MEMORANDUM

To: Dr. Michelle F. Eble

From: Charles Brian Kelly
Date: Monday, February 11, 2013
Subject: Patient Medication Information Analysis of Benlysta (belimumab)
The purpose of this memo is to present my analysis of several documents used to communicate with
patients and healthcare providers about the prescription drug Benlysta.
Introduction
Benlysta is a prescription intravenous (IV) infusion biologic medication. Since Benlysta is the first
prescription treatment approved for adults with systemic lupus erythematosus (SLE or lupus) in over
50 years, I feel that an analysis of documents used to communicate with patients and healthcare
providers about Benlysta is both timely and appropriate. Four different types of documents were
chosen for investigation including: the Benlysta website, the Benlysta medication guide, consumer
information, and the Benlysta package insert/prescribing information. Each document was then
analyzed and compared in terms of content/author, purpose and audience of document, rhetorical
appeals, design, and language.
Content/Author
Each document is designed to present information about Benlysta and its risks and benefits. A large
portion of each document is devoted to discussing the numerous side effects both common and rare to
Benlysta. Since treatment with Benlysta causes such a large increase in cancer risk, it is surprising that
the consumers information (located on a National Institutes of Health (NIH) website) lists potential
side effects near the middle of the webpage instead of at the top similar to the other documentation.
This may be because while the consumers information is composed by the American Society of
Health-System Pharmacists, Inc., the other three documentation sources are composed by Human
Genome Sciences Inc. and GlaxoSmithKline. Additionally, the U.S. Food and Drug administration
(FDA) reviews both the medication guide and prescribing information, so side effects must be
prominently listed.
Purpose and Audience of Document
Each document had both a distinct purpose and audience. The documentation with the most general
audience and purposes was the Benlysta website. The Benlysta website is an informal user-friendly
website that is designed to inform patients who currently have SLE not controlled by other treatment
methodsabout Benlysta and encourage them to discuss with their doctor whether adding Benlysta
treatment may help their condition. In order to inform patients about Benlysta, the website indicates
the desired outcome of treatment with Benlysta and some of Benlystas potential side effects, as well as
a short history of the development of Benlysta. The Benlysta website also has the purpose including
educating people about the myths and realities of SLE with webpages devoted to this topic as well as
inviting people to learn more about both Benlysta and SLE with a series of educational emails.
Whereas the Benlysta website was designed for patients not currently taking Benlysta, the medication
guide was designed for people already taking Benlysta and their pharmacist. The purpose of this
documentation is to inform the patient (and pharmacist) of the use of Benlysta and some of its potential
side effects. This documentation is written to help the patient make an informed decision about the use

of Benlysta. The consumer information on the NIH webpage is similar in purpose to the medication
guide but is designed with the consumer audience in mind.
While the Benlysta website, medication guide, and consumer information are designed for the patient
with the main purpose of informing about treatment with Benlysta and its potential side effects; the
prescribing information has a decidedly more professional audience in mind. The prescribing
information is designed for the physician or pharmacist and is an intensive reference for Benlysta in
order to help the both the physician and pharmacist in determining whether or not to prescribe Benlysta
to a patient. All aspects of the drug are listed including (but not limited to) all side effects, dosage and
prescribing information, clinical pharmacology, and clinical studies information.
Rhetorical Appeals
Each document was designed with a particular combination of rhetorical appeals. The most effective
use of all three rhetorical appeals was used by the Benlysta website. The website, being designed by
Human Genome Sciences Inc. and GlaxoSmithKline instantly establishes credibility (ethos) by
providing links to the FDA and the NIH about Benlysta. The homepage also appeals to logic (logos) by
describing treatment with Benlysta and some of its side effects. The website is also the only document
to consciously emotionally (pathos) appeal to the reader through the use of positive statements,
encouraging patients to Fight Back against SLE and through the use of patients undergoing treatment
as Benlysta Ambassadors.
The medication guide and the consumer information documentation mainly use the combination of
logos and ethos to appeal to readers. Their small attempt at emotionally appealing to readers can be felt
through their use of headings written in the form of questions. This attempts to make the document feel
as if the reader (patient) is having a conversation with the writer. Conversely, the logic-centered form
of the prescribing information helps to emphasize that it is mainly for health care professionals. Ethos
is conferred to the medication guide and prescribing information via the FDA, while ethos is
established for the consumer information by the NIH.
Design
The Benlysta website is extremely well designed and user-friendly. It uses the standard webpage
format with a page guide that is constantly in place on the right side of the screen. The site has a
homepage slideshow with various people of various ethnic groups and their families with emotional
messages on Fighting Back against SLE. The main colors (purple, yellow, white) of the website
mirror the colors used by the Lupus Foundation of America. This serves to emphasize that this
medication is for those people with SLE. The typefaces used are clear and the font size is well-chosen
both for amount of information that it allows on one page and for clarity.
The medication guide obviously a black and white handout designed with the conservation of ink in
mind. This is appropriate however, because this guide is supposed to be printed repeatedly to hand out
to patients before each dose of Benlysta. With this in mind, it succeeds as an informative handout due
to its easily readable typeface and larger than normal font. It also uses whitespace without looking
either too sparse in content or too crowded.
I find several problems with the consumer information webpage. The typeface seems thinner than
usual and the font is obviously smaller. The largest problem I see is the use of green and blue
typefaces. The blue typeface is a light blue that is hard on the eyes and is the same blue that is on the
background surrounding the whitespace. This adds only frustration on the part of the reader. The issue

with the green typeface is minor for most people, but for those who are red-green colorblind it could
indicate that a particular link is very important when it is not or vice-versa.
The prescribing information is probably the worst of the four in terms of design. While there is a large
amount of information, the typeface used has very thin letters. Additionally, the font used for some of
the information is smaller than most. I find it worrying that a physician may take a cursory glance for
dosage information and could misread a number because of the small font. The ability of the user to
click on a link at the top of the page to take them further down to the information needed is nice, but
there is not a link to take the user back to the top of the page. Perhaps a better design would include
this option.
Language
The language used in the Benlysta website is both informative and emotionally charged. However,
these two types of language are separated. The informative language is used in the bulk of the website
to state the usage and side effects of Benlysta and other treatment options. The emotionally charged
language is saved for the titles of the pictures in the slide show and the links to other websites about
SLE. This emotionally charged language often takes the form of encouraging people with SLE to
Fight Back against the disease.
The language used in both the mediation guide and consumer information takes on the format of a
prewritten question and answer session. A question is asked by the writer such as Why is this
medication prescribed?, and the answer is then stated. This format is more formal than the
emotionally charged language used in the Benlysta website. The language in both the medication guide
and the consumer information is used in such a way that the reader should feel as if they were
communicating with a health professional, such as a family doctor.
Unlike the language used in the other three documents, the language used in the prescribing
information is purely scientific information. There are no attempts to emotionally appeal to the reader,
as the reader is assumed to be a health professional. Every attempt has been made to state all
information in a straightforward, non-bias way in the most expedite manner with the most important
information coming first and all other information preceding it.
Conclusions
Each of these documents was written for a specific audience and with a specific purpose in mind. The
website was written to inform patients with SLE that are currently not taking Benlysta, about Benlysta
and its treatment options. It is written in an informal style with some emotionally charged phrases. It
seeks to describe the history, uses, and side effects of Benlysta in such a way as to encourage patients
to discuss Benlysta as a potential treatment for their SLE with their physician. It is well designed and
easy to use.
Both the medication guide and the consumer information seek to inform the patient taking Benlysta
about its treatment options, side effects, and potential questions that they should ask their physician.
They are designed as a printable hand-out (medication guide) and a website (consumer information).
They both take on the format of a prewritten question and answer session. The medication guide is
well designed, whereas the consumer information webpage has a few issues in terms of color
considerations.
The prescribing information seeks to inform the health care professional about Benlysta and its
treatment options. It includes dosing information as well as side effects. Its primary focus is to inform

not to persuade so emotional language is not used. It has a few issues with typeface selection and font
size.