Vioxx - Finally Merck Has Time for the Pain

The New York Times editorial mostly nailed the Vioxx verdict.  Some may remember hype because University of Rochester researchers figured out COX-1 and COX-2 pathways, got patents, and then didn’t cash in for the University when drug companies made a windfall.  Or did the Dodger get that wrong?

Anyway, there’s no money to be made in aspirin, and not much in motrin, advil and alleve being sold over the counter.  So the deal with Vioxx and its sisters is that it’s expensive, and prescription, the latter meaning free or nearly free for patients with prescription drug coverage.  Plus the doc gets to write a script [service at no cost and little time] and even get free samples to give out.

As a patient, you have to buy into the high priced spread being a better pain killer.  Which, it wasn’t.

Marketing something more expensive and no more effective [except for a few] was the crime to be prevented before the vascular effects emerged.


EDITORIAL
Punishment for Merck
Published: August 23, 2005
Merck deserves some sympathy, but not a lot, for the staggering loss it suffered last week in a case involving its painkiller Vioxx, which was withdrawn from the market because it raises the risk of heart attacks and strokes in a small percentage of patients. A Texas jury hit Merck with a symbolically staggering $253.5 million judgment (it will be reduced to $26.1 million under a Texas law capping punitive damages) even though the evidence that Vioxx actually caused the victim's death was extremely thin. The verdict may reflect the fact that Merck was facing an extremely capable lawyer, while its own lawyers committed blunders that alienated the jury. But before heaping too much sympathy on the beleaguered drugmaker, it is important to note that Merck brought a lot of this problem on itself - by failing to react quickly to evidence that Vioxx can be harmful in some patients and by promoting the drug beyond any rational use.
Vioxx is in a class of painkillers known as cox-2 inhibitors. These drugs are, in general, no more effective than many older nonprescription drugs at relieving pain. Their presumed advantage is that they reduce the risk of the gastrointestinal bleeding and ulcers that afflict a minority of patients who take the older painkillers. Unfortunately, aggressive marketing propelled them to wide use by people at little risk of gastrointestinal side effects