Even now, years after sales peaked for brand-name hormone pills to treat menopause symptoms, the story of how the drug industry's marketing machine pumped up demand by positioning them as elixirs of youth remains pretty compelling.
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A package of Prempro pills in 2003.
Over the weekend, the New York Times dug into the tale of Premarin and Prempro, two drugs sold to replace estrogen lost due to menopause. The medicines are prescribed mainly to relieve symptoms of menopause, such as hot flashes.
But Wyeth, bought recently by Pfizer, created a much bigger market for the remedies by playing them up as all-purpose anti-aging pills to fight dementia, heart disease and weak bones. Ads encouraged women to ask for the medicines and articles in respected medical journals encouraged doctors to prescribe them for all sorts of uses.
Critics say Wyeth minimized overplayed some of the benefits and minimized risks. A federally funded study subsequently documented an increased risk of breast cancer and heart attack for women taking Prempro, for instance, and no benefit in protecting "against mild cognitive impairment" in older women.
Lawsuits against the drug maker have unearthed oodles of company documents about the marketing of Prempro, including Wyeth-financed ghostwriting of favorable articles by prominent doctors. The Times and the Public Library of Science sued to have many of the sealed documents made publicly available. (See this online repository.)
Pfizer criticized the Times' story in a statement, saying it was "based on a misleading and selective reading of both the science and history of hormone therapy (HT) medicines."
Harvard professor Jerry Avorn, a critic of drug company marketing unconnected to the Wyeth litigation, told the Times the information from the lawsuits "helps us understand how a belief in a 'protective benefit' of estrogens on the heart was able to spread like wildfire through the medical community."
Avorn figures "thousands of doctors prescribed the drugs for millions of women" based on the rosy information, shown to be faulty by subsequent research. He's curious to see if "courts are able to connect the dots and make it clear whether this was a kind of medical ventriloquism on Wyeth's part."
For an example of how the so-called ventriloquism went down, see a recent post by William Heisel on the seduction of an academic frontman for ghostwritten hormone articles. Another post looks at the doctor's pattern of publications favorable to Wyeth.