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When "General Hospital" provides medical advice

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ABC's long-running soap opera "General Hospital" is getting criticized from an unlikely source -- The Journal of the American Medical Association (JAMA).

A recent JAMA editorial said a "General Hospital" plotline earlier this year involving a character named Anna Devane contracting a rare blood cancer called polycythemia vera (PV) was a promotion for pharmaceutical company Incyte (INCY). Incyte produces a medication called ruxolitinib used to treat the disease. Even worse, according to the JAMA, the medical information in the show was misleading.

The Devane character raised concerns with her doctor when he advised her to begin treatment for PV with phlebotomy, the removal of blood from the body for therapeutic reasons. She remarked, "That's it, I have to keep going to bloodlettings for the rest of my life." 

According to the JAMA editorial's co-authors, Dr. Vinay Prasad, an assistant professor of medicine at Oregon Health and Sciences University and Dr. Sham Mailankody of the Memorial Sloan-Kettering Cancer Center, those comments may "constitute subtle promotion of ruxolitinib," a medication that targets the underlying genetic mutation thought responsible for the disease process.

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"Although targeting the underlying mutation is attractive, the clinical benefit to patients, particularly those with early disease, remains speculative," the authors wrote. "Carefully conducted trials, which have not yet occurred, are required to justify an expanded role of this medication."

However, the bloodletting that the Devane character appeared worried about is currently the standard treatment for PV, along with older medications such as aspirin, interferon and hydroxyurea. PV sufferers have higher-than-normal blood counts, which can cause clots. Ruxolitinib has been approved only for a narrow subset of PV patients who can't tolerate the other treatments or have an enlarged spleen. The drug, however, has side effects including anemia.

"If we take away a couple of pints of blood every so often, people can go years, decades even without having any real problems," said blood cancer specialist Prasad in an interview. "That's the mainstay of therapy. We use a lot of older medicines that can lower that blood count and mimic phlebotomy."

Wilmington, Delaware-based Incyte formed a partnership with "General Hospital" actress Finola Hughes, who plays Devane, to raise awareness of PV and other "under-recognized" blood cancers to promote Rare Disease Day in February. Incyte's only drug approved by the Federal Drug Administration is ruxolitinib, which is marketed under the brand name Jakavi. It costs several thousand dollars a month and hasn't been proven to increase patients' lifespans, according to Prasad.

In a statement, Incyte denied its "General Hospital" promotion was misleading, arguing that patients with rare diseases often have trouble finding information about them and getting the support they need. The company reported $251 million in "net product revenue" from ruxolitinib in the latest quarter, a 37 percent increase from the same period a year earlier. Incyte forecast 2017 revenue for the medication of between $1.02 billion and $1.07 billion.

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"ABC and Incyte have been transparent about the partnership in all related materials," said Catalina Loveman, a spokeswoman for Incyte, adding that the response to the "General Hospital" storyline has been overwhelmingly positive. "Medical experts and a PV patient were consulted on the project to ensure that the disease education information portrayed on the show was both authentic and accurate."

A spokeswoman for ABC, which is owned by Walt Disney (DIS), didn't immediately respond to requests for comment for this story. Incyte declined to disclose how much it paid for the "General Hospital" promotion.

In an interview with the fan magazine ABC Soaps In Depth, actress Hughes said she felt it was important for her character to have a real disease because soaps have afflicted their characters with nonexistent ailments. She researched PV by speaking to someone who has lived with it for a decade.

Since PV affects only about two out of every 100,000 people, Prasad questioned why Incyte needed to raise the public's awareness of it other than to boost sales of ruxolitinib. Granted, in a small fraction of patients, PV can transform into a more serious condition such as myelofibrosis or leukemia after about two decades. 

"I'm a cancer doctor," Pasad said. "Polycythemia vera isn't the kind of condition that gets me very worried compared to the other diagnoses that I deal with. We have people who go a long, long time with this.

Countries such as the U.K. and the Netherlands ban drugmakers from marketing directly to consumers. But that's not the case in the U.S. -- where the industry spent a record $5.6 billion last year on consumer-directed advertising.

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