A Case Study in Pharmaceutical Manipulation

Pharmaceutical companies have repeatedly proved that they care more about their profits than the patients their products treat. They refuse to make medication affordable or available to people in the Global South, pay off doctors to prescribe their medication, and dramatically increase prices of life-saving drugs. Most of the misconduct of pharmaceutical companies goes unnoticed and unpunished. Sprout Pharmaceuticals’s development and marketing of Addyi in the early 2000s exemplifies the corruption and abuses that are rampant in the pharmaceutical industry. To prevent abuses of power and help patients, there should be greater restriction on pharmaceutical funding in the medical industry.

After the Food and Drug Administration rejected Addyi, Sprout Pharmaceuticals decided against improving their product and instead manipulated new drug trials. Addyi was designed to treat a lack of sexual desire, but women who took Addyi reported no increase in their daily sexual activity. The drug had serious side effects, including significantly decreased blood pressure which caused dizziness and fainting. These factors contributed to a strong case for rejection by the FDA. Instead of trying to improve Addyi, Sprout Pharmaceutical decided they needed to change the way they collected data in the drug trials. They broadened the study to measure satisfying sexual experiences per month. Sprout Pharmaceuticals also changed their definition of a satisfying sexual experience to include anything from an orgasm to a dirty thought. They found that women taking Addyi had less than one more satisfying sexual experience each month than the control group, allowing them to bring the drug to the FDA again. Their data manipulation shows the inherent flaws in relying on studies directed by pharmaceutical companies for drug approval. When the FDA is deciding whether to approve a drug, they use research that was done by the pharmaceutical industry. Even though these studies have to be approved by the Institutional Review Board, the people assigning trial conditions, collecting data, and analyzing its significance are biased favorably towards the drug. If the FDA or any other non-biased organization had been solely responsible for testing the drug, Addyi would never have made it to the FDA. Pharmaceutical-funded studies should not be considered when the FDA decides whether or not to approve a drug.  There are other checks designed to prevent bad drugs from getting approved. Pharmaceuticals must also show that there is a market for their drugs, but the drug companies have extensive experience manipulating the market.

Pharmaceuticals should not be allowed to fund medical education or diagnostic tests, but much of medical research currently relies on pharmaceutical money. This is the case with Addyi. Before Addyi, there was little to no awareness of Hypoactive Sexual Desire Disorder, the disorder Addyi treats. There hadn’t been any diagnostic tests for HSDD, so Sprout Pharmaceutical designed several different tests so patients could diagnose themselves. They used these tests to research the prevalence of HSDD. Sprout Pharmaceuticals funded several studies that discovered a high prevalence of HSDD, because they needed to prove to the FDA that there was a market for Addyi. 

Doctors are surrounded by misinformation about disorders. Many of the studies available to doctors about HSDD and Addyi would have been partially funded by Sprout Pharmaceuticals. If a doctor decided their patient had HSDD, they might use a diagnostic test that was also funded by Sprout Pharmaceuticals. At this point, it becomes challenging to separate medical information from a pharmaceutical agenda. Drug companies are willing to mislead doctors and patients as long as they make more money. Even if pharmaceuticals hire neutral third parties to do research, the neutral party has a debt to the pharmaceutical companies that will bias their discoveries. This level of bureaucratic influence is so embedded in medicine, few people pay attention. If Addyi had only manipulated diagnostic tests and paid for doctors’ education no one would have noticed, but Sprout Pharmaceuticals went further. They paid to start a social campaign for their drug that co-opted the language of feminist activists.

Several people in the upper or middle management of Sprout Pharmaceuticals had connections with social justice organization which they used to start the “Even the Score” campaign. This campaign played on real concerns and anger to spread their message. The campaign was successful; Addyi was approved by the FDA. Only after Addyi’s approval did members of the campaign find out that the main organizers were employees of Sprout Pharmaceuticals. There was no reason for them to suspect. Even the people who talked directly to employees of Sprout Pharmaceuticals didn’t know about their affiliation. Many of these employees had worked in different sectors of the medical field before and were able to manipulate previous connection to get support for “Even the Score.” It isn’t just the money of pharmaceuticals that influences the medical field. There is a flow of people between pharmaceuticals and medicine that makes it harder for individuals to differentiate pharmaceutical companies and employees.

Addyi is far from the only example of manipulation by a pharmaceutical company. When pharmaceutical money and employees are diffused throughout the medical industry, it is impossible to escape pharmaceutical influence. The purpose of medicine is to improve the quality of life for patients. This purpose is often counter to a company’s profit motive. If the medical industry wants to treat patients, it will have to confront the extent of pharmaceuticals’ reach. Pharmaceutical funding of medical education and diagnostic tests should be banned entirely and employees should be required to disclose when they are marketing one of their drugs. Without these measures, the pharmaceutical companies will continue to fill their pockets at the expense of patients.

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