Exploring Post-Training Alignment of Small Language Models for Biomedical Data-to-Text Generation: A Case Study of Medication Leaflet

Translating structured biomedical information into accurate, patient-friendly narratives remains a challenging biomedical data-to-text (D2T) task. While small language models (SLMs) are attractive for healthcare applications because of their lower computational cost, easier deployment, and improved data governance, the impact of post-training alignment on biomedical D2T generation has not been systematically studied. In this work, we compare four alignment methods: supervised fine-tuning (SFT), direct preference optimization (DPO), odds ratio preference optimization (ORPO), and group relative policy optimization (GRPO), using Qwen-2.5 models for medication leaflet generation. We further introduce FDALeaflets, a dataset derived from OpenFDA drug labels, to evaluate cross-regulatory generalization in a zero-shot setting. Selected aligned SLMs outperform GPT-5 on several reference-based metrics, whereas GPT-5 achieves better hallucination and adequacy scores on FDALeaflets under LLM-as-judge evaluation. Among RL-free alignment methods, ORPO achieves the best in-domain semantic performance, reaching a semantic textual similarity (STS) score of 0.9752. GRPO achieves the highest FDALeaflets STS (0.9407), exceeding GPT-5 (0.9295). These findings show that post-training alignment is a key factor in improving both semantic fidelity and generalization for biomedical D2T generation, while clinical safety and patient readability require human verification.