Etonogestrel may sound like the name of an exotic bird species, but it's actually the active ingredient in one of the latest pharmaceutical products at the center of product liability litigation – NuvaRing. It is part of a class of synthetic hormones (that is, hormone analogues that were developed in a laboratory) first created in Germany in the late 1930s.
Of course, the German government at that time was hardly interested in providing birth control (except perhaps for certain segments of society). However, this is eventually what the class of synthetic hormones known as progestins came to be used for in the decades following the Second World War.
For all its effectiveness and advantages over other forms of contraception, the Pill has one major drawback – it only works as long as a woman remembers to take it as prescribed. This is why NuvaRing was welcomed when it was finally allowed onto the market about ten years ago. One could simple insert it and not have to worry about it for another month.
In addition to preventing ovulation, NuvaRing also inhibits the action of sperm entering the vagina. Furthermore, because the synthetic hormones are released continually, a smaller dose is required than is the case with oral contraceptives.
That's the good news.
The bad news is that the primary ingredient, etonogestrel, is also a type of “prodrug” - a chemically inert substance that is activated by the body's own metabolism (and thus known as a “metabolite”) - known as desogestrel. As far back as 2007, medical experts were calling on the FDA to ban contraceptives with this ingredient because of the heightened risk of blood clots.
A year later, the first wrongful death lawsuit was filed over NuvaRing. The plaintiff claimed that the product caused the death of his wife from a blood clot. Since that time, well over seven hundred lawsuits have been filed against drugmaker Merck. They allege that Merck's marketing of the product was misleading and minimized the dangers of potentially fatal side effects.
Naturally, Merck denies this. The cases are now going to trial. It's worth noting however that about a year ago, even as the company was involved in litigation over deaths related to use of the product, Merck held a “medical seminar” for a group of European doctors - which turned out to be an alcohol-fueled party. The event featured exotic dancers waving large NuvaRings, a drunken sing-along of NuvaRing-promoting lyrics set to pop tune melodies, and a presenter from the company emphasizing that “NuvaRing is suitable for absolutely everyone!”
The presenter gave no information to the doctors on potential risks, however. When a reporter at the event attempted to interview a Merck executive, questioning why there was nothing in the way of serious medical research being presented, she was told to “go to hell.”
All of this is understandable when you realize that as of 2010, NuvaRing had generated well over half a billion dollars in revenue.
Cotton, Mark. "Schering-Plough, Akzo Nobel Sued Over NuvaRing Contraceptive Device." Thompson Financial News, 20 March 2008.
Edwards, Jim. “At Merck, an Undercover Video and 40 Deaths Plague NuvaRing Birth Control Brand.” CBS News, 19 April 2011.
Walker, Marie B. and Henry I. Bussey. “Should 3rd Generation Birth Control Pills be Banned? - Petition to Ban 3rd Generation OCs due to Increased Clotting Risk.” ClotCare Online Resource, March 2007. Available at http://www.clotcare.com/oralcontraceptivebloodclots.aspx.
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