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It was a classic market reaction to monopoly power. Publicly, some doctors railed against the company’s action, arguing that “the new drug is no more effective than the old” or that “it has created needless anxiety for many patients.” [26] Others threatened to boycott Metrodin or to shift to new entrants like Humegon, a fertility drug that won FDA approval in 1995. Yet, in the end, Ares-Serono released its new drug, and fertility clinics scrambled to prescribe it. Indeed, they continued to prescribe it even as the price of the new product climbed steadily. According to one fertility specialist, “They did what they always do . . . they bought the doctors with grants, and dinners, and research prizes.” [27] Any short-term discontent over prices subsided, and competition remained limited.

In the mid-1990s, a trickle of developments seemed to suggest a more finite future for hormones. Researchers at Australia’s Monash University, a leading site for reproductive breakthroughs, managed to remove immature eggs from a woman’s ovaries without using drugs or surgery. They then matured the eggs in a test tube and fertilized and transferred them. In other words, they completed a successful round of IVF without any hormone treatment at all. [28] If such experiments could be replicated on a large scale, they could reduce the market for fertility drugs, or at least create a plausible substitute for them.

In the meantime, though, hormones remain a quiet but critical component of the fertility trade. Between 1982 and 1992, Ares-Serono saw its sales rise by an average of 22 percent a year. [29] The company sold $260 million worth of fertility drugs in 1991 and then watched sales more than double again between 1992 and 2003. In 2003 alone, the company’s sales rose by 31 percent, to $519 million. Its profits were $390 million, an astounding 75 percent of sales. [30]