Friday, June 10, 2005

Drug Stabbing Time

Katha Pollitt, in last week's The Nation, laments the current sexism in America when it comes to sexual-drugs. The gist of the piece is that women are being discriminated against when it comes to the development, approval and supply of lifestyle sexual drugs. I can say with certainty that drugs are in development for both premature ejaculation - i.e. the prevention (delay?) of - and "Female Sexual Dysfunction", for example. You have got to hand it to big-Pharma, they really know how to coin medical conditions people don't know exist until the marketing departments get moving...

Anyway the development of the former is a lot further down the road than the latter. Pollitt does ask "Where's the female viagra they're always promising us?" Well, believe me "they" are trying and trying damn hard. In order to maintain profit growth the future of the pharmaceutical industry is to persuade people with more disposable income than sense (i.e. the Western World) that our lives are suffering in one way or another and that we need treatments for what ails us. Assuming that all people can be persuaded that they are not fulfilled by life for some reason or another (i.e. emotional problems, wherever they might manifest themselves; the bedroom, the mirror, in company, alone, pain, anxiety...), various treatments can then be developed and marketed and lots of money made. Obviously drugs are still being developed for clinical diseases but it's these lifestyle drugs where the mega-bucks are expected to be made, simply because the symptoms are so vague anyone can be diagnosed or even persuaded by good marketing to believe that they are "suffering".

I went off the point slightly there but, with regards to Female Sexual Dysfunction, the problem for the R&D departments is that sexual arousal in women is virtually exclusively stimulated by emotional factors, i.e. sexual arousal is in the brain, and that implies that, to arouse a woman that isn't being "turned on", mind stimulating drugs would be required, which would be, obviously enough, a little bit taboo. Viagra works best for men who are mentally aroused but not physically. Making women who aren't mentally aroused physically aroused is bugger all use, hence the lack of a "female viagra" to date.

Pollitt also mentioned that the FDA turned down an application for a testosterone patch for women who had had their ovaries removed on both health grounds and a fear that there was a potential for "off-label" or recreational use. Well, the FDA are incredibly strict about what can and can't be approved. There are huge numbers of people currently denied access to, for example, a proven multiple sclerosis drug (Elan's Tysabri) and a proven arthritis treatment (Pfizer's Bextra) because of isolated reports of fatalities, which are yet to be proven to be as a result of taking these treatments. I'm not suggesting, by the way, that either the testosterone patch might result in fatalities or that the FDA shouldn't be that strict (Tysabri and Bextra are drugs that were approved and later pulled because the clinical trials did not suggest these side effects were present), I'm just making the point that getting approval for any drug is immensly difficult. If, however, the "off-label" reason was a deciding factor then, frankly, that is a disgrace. I would imagine, though, that Proctor & Gamble, the developer, would resubmit for approval if that's the case.

Finally Pollitt makes the point that the cost of, for example, Viagra is covered by private health insurers in the States while the birth control pill is only covered (with loopholes) by legislation in 21 states. Again that is a disgrace too. I actually don't know if the birth control pill is covered by Ireland's Drug Payment Scheme but it should be as should all contraception and the "morning after" pill.
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