It was the Vioxx “scandal” that started me on this blogging journey nearly 2 years ago. The third post to this blog was entitled “Who Should Pay for Merck’s Obstructionism?” In that post I suggested that someone at the top should pay. Never did I dream that they would pay to have themselves exonerated!

As is often the case these days, whether you are talking about corporate greed or war crimes, it is hardly ever the leaders and managers who are held accountable. The same is true in this case for Merck, which has paid $21 million for an outside investigation that “largely exonerated the drug maker’s management of any wrongdoing in developing and marketing the painkiller Vioxx, citing much of the same evidence that critics say shows Merck acted irresponsibly” (see WSJ: “Merck Vioxx Probe Clears Officials Board-Ordered Report Says“).

[You can download the full report (large pdf file; 183 pages here.]

“[The] investigation found that some of Merck’s sales tactics were overly aggressive, but it pinned the blame on individual employees and said upper management was either not aware of or didn’t condone those practices.”

Where have I heard that defense before?

“One of [these practices] involved ‘neutralizing’ physicians that sales representatives had identified as ‘anti-Vioxx’ or ‘anti-Merck’ with payments, support for their clinical studies, trips to “elegant” locations such as New York or Hawaii, and medical-school grants. The report says these were merely recommendations and there is no evidence they were ever acted upon.”

No evidence. That’s all right then. Seems to me when my boss makes a recommendation, I better do something in line with that “recommendation” if I want to keep my job.

“The report also noted that a promotional aid called ‘the Cardiovascular Card’ used by Merck sales representatives to pitch Vioxx to doctors didn’t include data from a 2000 clinical trial that showed a higher incidence of heart attacks and strokes among patients who took Vioxx. But it excused this by saying that Merck provided a separate letter describing that trial to doctors who asked about it.”

Back in May, 2005, I posted information about the “Cardiovascular Card” and examined one of Merck’s internal documents related to how sales reps were trained to side-step the cardiovascular issue (see “Get a Load of Those Gams!“). I guess training comes under the heading “mere recommendation.”

The report also says:

“On the basis of our exhaustive review of the record, we have concluded that, prior to receipt of the APPROVe Trial cardiovascular results, none of the senior scientists at MRL [Merck Research Laboratories] believed that Vioxx was prothrombotic. Indeed, we were told by numerous witnesses, including [former research chief] Dr. Scolnick, [research chief] Dr. Kim and [former CEO] Mr. Gilmartin, that they, or their family members, were taking Vioxx up until the day that it was withdrawn from the market.”

It seems that this investigation is based wholly on hearsay evidence like the above. Statements by Merck’s upper management were just accepted at face value without any independent verification.

Merck’s actions in the months and even years prior to the “voluntary” withdrawal of Vioxx from the market has come under scrutiny not because any laws were broken, but because these alleged “obstructionist” actions violate a tenet of former CEO George W. Merck who said: “We try never to forget that medicine is for the people. Not for the profits. The profits follow, and if we have remembered that, they have never failed to appear.”

What Do You Think?

Is Merck’s Management Blameless?
Yes No Don’t Know

Here are links to more posts related to Merck’s Vioxx woes: