One pharmaceutical company is learning this week that reproducing a patient's story to "mentor" other potential patients may not sit well with US regulatory authorities, regardless of whether it represents the patient's perspective accurately.
Cambridge, Massachusetts-based manufacturer Vertex Pharmaceuticals was sent an Untitled Letter by the US Food and Drug Administration (FDA) warning it about its promotion of Incivek (teleprevir), a Hepatitis C (HCV) drug which FDA said was being marketed using a "misleading" branded story.
The branded story is told through the eyes of a patient, "JP", who tells the audience of his struggle with HIV and subsequent-but difficult-success using Vertex's Incivek, which he claims "cleared the virus" from his body.
FDA explained in its 25 May letter that Vertex has "overstated" the efficacy of Incivek because it suggests the drug is more effective than "substantial evidence or substantial clinical experience" has shown.
"While these claims may be an accurate reflection of James' own experience with hepatitis C and treatment with Incivek, this branded story misleadingly implies that most or all cirrhotic prior null responders infected with hepatitis C will successfully achieve Sustained Virologic Response (SVR) on Incivek combination therapy," wrote FDA in the Untitled Letter. "FDA is not aware of substantial evidence or substantial clinical experience to support this implication."
Put succinctly, "one patient's treatment response does not constitute substantial evidence," said FDA. Further, FDA said the testimonial "misleadingly implies removal of HCV from the body, when this is not the case." Instead, the virus may well have simply become undetectable while continuing to replicate, noted FDA.
The testimonial also minimized important risk information by downplaying the side effects of the drug, explained FDA. The testimonial recounts "JP" receiving the treatment, which caused him to lose significant amounts of hair and develop a rash. "But that was nothing," said "JP," referring to the side effects relative to the benefits of the treatment for him. FDA maintains this "minimizes the risk" of both side effects, and particularly the risks of the rash, which the agency called "serious."
FDA called on Vertex to stop using the branded story and respond to FDA's Untitled Letter within 15 days.
A Vertex spokeswoman, Nikki Levy, told The Boston Globe the company has never distributed the story and was now working to revise its content in light of FDA's informal warning.
Untitled letters are different from official FDA Warning Letters in that they do not include a list of potential agency enforcement actions and are generally less serious than are formal Warning Letters.
FDA - Untitled Letter to Vertex Pharmaceuticals
FDA - Copy of Vertex's Branded Story