women histories, incest sexual abuse. institutionalized. But what if ...

drugs aggressively advertised in magazines such as Newsweek,
Redbook, Mirabella, and The New Yorker. In recent years, drug
companies have bypassed physicians and marketed their products
directly to consumers. Eli Lilly's multimillion dollar campaign for
Prozac, for instance, includes ads in more than 20 magazines.
Some magazines, like Good Housekeeping and the Ladies' Home
Journal, contain so many drug ads you might be tempted to double-check
the cover to make sure you're not reading a professional
medical journal. Which is precisely the point: drug manufacturers
want consumers to play doctor by asking their physicians to prescribe
particular drugs. And 99
percent of physicians do comply
with patients' requests, market
research confirms. In this era of
"managed care," when physicians
are pressed to see as many
patients as possible in the shortest
amount of time, educated
patients who know how they
want to be treated are a dream
come true.
A dream come true, that
is, for physicians and drug companies—but
not necessarily for
the patients. We may believe
that by asking our physicians
for Premarin or Prozac we are
empowering ourselves by
becoming more assertive in our
relationships with our physicians,
because only we really
know our bodies and whaf s best
for our health. But in reality, the
drug companies are taking
advantage of our adherence to this Our Bodies, Ourselves credo. We
are intermediaries in a loop of influence that originates in magazine
ads and culminates in a prescription.
Last year alone, pharmaceutical companies spent nearly
$600 million advertising prescription drugs directly to
consumers—twice as much as they spent in 1995 and almost 10
times more than they spent in 1991, according to Competitive
Media Reporting, a company that tracks ad spending. None of that
money, however, seems to be spent on factual research: more than
half of the drug ads scrutinized last year by the Consumers' Union
advocacy group contained misleading information on risks and
benefits and false claims about efficacy.
Politics vs. Science
But as the case of the massively popular Premarin shows, the
In the end,
the consumer's ability to
get the best drugs for the
lowest price was sacrificed.
The saddest part of this whole
incident? Feminist politicians
and women's groups were
key players.
influence of drug companies goes far beyond false advertising.
Wyeth-Ayerst Laboratories is a pharmaceutical Goliath that garners
$1 billion a year in revenue from Premarin, the most commonly
prescribed drug in America. Owned by American Home
Products, Wyeth-Ayerst has maintained a monopoly on Premarin
ever since it began manufacturing the estrogen replacement in
1942. Even though the patent expired over 25 years ago, Wyeth
has gotten the FDA to change its guidelines in determining bioequivalence
in generics, making it difficult for competitors to match
Premarin. A lot is at stake: sales could reach $3 billion within five
years, with more than one-third
of all women in the United
States currently over the age of
50, and another 20 million
entering the menopausal years
within the next decade.
Because of the size of
that market, two small generic
drug companies have decided to
compete with Wyeth. After the
FDA concluded in 1991 that an
effective generic requires only
two active ingredients (estrone
and equilin), Duramed
Pharmaceuticals Corp. and
Barr Laboratories Inc. teamed
up to develop a urine-free
generic according to FDA
guidelines. In response, Wyeth
filed a citizens petition requesting
that one of Premarin's
ingredients (an obscure estrogen
called delta 8,9 dehydroestrone
sulfate or DHES) be
reclassified as a necessary component. Duramed has not been able
to replicate an equivalent of DHES and Wyeth holds the patent on
the estrogen. Furthermore, in 1995 the FDA found that based on
clinical trials, there was no evidence that DHES was anything
other than an impurity.
And so Wyeth shrewdly lined up the support of several
influential women's and health groups by making donations to
Business and Professional Women/USA, the American Medical
Women's Association, the National Consumers League, and the
National Osteoporosis Foundation, among others. Representatives
of these groups testified before the FDA on the drug company's
behalf, saying that they opposed the approval of a generic that
lacks DHES, despite the FDA's own contention that the estrogen
wasn't essential. The president of the Women's Legal Defense
Fund also testified, although this group did not accept money from
39 - on the issues