There is an excellent summary, which includes multiple relevant links, from the Kaiser Foundation daily Health Policy Report of the results of a US House of Representatives Committee investigation into how Merck marketed Vioxx. In short, the Committee charged that Merck trained its sales representatives to distract physicians from any concerns they had about Vioxx's adverse effects, and especially from the published results of the VIGOR trial that showed that Vioxx was associated with a higher risk of cardiovascular events then was naproxen. Representatives were instructed not to bring up the trial, and if asked about it, to refuse to discuss it.
The report concluded, "when concerns about Vioxx's safety arose, Merck appeared to use this highly trained force to present a misleading picture to physicians about the drug's cardiovascular risks."
It is tragic how a company once known for good science and good ethics descended to this level.
Undoubtably, this sort of dishonesty has had bad effects on patients, physicians, and the whole health cares system.
I'm still waiting for health care researchers to become interested in how concentration and abuse of power, and the resulting perverse financial incentives; cross-fires and double-binds; deception, disinformation, and propaganda; and coercion and intimidation have hurt patients, physicians, and the health care system.
But it's certainly time for more physicians, at least, to raise their weary heads from the trenches and start protesting these sorts of abuses. If we don't speak up, who will?
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