Addyi: Not the Women's Sex Pill You've Been Waiting For

By Sally Chew 10/11/15

How did a drug with a shady past and "marginal" benefits get FDA approval?

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There’s a new sex pill in town, the very first for women. Too bad for sufferers of “low desire” that the story of Addyi (flibanserin) is looking so shady. Questions persist about the quality of the drug and also the process behind its FDA approval in August. 

Clearly women deserve some sort of help by now from the laboratories that concocted Viagra 17 years ago and then product-after-product for men. And there are profits to be made on women’s sexual difficulties: Addyi’s maker was snatched up for $1 billion immediately after the drug’s approval.

Many of the prominent experts who advocated for Addyi's FDA approval were on the drug company’s payroll. 

But the pharmaceutical industry might be the wrong direction for women to look in the first place. Addyi revives a debate about whether drugs can ever genuinely be of service to women in this way—as opposed to talk therapy, a well-placed divorce or looking into whether some other medicine you’re taking (a sleep aid, for instance) might be killing the mood on its own.

Part of the problem with Addyi, according to some of its opponents, is that it works a little too much like men’s little blue pill. “Women are more complicated, it’s not just increasing blood flow,” Georgetown University doctor and pharma-policy wonk Adriane Fugh-Berman told Slate last year. 

One of the pink pill’s other big troubles is the allegation that many of the prominent experts who advocated for its FDA approval were on the drug company’s payroll. 

Some of these advocates put together a non-profit organization last year called Even the Score to help push the approval through. The FDA had already rejected flibanserin twice; perhaps a more (seemingly) grassroots approach was called for.

“It’s time to level the playing field when it comes to the treatment of women’s sexual dysfunction,” the group’s website argued then and argues still, alongside logos from the Center for Health and Gender Equity, Women’s Health Foundation, American College of Nurse-Midwives, Black Women’s Health Imperative, Sexual Medicine Society and many more.

In the run-up to the FDA’s decision, Even the Score contributed an authoritative voice to the discussion, along with compelling numbers such as that there are 26 sex drugs on the market for men, compared to zero for women—until Addyi. The group was able to get several members of Congress to write letters to the FDA and to summon a good deal of public awareness.

Whatever Even the Score’s genuine sympathies for women with sexual dysfunctions, however, its members’ reliability as advocates was widely taken to task the moment it was reported that some had been paid. (Interview requests to Even the Score and some of its members went unanswered.)

Meanwhile, the National Women’s Health Network, Our Bodies Ourselves and other women’s health organizations said they felt the group’s anti-sexism approach was an inappropriate distraction from questions about whether research on the drug had been rigorous enough.

The Addyi campaign hit pay dirt. Yet the question remains: Did the strategy corrupt the approval process? 

“The high-road answer is that the FDA is trying to treat women equally to men and be responsive to their sexual needs,” says Dr. Prudence Hall, a California gynecologist. “The more correct answer, however, is that the company created this political campaign using and manipulating women to push the approval through.”

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Sally Chew was an editor at Time Inc.’s Health.com as well as at Vibe, Out and POZ magazines. She also authored a true crime book and was a wire-service reporter overseas. She last wrote about marijuana, the way our ancestors smoked it and which drugs belong on the suicide list. You can find Sally on Linkedin and Twitter.

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