Thursday, 22 May 2008 20:28
Ohio Shares in $58 Million Vioxx Settlement
Ohio Netting $2.8 million from Merck Confirms Potent Message of “Our Daily Meds”
ePluribus Media OhioNews Bureau
COLUMBUS, OHIO: The Ohio Attorney General’s Office has reached a settlement with Merck & Co., Inc. resolving a three-year consumer protection investigation by 30 states concerning the company’s deceptive promotion of the painkiller, Vioxx, which confirms the seldom seen view of the American pharmaceutical industry as one that has transformed itself into slick marketing machine that has hooked the nation on prescription drugs, as detailed by Melody Petersen's blockbuster book “Our Daily Meds.”
In her book, which arrived on my doorstep today, Petersen “connects the dots to show for the first time how corporate salesmanship has triumphed over science inside the biggest pharmaceutical companies and, in turn, how this promotion driven industry has taken over the practice of medicine and is changing American life.”
In a media release to ePluribus Media OhioNews Bureau from the Office of Ohio Attorney General, now overseen by Tom Winters in the wake of office scandals that lead to the firing of three high-placed individuals and the resignation of the individual elected to the office in 2006, Marc Dann, Ohio’s share of the $58 million payment to the participating states will be $2,844,980. The judgment, which was filed in Franklin County and awaits court approval, will largely restrict Merck’s ability to deceptively promote any Merck product.
- “The extraordinary injunctive relief and the amount of the judgment send an important message to other companies,” said Nadine Ballard, Chief of the Consumer Protection Section in the Attorney General’s Office. “When you engage in deceptive practices at the expense of consumers, Ohio will aggressively take action to change industry practices and seek substantial civil penalties.”
The terms of the settlement, as detailed by the Ohio AG, require Merck to submit all “direct to consumer” (DTC) television drug advertisements to the Food and Drug Administration (FDA), wait for approval and comply with FDA comments before running the advertisement.
The states’ Attorneys General, the media release said, expressed concerns that Merck’s aggressive early DTC promotion of Vioxx drove hundreds of thousands of consumers to seek prescriptions of Vioxx before risks of using the drug were fully understood by doctors. Merck agreed to comply with any recommendation by the FDA to delay DTC advertising for new Merck pain relieving drugs.
OTHER CONCERNS OF STATES CONFIRMED IN "OUR DAILY MEDS"
According to details of the settlement contained in the media release, the other concerns of the states, which are either prohibited or curtailed, are outlined in grueling detail by Petersen in “Our Daily Meds,” the book she wrote after writing about the pharmaceutical industry for four years as a reporter for The New York Times and that earned her the Gerald Loeb Award, one of the highest honors in business journalism.
Key points Petersen makes are that America has become the top consumer of prescription drugs in the world, with nearly 65% of the population on physician-prescribed medication, as a result of the goal of pharmaceutical companies to make and sell what’s most profitable rather than what medicines can do the most good for the most people for the least cost. In 2005, she said Americans spent $250 billion dollars on such drugs, which made pharmaceuticals the most profitable business sector in America from 1995-2002.
Petersen reveals the deceptive use of scientific data when marketing to doctors. The vast majority of the industry’s marketing dollars, she writes, is directed not at consumers but at physicians. She writes: “The industry’s cash-filled coffers have given it a stranglehold on medical science. Most of the nation’s best academic medical minds have at some time been on the industry’s payroll as consultants. As the drug companies’ influence has grown inside our universities, research priorities have abruptly shifted to hurt the public’s interest. Professors see more money in working in the next blockbuster heartburn medicine than in studying the environmental causes of cancer.”
In Petersen’s introduction to “Our Daily Meds” she says that the “drug companies’ chain of influence is so complete that there are few people left to look objectively at the effects of their products on the nation’s health or at the consequences of their power for society.”
The settlement also mentioned as another concern the “failing to adequately disclose the conflict of interest of Merck promotional speakers when these speakers present in supposedly “independent” Continuing Medical Education and conflicts of interest in Merck sponsored Data Safety Monitoring Boards
- On this point, Petersen said: “A very powerful technique that the drug companies spend millions and millions of dollars on is hiring physicians to give lectures to other physicians on their drugs. So, it looks like this physician is up there giving his independent opinion on this drug. But, he often, he's been trained by an advertising agency. His slide presentation has been created by an ad agency. It looks like independent science, but it's not.” [ Petersen, Bill Moyer’s Journal]
A further stipulation in the settlement agreement pertained to the “ghost writing” of articles and studies. Speaking to Bill Moyers on PBS, Petersen said medicine marketers have a plan to deceive the buying public. “They have a technique, which they benignly call publications planning. And what this is they want to get as many articles published in our medical journals as they can that show their products in favorable lights, and will get physicians to prescribe them. So, they often hire a Madison Avenue ad agency to write up an article for them or a study and the name of the ad agency rarely appears in the published version. Instead, they hire doctors to put their names on as author,” she said.
Citing an example of how this tactic has been honed, Petersen pointed to the PTSD Alliance. The group whose name is about Post Traumatic Stress Disorder, of which it’s estimated that five percent of the American public suffered from, was really the creation of a public relations firm working for Pfizer to sell more Zoloft. In fact, she said, it was staffed by the public relations firm and its offices were the same address of the public relations firm.
One dark fact she noted that the drug companies do not want to publicize is the sad fact that experts estimate that that more than 100,000 Americans die each year not from illness but from their prescription drugs. “Those deaths, occurring quietly, almost without notice in hospitals, emergency rooms, and homes, make medicines one of the leading causes of death in the United States.”
She contends that the cost to care for patients harmed by their prescriptions is about the same as the cost for the medicines in the first place.
She says “physicians have lost their way” and believes the public doesn’t understand that nearly all doctors, in one way or another, accept gifts and cash from drug companies and come to depend on this corporate largesse as an important part of their income stream. Some physicians, she says, take hundreds of thousands of dollars a year, effectively putting them on the drug companies’ payroll.
In 1951, she said Congress changed the law so that we would require prescription for certain drugs and that before then, anyone could go into the drugstore and get whatever we wanted. By making this change, Petersen said Congress wanted an educated physician who had the best interest of his patients at heart and was independent from the pharmacies and the drug companies to be the gatekeeper.
Another term of the settlement the state attorneys general required Merck to submit all “direct to consumer” (DTC) television drug advertisements to the Food and Drug Administration (FDA), wait for approval and comply with FDA comments before running the advertisement.
Petersen says that of all the developed countries in the world, only America and New Zealand permit drug companies to advertise directly to consumers. While seeking approval from the Food and Drug Administration sounds good, Petersen says the FDA, which once was only beholden to the interests of the public, now have a second customer, the drug companies.
This change happened in 1992, when the drug companies started to pay fees to get their drugs reviewed and approved, she said. Now, she says, scientists inside the FDA are under increasing pressure from drug companies to do what the industry wants them to do.
- “The system is so out of whack the way it is today, you really have to be careful. Don't take any drug without understanding the risks that it could have. Find the doctor who has thrown the sales reps out of his office, who has said 'I'm gonna do what's right for my patients'. And there are a growing number of doctors who feel that way and think the thing that could do the most good is to have a law that bans doctors from taking money from drug companies. We need our doctors to be our independent advocates again.” [ Petersen, Bill Moyer’s Journal]
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