Vioxx "Loyalty Program" Detailed at Trial

The <"">Vioxx trial that is ongoing in Australia has shed new light on the questionable tactics Merck & Co. used to market its dangerous painkiller. Now, according to The Australian, it seems Merck orchestrated “patient loyalty programs” that, publicly, seemed to be about increasing “quality of life.” Privately, reported The Australian, Merck was only seeking improved “patient compliance” and retention while doubling “sales potential.”

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Vioxx was approved for use in the U.S. in 1999, quickly becoming a blockbuster for Merck, with annual sales of $2.5 billion. Vioxx was pulled off the market in 2004 after an analysis of patients using Vioxx linked the defective drug to over 27,000 heart attacks or sudden cardiac deaths in the U.S. from 1999 through 2003. Vioxx was also recalled in more than 80 countries that year. The Vioxx recall spawned thousands of product liability lawsuits and, in 2007, Merck agreed to settle most U.S. Vioxx claims for $4.85 billion. But, Merck continues to defend lawsuits in other countries, including Australia.

The Australian cited internal court documents that show Merck’s Australian arm—Merck, Sharp and Dohme—planned a “patient support program” when it launched Vioxx to increase “patient retention.” Citing marketing briefs presented in court, The Australian said the drug giant presented a patient program in 2002 developed to calm consumer concern about Vioxx safety and sought to “block” the launch of a rival anti-arthritis drug.

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Graeme Peterson is the lead plaintiff on the civil case brought on behalf of more than 1000 Australians. Peterson blames Vioxx for his heart attack in December 2003 and alleges Merck knew about Vioxx’s heart risks, yet minimized them before it withdrew the drug in 2004, said The Australian. We recently wrote, citing The Australian, that leading American cardiologist Douglas Zipes testified that Vioxx played a “substantial contributing role” to the heart attack suffered by Peterson and “strongly believed” Vioxx was a significant contributing factor.

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Richard Harper, from Melbourne’s Monash University told the court that Vioxx “exacerbated” Peterson’s risk factors saying, “I believed Vioxx doubled his risk of heart attack. It increased the risk of someone who was already at a high risk,” quoted The Australian last month. One of the claims being made in the large class action is that Merck was aware of Vioxx’s cardiovascular risks long before it withdrew the drug.

Although Merck continues to fight the class action, a 2002 patient program, entitled “Vioxx—A Step in the Right Direction” revealed that while the program’s “external” objectives included myriad forms of patient education, internally, the objectives differed sharply and were not as altruistic as Merck would have us believe. For instance, said The Australian, there is documentation regarding several significant challenges faced over Vioxx’s cost and safety. To resolve this, according to one internal document, the plan stated, “Increase the average treatment time from three months to six months, effectively doubling sales potential for these patients,” and “Assist in blocking the launch of valdecoxib (rival drug) by taking up as many Vioxx patients as possible prior to the Bextra launch and holding them for the launch period,” quoted The Australian.

The document also discussed targeting General Practitioner (GP) physicians to recommend Vioxx to patients, who would then be provided with a welcome packet and the potential for a “prize of nominal value.” The document also stated that, “The patient is then asked to commit to remaining on therapy for the duration of the program unless they experience AEs (adverse events) etc in order to realistically achieve their goal,” quoted The Australian.

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