Re: Bayer s false and deceptive marketing for its Men s Multis for prevention of cancer

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June 18, 2009 VIA REGULAR MAIL AND FAX TO 973-254-4853 Gary S. Balkema, President Consumer Care Division Bayer HealthCare LLC 36 Columbia Rd Morristown, NJ 07962-1910 Re: Bayer s false and deceptive marketing for its Men s Multis for prevention of cancer Dear Mr. Balkema: The Center for Science in the Public Interest ( CSPI ) intends to file a lawsuit against Bayer HealthCare LLC ( Bayer ) for fraudulent and deceptive practices in the marketing and sale of Bayer s One A Day Men s 50+ Advantage multivitamin and Bayer s One A Day Men s Health Formula multivitamin (jointly, Men s Multis ). This letter describes Bayer s illegal practices and offers settlement to avoid the necessity of a lawsuit. If litigation is necessary, CSPI plans to seek an injunction prohibiting Bayer from representing (either expressly or implicitly) that any of its products can be used in the diagnosis, cure, mitigation, treatment, or prevention of disease. CSPI also may seek corrective advertising, restitution, damages, disgorgement, and attorneys fees. Facts Giving Rise to Bayer s Liability The details of Bayer s wrongdoing are set out in a complaint CSPI is filing today with the Federal Trade Commission, a copy of which is attached and incorporated herein by this reference. In summary, these are the facts giving rise to Bayer s liability: Bayer promotes the extra selenium in its Men s Multis for the mitigation, prevention, treatment, or cure of prostate cancer in several ways: on package labels, on its website, and in television and radio advertisements. Bayer has run at least 11 different television ads and at least 9 different radio ads since 2008 linking its men s multivitamins to the prevention of prostate cancer.

June 18, 2009 page 2 For example, the back of the package for One A Day Men s Health Formula bears this claim: Did you know that prostate cancer is the most frequently diagnosed cancer in men and that emerging research suggests Selenium may reduce the risk of prostate cancer? Similarly, one of the radio ads claims: Prostate cancer. It s an important subject. Did you know that there are more new cases of prostate cancer each year than any other cancer? And here s something else you should know. Now, there s something that you can do that may help reduce your risk. Along with your regular doctor checkups, switch to One A Day men s. A complete multivitamin plus selenium, which emerging research suggests may reduce the risk of prostate cancer. One A Day Men s. Because staying healthy is serious business. Bayer s website expands on these claims: Did you know that 1 in 6 men will face prostate issues? Prostate cancer is the most frequently diagnosed non-skin cancer in men, and emerging research suggests Selenium may reduce the risk of prostate cancer. The attached FTC complaint discusses the research in detail, but, in summary, the research does not substantiate Bayer s cancer claims and in fact shows that the amount of selenium in the Men s Multis may be harmful. The Nutritional Prevention of Cancer (NPC) trial, upon which Bayer presumably relies, shows that the benefit of selenium supplementation for the prevention of prostate cancer was limited to a very small subgroup of men with the lowest levels of blood selenium and low baseline PSA scores. More importantly, analysis of the NPC data found nearly a three-fold increased risk of diabetes in the men who were assigned to take selenium and who had the highest levels of blood selenium at the start of the trial. In making its claims, Bayer ignores the findings of the federally funded Selenium and Vitamin E Cancer Prevention Trial (SELECT), the most important and compelling study. It did not find any evidence that selenium reduces the risk of prostate cancer in average, healthy men. The SELECT trial was designed to last up to 12 years. However, in October 2008, it was abruptly terminated after the study s independent Data and Safety Monitoring Committee reviewed the SELECT data up to that point and concluded that selenium and vitamin E, alone or together, did not prevent prostate cancer in men. The Data and Safety Monitoring Committee was also concerned that more new cases of diabetes may have occurred in men taking selenium alone, compared to the men taking the placebo.

June 18, 2009 page 3 In January 2009, the details of the SELECT trial were published in the Journal of the American Medical Association for all to read. The authors conclusion: Selenium or vitamin E, alone or in combination at the doses and formulations used, did not prevent prostate cancer in this population of relatively healthy men. In fact, the American College of Physicians recommends against use of selenium supplements: Selenium supplements appear to increase the risk for diabetes. Although the findings need to be confirmed, long-term selenium supplementation should not be viewed as harmless and a possibly healthy way to prevent illness. Despite the public announcement of the failure of the SELECT trial to find any effect of selenium on prostate cancer risk, despite the possible increased risk of diabetes, and despite the recommendations of the American College of Physicians, Bayer continues to advertise the selenium in its Men s Multis as a way to prevent prostate cancer. If Bayer has additional scientific substantiation for its prostate cancer claims for Men s Multis, please provide it to me as soon as possible. In the absence of being provided with such additional substantiation, CSPI will presume that none exists. Bayer s Multiple Violations of State Consumer Protection Laws Bayer s claims (1) are illegal claims of disease prevention, (2) do not have prior substantiation, (3) fail to warn of the possible increased risk of diabetes, and (4) are generally false, misleading, and deceptive. Therefore, the labeling and marketing of these Men s Multis are unfair and deceptive under state consumer protections laws, such as Massachusetts G.L. c. 93A, Texas Business & Professions Code 17.41 et seq., District of Columbia Code 28-3905 et seq., New Jersey Statutes Ann. 56:8-1 et seq., California Business & Professions Code Sections 17200 and 17500, and California Civil Code 1770(a)(5) & 1770(a)(14) (jointly, UDAP laws). For the same reasons, these Men s Multis are both adulterated and misbranded in violation of state food and drug laws, such as the California Food, Drug, and Cosmetic Act, California Health and Safety Code 110660. As the manufacturer and distributor of these Men s Multis, Bayer is responsible for the injuries caused by its actions. Consumer injury occurs each time a consumer sees marketing for or purchases one of these products. Each occurrence is a separate injury. E.g., Aspinall v. Philip Morris Companies, Inc., 442 Mass. 381, 813 N.E.2d 476 (Mass. 2004).

June 18, 2009 page 4 Settlement Demand In light of the foregoing, CSPI demands the following to settle this matter at this time before filing suit: Entry of a permanent injunction that prohibits Bayer from representing (either expressly or implicitly) that any of its products can be used in the diagnosis, cure, mitigation, treatment, or prevention of disease. Entry of a permanent injunction that prohibits Bayer from any representation with respect to any disease for its Men s Multi s. Entry of a permanent injunction that mandates a series of corrective advertisements to correct Bayer s prior consumer deception with respect to the cancer-preventative benefits of its Men s Multis. Disgorgement of Bayer s profits from the sale of its Men s Multis since 2002, when it began making prostate claims. This offer of settlement will remain open for 30 days from the date of this letter, pursuant to Cal. Civ. Code Sec. 1782 and other state statutory notice requirements, after which it shall be automatically withdrawn and become null and void. Please have your own counsel contact me if Bayer is willing to discuss settlement or needs additional information about this lawsuit. Yours truly, Stephen Gardner Litigation Director cc: Michael F. Jacobson, Ph.D., Executive Director Katherine Campbell, Staff Attorney

Attachment Complaint to Federal Trade Commission