My Vioxx Rant: Shed No Tears For Merck

Maybe I should just start a separate blog about Drug Company evilness. From today's New York Times:

ATLANTIC CITY, April 5- Delivering a sharp blow to Merck, a New Jersey jury found Wednesday that the company had not properly warned patients of the dangers of its drug Vioxx and had caused a heart attack suffered by John McDarby in 2004. The jury awarded Mr. McDarby, who had taken Vioxx for four years, $3 million in compensatory damages and Irma, his wife, an additional $1.5 million.

Merck stock skidded 3 percent in after-hours trading after the late-afternoon verdict, the second multimillion-dollar award against the company in the four Vioxx cases that have reached juries. Lawyers for plaintiffs predicted that the victory, which came after a month of testimony, would cause the number of lawsuits against Merck to soar.

Poor Merck....Not. Had they not acted like fat little piggies who couldn't get enough of your or your insurance companies money, these lawsuits probably never would have happened, and they more than likely would be making a profit on Vioxx right up to today. It's a long story I know, but read on to see why.

Psst...wanna know a secret? Vioxx and it's cousins, Bextra (also pulled from the market), and Celebrex (still around) DON'T WORK ANY BETTER THAN OLDER PAIN RELIEVERS. Don't believe someone who goes around calling himself a Drugnazi? Let's take a look at the official Vioxx prescribing info for osteoarthrits:

At doses of 12.5 and 25 mg, the effectiveness of VIOXX was shown to be comparable to ibuprofen 800 mg TID and diclofenac 50 mg TID

(TID incidentally, is a medical term that means "we're too lazy to write out 3 times a day")

for rheumatoid arthritis:

VIOXX 25 mg once daily and naproxen 500 mg twice daily showed generally similar effects in the treatment of RA. A 50-mg dose once daily of VIOXX was also studied; however, no additional efficacy was seen compared to the 25-mg dose.

for general pain relief, including menstrual pain:

The analgesic effect (including onset of action) of a single 50-mg dose of VIOXX was generally similar to 550 mg of naproxen sodium or 400 mg of ibuprofen.

Seeing a pattern? Those new, fancy $100 a month meds you saw on TV worked no better than plain old Ibuprofen, naproxen, or diclofenac, which go generally for less than $15.

Not that Vioxx and friends were useless. A problem some people run into with Ibuprofen and other meds in its class (called NSAIDS) is stomach upset. Sometimes people can suffer serious GI (gastrointestinal) complications from taking NSAIDS. Sometimes. Millions and millions of people however, have taken NSAIDS for years with no problem. If you've ever taken Aspirin, Motrin, Aleve, Advil, or Orudis over the counter, you're one of them. But boy, it really would be nice if we could help those people who can't tolerate them, wouldn't it?

That's where Vioxx and friends came in. They were undoubtedly easier on your stomach. According to the VIGOR study (drug companies love to give cute little names to their clinical trials), GI problems were reduced around 50%. Whoo Hoo! We've got us a miracle drug! No need to read any more...seriously...just go and talk to your doctor about Vioxx. Hopefully just demand that he write you a prescription....so you can dance around the ice the way you saw Dorothy Hamil do in the ad on TV.

If you did read more of that VIGOR study however, you would have seen this:

The VIGOR study showed a higher incidence of adjudicated serious cardiovascular thrombotic events in patients treated with VIOXX 50 mg once daily as compared to patients treated with naproxen 500 mg twice daily. This finding was largely due to a difference in the incidence of myocardial infarction between the groups. Adjudicated serious cardiovascular events (confirmed by a blinded adjudication committee) included: sudden death, myocardial infarction, unstable angina, ischemic stroke, transient ischemic attack and peripheral venous and arterial thromboses.

Some definitions, for you non-medical types:

myocardial infarction= heart attack
unstable angina= unpredictable bouts of chest pain
ischemic stroke= a blod clot blocking flow to your brain
transient ischemic attack= a blood clot slows or temporarily blocks blood flow to your brain. Also known as a "mini stroke"
peripheral venous and arterial thromboses= blood clots get stuck in other parts of your body.
sudden death= sudden death

So what all this boils down to is this. When you took Vioxx or one of it's friends you were trading lower GI risks for higher cardiovascular risks. Common sense would say that Vioxx & friends should only have been prescribed for people at serious risk for GI problems or who couldn't tolerate the older NSAIDS. I'll sign my next paycheck over to anyone who ever heard that from a Vioxx sales rep though. Merck ran those TV ads for you and gave your doctor a song and dance that had them writing Vioxx or one of its cousins for every little owwie that came into their office, then had no problems cashing the checks that came in the door as a result. Had they made the slightest little effort to make sure their med was being prescribed appropriately, it would probably still be on the market as an alternative pain reliever for people at risk for GI problems. But in the end greed ruled, and destroyed.

I know I'm supposed to be a funny guy, and this post wasn't very funny. Especially for the people who are now dead. Merck, however, was at one point was laughing all the way to the bank. I guess humor all depends on your perspective.