The New Yorker comments on the Vioxx lawsuits

25 Jan
2005

Don’t do the Math

In the business world, bad news is usually good news—for somebody else. Ever since Merck announced, this past fall, that the pain reliever Vioxx could be linked to an increased risk of strokes or heart attacks, ads from lawyers trolling for potential plaintiffs (“Hire a Texas Vioxx lawyer,” “Vioxx injury claims”) have become ubiquitous on the Internet and cable television. Merck is already defending itself against almost five hundred lawsuits, and the number is expected to soar in the next few months. One Wall Street analyst has estimated that the company could face a total bill of more than fifty billion dollars. The impending parade of jury verdicts and out-of-court settlements may render a kind of rough justice. But you may not realize just how rough.

This interesting analysis focuses on the problems that risk-benefit analyses can cause companies when lawsuits occur. The final paragraph should make us all pause:

Obviously, there’s something wrong with a system that discourages the careful weighing of costs against benefits—we want companies to learn as much as they can about the downsides of their products. But companies like Merck, which spend hundreds of millions on ads targeting consumers, have themselves to blame, too. Instead of getting people to think about drugs in terms of costs and benefits, these ads encourage people to think of medicine in the same way they think of other consumer goods. It would be one thing if Merck had marketed Vioxx only to people who really needed it—people who couldn’t take ibuprofen or aspirin safely. Instead, the company marketed it aggressively to everyone, so that some twenty million Americans had Vioxx prescriptions. That’s why the potential damages against Merck are so vast. If juries have a hard time accepting a risk-benefit trade-off when it comes to drugs, it’s in part because the drug companies have convinced them that no such trade-off has to be made.

I believe that this paragraph gives great support to the comments that I wrote earlier today. The pharmaceutical industry, for their own protection, should support independent research on drugs. Only common sense and tradition are preventing this.

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Related posts:

  1. An interesting perspective on the Vioxx damage award
  2. Vioxx recalled
  3. Risks and benefits – what if Merck starts selling Vioxx again?
  4. More on Vioxx
  5. Another comment on Vioxx (now revised)

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2 Responses to The New Yorker comments on the Vioxx lawsuits

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ali

January 25th, 2005 at 4:36 pm

i feel like i’m approaching a dead horse with a stick, but don’t doctors share the responisibility for the “some twenty million Americans” with vioxx prescriptions (those with the ability to safely take aspirin or ibuprofen, that is)? maybe i don’t understand the prescription process – is it that patients are demanding drugs as consumers, and doctors are just the gatekeepers to their consumption? wouldn’t a doctor have the ability (responsibility) to say “what you have would be better treated with tried-and-true x” – rather than filling a prescription for the latest shiny package with the cool name?

Avatar

Shannon Brownlee

January 26th, 2005 at 7:16 pm

Doctors should indeed shoulder some of the blame for the Vioxx fiasco, but probably not your community internist or even your rheumatologist. Rather, resposibility for the over-prescribing of Vioxx also lies at least in part with the academic physicians who served as unofficial company spokesmen and women for Merck, and for Pfizer, and for other pharmaceutical companies who use “KOLs” or Key Opinion Leaders, as they are known on Madison Avenue, to market their blockbuster drugs to physicians. These KOLs are generally highly regarded academic physicians who are paid consulting fees and speakers fees by the companies, and who in turn talk up their benefactors’ drugs at CME conferences, medical meetings, and to medical students. This is the soft-money side of pharmaceutical marketing, the quiet manipulation of expert opinion, which ultimately carries great weight with community doctors and affects their prescribing patterns. The trouble is, the practice of accepting industry largesse has become so commonplace and so acceptable that academics don’t really know that they are being used by pharma — or maybe don’t want to know.

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