An "Even the Score" petition is currently charging the U.S. Food and Drug Administration (FDA) with sexism for not having approved a sexual pharmaceutical drug for women. However, although drawing heavily on feminist rhetoric of "equality" and "choice", the campaign was created by profit-driven drug companies with sexual pharmaceuticals in the pipeline.
I’ve always lamented that Canada’s federal health agency maintains a closed-door approach to pharmaceutical regulation. Health Canada makes no room for public or independent input into the drug approval process.
On October 27 and 28, I attended two pivotal FDA hearings in Silver Spring, Maryland. As a sociologist who has examined the sexual pharmaceutical industry since the rise of Viagra, the first hearing I ever attended on the subject of sexual pharmaceuticals was in 2010 when I signed up to testify against the approval of Flibanserin. Heralded by its makers and in the media as a "pink Viagra", Flibanserin is in fact a daily-use "desire drug" now twice deemed to be unsafe and ineffective by the FDA.
But in a more unusual move, the FDA billed the meeting last month as a chance for patients, patient advocates, and experts to weigh in on the main diagnosis that sexual pharmaceuticals for women promise to treat: Female Sexual Interest/Arousal Disorder (FSIAD). Despite the fact that FSIAD is a highly contested diagnostic category, it was selected in the ranks of HIV, Parkinson's, and sickle cell disease as a disease category with "unmet drug needs".
It seems admirable that the FDA is allowing non-industry people to have a voice in the drug regulation process. However, I wondered from the start whether the intention of this meeting was actually to appease those behind the Even the Score petition.
It turns out I was right to suspect that the companies behind this faux-feminist campaign would play a major role in this hearing.
The first day of the meeting was dedicated to "patient" and "patient advocate" perspectives. Upon arrival I noticed two busloads of women carrying goody bags, wearing matching turquoise pashmina scarves, and buttons that read "women deserve". We later learned that Sprout Pharmaceuticals (the makers of Flibanserin) and Veritas, a PR firm hired by Sprout, had paid many of these women’s travel to the meeting, a fact they had to disclose before testifying.
Day two was billed as the scientific portion of the meeting. To my dismay, the majority of the panel members recruited by the FDA are well-known to be working with or to have worked with drug companies on researching and developing sexual pharmaceuticals. With the notable exception of Dr. Rosemary Basson, a Vancouver-based sexual medicine physician, the majority of panelists seemed interested in which diagnostic criteria and endpoints would capture the widest net of women’s sexual problems in clinical trials.
While only able to speak in a few audience-designated spots, myself and allies from the New View campaign, a grassroots organization which challenges the medicalization of sex, managed to contribute our own two cents. We reminded the panel that despite numerous attempts and millions of dollars spent, we cannot "even the score" since drug companies have yet to produce a sexual pharmaceutical drug for women that meets adequate safety or efficacy standards. We expressed concern over the numerous social and interpersonal factors that could hinder desire that will not be solved with a pill. We also noted that there seemed to be confusion among patients and panelists about what constitutes "normal" sexual desire in the first place.
In my closing comments, while commending the FDA for doing the right thing so far despite mounting industry pressure, I was emphatic on one final point about the meeting on the whole. As drug companies dream up new ways to push their agendas, the line between the drug industry, "patients", and "patient advocates" is increasingly thin.