Healthy Skepticism Library item: 15739

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.
Vioxx 'loyalty program' to lift sales
The Australian 2009 Jun 8
http://www.theaustralian.news.com.au/story/0,25197,25602208-2702,00.html

Full text:

PHARMACEUTICAL giant Merck and Co planned to set up patient loyalty programs with the public goal of increasing “quality of life” but privately to “improve patient compliance” and double the “sales potential” of its anti-arthritis drug Vioxx.

Internal documents tendered to the Federal Court reveal the Australian arm of the company proposed a “patient support program” at the launch of its blockbuster drug in 2000 to maximise “patient retention”.

The marketing briefs, presented by the plaintiff in a class action against Merck & Co and its Australian company Merck, Sharp and Dohme, also show staff proposed another patient program in 2002 to overcome Vioxx safety concerns and “block” the launch of a rival drug.

Lead plaintiff Graeme Peterson – on behalf of more than 1000 other Australians – blames Vioxx for his heart attack in December 2003. He also alleges the company knew about the cardiovascular risk of the drug and played it down before its voluntary withdrawal in 2004.

Merck & Co is fighting the class action, claiming there is no definitive scientific proof Vioxx caused heart attacks and that it acted responsibly.

The 2002 patient program, called Vioxx – A Step in the Right Direction states the “external” objectives of the program are to provide patients with education on the management of their osteoarthritis, including information on diet, exercise and treatment.

“Promote greater patient involvement in their disease management,” is one external objective. “Provide a value-added service to patients in order to improve diseases outcomes without placing additional counselling/education burden on existing GP”.

But the internal objectives paint a different picture. The document states there are several significant challenges to Vioxx – including negative publicity around the cost and safety issues – and an innovative patient program would increase patient loyalty to Vioxx.

“Increase the average treatment time from three months to six months, effectively doubling sales potential for these patients,” one internal document states. “Assist in blocking the launch of valdecoxib (rival drug) by taking up as many Vioxx patients as possible prior to the Bextra launch and holding them for the launch period.”

The document also details how the program would work, saying select GPs would be targeted and asked to recommend it to patients on Vioxx. Once signed up, the patient would get a welcome letter, a mini-diary, be asked to select a six-month goal like the ability to “garden again” and the chance of a “prize of nominal value”. “The patient is then asked to commit to remaining on therapy for the duration of the program unless they experience AEs (adverse events) etc in order to realistically achieve their goal,” it states.

The other patient program – proposed at the launch of the drug in Australia in 2000 – was given a provisional budget of $471,948. It aimed to have 20,000 patients enrolled by the end of the year and would have entailed sending welcome packs of a Vioxx pen, wash-bag and information on osteoarthritis as well as seasonal newsletters.

“A customer support program can assist … by adding value for doctors and maximising patient retention and compliance via direct communication,” the marketing brief states. It states the “external” program objectives that representatives should tell patients as providing education and support on arthritis.

The “internal” goals included retaining existing patients and improving patient compliance.

The trial resumes tomorrow.