Health: Did Wyeth Give This Woman Cancer?

Wyeth — the maker of Prempro, a hormone replacement drug linked to breast cancer — had warnings on its labels. But its campaign to sell the drug may have sent a different message

"GHOSTWRITING" — THAT’S WHAT the media’s been calling it. Big Pharma got blasted in August by the New York Times over how pharmaceutical companies — Wyeth being the lead example — apparently pay employees of medical-writing firms to draft scientific articles that promote company viewpoints. The articles are then sent to doctors involved in the research who read and attach their names to said articles, so that other doctors assume they’re perusing work written by fellow physicians, with no mention of the pharmaceutical companies’ role in it all.

Not true, insists the Wyeth camp. Steve Urbanczyk, Hubbard’s co-counsel, admits to a “strategic publications development committee” that determines where there are holes in the literature regarding science that’s related to Wyeth drugs. “The topics are strategically chosen,” he says, “but the literature is balanced and scientific. Wyeth pays firms to help doctors publish articles that are beneficial to other doctors.” It’s just like in post-WHI 2003, he says, when doctors were terrified of any use of progestin: “We see something like that, and we think it’s a good idea to put out a full review of all the science.”

But the Wyeth paper trails look damning. They look, in fact, like a third prong of HRT marketing. Consider the 2002 memo from a manager at DesignWrite, a medical-writing firm in Wyeth’s employ, to Wyeth’s “Menopausal Health Pub Management,” discussing the firm’s then-president of women’s health care, Mike Dey, who “has charged the Publication Committee with increasing the number of positive Premarin-related publications (Mike would like us to publish at least one study per month). This increase in publications is necessary to challenge the media’s recent focus on the … negative information on HRT.”

There are also the Publication Plan Tracking Reports, a detailed compilation of dozens of Wyeth-planned HRT articles. The invasion at Normandy wasn’t this strategically organized. The committee designed a chart of neat boxes: first the topic of the message to be conveyed (i.e., “Breast Cancer Message”), then the narrower theme/title of the article (i.e., “Is There an Association Between Hormone Replacement Therapy and Breast Cancer?”). (The answer in the published paper? “Difficult to evaluate.”) Then: who will actually write the paper; the “confirmed author” whose byline will appear; the date the paper is due; the due dates for multiple revisions between the writer and Wyeth and the “confirmed author.” Then come the target date and the journal for publishing. The chart shows article after article: Accepted. Check. Published. Check.

YOU PROBABLY HAVE Wyeth to thank for much of what’s in your medicine cabinet right now. Your Advil. Your Dimetapp. Your Centrum and Anbesol and Robitussin. Then there are the prescription drugs, heavy hitters like the antidepressant Effexor; Zosyn, the hospital antibiotic for drug-resistant bacteria; Prevnar vaccine to protect children from diseases — like meningitis — that are parents’ worst nightmares; Enbrel for crippling rheumatoid arthritis. And somewhere in Wyeth’s sprawling pharmaceutical headquarters in Collegeville, medical scientists are working with the World Health Organization on a drug that fights river blindness, which currently threatens the eyesight of 100 million Africans. They’ve donated the drug for clinical trials, and vow to give it away — not sell it — should it prove effective.

Buzz among the 5,000 area employees these days isn’t about that, however, or Prempro, or even the recent ghostwriting exposés (though thanks to the publicity, it looks like regulations against that practice are forthcoming), but about the $68 billion Pfizer buyout of the company scheduled to go down this month. (Pfizer itself just handed over $2.3 billion to settle federal charges for alleged marketing excesses in selling one of its own drugs, the painkiller Bextra.) The future of Wyeth as Wyeth is still a bit uncertain.