How Big Pharma Failed Women’s Health

By Nicole A. Swartwood

Nicole currently works as a Research Analyst at the Harvard T.H. Chan School of Public Health. She received her Master of Science in Public Health from Emory University. Nicole also holds Bachelors in Science in Mathematics and Microbiology as well as Bachelors of Arts in German Studies, Religious Studies, and History, all earned at the University of Tennessee-Knoxville. 

The development of the oral, hormonal contraceptive was groundbreaking, revolutionary, liberating. The first advertisement for these oral contraceptives depicted Andromeda, who in Greek mythology is chained to a rock in the sea, breaking free; this advertisement championed that once women were released from the modern chains of a tempestuous menstruation cycle they would be free to live a life of fuller potential.

How could such a tremendous development lead to such a tremendous failure on the part of big pharma? Somewhere, along the way, pharmaceutical companies realized something about Sanger’s brainchild – it not only prevented unwanted pregnancies, but it also treated a slew of other conditions, from blood disorders, migraines, asthma, among many others.

With these realizations, however, we have rebound women on the rock of personal health surrounded by the sea of family planning. The use of hormonal contraceptives to treat chronic conditions creates a dilemma: do I treat my medical condition or do I attempt to conceive a child?

At this point, the author wishes to assert that she is not equating child-bearing with femininity and acknowledges that there exists a subset of the population that is content using hormonal contraceptives for their medical conditions. This critique is exclusive of that group (which may have their own concerns regarding access to birth control); it is for the women who have to choose between preserving their health and conceiving a child.

So why point the blame here at big pharma for expanding the use of a pre-existing drug? With the lengthy, involved drug development process, it has become common procedure to explore alternative uses of pre-existing, FDA-approved drugs; once a drug has been approved for use for one condition it does not have to be “re-approved” for treatment of a different condition. One-time approval is approval for universal applicability. The problem, however, lies in the focal shift of pharmaceutical companies from research and development to marketing of their products.

Since the development of hormonal contraceptives in the 1960s, efforts to develop new birth control drugs have stalled. The medical field has diversified the delivery method, leaving patients with a suite of choices from oral, IUDs, and inter-dermal transplants, but these methods have relied on co-opting existing technologies instead of new drug development. While this is a problem separate from the one being discussed above, it does reveal the new priority of big pharma – create and use drugs to maximize profits.

Despite this priority and the widespread applicability of birth control, big pharma should re-dedicate themselves to the development of new treatments – treatments that do not require an unnecessary, gendered decision from women to choose between her own health and bearing children. Why is it that women are faced with this choice? Several of the diseases that are currently controlled by birth control also face men – they receive treatment, so there must be alternative mechanisms of control. Would we ask men to face sterilization in order to manage their conditions?

The author issues a call for renewed drug development on two fronts – for new, treatments for these diseases being treated by hormonal contraceptives and for novel birth control treatments. It is time for a new pharmaceutical revolution for women’s health concerns – a revolution that truly allows women to break free of their gender chains and no longer be limited by gendered health choices.

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