Healthy Skepticism Library item: 1159
Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.
Publication type: news
Hormone Therapy Doubles Risk Of Dementia: Network Calls For Curbs On Drug Company Influence Over Prescribing
National Women's Health Network 2003 May 27
Full text:
Ten months ago, we learned that combined menopause hormone therapy increased the risk for breast cancer, heart attack, blood clots and stroke (JAMA. 2002; 288: 321-333).
Two months ago, we learned that combined menopause hormone therapy offered no benefit for mood, sexual function or vitality (N Engl J Med2003; 348).
Today, we have learned that combined menopause hormone therapy doubles
the risk of developing dementia (JAMA. 2003; 289: 2651-2662).
These study results pose two questions for us. The first is what will women do? And the second is why didn’t we have this information earlier, before tens of thousands of women had been harmed by using unproven drugs?
Now that we have the information, women will weigh it in light of their individual health needs and histories and will make the best decisions they can for themselves. Knowing the risks, some women may still choose to take hormone therapy for temporary relief from hot flashes or to prevent bone fractures, but no woman of any age should use this drug regimen for any other reason. Women must demand that any doctor recommending menopausal hormone therapy support that recommendation with strong, scientific evidence from a randomized control trial proving that the drugs are effective for the reason they’re being prescribed.
Women can, and will, take on this responsibility. But they shouldn’t have to. In this country, our medical and drug regulatory systems are supposed to guarantee us high quality care and assurances that the drugs prescribed to us are safe and effective. But these systems have failed women because political pressure has prevented effective regulation of the pharmaceutical industry.
Combined hormone therapy has been promoted for almost twenty years for long-term use by healthy women. During this time millions of women have used it and each year tens of thousands of women have suffered serious harm, including breast cancer, blood clots, heart attack, and even dementia, as we have just learned.
The die-hard defenders of hormone therapy will claim that the study results don’t apply to all women or all hormones. But there’s no evidence for those claims. And after decades of selling unproven drugs to women, it’s long past the time when women can accept such claims based on faith. We must demand evidence to support the drugs being prescribed to us.
“We have to ensure that our regulatory agencies have the resources they need to protect us and we have to demand that doctors prescribe based on evidence, not on drug company marketing,” says Cynthia Pearson, executive director of the National Women’s Health Network. “Health care providers and drug regulators have been unable to rein in drug company marketing and women have suffered.”
The Food and Drug Administration has made science-based decisions about hormone therapy, but the agency does not have the authority or the resources to stop the drug companies when they stretch the truth, distorting the facts and misleading health care providers and women. Doctors have let women down by not practicing evidence-based medicine. If doctors are going to deserve the place of trust they command, they
must accept the charge of seeking independent evidence for claims made by drug companies.
Health care providers often lack the time and motivation to seek out independent sources of information about new drug developments and instead have come to rely heavily on marketing materials, sometimes disguised as educational resources. Drug companies have used every marketing tool imaginable to persuade health care providers and women that hormone therapy drugs offer important, desirable and yet unproven benefits. Drug sales representatives make weekly visits to doctors’ offices bearing free drug samples, office supplies emblazoned with brand-name logos and expensive gifts. Drug ads fill medical journals, saturate medical conference materials, and are embedded in medical education lectures, paid for by drug company sponsors. Drug companies influence the vast majority of information that health care providers receive.
This marketing investment has paid off in billions of dollars of profit at the cost of harming tens of thousands of women. This has to change. It’s time to curb drug company influence. The Network calls for the elimination of drug company money from medical education; granting FDA the authority to pre-approve drug ads; and preventing people with significant financial ties to industry from participating in the
development of professional practice guidelines.
