Merck Found to Have Breached UK Drug Code of Conduct by Improperly Modifying Recommended Guidelines

Merck & Co. is in the midst of the greatest debacle in the history of the pharmaceutical industry over claims that its embattled COX-2 inhibitor, Vioxx, should never have been approved.

In the course of litigating the 8,000 or more wrongful death and personal injury lawsuits involving the drug, there have been accusations made that the drugmaker not only withheld negative information about Vioxx, but that it also manipulated data in the single most important clinical test by deleting any reference to a number of heart-related deaths.Now comes word from the UK that Merck has been found in breach of that country’s drug industry’s code of conduct for improperly changing professional advice distributed to doctors treating high blood pressure in a manner that was designed to favor its own drug, Cozaar.

The charges that will be ruled on next week (against Merck) by the Prescriptions Medicines Code of Practice Authority arise out of  an examination of the close links between drugmakers and medical associations in the UK.  A similar problem exists in the U.S. where there has been an ongoing effort by a number of consumer watchdog groups to do away with the problematic conflicts of interest that permeate the relationship between physicians and the pharmaceutical industry.

In the UK matter, Merck produced promotional materials that described to doctors the so-called “ABCD algorithm” that was developed by the British Hypertension Society (BHS), a group of medical specialists.

The program includes advice on the treatment for hypertension that includes consideration of the patient’s age, ethnicity, and reaction to different treatments. In addition, the NHS specifically recommends that inexpensive generic drugs known as ACE Inhibitors should generally be the first treatment of choice.

When Merck produced reference material in the form of thousands of cards, posters, and mouse-pads to be used by doctors in their practice, the drugmaker changed the order and phrasing with respect to the recommended medications in order to give greater prominence to its own branded blockbuster drug, Cozaar – almost $3 billion in 2005 – which is far more expensive than the generic ACE Inhibitors.

The former president of the BHS called Merck’s action “a shame and an error.” Merck UK has announced it does not intend to appeal the ruling.

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