Wednesday, October 20, 2004

Blind-Siding the Back Ache

A couple of days ago a Washington Post article about the withdrawal by Merck & Co. of their flagship painkiller Vioxx caught my eye. Reason being, I’d written a column just a little over two years ago that questioned the sanity of advertising drugs like they were luxury automobiles and the Vioxx ad was my target. All glitz and a Dorothy Hamill endorsement graced the four-color page, followed by the grim reality of the small print on the turnover side.


Consumer marketing of drugs? When has the consumer ever been capable of evaluating his personal health choices? Consumer marketing brought us fast-food obesity, heavy metal ‘music’ and Paris Hilton. How could anyone, much less the Food and Drug Administration, agree to allow pharmaceutical companies to directly approach the public with complex drugs that have byzantine side-effects? Merck ponied-up $195 million in advertising.


A Google search of Vioxx brings a paid placement for a legal firm seeking class-action clients. Ah, the greed of the drug creator is so quickly overtaken by the greed of the litigator. The user it seems has been abandoned by both except as a target.


Interestingly, the Post article appears empathetic toward Merck. “Now their wonder drug was suddenly under a cloud and Merck officials faced a difficult decision about how to handle the catastrophe.” Further into the article, a Cleveland cardiologist is quoted as estimating that, among its 20 million users, Vioxx may have unnecessarily caused as many as 30,000-100,000 heart attacks and strokes. Thirty thousand to one hundred thousand ordinary citizens also “faced a difficult decision about how to handle the catastrophe.” My scorecard reads, Merck one costly misadventure, the public a personal disaster of huge proportion. In fairness, a very high percentage of Vioxx users probably got reliable pain relief without problems. But it was certainly a roll of the dice by consumers who hadn’t the vaguest idea of how the game was played.


Where have all the physicians gone? Abdicated to leave the drug companies in charge? Cowed by their insurance premiums, overwhelmed by paperwork, no longer with personal knowledge of their patients, the medical community has to a very large degree left us to the wolves at the watering-hole. The AMA ought to get off their asses and put doctors back in charge of health care while there still are doctors. The small print that Merck uses to assure consumers they ought not to use Vioxx without consulting their physician doesn’t count.


The AMA needs to come down four-square against:
· The advertising of drugs directly to consumers
· The use of “infomercials” in health care
· Kickbacks to doctors prescribing drugs
· Any medical article, endorsement or opinion that hides a financial incentive or interest
That would be a start.


Then they might take up the deplorable national conditions that have allowed the insurance and legal lobbies to so screw up our access to doctors that we are left to blindly flail around among the pages of slick magazines, looking for Dorothy Hamill’s health advice.


Nothing personal, Dorothy---I loved you as a skater.