Bristol-Myers Squibb began a direct-to-consumer ad campaign for Opdivo in late September. 

A pair of commentaries criticized Bristol-Myers Squibb’s direct-to-consumer ads for Opdivo, its immuno-oncology drug, arguing that the ad’s message is misleading.

Bristol-Myers Squibb CEO Giovanni Caforio has already had to defend the company’s first branded cancer TV spot for Opdivo to investors. In January he said that the ad’s purpose is to dispel pessimism about new cancer drugs given the history of oncology therapies that lack “significant value,” even though Opdivo only has a second-line lung cancer indication.

See also: Bristol-Myers Squibb turns to DTC to promote Opdivo

Caforio may soon have to go bat for the drugmaker’s marketing strategy for Opdivo again, as criticism for the ad has mounted this past week. An op-ed in The New York Times said the ad overpromises the drug’s effectiveness, while a JAMA editorial said the ad can cause confusion among patients.

The commentaries highlight a common tension in DTC advertising — the makers of such ads say the medium’s ability to facilitate a productive doctor-patient dialogue about a serious disease is valuable, while critics say that such discussion drives hype and misconceptions. 

BMS developed the ad to inform families about a new treatment option and to encourage “patients to have an informed discussion with their physician about available treatment options,” spokesperson Danielle Halstrom said in a statement.

See also: Opdivo bet backfires, creates opening for Merck to pursue DTC

The op-ed in The New York Times, published last Tuesday, blasted the ad, saying that the drug’s “velvet-voice narrator” and “actors portraying lung cancer patients playing with babies and watching Little League games” would be uplifting “if it weren’t so utterly misleading and exploitative.” Matt Jablow, the author, lost his wife to stage 4 lung cancer. Opdivo was one of the drugs she took in her treatment regimen. He wrote that the promise of immuno-oncology drugs is an exciting development but the drugs’ effectiveness is “far from guaranteed, particularly in patients with late-stage forms of the disease.” 

Dr. Lowell Schnipper, an oncologist at Beth Israel Deaconess Medical Center in Boston, writing in JAMA Oncology, also last week, argued that the ad does not facilitate a productive conversation. “It is difficult to conceive that a medical oncologist would fail to discuss the potential use of [Opdivo] or another immunomodulatory agent for second-line therapy of squamous non-small cell lung cancer,” he wrote. 

BMS spent $37 million on Opdivo ads in the first quarter of 2016 and a total of $125 million advertising the drug in 2015, according to Kantar Media. The drugmaker has spent significantly more money marketing Opdivo than Merck has for Keytruda — a competing immuno-oncology therapy.