Healthy Skepticism Library item: 18678

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Moynihan R
The merging of marketing and medical science
ABC News 2010 Aug 30
http://www.abc.net.au/unleashed/stories/s2996546.htm

Full text:

It’s not often you get to watch a new disease being manufactured before your very eyes. But that’s exactly what’s been happening with a little known condition called ‘female sexual dysfunction’ or FSD.

And as the evidence uncovered in Sex, Lies and Pharmaceuticals clearly demonstrates, the global drug giants have played a key role in helping to construct the basic scientific building blocks of this new disease, in the hope of creating new billion-dollar markets for their products.

It’s a fascinating and frightening case study in the increasingly familiar merging of marketing and medical science.

No one disputes that sexual problems are real, and that for some women and men they can be debilitating. Yet while the notion of a widespread medical condition called FSD is highly questionable, a coming tsunami of marketing is set to convince millions of otherwise healthy women that they are suffering with a treatable sexual dysfunction.

Virtually unheard of not so long back, FSD burst onto the global stage in 1999, with bizarre but widely trumpeted claims it affected 43 percent of women. Viagra had just been approved for men, and as sales soared, the fantasies of pharmaceutical executives soon turned to a similar mass market among women.

Sex researchers, for a long time locked outside the hallowed halls of the health establishment, were suddenly inundated with offers of fine food, flattery and funding, from the friendly folks in pharma, and a new science of sexual medicine was born. Over the next 10 years companies with obligations to shareholders to widen the numbers of people defined as sick, and narrow the solutions offered to them, would not just sponsor the science of FSD, on occasions they would actually help to create it.

Corporate staff would participate in scientific conferences where the uncertain nature of FSD was hotly debated; companies would orchestrate surveys to prove how widespread sexual problems were; and perhaps most chillingly, company employees would help design the diagnostic tools used to label otherwise healthy women as disordered, opening the pathway to long-term treatment with costly and potentially harmful medicines.

And at the centre of all this sponsored science was the special long-term relationship between a small circle of senior researchers and a powerful industry whose sales are approaching a trillion dollars a year. In 2000, when a key definition of FSD was published – with claims it affected up to one in every two women – 18 of the 19 ‘thought leaders’ who wrote it had financial ties to a total of more than 20 companies.

‘During the process of defining the disease’ said Darby Stephens, then a drug company research manager, ‘we’ve been able to get thought leaders involved in female sexual dysfunction, and really work closely with them to develop this disease entity, so that it makes sense.’ The Californian based Vivus was trying to test a genital cream for women said to have ‘arousal disorder’.

As Viagra sales were booming, there was no time to waste. ‘We’re hoping to be able to expedite the process of drug development and disease development’ said Stephens, during a candid interview for a film called Orgasm Inc, which colourfully documents this extraordinary process of ‘disease development.’

‘We’re hoping to … expedite the process of … disease development’.

At a time when Pfizer still hoped Viagra might work for women, it funded a global survey of almost 30,000 people, finding frighteningly high rates of sexual problems across almost 30 countries. Yet Pfizer not only funded the survey and participated in running it, the whole thing was a ‘marketing effort’ orchestrated by the company to gauge interest among different nations, according to a key study investigator. Similarly Pfizer sponsored and helped create a scientific questionnaire to measure FSD, and then funded an educational package for doctors featuring claims that up to 63 per cent of women were affected by it.

Declining a request to be interviewed for the book, Pfizer said via a statement it had ‘conducted a number of studies over the past 15 years designed to understand the causes and nature of FSD and its impact on women.’ In relation to its financial ties with professional and patient organisations, the company said it likes to help efforts that ‘strengthen communities and work towards a healthier world.’

While Pfizer was busy testing Viagra for women, the American household products giant Procter & Gamble, or P&G – which boasts annual sales of almost $80 billion and is famous for selling soap- had high hopes its new testosterone patch would lift the low libido of post-menopausal women. P&G funded and helped run a scientific survey which found one-in-ten post-menopausal women suffer with the condition called ‘hypoactive sexual desire disorder’ or HSDD, another of the controversial sub-disorders of FSD.

Similarly, company staff designed a questionnaire to assess how well their testosterone patch worked, and then funded educational seminars to teach doctors the ‘rationale for testosterone use’ in women with HSDD. Sponsored ‘educational’ seminars for doctors are not rare events. In Australia drugs companies fund more than 30,000 every year, with a third taking place in restaurants, hotels and resorts.

More recently it’s been the turn of the German drug company Boehringer Ingelheim to construct this science, its paid consultants ‘educating’ doctors, its staff helping produce yet another survey finding widespread suffering, and employees helping design the tools to diagnose the condition. The Decreased Sexual Desire Screener is a simple five-item questionnaire, launched last year by the company as a ‘new, easy to use’ diagnostic tool to assess women with HSDD – the target condition for the company’s experimental sex drug, a failed anti-depressant which affects the brain’s chemistry. That’s right … a drug company is helping to design a diagnostic instrument to label women with a disorder, so they can qualify for that same company’s drug.

According to a Boehringer press release the tool ‘enables clinicians who are not necessarily experts in female sexual dysfunction to diagnose the condition with high accuracy in a few minutes.’ Certainly this is nothing if not efficient. Like P&G, which sold its pharmaceutical business last year, Boehringer declined to be interviewed during research for Sex, Lies and Pharmaceuticals.

While all this might seem stranger than fiction, it’s worth remembering ‘female sexual dysfunction’ is just one example of a much bigger problem: an unhealthy medical system so entangled with industry that even the conditions themselves are influenced by marketing.

So next time your doctor offers you a disorder, a disease, or a dysfunction to describe the ordinary ups and downs of life, it might be worth trying to find out who constructed the science, and at the very least inquire as to who paid for the wining and dining at their most recent ‘educational’ event.