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David Epstein

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Plato tells us that the philosopher Sophocles was once asked if he was upset at being too old to make love. Sophocles responded that he was happily free of his libido, as “it is like escaping from bondage to a raging madman.” Well, Sophocles would’ve made a garbage pharmaceutical rep. He should’ve said: “Bro, can you please classify this as a disease and develop an incredibly expensive, moderately dangerous and mostly useless drug to treat me even though I just told you I’m doing great?”

According to an investigation by the Milwaukee Journal-Sentinel and MedPage Today, that’s sort of like what happened with the drug Addyi, intended to treat women for a lack of interest in sex. (Full disclosure: If you’re not interested in this newsletter, just hang in there a few weeks; I’m developing a drug to make you interested.) Your six Ws:

What?

Addyi has been called the “female Viagra.” Except, it’s not a good analogy, because Viagra treats erectile dysfunction in men who want to have sex. Addyi, for $800 a month, is meant to treat the lack of want, not previously felt to be an illness. The Journal-Sentinel/MedPage Today investigation notes that a 1999 study — conducted by researchers tied to drug companies — reported that 43 percent of women have some form of sexual dysfunction, with many lacking an interest in sex. (Totally weird, since all of their partners probably starred in Hamilton and go to the gym every day.) The study didn’t ask the Sophocles question: Are you upset about it? According to the Journal Sentinel/MedPage Today, “A diminishing interest in sex naturally occurs as people age. It is not life-threatening.” How about speak for yourself, Journal-Sentinel/MedPage Today.

What should I know?

Before you take “the little pink pill” — they made it pink, because everyone knows women only take pink pills — just know that if you have any alcohol it might cause a dangerous drop in blood pressure and you might pass out. Huh, a drug that makes women pass out when added to a little alcohol. I’m thinking so hard right now and I really just can’t figure out who the market for that will be. Come on brain, work … alcohol, drug, increasing sexual desire, making women pass out … nope, I’ve got nothing. Seems like this puppy is safe.

What else?

The FDA ordered Sprout Pharmaceuticals, maker of Addyi, to conduct a study on that little passing out issue. So Sprout rounded up 25 subjects, including — Nice work, Sprout! — two actual human women. Score one for diversity in medical research on drugs made for women. The downside — I know, so ProPublica, always looking for a downer — was that some of the subjects suffered mondo blood pressure drops and passed out. In fairness, the 23 men in the study were lacking a female sex drive, so it was worth the risk.

Wait, there’s more?

According to the investigation, an FDA staff member reviewing the drug noted that female nondrinkers may have an even more severe reaction. Ok, I think I get it: Addyi is dangerous for women who’ve had a drink and for women who haven’t. And also for men. But those idiot men shouldn’t even be taking it, except for when the maker of the drug enrolls them in a study and they pass out.

Why did the FDA approve it?

It was actually rejected twice, and then approved, thanks to an editorial in a major medical journal by an advocacy group that Sprout Pharmaceuticals funded. That got several geniuses in Congress to pressure the FDA to approve the drug. Within 48 hours of approval, Sprout was purchased for $1 billion by Valeant, which is being investigated for price gouging and mail-order pharmacy shenanigans.

Wait, does it work though?

An independent study found that Addyi produced just 0.5 additional “satisfying sexual events per month” compared with a placebo. Well, that sounds … halfway nice? (According to the Journal-Sentinel/MedPage Today, Valeant said that most women won’t pass out from Addyi, and that further studies are ongoing.)

They Said It

An FDA spokesperson, on the fact that the drug barely seems to work: “As with all medications, some patients will obtain more benefit than others. Because (the condition) is symptomatic, patients can gauge whether they have meaningful benefit from Addyi.” And here I thought the FDA’s raison d’être was to keep patients from having to test drugs themselves.


SRSLY Shortstack

New York City is really expensive, in part because of high taxes. But for a lucky group of dead people, that’s no longer a concern, and not just because they’re dead. According to the Wall Street Journal, the city’s Department of Finance has continued to apply tax breaks to properties once owned by these now ex-senior citizens. (“Winning!” as Charlie Sheen would say.) The current owners — surprise? — have not been raising their hands to let the city know they should be paying more taxes. Hence, tens of millions in lost taxes. Like Ben Franklin said, the only certain things in life are death and post-death tax breaks.

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“Shots fired at”/“Shots heard near”... Tomayto/Tomahto

Additional research by Kate Brown.

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ProPublica does not vouch for the accuracy of stories appearing on SRSLY. We select, review and summarize key points from accountability stories that may not have gotten wide exposure. But we are not able to independently vet or vouch for the accuracy of stories produced by others. We will inform readers if we learn that stories have been challenged publicly or corrected.

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