The Aspirin Wars: Money, Medicine, and l00 Years of Rampant Competition

“The Aspirin Wars: Money, Medicine, and 100 Years of Rampant Competition,” by Charles C. Mann and Mark L. Plummer, Alfred A. Knopf, NY, 1991. This is the story of Aspirin, specifically Bayer Aspirin, from its discovery on October 10, 1897, through its growth phase to become the first blockbuster drug, the complications of the war years, stiff competition from products like Tylenol and Advil, and finally its use as a daily regimen to prevent heart attacks. Along the way, we learn the story of the FDA and the FTC in regulating over the counter drugs and their advertising. We get a glimpse of the inner workings of a German chemical company during the Nazi era. The authors provide a non-technical summary of subjects like prostaglandins.Aspirin, aka acetyl salicylic acid or ASA, had been prepared years before 1897, but Bayer had it tested and recognized its medicinal properties. Bayer, then known as Farbenfabriken vormals Friedrich Bayer & Company (Dye Factory formerly known as Friederich Bayer & Company), had begun as a small specialty dye manufacturer. The dyes were in the coal tar family. Chemicals from coal tar wastes had found utility as drugs. Bayer had begun in 1863 as Bayer and Weskott, a trader of natural dyes with a worldwide network of sales agents.Synthetic dyes were first discovered by William Perkin in England in 1856. Textile mills were a key part of the industrial revolution in England. Discovery of dyes there is not surprising, but how Germany came to dominate the dye industry through is another story. Germany had a well educated work force from the Prussian education system which provided free public education for all beginning in 1815. It also offered academic or technical high schools based on testing and apprenticeships for technicians. In addition, Justus Liebig established the first chemistry school at the University of Giessen in 1822. Chemists everywhere trained under Liebig. Perkin was a student of AW Hoffman, a Liebig student. Organic chemistry was founded in 1828 in Germany. By the time synthetic dyes arrived, the principles of chemical structure had been established. Dyes were the first organic chemicals to be industrialized.War with Germany posed major problems for Bayer. Aspirin had global potential. Bayer acquired a dye plant in Rensselaer, NY (near Albany) and equipped it to manufacture aspirin in 1902. It had two vessels made of pure silver, the only metal that could resist corrosive acetic acid at the time. The US entered World War I on April 6, 1917. The government confiscated German assets under the War Powers Act. On December 12, Bayer’s US assets including plants and trademarks were sold to Sterling Products, Inc., a small patent medicine firm known for lavish advertising. In 1920, US courts ruled that the aspirin tradename was generic. Similarly, in 1915, the English Board of Trade voided the aspirin trademark in UK. Hence, in the US and UK, any supplier could label their product as aspirin.German companies hoped the Allies would return confiscated property after the war, but that did not happen. Sterling had the problem that they lacked the expertise to run the plants they acquired. After much negotiation they signed a 50 year agreement with Leverkusen, the German headquarters of Bayer, to share profits on aspirin products sold in Latin America.From his travels in the US, Carl Duisberg, the head of Bayer, found the trusts like Standard Oil attractive. Dyes were not as profitable as they should have been due to competitors cutting prices. Duisberg tried to set up dye cartels, but they did not last. Finally, German chemical companies created IG Farben in 1916. The full name was Interessengemeinschaft der deutschen Teerfarbenfabricken (Community of Interests of the German Tar Dye Factories). Included were Bayer, Hoechst, BASF, Cassella, Kalle, and Agfa. Members co-ordinated activities and shared profits.After World War II, twenty-three IG executives were tried as war criminals at the Nurenburg; 10 were acquitted. IG Farben is criticized for use of slave labor during World War II (especially in their factory at Auschwitz), for manufacturing Zyclon B, the poison used in the death camps, and for its support for the Nazi government. Manufacture of poison gas in World War I and synthetic nitrates are also cited. The book reports that the British blockade cut off export markets. Manufacturing for the war effort was an available alternative. The oil-from-coal plant at Leuna proved uneconomical. The Nazi government agreed to make the plant profitable. Working with the Nazis was a challenge. When executives met Hitler the first time, he demanded a sizable contribution to the Nazi party. Supplying aspirin to Latin America during the war posed difficulties. Sharing technology or materials with the enemy was punishable by death.The Food and Drug Administration grew out of the Pure Food and Drug Act of 1906, which was intended to regulate patent medicines. Without regulations wild claims could be made and ineffective, even toxic ingredients used. The champion was Harvey Wiley of the Chemical Division of the Department of Agriculture. He believed if ingredients were shown on the label, consumers could make better choices. The act passed after a series of articles in Colliers and especially after publication of Upton Sinclair’s The Jungle.The Federal Trade Commission created in 1914, the same year as the Clayton Antitrust Act, to regulate unfair methods of competition. In the 1930s, competition caused more advertising of over the counter medications. Between 1934 and 1938, the FTC found 13 aspirin makers guilty of false advertising. The Food, Drug and Cosmetics Act of 1938, requiring that new drugs be proven safe, had languished in Congress for months, but passed after 73 people died from a sulfanilamide drug made with a toxic solvent.In the 1960s, the age of television advertising, the FTC began to require evidence to support advertising claims. Claims from Anacin or Bufferin of more effective or faster acting were challenged. By 1973, Tylenol from Johnson & Johnson had become the leading analgesic–having beaten Datril from Bristol-Myers.After the thalidomide incident, in 1962 Congress passed an amendment to the Food, Drug and Cosmetics act requiring that drugs be proven effective.Next came ibuprofen, discovered by Boots in UK in 1961. Upjohn brought it to the US for sale by prescription as Motrin. OTC products were offered by Bristol-Myers as Nuprin and American Home as Advil. Use of the Bayer name continued to fester. In 1977, Bayer AG acquired Miles Laboratories, and in 1986 changed the name of its US business to Bayer USA. Bayer aspirin’s share of the US market fell to 6% in 1986.The book tells the story of anticoagulants. Heparin the first anticoagulant was discovered at Johns Hopkins in 1916. It was isolated from the liver. Dicumerol was isolated as the cause of sweet clover disease in 1939. Cattle that eat spoiled sweet clover bled to death due to the presence of this natural anticoagulant. By 1941, dicumerol was in use to reduce the death rate from heart attacks. In the same year, aspirin was shown to be an effective anticoagulant. The idea that daily doses of aspirin could reduce heart attacks was apparent, but proof was difficult. Large studies were needed to be statistically significant. A large study completed in 1980 was inconclusive. Reevaluation of the data from multiple studies confirmed that aspirin reduces heart attacks. Margaret Heckler, Secretary of Heath and Human Services, announced the aspirin a day recommendation in 1985. Studies of reducing strokes and other conditions followed.In 1972, John Vane of Royal College of Surgeons (following up on work by Henry Collier of Royal Free Hospital Medical School at the University of London) discovered that aspirin inhibits prostaglandin synthesis. This is thought to be the way aspirin blocks headaches.Bayer AG acquired Sterling Winthrop's over-the-counter (OTC) drug business from SmithKline Beecham in 1994. Finally, Bayer reclaimed the U.S. and Canadian trademark rights to "Bayer" and the Bayer cross and the aspirin trademark in Canada after 77 years.The book ends before the arrival of Celebrex, another NSAD, in 1998, discovered by GD Searle/Monsanto and marketed by Pfizer.The authors cover aspirin, part of Bayer AG, the regulation of over the counter drugs, competitive analgesics, marketing, advertising, prostaglandins, and anticoagulants. Most of the book is very well written and highly readable. The authors describe some negotiations in excruciating detail. Credit their thorough research. The bibliography cites research publications as well as extensive legal cases. This will be a valuable read to those with an array of interests. Photos. References. Index.

I didn't really know what I expected this book to be, so I guess I have leave to judge it 'as it is'.Making Aspirin, and promoting it, and surviving cut-throat competition, and patenting it in its' various forms, and protecting market share over decades, and then continually revisiting all the myriad legal and medical issues both real and imagined... God, what a mess! There was a huge amount of money at stake, and the litigation and quarrels over every aspect of Aspirin kept many a lawyer very gainfully occupied for years and years.I cannot imagine the mind-bending amount of research and patience the authors must have had to make this book, and still make it readable (more or less). The effort alone to sift through all the stale convoluted legal details was by itself heroic!Read this book, not just for the excruciatingly detailed description of Aspirin in all its' aspects, but also to honor the extreme efforts of the authors to write the book.

interesting read on how big parma manipulates us to spend alot of money so they have huge profits

I grew up using aspirin. It has always worked for me. This book replaces the original copy I misplaced. It tells how aspirin was created and why it is so good for so many things. I will not take Tylenol or Ibuprofen.

An excellent book. Based on the marketing and publicity bulls*** surrounding aspirin and similar common drugs, but the hype and lies applies equally well to much of the modern marketing industry. A great and informative read.