Case 5: Discussion Case Question 1
Do you believe that Merck acted in a socially responsible and ethical manner with regard to Vioxx? Why or why not? In your answer, please address the company’s drug development and testing, marketing and advertising, relationships with government regulators and policymakers, and handling of the recall.
There is considerable controversy surrounding this case study; I believe problems in the pharmaceutical industry continue today due to politics and lobbying. Overall, I believe that Merck acted in a socially responsible and ethical manner with regard to Vioxx. According to Gilmartin (2011), “After analyzing the data further and consulting with outside experts, the Merck scientists recommended that we voluntarily withdraw the drug. They said that it might be possible to go to the FDA, add warnings to the label, and keep Vioxx on the market, but they believed that the most responsible course of action in the interests of the patient was to voluntarily withdraw the drug. I, along with the rest of my management team and the board, agreed with the recommendation, and the drug was withdrawn.” As for management of the recall, I believe it was done well, without pomp and circumstance and in a manner that focused on the patient rather than the loss the recall was going to have on Merck.
In my opinion, if Merck had been focused on revenues, it would have gone back to the FDA to simply add more warnings to the label to keep Vioxx on the market. Instead, the corporation withdrew the drug and forfeited those revenues in the best interest of patients.
As for Merck’s drug development and testing, something seems to be fishy. At one point a scientist raised concern but those concerns weren’t followed up on. According to Winslow and Johnson (2008), “The reports, based on internal Merck documents that surfaced during litigation over its withdrawn painkiller, Vioxx, reprise some allegations the company faced in courtroom testimony. But researchers said the studies provide an unusual inside look at how pharmaceutical companies can use academic collaborators and medical journals as important tools to market their drugs. They also fuel a growing debate over drug companies' conduct in controlling and reporting results of clinical trials.” It seems that Merck may have swept this concern under the rug which I believe is unethical. That said, sometimes information is not known by the right parties.
In thinking about the corporation’s approach to marketing and advertising, all pharmaceutical companies provided ‘gifts’ to promote goodwill among physicians. Merck cannot be singled out for this approach. However, $422 million is a considerable about of money to have spent on marketing one drug to physicians. Merck also cannot be singled out for using celebrities to market its product as other pharmaceutical corporations did the same thing. I struggle with television advertising because there is simply not enough time to disclose the amount of information that should be disclosed in a 30 second spot. I think the quote from Hank McKinnell, CEO of Pfizer, as quoted by Lawrence and Weber (2014), says it all, “I’m beginning to think that direct-to-consumer ads are part of the problem. By having them on television without a very strong message that the doctor needs to determine safety, we’ve left this impression that all drugs are safe. In fact, no drug is safe.”
The relationships Merck has with government regulators and policymakers is clearly strong. According to Lawrence and Weber (2014), “Merck spent $40.7 million on lobbying between 1998 and 2004.” That is an impressive amount of money spent in six short years. I do not believe these types of relationships to be healthy as it has a negative downstream impact on physicians and patients.
Case 5: Discussion Case Question 2
What should or could Merck have done differently, if anything?
There are a handful of things that Merck could have done differently in the handling of