Schering uses German medical association to promote HRT

Several thousand German gynaecologists have been the target of a campaign promoting postmenopausal hormone replacement therapy (HRT) which claimed that the negative findings of a major US study were of “highly limited relevance” to the German population. The message was, in part, disguised as the official statements of a large professional organisation for gynaecologists, the Berufsverband der Frauenärzte.

The campaign came after the sudden ending of part of the Women's Health Initiative's study into HRT in the United States in July 2002 (BMJ 2002;325: 61). The study, involving 16 600 women, showed a small increased risk of breast cancer, cardiovascular disease, blood clots, and stroke among women taking a combined form of postmenopausal HRT.

Just three days after the news concerning the US study most German gynaecologists received a fax from Professor Alexander Teichmann, from a clinic in Aschaffenburg, southern Germany, and head of the Berufsverband's hormone commission. He wrote that “the presented data are of highly limited relevance for German circumstances.”

Doctors became suspicious when they realised that the statement had been sent out from fax servers of two German companies that sell hormone treatments, Schering Germany and Jenapharm, a subsidiary of Schering AG in Berlin.

The fax also included an “information sheet” that doctors could copy and hand out to their patients. This sheet was, it said, authored by Professor Teichmann and members of the Berufsverband. However, after being criticised in the Deutsches Ärzteblatt, the official journal of the German Medical Association, for his apparent involvement in the leaflet, Professor Teichmann declined to take responsibility for it. “I had never seen the information for patients before it was sent out,” he said. Schering then admitted that the text had been written by the company without the involvement of Professor Teichmann or the Berufsverband. The company “regretted the misunderstanding.”

The information sheet provoked criticism in the journal because it did not mention that part of the US trial had been stopped early for safety reasons. However, according to a company spokesperson, Schering provided only logistical help and did not influence the wording of the paper.

• Since at least April 2001 Jenapharm has been registered as the owner of the commission's internet domain name. After a press inquiry about the domain last November the company removed the web page in a matter of hours.