WP on the Vioxx litigation

Some common sense talk fueling the fire for tort reform:

Open societies flourish because they are driven by intelligence and information; the U.S. tort system creates an enclave of idiotic whimsy in the heart of the most open society in the world. But the Vioxx litigation does not merely celebrate dumb prejudice. It’s extraordinarily expensive. For this year alone, Merck has set aside a legal war chest of $685 million. The Vioxx lawsuits could eventually cost it between $10 billion and $50 billion.
Did those numbers sink in properly? The midpoint of those estimates — $30 billion — is six times more than the federal government spends annually on cancer research. Or, to put it another way, $30 billion is about five times Merck’s annual earnings, meaning that one of the world’s top pharmaceutical research establishments is fighting for survival. At a time when Americans fret over relative decline in science and business, it’s insane to sink a flagship scientific company in order to line the pockets of unscrupulous lawyers.

(via PointofLaw.com)

Comments

Anonymous
My question to you kevin is are you surprised? It is all about the money after all. Though I am sure we both agree that the initial studies supported removing vioxx from the market, it is going to take time to look at the level of risk with vioxx. But with the smell of money in the air the slime balls have come out. Look at the latest judgment in south texas. A 71 yo hypertensive, overweight, male with CAD s/p CABG who is STILL SMOKING takes vioxx for anywhere from 7-25 days and the jury determines IT’S VIOXX’s
FAULT? Awards almost 8 million (tried to award 32 million). So a few weeks of vioxx outweighs decades of tobacco abuse? What is wrong with this picture? I guess that’s what happens when you get 10/12 biggest morons in south texas selected on the jury (good jury “selection” guys). You remember Dow-Corning and the breast implant fiasco. Judgement’s in which the implants were blamed for all sorts of immune-medicated disease. Drove Dow-Corning bankrupt. Of course this all was based on “junk science”. Now that the appropriate science has been done this was clearly all BS. Do you think the plantiff’s and their attorney’s gave back one cent? No. It takes time to do good science. But after all now that there is money in the air who cares about good science. I am sure if this goes full swing Merck will end up bankrupt too. 5-10 years from now when the good science has been done we will find out that vioxx may or may not be clearly associated with a significant increase in MI’s. But by then it will not matter. The pharmaceutical industry will be going to China next. We will lose yet another industry. Pretty soon the lawyers won’t have anybody left to sue.
WilliamManginoMD
I agree 100%. However; there are some complicating issues surrounding this controversy.
A lot of money was made by a lot of people, riding the economic wave of NSAIDS that were advertised as being essential ‘Cure-all’s’ for chronic pain conditions; unfettered by the presence of potentially detrimental complications [or so they claimed ].
The general public made money-through investing in these drugs, as did the pharmaceutical industry.
In addition, the ‘War on Prescribing’ being carried out against doctors, uses – as one of its lynchpins – the purported efficacy of these medications as an accusatorial tool to denigrate the use of other medications – such as the opioids – which are also effective; as if to imply that anyone taking an OxyContin is a ‘Drug-seeking’ fiend, not worthy of membership in society.
Meanwhile, the medical profession and the ‘Celebrex retiree’s’ go about their daily routines oblivious to, and unconcerned with, an entire population of patients who would benefit from opioids – not withstanding the vilification of this class of medication and the fact that the safety profiles of opioids are better suited to support their increased usage- without sending 16,000 patients to the hospital each year for complications related to the use of NSAIDS.Especially in the aged population, where NSAIDS are much more likely to create complications than would be true for opioids.
Forget the nonsense about addiction [ which is unlikely if the medications are taken for legitimate pain ] along with the rest of the ‘myths’ surrounding opioid usage.
VIOXX and CELEBREX are good medications. Methadone is an adequate and cheaper drug for chronic pain. The OxyContin drug reps are also somewhat guilty of overzealous marketing.
I merely point out to you that this entire issue, dangers of cardiovascular insult from NSAIDS aside, has boiled down to economics. Does Merck deserve to be put out of business? NO
Is society guilty of discriminating against one of it’s subsets? YES
Has law enforcement tried to gain an unfair advantage by touting societies’ blind acceptance of a marketing scheme in order to further an unjust ‘War’ against pain sufferers and the doctors who try to care for them. ABSOLUTELY
But – what is the difference – as long as everybody makes a buck !!
William Mangino M.D.
Anonymous
” Or, to put it another way, $30 billion is about five times Merck’s annual earnings, meaning that one of the world’s top pharmaceutical research establishments is fighting for survival.”
Nonsense. That number is about 5 times Merck’s annual PROFIT, based on last quarter’s profit of $1.5 billion.
These cases will likely take a decade. Which means that based on this quarter’s earnings, Merck will make about $60 billion in that time. If they pay $10 billion out for Vioxx, then they will still have $50 billion in profit – that’s profit, not operating expense (including the expense of developing new drugs).
If you’re going to use scare tactics, at least use the known numbers correctly. That $50 billion estimate was pulled out of thin air, but even using that, Merck still made $10 billion in profit over that time. If you’re going to try and generate sympathy with made up numbers regardless of Merck’s liability, at least use numbers that don’t end up with Merck still making $10 billion.
As for Dow Corning, the only studies that have been done which claim the breast implant litigation was “junk science” were funded by Dow Corning.
“The pharmaceutical industry will be going to China next.”
OK, if you say so. I imagine they can’t wait to go somewhere where patent protection is virtually nil.
Anonymous
Given the documents that have come out showing that Merck intentionally had its reps downplay the risks of Vioxx to you physicians, do you feel like you were given accurate information on its risks?
Anonymous
Since when did making false statements about a major companies’ profits become common sense, Kevin?
Anirban
As for Dow Corning, the only studies that have been done which claim the breast implant litigation was “junk science” were funded by Dow Corning.
Are you referring to the epidemiologic study by Dr. Sherine Gabriel of the Mayo Clinic in New England Journal of Medicine on whether breast implants increase the risk of certain diseases and symptoms .It was supported by Plastic Surgery Educational Foundation and by a grant from the National Institutes of Health. Where Dow-Corning comes into the picture? The link is here.
http://content.nejm.org/cgi/content/full/330/24/1697
Anonymous
Correct Aniban the studies completed CLEARLY SHOW THAT THERE IS NO ASSOCIATION BETWEEN BREAST IMPLANTS AND IMMUNE MEDIATED DISEASE. Clearly we are dealing with a lawyer who has no clue what he is talking about let alone what good science is. Who care about the truth when money is involved.
Anonymous
Dr. Mangino,
I get the impression that you are an advocate of opioid usage. A representative of the main malpractice insurer in my state told me that they are currently facing three lawsuits due to opioid prescribing. In all three cases a patient was prescribed chronic opioids by a physician. The patients all continued to drive and were involved in motor vehicle accidents in which third parties were injured. The injured third parties are now suing the doctors for malpractice. The malpractice is based on the claim that the opioids impair driving ability and that the doctors should have made sure that these patients were not driving. DR. MANGINO, DO YOU MAKE SURE THAT PATIENTS YOU PRESCRIBE OPIOIDS DO NOT DRIVE? IF SO, HOW DO YOU MAKE SURE THEY ARE NOT DRIVING? IF NOT, YOU MAY END BEING THE TARGET OF A LAWSIT WHEN THEY ARE INVOLVED IN AN ACCIDENT.
WilliamManginoMD
Hi anon 5:45 AM.
None of my patients have ever filed a lawsuit against me.
Sorry to hear that some doctors in your state are being litigated against.
When patients take opioids, as directed, they should not be impaired by those dosages.
This means that the doctor is knowledgeable enough to prescribe these medicaions in the proper manner – and the patient adheres to taking the medication as prescribed.
There is no bona-fide medical reason why patients who take these medications should have any problems driving that would not have been caused by other factors, such as the concomitant use of other drugs or alcohol at the time of those accidents you refer to.
The information you provided to me is “Triple Hearsay.”
You were told that somebody said that somebody did something which involved yet even another person.
Maybe it would be good if you asked your family doctor if he prohibits patients taking insulin from driving – based on the rare and unlikely chance that too much insulin had sent these patients into a hypoglycemic spell-causing a car accident.
Thank you for your inquiry into my practice habits. Hopefully this reply will clarify the issues and dispell any concerns of yours that anyone might even try to mount a successful lawsuit against me.
William Mangino MD
Anonymous
Dr. Mangino,
Is this hearsay?
http://www.usalaw.com/a-aa-doctors-sued-drugs-auto-crash.html
WilliamManginoMd
Dear anon 11:05,
I wrote you an explanation of what I believe are the standards for opioid prescribing, as related to some questions you asked about practice habits.
I am not going to start reviewing auto accident cases you forward to me or point out to me on websites.
If you read my answer you should clearly be aware that proper prescribing should not be a contraindication to driving.
If you don`t agree – that is your right.
I believe what you originally conveyed to me was hearsay. You told me that in your state some representative of a medical malpractice carrier told you that there were accidents and they were related to overprescribing opioids and now the auto insurers were mounting a lawsuit against the doctors. All that may be factual – but your impression – or anyone else’s as to your statements, or your medical malpractice friend’s impression, and all of those allegations apparently are not, as yet, proven.
Why don`t you wait til this case is over and, at that time, present a review of the findings.
Until that time comes, I don`t have any other opinion about these circumstances.I`m trying to be nice and helpful to you.
Next time you address any questions to me-put your name on the communication.Provide the name of this ‘ representative’ you speak of – otherwise I`m not interested in debating this with you.
You asked questions about what basis I used to prescribe. Without knowing who you are I answered your questions faithfully and truthfully-according to scientific opioid prescribing facts-which are proven. If you are trying to tell me that there are doctors who prescribed opioids and those opioids caused an accident- thats not my problem, and it never will be-trust me.
If I can help in some other way-I will.Best wishes in resolving this issue.
Dr. Mangino
Anonymous
“DO YOU MAKE SURE THAT PATIENTS YOU PRESCRIBE OPIOIDS DO NOT DRIVE?”
Let us follow this reason to it’s logical conclusion. Then nobody taking any benzo’s should be driving. People taking sedating H1 blockers (benedryl), should not be driving, people with diabetes on insulin should not be driving, people who have taken sleeping pills the night before should not be driving (just in case). People taking anitnausea meds should not bedriving. People taking ANY medications which include somnolence should not be driving. Should people be warned of medication side effects yes. Should a person with widly metatstatic cancer on 100 mg oxycontin BID be driving…probably not. But there is a huge difference between that patient and somebody taking an occ. percocet. To make an assinine blanket statement like “DO YOU MAKE SURE THAT PATIENTS YOU PRESCRIBE OPIOIDS DO NOT DRIVE? is idiocy at it’s worst. But this is america where there is no longer personal responsibility. When in doubt find an attorney.

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