Role of Big Pharma in question after half a century of the pill

An independent study is needed of the pill’s impact on women’s lives.

IF YOU don’t know it yet, you will soon. This year in the US, Bayer Schering Pharma is celebrating the 50th anniversary of the oral contraceptive pill. Our turn comes next. The company launched the pill in Australia in 1961.

As head of a women’s reproductive rights advocacy group, I got the news early, in a letter from Bayer’s business unit telling of their planned “national communication program” to inform the public of “this important milestone in women’s healthcare”.

It invited me to “begin a dialogue of collaboration” that involved, as far as I could tell when I rang the number supplied, my group singing from the Bayer song sheet about the company’s “proud heritage” and current practice of “providing women with reliable and trusted contraceptive options”.

Already the media blitz has begun, with reports of a study showing that women taking the pill have a lower risk of dying from any cause when compared with women who have never taken it. In fact, the research, partly funded by Schering – and with authors who list as competing interests the receipt of payments from Schering Plough and Wyeth Pharmaceutical – concludes only that “at least in … [a] relatively healthy … cohort, oral contraception is not significantly associated with a major public health problem”.

A more critical non-profit-driven analysis of the pill’s impact on women’s health and lives reveals long-standing feminist scepticism about the first drug in history to be approved for long-term use by a healthy person. It was known before the first pill ever hit the market that estrogen increased the risk of cancer, but the first pill contained massive amounts of it – seven times as much as is used today.

In 1969, investigative journalist Barbara Seaman blew the whistle with The Doctor’s Case against the Pill. The book prompted a US Senate investigation that saw the pill become the first prescription drug to be accompanied by package insert warnings. Seaman was blacklisted for her trouble.

Magazines, under pressure from the pharmaceutical industry threatening to withdraw advertising dollars, refused to run her stories.

The pill provides no protection against sexually transmitted infections, as some of those who came of age in the era of HIV/AIDS learned at their peril.

Second and third-generation pills may put users at increased risk of deep vein thrombosis (especially if they are overweight), heart trouble (if they smoke), breast cancer (in the short term) and cervical cancer (in the longer term), although for some cancers, the drug seems protective.

The pill is contraindicated for women with a history of migraines, jaundice or liver problems and safety scares are not a thing of the past. In the mid–1990s, women in some parts of Europe were told that “third generation” pills posed a greater risk of potentially fatal blood clots than their just-as-effective predecessors.

The accumulation of such data led Public Citizen, a US consumer advocacy group, to petition the US Food and Drug Administration in 2007 to remove the pills from sale.

Despite all this, Seaman said shortly before her death in 2008 that if her daughters had wanted to go on the pill, she might have cried, but if her granddaughters should choose to, she could “live with that”. Not that she believed no questions remained, including those about possible interactions between the pill and antidepressants, the most common drug prescribed to Australian women.

Indeed, what becomes clear from looking at what data exists, is the corruptive effect of pharmaceutical money on the knowledge necessary to give women the information they need to make informed medical choices. Drug company-sponsored research tends to focus on potential new indications for old pharmaceuticals, or the relative benefits of a company’s new drug, compared with older offerings. Little research is available that compares drugs with non-pharmaceutical responses to women’s healthcare needs.

The sexual revolution underwritten by the pill was, on balance, a boon for women, though it too came with downsides. The enthusiastic promotion of the pill by population control agencies, the medical establishment and the pharmaceutical industry – a tripartite cheer squad that continues to this day – led quickly to a view that all women were or should be “on it”.

This has largely absented men from fiscal and social responsibility for contraception and the consequences of unplanned pregnancies (bye-bye shotgun marriages), despite the persistence of unlawful abortion

and the stigma of single motherhood.

Drug companies aren’t feminist organisations, nor deliberate drivers of radical social innovation designed to benefit women. They are businesses, seeking profits for shareholders through the creation and marketing of pills that, ideally, we can be persuaded to ingest every day for much of our lives.

The anniversary of the contraceptive pill is indeed a time for reflection on the role of Big Pharma in our health and lives. Just remember what the aptly named band Public Enemy says: Don’t Believe the Hype.

Publication history

Role of Big Pharma in question after half a century of the pill  The Age