SELLING THE
PILL LIKE SOAP
The
Sunday Times (London) May 17 1987
BRIAN
DEER questions the campaign techniques of marketing a
new contraceptive pill launched last week
IN Chicago last autumn I had the good
fortune to take part in one of the drug
industry’s regular jamborees. Top doctors,
salespeople and a sprinkling of selected journalists
flew in from all over the world and had an enjoyable
expenses-paid week at the luxury Palmer House Hilton
hotel pursuing what was dubbed “a scientific
symposium” on the pill.
The
international pill giant Schering AG was at that time
seeking to convince doctors that they should
prescribe women the company’s low-dose triphasic
- known in the UK as Logynon. Since Schering also
make 11 other contraceptive pills, I asked their
spokesman in Chicago, a charming Dutchman called
Melisse, why his company didn’t withdraw these
earlier products in favour of the new one.
This seemed
especially pertinent, since Logynon, and its American
brand variant Tri-Levlen, were being flaunted before
the world as the latest word on contraceptive safety.
According to the official promotions, the triphasic
pill “follows a woman’s natural hormone
patterns” and is “second to none for low
total hormonal dose”.
Chomping on a
later-breakfast croissant, Melisse responded that if
women were “getting on” with
Schering’s old higher-dose monophasic pills,
there was no reason for doctors to switch them. This
sounded familiar, being a widely accepted view even
among people who have not been flown free of charge
to expensive locations, but demonstrates a
complacency which puts the onus on unsuspecting women
to take the initiative to change.
In a situation
somewhat removed from the temptations of Chicago, it
might be worth questioning the current approach to
this important issue. Is it really the case that
manufactured hormones, which have such a profound
effect on a woman’s body, should be sold to
doctors and their patients with much the same sort of
fads and sales techniques as soap powders or dog
food?
I can already
hear the cries from doctors. “What a disgraceful
suggestion,” is the most likely formulation.
“It is inconceivable,” some will
maintain, that family practitioners, let along
specialists in family planning clinics would ever
allow pharmaceuticals to go the way of Persil, or
Kennomeat. No way will any pill be prescribed with
anything other than the best clinical judgment.
Before they
write in, however, I should draw their attention to a
recent survey of 1100 women reading The Sunday Times
Look page. Nearly half were currently on the pill and
of these over 50% were still taking relatively high
dose brands, despite the widely accepted wisdom that
such pills have a greater risk of causing serious
side-effects such as blood clots, which can be fatal.
Another finding was that half the women were never
advised about side-effect risks.
I would also
ask any physician to explain the latest advertising
campaign, launched last week by Schering to promote a
pill which is claimed to be even better than Logynon.
It is called Femodene and is so marvellous that the
advertising sent to doctors is headlined
“Healthy women” and asks: “Should any
woman start with any other combined pill?”
What
substantiates such optimism? I cannot tell - and I am
sure no doctor examining the promotion can tell
either. For the whole campaign to sell Femodene is so
far unsupported by any published medical evidence.
This is in itself extraordinary, but what is more
surprising is that Schering also made such claims to
newspapers about Femodene before other scientists
could verify them through such published research.
Schering’s
response is that a study of 24 women has been accepted
for publication in the American magazine
Contraception. This tiny study, however, may well be
contradicted by subsequent inquiries, since little
research is conclusive. And it is widely accepted
that it is unethical to use the national media on
behalf of a product prior to publication in a
scientific journal.
Schering also
point to the fact that if Femodene has a lower
hormone dose than other pills it is therefore
reasonable to infer that it disrupts a woman’s
metabolism less and is likely to be safer. But this
pill contains a completely new and stronger hormone,
called gestodene, so such assertions may be the
equivalent of saying that a double whisky is a
smaller dose of alcohol than a pint of beer.
Of course,
Femodene has been licensed by the government, through
the department of health’s Committee on the
Safety of Medicines. But although the CSM may do its
best to safeguard the public, it has been known to be
wrong. And the people who actually review the drugs
data for the Committee are not often known for their
specialist standing.
We cannot just
accept the manufacturer’s unverified statement
that a product is best - especially in the case of
Femodene, which among other things, will cost the NHS
twice as much as the earlier triphasic pill
generation. And only last September The Sunday Times
killed the idea that researchers can be automatically
trusted, by exposing Professor Michael Briggs, one of
Schering’s top researchers, who faked his pill
safety investigations.
It could, of
course, be that doctors are aware of such problems
and will not prescribe Femodene until they have been
satisfied by independent research published in
reputable journals. Schering may be unhappy, but the
joys of Chicago, or Singapore, or Santiago, or all
the other places it has since set up its stalls,
should not distract the drug industry from the needs
of women at home in Britain.
See also The pill: Professor's
safety tests were faked
Copyright,
Times Newspapers Ltd. All rights reserved. No portion
of this article on Femodene, Logynon and the
contraceptive pill may be copied, retransmitted,
reposted, duplicated or otherwise used without the
express written approval of the copyright owner.
Responses, information and other feedback are
appreciated - via Brian Deer's homepage.
