Big Pharma 

Big Pharma

Great piece by David Olive in the Toronto Star on the Vioxx fiasco.

Merck has a tradition, compared to other Big Pharma companies, of balancing solid research with profits. After all, it was Merck-sponsored research that led to the Vioxx recall. On the other hand, there were earlier studies, some based on Merck data, showing the same dangers, and lawsuits had been filed as early as 2001. Yet the VP for Research at Merck responded to the new study with words like "stunning" and "astonishing" ("I'm shocked! shocked!").

Olive says all these companies have a business plan which requires new product--either brand new patent-protected prescription medication, or a new application for an existing product. (A new application should bring new customers, at a minimum; it may even bring a new patent, protected for 20 years). But the new product is not coming fast enough, so all these companies are forced (for the sake of profit) to oversell what they've got.

Vioxx should only have been prescribed for patients with both arthritis and a known problem such as
stomach bleeding--and then only for a limited time. Instead it was prescribed willy-nilly to patients with chronic pain--many of whom were responding to TV ads.

Pfizer, maker of the only other COX-2 drugs on the market, Celebrex and Bextra, has wasted no time buying full-page newspaper ads encouraging Vioxx patients to promptly switch to its offerings. John Klippel, president of the non-profit Arthritis Foundation, despairs of that, telling the Wall Street Journal that osteoarthritis, for one, "is clearly associated with being overweight and paying less attention to exercise." Pfizer's COX-2 inhibitors have not been tested as thoroughly as Vioxx in post-launch studies, and in Dr. Klippel's estimation, should be avoided unless older and cheaper over-the-counter drugs prove ineffective.

Merck and Pfizer targeted their COX-2 drugs to a wide audience, when most medical experts believe they should be prescribed narrowly to those suffering the most severe gastrointestinal problems, and should never have been aggressively marketed as a widely useful painkiller.