Most of us know that even the best of ads contain a kernel of truth surrounded by deceit and exaggeration. That’s one thing when you’re talking about which car to buy or laundry detergent to use. It’s another when it comes to the best way to treat a health condition or where you’ll get that medical treatment. As a physician, I define helpful health information as balanced and precise. When it’s not it makes good care so difficult.
Every morning I watch the news from New York City. And almost every time I see a commercial from a prominent New York hospital that features an extraordinary patient with even better results. There is never any mention of the risks the patient was exposed to, no information about how other similar patients did overall.
This week, a study analyzing the nature of such ads for cancer treatment centers was published in the Annals of Internal Medicine. Researchers from the University of Pittsburgh (financed by the National Institutes of Health) looked at 409 ads from 102 centers across the country. Practically all of them (85 percent) were designed to arouse emotion. Of those, 41 percent referred to cancer treatment as a “fight” or a “battle” and 30 percent of them induced fear. Half of the ads included patient testimonials, which most often focused on survival, but no one said what the typical patient might expect. Six percent of the ads described the treatment or center as “miraculous,” “remarkable,” or “extraordinary.” Just 2 percent of the ads mentioned risk and just 5 percent discussed costs or health care coverage. Only 15 percent included disclaimers.
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Surprisingly, 94 of the ads came from National Cancer Institute designated centers. Compared with other centers, they were even more likely to use emotional appeals and testimonials.
For more than two decades the pharmaceutical industry has spent billions of dollars supposedly improving our health by marketing its products—prescription drugs—directly to consumers. And it’s disheartening to see medical institutions follow suit, using many of the same strategies to grab consumers’ attention and appeal to their hopes and fears.
Proponents claim that such advertising, whether for drugs or treatment centers, increases awareness of a disease, prompts people to see their doctor, and helps foster doctor-patient partnerships. And they might be right if marketers focused on those objectives—but they don’t. Their goal is to sell their product regardless of risk or cost. Multiple studies and expert analyses suggest that up to 30 percent of health care products and services are unnecessary, if not wasteful, and many are potentially harmful.
Attempts at regulation have fallen short. Drug ads and other marketing strategies have resulted in multiple lawsuits with settlements worth billions and felony convictions related to illegal marketing of drugs. For example, the pain reliever Vioxx (rofecoxib) was heavily advertised directly to consumers until it was pulled from the market in 2004 because it increased the risk of stroke and heart attack. Millions of people were taking the drug at the time, and it’s estimated that it contributed to between 30,000 and 55,000 deaths. Misleading advertising campaigns have also been a key factor in promoting the misuse of antibiotics and the overprescribing of narcotics.
Most policymakers hoped that “professionalism” would prevent this kind of hucksterism. Modern cancer treatment has plenty to offer without resorting to exaggeration and emotional manipulation. Most centers have good data about their outcomes and risks that they share with each other—but not with the public. And that data shows there is a lot of variation in actual outcomes for individuals and by centers. It’s easier to find one patient who has done well and is willing to tell her story than to tell the whole story.
Direct-to-consumer advertising in health is a failed experiment. Marketers cannot stay within reasonable boundaries even when serious diseases such as cancer are involved. We can’t afford a health care system that gives us 30 percent more than we need, harms us, and is driven by marketers. Surely given all the problems we have in health care, we can find something more productive to do with those billions of dollars.
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