Should women really be celebrating the new libido drug?
Flibanserin, the newly approved drug that has been touted as the "female Viagra" and decried for its risky side effects, has been under an intense media spotlight for the past two days. Just days after Sprout Pharmaceuticals received federal regulators' blessing to market the drug, the small company got scooped up by a Canadian drugmaker for $1 billion.
The frenzy around the drug, known by the brand name Addyi, from both supporters and critics, merits a quick reality check. Here are three takeaways to keep in mind when thinking about this drug.
1) The drug's effects are small, and it's nothing like Viagra.
Women taking the drug every day had, on average, between 0.5 and 1 more satisfying sexual encounters per month than women taking a sugar pill. That's up from an average of two to three sexually satisfying events per month before they started taking the drug.
"The benefits seem to be very modest at best," said Fred Berlin, director of the Sexual Behavior Consultation Unit at Johns Hopkins School of Medicine. "I think it's important to not overstate the potential usefulness of this."
Whereas the pill is often compared to Viagra, it is fundamentally different: Viagra and other erectile dysfunction drugs address the physiological problem faced by men who want to have sex but can't get an erection. Flibanserin interacts with neurotransmitters in the brain to try to increase women's desire for sex in the first place and can't be taken episodically, when a woman wants to have sex — it has to be taken every day.
"At a basic level, the comparison to Viagra completely end at the word 'sex,'" said John Jaeger a partner at Decision Resources Group Consulting.
2) No one knows the price yet, but it may be expensive.
With all the efforts to bring down health care spending, this drug isn't likely to be at the top of the list of medicines covered by drug insurance plans. Jaeger said that in his preliminary talks with insurers, it's become clear that the drug is likely to be put on a "non-preferred tier," meaning the co-pay will likely be in the range of $75 to $100 a month.
"I don’t see somebody paying $100 a month co-pay ad infinitum so they can have sex once or twice more per month," Jaeger said.
3) Drinking and sex often go together, but this drug shouldn't be taken with alcohol.
Flilbanserin can cause fainting and severely low blood pressure when a woman taking the drug drinks alcohol. The Food and Drug Administration will require the drug's manufacturer to conduct three studies to understand the risks of taking the medicine and drinking.
So, is this drug really the feminist victory that it seems? Berlin said he worries that the drug may make women who have low libido but aren't distressed by it think they need to conform to a new societal norm.
"If they’re O.K., and aren’t in distress, they shouldn’t be starting to think they’re having some pathology," Berlin said.
Aside from the worry it may pathologize normal behavior, analysts and physicians also worry that the drug could be politicized. Women's groups have celebrated the drug, as evidence that women's health problems are finally being put on the same platform as men's. But some people wonder if instead of being a drug that evens the playing field, it actually reveals how women's and men's health continue to be treated differently. Would a sexual desire drug for men with similar risks and limited benefit be approved if it had similar results? Why are women's sex problems treated as a psychological problem and men's sex problems treated as a physiological issue?
"I certainly don’t think it promotes sexual emancipation," said Leonore Tiefer, a clinical psychologist at the New York University School of Medicine.