Healthy Skepticism Library item: 15440

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Rout M.
Gifts from Merck 'encouraged' Vioxx brand loyalty
The Australian 2009 Apr 19
http://www.theaustralian.news.com.au/story/0,25197,25345076-23289,00.html

Full text:

THE international drug company that manufactured anti-arthritis drug Vioxx gave expensive gifts to doctors as well as providing “brand reminders” such as pens and travel wallets to promote the drug.

The Federal Court heard yesterday that sales representatives from Merck & Co gave presents to GPs ranging from a “bone model set” to smaller gifts and that doctors who received such gifts from pharmaceutical companies, including Merck, were more likely to prescribe the drug.

Marketing expert Robert Donovan, from Curtin University, told the court that doctors who receive gifts feel a “sense of reciprocity” to the company.

“They (doctors) would have a greater likelihood of prescribing the drug than if they didn’t receive the gift,” he said.

Professor Donovan was called by lawyers acting for Graeme Peterson, the lead plaintiff in a class action against US company Merck & Co and its Australian subsidiary Merck, Sharpe and Dohme. Mr Peterson claims Vioxx caused heart attacks and strokes and the company played down risks of the drug before it was voluntarily withdrawn in 2004.

Vioxx was launched in 1999 and at its height was used by 80million people worldwide, as it did not cause stomach problems as did other anti-inflammatory drugs. Merck last year settled thousands of lawsuits in the US over the effects of Vioxx for $US4.85 billion but made no admission of guilt.

Professor Donovan said in his witness statement tendered to the court on Wednesday that he inspected Merck documents and found that the company provided a “variety of free merchandise” to GPs.

Under cross-examination yesterday by lawyers acting for Merck, Professor Donovan acknowledged that the sense of loyalty felt by doctors to repay the drug company would not breach their obligation to their patients.

The professor of behavioural science also said in his witness statement that Merck sales representatives were being trained to believe that the vascular risks of Vioxx were a “myth” or “bollocks”.

He quoted an internal document where a Merck employee had described the cardio-vascular risk of the drug as “bollocks” in the title. The court heard yesterday this was a draft document and its title was replaced by one deemed more appropriate by the marketing team, “CV (cardio vascular) and renal objections 101”.

But Professor Donovan denied this diluted his arguments about the culture of Merck and its internal training.

“Whether or not they were told that it was bollocks … the existence of a document like this supported my statement that they were told that the risk was non-existent,” he said. “I cited that document as indications of the mindset, if you like, of those doing the training.”

Professor Donovan disagreed with statements by counsel acting for Merck, Peter Garling, that he should withdraw the claim given the document was a draft.

“If it can be established that it was never used, even in an informal sense, I would withdraw it in terms of actually delivered,” he said. “But in terms of portraying the tenor of the training, I think the document exists. I was given the document. I assumed it was a valid document reflecting at least some of the training people’s mindset.”

The trial continues.