I have a confession to make. I am not a big fan of prescription drug advertising on TV. That includes drugs like Humira for Crohn’s disease, Trulicity for type 2 diabetes or Emgality for migraines. But what really gets me irritated are the commercials for cancer meds such as Keytruda, Piqray or Versenio. Do you think there should be ads for cancer drugs on television?
Repetition – Repetition – Repetition
If you watch any television, you know that the drug ads come at you fast and furious. When I first noticed that some cable television shows were repeating the identical drug advertisement two or three times during the same commercial break, I assumed it had to be a big mistake.
Au contraire. This is now commonplace. When a pharmaceutical commercial is shown over and over again within minutes you get the sense that it must be working. These are expensive ads to produce and air. Drug companies do not waste money on promotions that don’t work.
A Medical Education Takes Years!
Medical training is both rigorous and expensive. After four years of medical school, it is not uncommon for a graduate to spend anywhere from three to seven more years in residency and fellowship programs to achieve expertise as a specialist.
Oncologists have an incredibly challenging career. That’s because cancer treatment is complicated and constantly evolving. What might have been considered standard of care five years ago for breast cancer could be quite different in 2021.
Imagine you are a lung cancer specialist who has gone through a decade of intense training. Now, a patient walks into your exam room and asks you for a specific medication based on a television commercial. How would you feel?
A Specialist Speaks Out About Ads for Cancer Drugs:
We interviewed renowned hematologist-oncologist, Vinay Prasad, MD, MPH, on our nationally syndicated public radio show a few months ago. We asked him about his reaction to ads for cancer drugs.
“You are seeing ads that say if you have non-squamous non-small cell lung cancer, ask your doctor if immunotherapy is right for you. That’s a really small group of people.
“How on earth can the company justify having an ad for such a small group of people? It raises the possibility you’re going to ask that of your doctor and there’s some evidence to suggest that kind of request may more likely lead to the prescription of those products…
The Cost of Advertised Drugs:
“It says something about the cost of these drugs that you can advertise to everybody for just a small group of people watching the TV. It speaks to just how much these drugs cost, how expensive they are…
“The next thing it speaks to is whether or not the average person watching TV who may have lung cancer knows if they have the particular type of lung cancer the TV commercial is talking about. They may not know if it applies to them…
“I guess I don’t know if people are empowered or if they are misled by this information. Are they put on a better path or are they put on a path that’s meandering and takes them away from best care?”
TV Ads for Cancer Drugs?
One lung cancer drug, Keytruda (pembrolizumab), is for:
“…non-small cell lung cancer that has spread. Keytruda can be used for adults who test positive for PD-L1 and whose tumors do not have an abnormal EGFR or ALK gene.”
This reinforces Dr. Prasad’s point about how difficult it would be for a patient to know if this drug would be appropriate.
Keytruda could cost as much as $12,500 a month. If someone’s insurance does not cover it, they’re in a terrible bind. They’ve been told this wonderful medicine could help them live longer, but few people can afford to fork over that kind of money.
Then there are the side effects. The announcer warns people that Keytruda can:
“…cause the immune system to attack healthy parts of your body. This can happen during or after treatment and may be severe or lead to death.”
The rapid-fire list of other side effects is long:
“New or worse cough, chest pain, shortness of breath, diarrhea, severe stomach pain or tenderness, nausea or vomiting, rapid heartbeat, increased hunger or thirst, constipation, dizziness or fainting, changes in urine or eyesight, muscle pain or weakness, joint pain, confusion or memory problems, fever, rash, itching or flushing. These are not all the possible side effects.”
Big Pharma’s Perspective:
Elisabeth Rosenthal, MD, is a journalist, best selling author and Editor-in-Chief of KHN (Kaiser Health News).
“Holly Campbell, a spokeswoman for PhRMA, the pharmaceutical manufacturers trade association, said that advertisements help patients make better decisions. Drug makers are ‘designing their advertising to provide scientifically accurate information to help patients better understand their health care and treatment options,’ she said.”
We are all for helping patients make better decisions. The question we are asking is: do ads for cancer drugs that last a minute or two accomplish that goal?
A Commercial for Piqray:
“They say life is all about making choices. Well, I didn’t choose metastatic breast cancer. Not the exact type. Not this specific mutation.”
While the patient’s voice says “not this specific mutation,” the message on the screen flashes for two or three seconds:
PIK3CA gene mutation and
“Phosphatidylinositol-3-kinase catalytic subunit alpha (PIK3CA).”
Then the voice says:
“But I did pick hope”
On the screen are the large letters PIQ
The viewer is told that the treatment “goes right at it.”
The announcer tells us to discover Piqray:
“The first and only treatment that specifically targets PIK3CA mutations in HR positive, HER2 negative MBC [metastatic breast cancer] which are common and lead to cancer growth.”
Then the announcer speeds through the “serious side effects,” which include:
“Severe allergic and skin reactions, high blood sugar levels and diarrhea that are common and can be severe, and lung problems known as pneumonitis…Common side effects include rash, nausea, tiredness and weakness, decreased appetite, mouth sores, vomiting, weight loss, hair loss and changes in certain blood tests.”
The commercial ends with the words:
“Ask your doctor about Piqray”
Are Ads for Cancer Drugs Appropriate?
In our opinion, the FDA should reconsider allowing commercials on television for drugs to treat cancer, multiple sclerosis or other challenging diseases. An informed oncologist should be up-to-speed on the best treatments for any given form of cancer.
Patients should not be expected to make therapeutic decisions based on short TV ads for cancer drugs. After all, doctors need years to master the best treatments for complicated conditions. How can patients determine if a medication they see advertised for 90 seconds is right for them?
What do you think? Share your thoughts about ads for cancer drugs and other Rx medications in the comment section below.