Upjohn's Contraceptive Hit by U.K. Official, U.S. Church

This spring, the Michigan-based Upjohn Corporation found its contraceptive, Depo-Provera, at the center of controversy on two fronts: from the British government, and from U.S. church stockholders.

Depo-Provera is a long-lasting, injectable contraceptive for women. It can cause heavy bleeding, weight gain, headaches, nervousness and depression. More serious risks include infertility, diabetes, and breast, cervical, and endometrial cancer.

The drug has never been approved for use as a contraceptive in the U.S. (See MM, August 1980, February 1981, and September 1981.)

The British government delivered a blow to Upjohn's promotion of Depo-Provera when the Minister of Health, Kenneth Clarke, rejected Upjohn's application to market Depo-Provera for long-term contraceptive use in the U.K.

"In relation to the long-term use of the product, the risk of using Depo-Provera outweighs the benefit," Clarke wrote in a letter to Upjohn dated April 21, which was quoted in SCRIP World Pharmaceutical News. (Depo-Provera is approved for short-term use in England.) Upjohn is appealing Clarke's ruling.

Clarke's decision on DepoProvera marks a victory for women's groups and consumer health groups that have been lobbying against the use of the contraceptive. In Britain, an organization called "Ban the Jab" has been active in this campaign.

Clarke took pains to deny that these groups had any effect on his decision. "We have not allowed ourselves to be influenced by any `political' campaigning about this product," Clarke said in an April 21 letter to the Committee on Safety of Medicines, reprinted in SCRIP.

After its British defeat, Upjohn faced a shareholder challenge on its home front. At Upjohn's May 18 annual meeting, the United Presbyterian Church, holding 1,600 shares of Upjohn stock, proposed a shareholder resolution requesting the company to send a report on Depo-Provera to all shareholders.

"The report requested would help shareholders make up their own minds about the advisability of Depo-Provera's use, both in this country and similarly for women in other countries," explained the proxy statement of the United Presbyterian Church. "There has been considerable scientific and ethical debate over Depo-Provera's health risks and potential for use as a contraceptive," Doris Campbell, speaking on behalf of the Unitarian Presbyterian Church, said at the annual meeting. "Part of that abuse is Depo's use in situations that we believe imply the double standards of both racism and sexism."

Upjohn staunchly defended its product. "We have complete faith in the scientific and medical merits of the drug," management said. "While studies of Depo-Provera in animals have posed theoretical risks of breast and uterine cancer in humans, we believe extensive clinical studies of women using the drug have not provided support for these theories."

Upjohn shareholders voted down the resolution, 93% to 7%. Still, the church was "very pleased with the shareholder support," said Chris losso of the United Presbyterian Church's social responsibility office. Iosso noted that 7% is a high score for shareholder resolutions that don't enjoy management support.

The controversy surrounding Upjohn's Depo-Provera contraceptive shows no sign of dissipating, particularly since the U.S. Food and Drug Administration has granted Upjohn a request for a Board of Inquiry hearing on whether it can market Depo-Provera as a contraceptive in the United States.

The three-person Board of Inquiry is scheduled to meet sometime this year-to rule on Upjohn's application.