The Vioxx vultures are circling. It's not a pretty sight. Damaged patients who understand nothing about drug development and everything about a bit of money are clogging up the media with their hard luck stories.
‘I just want people to know that the drug companies can't do this to people without telling them.’ Rubbish! She just wants a cut of the large amounts of cash that the lawyers are promising her. Did she read the drug insert? One more side-effect added to the list would have made no difference because it's almost certain she didn't read the one she was given. There are far too many people out there who don't realise that any drug that has any sort of action will — not may — have side-effects, and some of them will be worse than the disease they were prescribed for.
Vioxx is particularly difficult. It doesn't cause an obscure cancer, or a rare fibrotic reaction. Vioxx protects against an expected and common side-effect of non-steroidal anti-inflammatories, and one that kills people. People eat NSAIDs by the bucketload because they can then move around more easily, but every now and then someone bleeds to death from their gut. Vioxx makes it less likely that will happen, and not so long ago was regarded as a wonder drug that might prevent cancer as well. Sadly, there really is no such thing as a free lunch: yes, it probably did inhibit carcinogenesis, but the cost was heart attacks and strokes.
But heart attacks and strokes are common, really common; so how will anyone be able to decide whether Vioxx caused Mr Jones' or Mrs Smith's cardiovascular event? Well they won't be able to. But that won't deter the lawyers and expert witnesses. If I were Merck, my first question of any plaintiff would be, ‘Do you smoke?’ That ought to cut out a good few, but the law isn't quite as sensible as that.
Merck may have sat on knowledge about this side-effect for longer than they should, and we need to know the truth about it. We need sensible regulation that allows companies to protect their commercial interests while not sacrificing patients to them. This is something the state, not consumer law, should be sorting out.
Meanwhile, the same newspapers criticising the drug companies because of unexpected side-effects are clamouring for expensive new cancer drugs to be speeded through their trials so patients can receive them more quickly. Sometimes it's easier being a journalist than a doctor.
- © British Journal of General Practice, 2005.
