Drug adverts aimed at cancer patients difficult to read

Oncology drug advertisements that ran in patient-focused cancer magazines presented the drugs' benefits differently -- earlier in the advertisement text and in larger type size -- than their side effects or risks, according to an analysis by researchers at Dana-Farber Cancer Institute in Boston.

The findings were presented the American Society of Clinical Oncology's annual meeting in Atlanta.

"Direct-to-consumer advertising of oncology medications typically focuses on the drugs' benefits, as would be expected, but it does so in a manner that might lead some cancer patients to not appreciate equally the drugs' potential side effects and risks," says Gregory Abel, MD, MPH, the study's first author. "Oncology providers should be aware of these advertisement characteristics, as they may influence patients' perceptions of and requests for these medications."

The researchers reviewed all advertisements for oncology drugs that appeared in three cancer patient-focused magazines, CURE, Coping with Cancer and MAMM, in 2005. They analyzed the advertisement copy for readability using the Flesch Reading Ease measurement. They also assessed the type size and the placement of the benefits and side effects/risk information, as well as the advertisements' presentation of clinical trial data, apparent patient testimonials, images of patients, physicians and/or celebrities, and claims about effectiveness, social-psychological enhancements, ease of use, and/or safety.

A total of 75 medication-specific advertisements appeared in the magazines, but only 15 were unique, as some of the advertisements ran repeatedly during the year. The advertisements were found to be difficult to read overall, but the text outlining the benefits had the highest readability score. Information about the drugs' benefits, on average, appeared in the top third of the advertisement text, while descriptions of side effects and risks typically ran in the bottom third. Also, the largest type size of the text explaining the benefits was about twice as large as the largest text outlining side effects and risks. Interestingly, the amount of text devoted to benefits versus risks and side effects was roughly the same.

None of the advertisements included information about costs or contained celebrity or physician endorsements. About two-thirds (67 percent) referenced clinical data and 80 percent contained images of patients.

"We found that appeals to medication safety are infrequent in oncology print direct-to-consumer advertisements, while appeals to medication effectiveness are ubiquitous and often made through the presentation of clinical trial data," explains Abel, who is also an instructor in medicine at Harvard Medical School. "Such appeals to the scientific efficacy of cancer-related medicines, while suitable in the setting of clinical encounters, may not be appropriate when made directly to consumers via language that is difficult to read."

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