Kevin, M.D - Medical Weblog

Merck's Vioxx victory: The blogosphere responds

PharmaEdge:
"Clearly, pharmaceutical companies have a responsibility to inform the public about the dangers of the products they sell. Twelve New Jerseyans, however, have provided us with news that that liability is limited. Just having a heart attack while taking Vioxx, at least in this case, is not sufficient to collect the Big Money."

The Uncooperative Blogger:
"I am glad it turned out this way, because I was afraid of what this would do to drug research and development in this country. There are allot of people out there, me being one, that suffer from illnesses that there is no known cure, or relief from. If the Jury went the other way, it could have caused companies to rethink investment in this field, or cause such a long delay in testing that it could have set us back a decade. So don’t start with that big pharma stuff with me. There are other reasons to be at the heels of 'Big Pharma' but this is not one of them."

Drugwonks
:
"Merck has just been vindicated completely in the second Vioxx case, without nuance, qualification, or conditional subparagraphs attendant upon article A, clause 4, section f(ii), subsection d(5)(j)(14)(b). And so for at least today, America will not take from the children and give to the lawyers."

Fred Cohen
:
"So, Merck clean-swept this case, coming away with a no-fault, no-damages-owed jury verdict. This was a pretty weak case scientifically, so the finding of no-fault in the plaintiff's death shouldn't be terribly surprising. What is more surprising, and what probably accounts for the positive market reaction, is the finding that Merck didn't mislead patients or commit fraud during its development and marketing of Vioxx. The plaintiffs apparently presented ample evidence to support their claims of malfeasance, so this verdict has to raise some doubt in the minds of other plaintiffs' lawyers. I think it makes the likelihood of a settlement for cases with prolonged exposure to Vioxx likely (that is no change in my opinion), but raises doubts as to Merck's eventual willingness to settle the borderline or clearly out-of-bounds cases. It's possible that Merck will continue the strategy of trying such cases until plaintiffs either realize that such suits are fruitless or agree to settlements on favorable terms for Merck. Either way, the outcome of the case is relatively good news for Merck, as it relieves some of the uncertainty in their intermediate-term liability exposure. But the biggest problem for Merck in the intermediate term isn't their liability exposure, it's their lack of exciting product, their employees' broken morale, their management's inability to do much right lately, and their difficulty in finding and retaining top talent to turn things around. This last factor will decide their ultimate fate. Merck has bled top talent like a stuck pig for the last couple of years, and they took with them the ivy-adorned cachet that Merck formerly touted to newbies. Merck needs some creative HR planning along with a strong PR campaign aimed at industry veterans to turn around this train."

Update -
Monty's Bluff:
"After today’s verdict in their favor, Merck is now 1 for 2 in its Vioxx trials. Given that the company faces over 6,500 product liability suits, their lawyers have little time to rest. Think about that number. 6,500. It will be a long time before Merck will be able to move on from Vioxx with that many suits being covered in local newspapers around the company.

I wonder if at the end of all this, Merck will end up pulling a Wyeth. You might recall that AHP (American Home Products) changed its name to Wyeth to escape the notoriety of the fen-phen diet drug problems. After 6,500 individual trials, if Merck stands by its plan to defend each lawsuit separately, the Merck name might not be one worth keeping."

Evan Schaeffer:
"If there's a winner on the plaintiffs' side, it's Mark Lanier, the lawyer who won the first trial for his client in Texas. He's looking pretty good right now. Even so, comparisons between Lanier and Chris Seeger, the plaintiff's lawyer in New Jersey, are unfair. Seeger is a competent lawyer who was well-prepared for his case. While there will be many theories as to why the results in the two cases might have been different, analyzing those results based solely on the respective lawyers is too simplistic. Behind the scenes, of course, that's exactly what plaintiffs' lawyers around the country will be doing. But aren't trash-talking and chest-thumping better left to rap stars, professional wrestlers, and U.S. Congressmen?"

The Settlement Channel
:
"The Humeston case had some flaws that were pounded home by the defense, despite an otherwise excellent job by Attorney Chris Seeger. The defense did a good job of painting Humeston as someone with a long history of cardiac issues and stress and raised sufficient doubt over the impact of Vioxx on the heart attack he had. Not necessarily fair or accurate, but obviously effective, and who said life was fair."

Comments

  1. Anonymous Anonymous  

    "And so for at least today, America will not take from the children and give to the lawyers."

    Lot of children take Vioxx?
  2. Anonymous Anonymous  

    ""Obviously, this is disappointing," said Frederick Humeston, 60, the plaintiff in the New Jersey case. "I put everything on the line for this … [but] there are goals in life not everyone gets to achieve. You have to learn to deal with it."

    Poor Frederick, he has to go back and work at the US Postal Service.
    He can always sue the USPS for causing his heart attack.
    This guy took Vioxx for 2 months and for a while there he thought he's hit the jackpot.
    The moral of the story is that if you took Vioxx and you're still alive you don't get nothing. And if you took it and died, your wife and her lawyer gets everything.
  3. Outcome bias explains the difference in verdicts, presumably with similar testimony. The Texas plaintiff was dead. The best plaintiff is a cheerleader, with brain damage, wheeled into court on a respirator.

    Outcome bias affects all parties to a trial. It violates the fair hearing portion of procedural due process owed to defendants.
  4. Anonymous Anonymous  

    Or it might just be that they were two different cases with two different sets of facts.
  5. Anonymous Anonymous  

    The Forgotten Benefits of Aspirin

    Almost on a daily basis, one may read about a new medication being developed or approved for the benefit of patients. At times, these announcements may praise the innovation and novelty of such drugs that are new and possibly available to all in need of it.
    But it’s possible the one super drug is not new and really is a super drug. In fact, it’s one of the oldest medications available, and that would be aspirin- the first non-steroidal anti-inflammatory drug (NSAID).
    Noted as ASA by doctors typically, aspirin effects have been noted for thousands of years, as the active ingredient comes from the bark of a White Willow tree, and long ago, patients with pain or a fever would chew on this bark for relief. Yet due to the harshness of the natural chemical of this bark, Bayer decided to synthesize it to make it more friendly to the user.
    Fast forward to over a hundred years ago and Bayer pharmaceuticals (pronounced ‘Beier’), which is the same company that brought us heroin and mustard gas, as well as methadone. The company originated in Germany, but presently has its U.S. headquarters in New York. Felix Hoffman, seeking to develop an agent for his father’s rheumatism, was involved in the development of what is known now as aspirin. And it was a difficult task to develop this drug, as it was toxic to the stomach due to the nature of the active ingredient again obtained from the bark of the white willow tree. Dr. Hoffman and others at Bayer developed a drug that proved to be tolerable to patients while keeping the active ingredient in tact through a method of delivery developed by Dr. Hoffman’s team at Bayer. After launching the medication, aspirin was priced at about 50 cents an ounce, as at the time it was only available in power form. Soon before 1920, aspirin developed the tablet form of the drug and was then available by prescription. Regardless, aspirin was responsible for one third of sales for Bayer during this time, due to its popularity at that time.
    While all drugs have side effects, aspirin is one of very few drugs that provides great efficacy and indications, with limited side effects. In fact, some of aspirin’s additional uses have been recently discovered. This may be why the New York Times called aspirin a wonder drug in the 1960s. In the 1970s, the mechanism of aspirin was isolated, which is the blockage of prostaglandins.
    With Aspirin and its potential life-extending benefits:
    Aspirin has been associated with decreased risk of asthma and prostate cancer in the elderly. Also, aspirin has been linked with lowering the risk of breast cancer and colon cancer as well. Aspirin is a blood thinner, and has been associated with decreasing the risk of heart attacks and strokes in certain patient populations, as the drug prevents clots. This was first suggested in the 1940s and the FDA suggested that it be the drug of choice for those who experienced a heart attack over a decade ago. Aspirin intake is beneficial for those after coronary bypass procedures. A topical formulation of aspirin was developed recently for those experiencing Herpes pain. The drug has been proven beneficial for those experiencing migraine pains. Aspirin at low doses is taken by many as a preventive drug to decrease cardiovascular incidents that may occur.
    Aspirin has been the best selling painkiller since the 1950s. It is not as addictive as other choices for patients regarding pain relief in particular. It is also the most studied drug- with over 3000 scientific papers published worldwide. Also, over 15 billion tablets of aspirin are sold annually, which amounts to about 80 million aspirin tablets consumed daily by others. This amounts to over 16,000 tons of aspirin consumed during this time, or about 70,000 metric tons of aspirin a year. Over a decade ago, a study was performed and concluded that twice as many people would choose aspirin over a computer, given the two choices, because of the benefits of the drug.
    Side effects would include GI bleeding if taken in large amounts, along with an association of Reye’s syndrome in children, yet both are relatively rare. Yet all things considered, clearly the benefits of aspirin outweigh any risks of the drug.
    Lately, there have been issues with other NSAIDs, such as Cox II inhibitors, without full recollection or knowledge that aspirin is in fact the world’s most widely used drug, and for good reasons.
    At times, something newer is not always better

    “We might die from medication, but we sure killed all the pain.” --- Conor Oberst

    Dan Abshear
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