IF YOU FOUND yourself on the jury for Weiss v. Wyeth or Kendall v. Wyeth or any of the 1,500 other v. Wyeth cases on the docket at the Philadelphia Court of Common Pleas right now, you’d probably get to know some major characters in this courtroom drama quite well. There would be Tobi Millrood, a lean-framed pharmaceutical litigator with an intense blue-eyed gaze behind square specs. He would tell you that Collegeville-based Wyeth spent years pushing its hormone replacement therapy drug Prempro for unsafe long-term use, overstating its benefits and understating its risks. You’d meet Heidi Hubbard, maybe the least scary lawyer working for any pharmaceutical company anywhere, with a sweet, clear voice and big eyes. She’d say that science is unable to pinpoint the exact causes of breast cancer, and thus “It is a misrepresentation to say that hormone therapy causes breast cancer.” There’d also be Esther Berezofsky, another prominent pharmaceutical litigator and a former clinical psychologist with a slight New York accent and swingy blond hair who’d tell you that the history of HRT is a history of misleading women, misleading physicians, misleading the public. There’d likely be Joe Camardo, a wiry gray-haired doctor who’s the senior vice president of Wyeth’s medical affairs, who says, “We constantly reevaluate our position in our drugs. We believe in this drug,” and you’d also probably hear from his colleague, bird-like Ginger Constantine, a women’s health exec and clinical researcher who calmly insists that hormone therapy drugs are and have been the most studied drugs in the country, and that science has always been Wyeth’s number one pursuit. She’d invoke a list of studies to prove this.
If you were on a jury, you’d be in a crossfire. And you’d probably be hoping that somewhere in all this talk, the scientific data would just speak for itself. But then you’d find that with Big Pharma, it’s damn near impossible to separate the science from the marketing from the law from the lengths to which a drug company goes to get us our drugs (its drugs). That this is especially true in the case of Prempro. And that this is what it boils down to, and why it matters:
Joy Henry, of Henry v. Wyeth, a 75-year-old from Camp Hill, wears a prosthesis in place of her left breast. She would tell you it never occurred to her — nor, she thinks, to her doctor — that taking Prempro would do anything but help her. And that she wishes she could go back and make another decision, knowing what she knows now.
PREMPRO IS THE offspring of Premarin, the matriarch of the drug family that comprised Wyeth’s top sellers from 1994 to 2001. For years, the Premarin family dominated the hormone therapy market, earning the company as much as $2 billion a year while relieving millions of women of their most wretched menopausal symptoms. And Prempro seemed like a wonder drug: Not only could it curb debilitating hot flashes, but it was also thought to prevent osteoporosis and lower the risk for heart disease — the number one killer in women over 65.
But in 2002, everything changed. A long-term government-sponsored study of the drug ended abruptly when researchers found that not only did Prempro not offer any heart benefits; it actually slightly increased the risk of heart attacks, embolisms and strokes. And then there was the clincher: breast cancer. The study, part of a larger effort called the Women’s Health Initiative (WHI), showed a 26 percent increase in risk for breast cancer over the general population.