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When “Big Pharma” Makes It Tough to be a Skeptic

Skepchick

Rebecca Watson

February 25, 2011

But this is what it means to be a skeptic – doing your research and understanding that an industry can be suspect and immoral without necessarily being pure evil.

As an outspoken skeptic with a large audience and a keen interest in not dying of horrific diseases, I’m often accused of being in the pocket of “Big Pharma,” the shady multinational conglomerate of drug companies that makes money by poisoning our water supply and injecting children with heroin and thumbtacks.

Critics of Big Pharma rush to comment whenever I post a video describing the relative safety of vaccines, the effectiveness of achieving herd immunity, or the underhanded tactics of frauds like Andrew Wakefield. I am told that I must be cashing checks to defend products produced by pharmaceutical companies, since there is so much anecdotal evidence that they are evil.

When I first started getting comments like that, I had to laugh – back in 2003, I worked for a progressive activist organization in Seattle that was fighting the pharmaceutical industry in the hopes that Medicare could be reformed to include coverage for prescription medication.

When Medicare was enacted in 1965, prescription drugs weren’t very expensive and so it wasn’t a great burden for the elderly to pay full price for their medicine. A few decades later, the costs skyrocketed in the US with the pharmaceutical companies’ newly discovered power of marketing directly to the consumer: “Be sure to ask your doctor how Fungallipitox can work for you.” I knew many seniors in the area who took buses a few hours north to Canada, where their inhalers cost $20 per month instead of $200.

My organization and others like it eventually found a bit of success fighting the extraordinarily powerful pharmaceutical lobby ( tied with the financial lobby as the US’s largest), and in 2006 a prescription drug benefit was added to Medicare. Unfortunately, there are still gaps that leave many seniors paying a large portion of their income to keep themselves alive.

But this is what it means to be a skeptic – doing your research and understanding that an industry can be suspect and immoral without necessarily being pure evil. I know that pharmaceutical companies play dirty, but I also know that vaccines save lives.

All of which brings us to sex, and whether or not women are having enough of it. I know, way to bury the lede, right?

Female sexual arousal disorder is a hot new area of interest for pharmaceutical companies, who, you may recall, recently solved all of mankind’s problems by inventing Viagra. Viagra works by increasing blood flow to the genitals, thus curing erectile dysfunction, a disorder coined by Pfizer. Interestingly, it works the exact same way in women.

The problem that pharmaceutical companies face is that women don’t necessarily seem to react the same way to Viagra. Some feel their sexual problems are fixed, and others feel no difference. Women and their bodies, as you may know, are grand mysteries. Like unicorns. And for some reason, simply stimulating their genitals is not necessarily a guaranteed way to get them interested in having intercourse. “I’ve baked this lovely cake and set it in front of the unicorn, but the unicorn isn’t eating. Why is the unicorn not eating?”

“Perhaps we can invent a pill that will make the unicorn want the cake?”

“Yes!”

And so it was that the pharmaceutical companies created a pill: Flibanserin (sexy!), which directly affects the brain to trigger sexual desire.

With Viagra, the data showed that it could drastically improve the sex lives of men, and so it is difficult to fault drug companies for coining a phrase, tutoring doctors, and marketing their cure to the general public. In the case of female sexual arousal disorder, though, things are a bit more nuanced.

Dr. Petra Boynton recently spoke publicly about being offered £250 by a pharmaceutical company to sign her name to a pre-written paper that would tell doctors how many women suffer from arousal disorder. That same company offered her £1000 to attend sessions where she would hear more about the disorder before being encouraged to go tell her students, doctors, and the media about the issue. All of this was done before clinical trial data was made available.

She refused. She believes that the data supporting the safety and efficacy of these medications is unconvincing, noting that they perform only slightly better than placebo and they are never compared to alternative psychosexual therapies.

Dr. Ben Goldacre is similarly unconvinced. He also points out that much of the data on female sexual arousal disorder is suspect – for instance, one of the most cited papers on the prevalence of the disorder claims that 43% of women have it. This is based on a three-question survey that was sent out to 1749 women; an answer of “yes” to just one question is all that is needed for that woman to be labeled with the disorder. One of the paper’s authors later admitted that he held a paid advisory position with Pfizer.

It’s difficult for me, as a pro-sex feminist skeptic, to argue against a medical treatment that might improve the sex lives of women. It would be wonderful for pharmaceutical companies to once again coin a new disorder, and in doing so open up conversation about it. Ideally, this would encourage women to feel more comfortable opening up more about their sexual health problems, and researchers would commit more time and resources to studying these problems and putting them into context. Is the woman under stress? Is she unfamiliar with her body? Is her partner unwilling or unable to satisfy her? Or is she having a biological problem?

Unfortunately, that doesn’t seem to be the path we’re on. Instead of exploring those questions and encouraging sex education, pharmaceutical companies’ marketing departments are selling a magical cure-all pill that likely won’t cure anything at all in the women they are targeting. It’s classic Big Pharma: questionable trial results, paid opinion leaders educating doctors, marketing departments guiding research, and other underhanded, non-science-based tactics. As skeptics, we should speak out against this behavior when it is uncovered, and it will only strengthen our position when we are defending the Big Pharma products that are actually saving lives.

Rebecca Watson

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Rebecca leads a team of skeptical female activists at Skepchick.org and appears on the weekly Skeptics' Guide to the Universe podcast. She travels around the world delivering entertaining talks on science, atheism, feminism, and skepticism. There is currently an asteroid orbiting the sun with her name on it. You can follow her every fascinating move on Twitter or on Google+.