Contraception, who cares?

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  • 06/18/2012
From the June edition of MedAd News:

Contraception, who cares?
By:  Peter J. Pitts

During an episode of “Mad Men,” someone asks (apropos of an advertising campaign for pantyhose), “What do women want?” Strolling by, agency principal Roger Sterling quips, “Who cares?”

Who cares, indeed?

There’s been a lot of news lately about pharmacists not wanting to be forced to dispense medicines about which they have moral objections, specifically Plan B, “the morning after pill.” A thorny topic, to say the least. Yet, despite all the hoopla from the usual suspects, there has been total silence from an important voice in the debate – the pharmaceutical industry.

On the one hand, that’s not surprising. Why, after all, would anyone want to interject themself into such a no-win, high stakes, high profile battle? But doesn’t a manufacturer who makes a product have a responsibility to stand up and be counted when their product is under attack?

(And, let’s face it, contraceptives are under attack. No value judgment here – just a fact.)

What? Pharma take a stand? Not only is this not unheard of, it is regular and accepted practice when scientific questions are raised. It is regular and accepted practice when safety and efficacy are debated.  It is regular and accepted practice when legislative questions arise.

Here’s a relevant example – pseudoephedrine. When many state and federal legislators wanted to ban (or severely restrict) the availability of many OTC products in order to address the scourge of methamphetamine (pseudoephedrine is a common ingredient, or “precursor,” in the manufacture of methamphetamine) both manufacturers and their trade association (the Consumer Health Products Association) went on the offensive.

But, then again, there’s no pro-meth lobby.

When it comes to pharmacists not wanting to dispense Plan B – there’s nothing but silence from the manufacturer. Has Planned Parenthood approached Teva (the maker of Plan B) to enlist its support? If so, what explains the company’s silence? And, if not – why not? Doesn’t Teva have the courage to speak out in favor of its own product? When the initial Rx-to-OTC switch debate was raging, Barr Labs (subsequently purchased by Teva) was quite vocal in its support of Plan B as an avatar for reproductive rights. Today – silence. Qui tacet consentire videtur? Not likely. So why is mums the word?

Could it be that leveraging reproductive rights at FDA was in Barr’s financial interest but that debating it “in the streets” isn’t? Is Teva afraid (should they side with Planned Parenthood and other such organizations) that there might be a boycott against many of its other products? 

Mums the word? Consider this couplet from Piers Plowman:

Thou mightiest beter meten the myst on Malverne hulles
Then geten a mom of heore mouth til moneye weore schewed!

That translates as, “You may as well try to measure the mist on the Malvern Hills as to try and get her to speak without first offering payment,” or, in more modern parlance, “Show me the money.”

Why the silence from Teva?  

It’s a shame and a sham that a principled stand on reproductive rights was silenced when it became associated with potential commercial risk – just as Secretary Sebelius’ recent reversal of FDA on further Plan B access was done to mitigate potential political repercussions. When politics and profit come before the public health – bad things happen.

As my father used to say, “A principle doesn’t count until it hurts.”



Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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