In The Story Of Vioxx, A Media Angle

By: Hillary Profita
Topics: Media Issues

(AP)

You might recall a big medical news

story from 2004

– the painkiller Vioxx, a drug used by about 20 million Americans at the time, was pulled from shelves by its manufacturer after it became clear that it posed a higher risk of heart attacks and strokes than previously reported. The manufacturer, Merck, now faces more than 10,000 lawsuits over the drug. But as today's Wall Street Journal (subscription required) reports, far less attention has been paid to the role that the oft-cited and highly respected New England Journal of Medicine played in the matter:

"While Merck has taken the brunt of criticism in the affair, the New England Journal's role in the Vioxx debacle has received little attention. The journal is the most-cited medical publication in the world, and its November 2000 article on Vioxx was a major marketing tool for Merck.

Last December, the journal repudiated the Vioxx article in an 'expression of concern,' but only after the drug had been recalled and more than five years after the article appeared. Had the journal acted before the recall, its authoritative voice almost certainly would have damped the Vioxx boom."

The Journal takes an exhaustive look at NEJM's missteps as well as the broader implications of such practices among medical journals in general. One doctor told the Journal that while NEJM should be praised for eventually issuing doubts about the article, they should have corrected it far sooner: "Had it acted earlier, he says, sales of Vioxx, 'would have been killed.'"

We've touched on this issue before, since medical reporting relies heavily on the content of journals like NEJM, and the potential that the data within them is misleading means reporting on it will require a lot more skepticism. Back in February, medical correspondent Elizabeth Kaledin discussed with us the implications of news that a South Korean scientist had falsified data in a science journal study that showed he had created stem cells from a cloned human embryo. Kaledin told us at the time that, like most medical reporters, she relies heavily upon research from science journals, so the revelations about Hwang made her feel particularly vulnerable: "Following the revelations about Hwang's work, she said that she would 'definitely read journal articles with more skepticism and will ask many, many more questions from impartial observers about the integrity of the research.'" However, Kaledin added that answering those questions is particularly challenging when it comes to the content of a journal article: "'Let me say how hard it will be to separate fact from fiction here. I am a reporter … not a stem cell scientist ... or a cardiologist … or an oncologist. No one can be a master of all scientific specialties. We rely on the journals and their panels of experts to weed out the diamonds from the dust. So the fact that a peer reviewed journal can't discern what is fraudulent data definitely makes me feel vulnerable.'"

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by peterbaldwin-2009 May 16, 2006 1:01 PM EDT: From the PLoS website: "PLoS Medicine is an open-access, peer-reviewed medical journal published monthly, online and in print, by the Public Library of Science (PLoS), a nonprofit organization." An international perspective always helps. Most brainwashed Americans believe that direct marketing to patients or schoolkids on stimulants is normal.; Reply to this comment


by peterbaldwin-2009 May 15, 2006 5:00 PM EDT: I meant high risk benefit ratio; Reply to this comment


by peterbaldwin-2009 May 15, 2006 4:53 PM EDT: Making NEJM the whipping boy for the Vioxx debacle looks suspicious. Even if we assume, arguendo, that the NEJM acted at the behest of Big Pharma in 2000, does that then rightly earn them scapegoat status, when it is the FDA that is entruted with the responsibility of scrutinizing drugs for safety? And aren't the pharmaceutical companies themselves responsible for pulling drugs that they know are unsafe. What is particularly disturbing though is that Vioxx, as a simple palliative, has about a zero risk/benefit ratio. There are plenty of safe alternatives, unlike AIDS or cancer drugs where untoward effects and toxicity is part of the equation in deciding whether or not to use.; Reply to this comment