The study examines the content of such advertising and we hope will at least bring awareness to the fore.
Researchers examined cancer center advertising content in the top 44 US television networks and 269 consumer magazines in 2012. During that time there were 409 unique clinical advertisements placed by 102 cancer centers. It's also worth noting that in 2012 more than 1500 cancer programs were accredited by the American College of Surgeons, and this number remains on a strong upward trajectory, along with a predicted increased in the number of cancer cases as the population ages; a 45% increase in cancer incidence is expected by 2030! Okay, so what about the ads?
The majority of both television and print advertisements featured treatments (88%), and were emotional in content (85%). Emotional appeals included evoking hope for survival in 61%, positioning cancer treatment as a fight or battle in 41%, and inducing fear in 30%. About half of the ads featured patient testimonials, usually focused on survival.
In contrast, only about 18% of the ads featured cancer screening, risks of therapy 2%, costs of therapy in 5%, and insurance matters 0%. Disclaimers about outcomes were seen in only 15% of advertisements, and never described the results a typical patient might expect. Hmmm. If the rationale for placing ads includes a desire to provide potential patients with treatment options, this look at advertising practice seems a bit skewed at best.
So, should we either abolish or regulate more closely direct-to-consumer advertising? Recognizing that the public has a vested interest in an answer to that question, an editorialist in the same issue of Annals reveals data from a survey asking the question of whether medical advertising directly to consumers should be modified or abolished, and the majority of respondents answered no. In point of fact only a small percentage were in favor of any regulation at all. What then? Rick and I agree that a more even-handed approach would be welcome, with perhaps development and advertisement of an objective, independent database comparing prices, services, and outcomes regionally and nationally among cancer centers. Perhaps such a strategy, if utilized by consumers, would help level the playing field with regard to informing consumer choice.
Other topics this week include the possible utility of venlafaxine for hot flashes in menopause in JAMA Internal Medicine, several studies on treatments for pulmonary fibrosis in NEJM, and a new antibody for asthma treatment in the same issue. Until next week, y'all live well.