July 27th, 2011
If I hadn’t already felt like a pawn in the eyes of the pharmaceutical industry — another warm body off of which to profit — I sure do today. Drug manufacturers are educating women about yet another new condition it can cure: too many periods. I discovered the new condition on the back of the May/June issue of ”Nurse Practitioner World News” sticking out of my mailbox. An advertisement for Seasonique™, an oral contraceptive offering “fewer periods, and now more savings, ” proudly displays a vibrant, healthy, happy, Patagonia-clad woman is enjoying a fresh walk down the beach. She is walking in confidence — period free!
What is so disturbing about this new birth control pill is not that it is available, but that the pharmaceutical industry has positioned itself to convince physicians, nurse-practitioners and midwives that it ‘knows’ what women want. Suddenly big pharma understands the needs and desires of fifth-wave feminists?
I’ve used the pill (also called OCPs, or “oral contraceptives”) a few times in my teens and twenties. Back then, birth control pills seemed like the best fit for me. They weren’t messy, they weren’t scary in the way that IUDs or injections were, or freaky the way implants were. And they worked. The pill was commonly pushed by OB/GYNs as such a benign medication that women could essentially forget they were taking a daily dose of synthetic hormones every day — I did, until I recognized that some of my new symptoms were the result of the additional hormone load. I remember feeling like some other entity had come in and taken up residence in my body. In a sense, I lost connection with myself.
Despite my personal experiences with birth control pills, I am ALL for choices in contraception. I do wish the trade-off for effective birth control was not exposure to more exogenous hormones and an increased risk of certain cancers. Pills like Seasonique™ expose women to an additional 13 weeks of exogenous hormones over the regular combined OCPs. As an American woman I have a 1 in 8 chance of developing breast cancer in my lifetime — much higher odds than developing ovarian or uterine cancer. Birth control pills slightly decrease the risk of ovarian and uterine cancer, while potentially increasing the risk of breast and liver cancer in some women.
In 2006, the Mayo Clinic determined that women who used the pill before their first pregnancies had a 44% higher risk of breast cancer than women who had not used the pill. Yet, in a MAYO article discussing the use of birth control pills, the only noteworthy side effect mentioned is spotting. ”You may notice bleeding or spotting between periods (breakthrough bleeding) when you extend the number of days between periods.”
Beyond the cancer risk, decades of research on traditional OCPs is clear about the other major risks including heart disease, stroke, and blood clots. There are NO long-term studies (more than a few years) on birth control pills like Seasonique™ to alter our cycles and eradicate a portion of our menses.
What price are we willing to pay for “seasonal” periods, now that they are an option? Are we willing to be guinea pigs?
While doing a quick search for background information on Seasonique™ I learned that in 2004 the pharmaceutical industry is estimated to have spent spend $57.5 BILLION dollars on advertising. Yes, that’s almost 58 BILLION dollars on advertising. (Did that register?) Big pharma spends TWICE as much on advertising as it spends on research, quality and safety control, and development of existing and new medications. I also learned that maker of Seasonique, Teva Pharmaceuticals, was sued for Medicaid fraud in 2003 by the state of Massachusetts along with 12 other drug makers. These companies allegedly inflated the prices of their medications, causing Medicaid to waste tens of millions of dollars in inflated reimbursements. Think about the grandparents who have to choose between eating and fulfilling their prescriptions while the folks at Teva Pharmaceuticals are raking in obscene profits. All 13 companies in the Mass Medicaid fraud suit settled, returning roughly $23 million dollars back to the state’s Medicaid program.
It is no secret that drug companies have a major influence over which drugs physicians prescribe. In 2000, drug companies spent over $20 BILLION dollars on private sales meetings between their drug reps and physicians. Big pharma knows from experience that targeting susceptible physicians will ensure humongous profits. A former drug rep for Eli Lilly describes the nature of the drug rep/physician relationship:
It’s my job to figure out what a physician’s price is. For some it’s dinner at the finest restaurants, for others it’s enough convincing data to let them prescribe confidently and for others it’s my attention and friendship…but at the most basic level, everything is for sale and everything is an exchange. —Shahram Ahari
Think about this the next time you are discussing birth control options with your OB/GYN — or any medications for that matter. I would like to believe that ethics would prevail and providers would place true informed choice about the risks and benefits of medications above cozy perks from the drug reps. But I recall my own experiences. I fear for young women going in for well-woman exams and birth control. They are likely to come home with free packs of pills, completely unaware of the money, advertising, and unethical schmoozing involved in getting those pills to the providers desk.
I want the pharmaceutical industry to adopt a shred of decency and stop inventing and selling made-up conditions to women, and start spending more money on making safer drugs than on advertising them to us. I want honest discussion about the possible risks. I want safer choices. What do you want?