As Seen on TV, an occasional column, brings you the inside story behind TV ads for drugs and health care.

A for-profit hospital system focused on complex and advanced cancers has drawn scrutiny for touting sky-high survival statistics buoyed by disproportionately healthy and wealthy patients. Now, new research provides the fullest portrait to date of the massive nationwide ad blitz launched by Cancer Treatment Centers of America to attract patients.

The CTCA spent $101.7 million promoting its services in TV, print, online, and other ads in 2014, accounting for nearly 60 percent of all ad spending by US cancer centers that year, according to a new study from researchers at Indiana University and the University of Pittsburgh.

The study, published in JAMA Internal Medicine on Monday, said that more than half of CTCA’s ad spending in 2014 went for venues aimed at a national audience. That reflects a population of many patients with the means to travel far from their homes to seek care at one of CTCA’s five centers in or near Atlanta, Chicago, Phoenix, Philadelphia, and Tulsa, Okla.

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The new study, which drew from data collected by the media research firm Kantar Media, didn’t break down CTCA’s ad spending on different media. But data requested by STAT from the media research firm iSpot.tv shows that CTCA has been ramping up its TV ad spending even beyond the period captured in the study. The company has bought more than $107 million worth of TV ads, which aired tens of thousands of times over the past two and a half years, including $30 million worth of air time so far this year, the information from iSpot shows.

The Kantar and iSpot data reflect the list price of TV ad space and don’t account for any discounts CTCA might have negotiated.

Peter Yesawich, CTCA’s chief growth officer, said the company spends as much as it does on advertising because of its national footprint (unusual compared to most regional cancer centers) and its desire to inform patients about medical options and advances.

“Certainly there’s some controversy around the fact that not just us but also other cancer providers use things like advertising to tell their story,” Yesawich said. “But we believe very firmly that we would like very much to ensure that people who are looking for the latest information on diagnostics and treatment certainly have an opportunity to evaluate treatment options with us.”

The backstory

CTCA is leading a small pack of cancer centers across the country that have been driving a surge in ads over the past decade. Of the hundreds of US cancer centers, just 20 accounted for 86 percent of the industry’s total ad spending in 2014, the study found. That’s even amid a building boom bringing new competitors to the mix.

The study found that the prestigious MD Anderson Cancer Center and Memorial Sloan Kettering Cancer Center were the next top advertisers after CTCA, spending $13.9 million and $9.1 million, respectively, in 2014. But among the 20 centers driving the spending, more than half — including CTCA — aren’t designated by the National Cancer Institute, and three aren’t accredited by a program of the American College of Surgeons that requires cancer centers to report certain performance data.

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“Cancer centers with the highest spending are not necessarily centers that provide the highest standards of care,” said Laura Vater, a fourth-year medical student at Indiana University and the lead author of the new study. “It’s very important for patients to view cancer center advertisements with scrutiny,” ideally with the help of a health care provider.

The pitch

CTCA’s many TV ads tend to present inspiring stories of patients who come to the company’s cancer centers after receiving a grim diagnosis. Consider the ad for which iSpot estimates CTCA has spent the most on TV airtime in the past year and a half.

A middle-aged woman with her husband by her side talks about learning she had advanced colon cancer that had spread to her liver. She sought a second opinion from a doctor at CTCA who proposed a minimally invasive surgery to tackle both organs in the same operation. “That option gave us so much hope. Where else are you going to get that?” says the woman’s husband in one version of the ad.

 

In another version of the ad, inscrutable charts with numbers like 91 percent and 96 percent flash across the screen while an off-screen narrator urges viewers to go to CTCA’s website to learn more about the company’s treatment results and how they compare to national averages.

According to a 2013 Reuters investigation, the impressive survival rates that CTCA reports are biased by a patient population that is disproportionately non-elderly, well-insured, early in disease progression, and well enough to travel — and in some cases carefully selected that way.

Yesawich said that since the publication of the Reuters report, CTCA has begun publishing statistics on the five-year survival results of its patients and added a disclaimer to its online charts indicating that there is no direct national comparison to its patient population.

Are the ads working?

It can be tricky to connect the dots between more advertising and more business, but CTCA’s ads seem to be paying off. Although the privately held company doesn’t disclose its revenue figures, patients are flowing in: CTCA says it expects to treat nearly 7,400 new patients next year, up from 6,000 patients in 2013.

And Yesawich said that by the company’s own internal metrics, its advertising is increasing consumers’ awareness, knowledge, and image of its brand. CTCA was perceived more favorably than any other US hospital, and fifth most favorably among all American brands, according to a survey of consumers conducted last year by the market research firm YouGov.

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