Doctors warn General Hospital cancer plot may be a sneaky pharmaceutical ad campaign

Doctors are sounding the alarm about a cancer plot line on the long-running soap opera General Hospital, warning that it may lead to the over diagnosis of a rare disease, and the use of a drug to treat it. The episodes were produced in collaboration with a drug company.

This year on the ABC series, the character Anna Devane, portrayed by Finola Hughes, is diagnosed with polycythemia vera (PV), a deadly but extremely rare blood cancer than affects approximately 1.9 in 100,000 people. 

"I was pretty surprised that a daytime soap opera would be talking about a very specific disease that happens to be a rare one,"  Dr. Vinay Prasad, a hematologist-oncologist in Portland, Ore., told As It Happens host Carol Off. 

I wouldn't call it a public service announcement because I'm not sure that the benefit is to the public.-  Dr. Vinay Prasad 

He and his colleague Sham Mailankody started looking into it, and quickly learned the soap's story stemmed from a partnership between ABC and Incyte Corporation, a U.S. pharmaceutical company whose only Federal Drug Administration-approved drug, ruxolitinib, targets the genetic mutation that causes PV.

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"The people who work at these companies are smart people. They have thought about whether or not these kinds of promotions will have a return on their investments," Prasad said. 

He and Mailankody have outlined their concerns in an editorial in the medical journal JAMA.

Neither Incyte nor ABC responded to As It Happens' request for comment.

In a press release, Incyte said the partnership is in recognition of Rare Disease Day, and aims to "raise awareness and inspire patients and caregivers impacted by these under-recognized blood cancers."

While the FDA regulates direct consumer advertising of drugs in the U.S., it holds no sway over what's called disease awareness marketing. 

"Disease awareness efforts that are funded by the pharmaceutical industry are actually quite common," Prasad said.

"I wouldn't call it a public service announcement because I'm not sure that the benefit is to the public. I worry that the benefit of these campaigns is to the company, and the public may, in fact, be harmed."

General Hospital never names the drug specifically. But when Devane is first diagnosed, she disparages the lifelong anticoagulation and phlebotomy she's expected to undergo and bemoans the fact that doctors want to treat her symptoms and not her disease.

"Is that language a subtle promotion of the company's drugs? Because unlike all of the other ways we treat this condition, which may arguably be thought of as treating the symptoms ... only this company's drug treats what many people believe is the underlying generic driver of the disease," Prasad said.

"The common misconception is that treating the underlying driver is always better. It may be better, but it may not be better, and the only way to know for sure are well-done clinical studies. But unfortunately those have not happened in this disease, so we can't say for sure that this company's drug is better than any other option."

Prasad is concerned this could lead to overdiagnosis and unneeded treatment, as PV's symptoms are fairly common, making exact diagnosis tricky. 

"If you got everyone who watches this TV show to go to their doctor and say, 'Hey, test me for this rare condition,' you will find a lot of people who look like they have this rare condition, but they probably don't really have it," he said.