Sometimes it is easy to forget how deadly serious the news
business can be and how dependent Americans are on us for
accuracy and the truth.
A handful of important topics came to mind this week as I
considered how easy it is to under-estimate the power of the
media on the everyday lives of the people in our audiences.
The most important one that comes to mind is the recent story
that the arthritis medicine, Vioxx, has been taken off the
market by its manufacturer, Merck & Co., because of studies
indicating it may be a contributing factor to heart attacks
and strokes. Specifically, the company said it was withdrawing
the drug following a review of data from a three-year colon
cancer trial. They say that in this study, there was an increased
relative risk for confirmed cardiovascular events, such as
heart attack and stroke, beginning after 18 months of treatment
in the patients taking Vioxx compared to those taking a placebo,
Merck said in a press release.
When you are a healthy journalist, or a young one, this story
can seem like no big thing and in fact, it could seem rather
boring to the average scribe. Arthritis? Heart attacks? Strokes?
Old people's diseases, right? Wrong. You would be surprised
how many young people, including little children, suffer from
painful arthritis. Young athletes are a growing crop of arthritis
suffers, both boys and girls, because of the pressure of competitive
sports and the push to play, no matter what the athlete's
physical condition might be.
This brings me to the point of how the media is covering the
Vioxx story, and how the media is also responding to claims
that similar drugs like Celebrex or Bextra may also be problem
How did all this happen? Were the Vioxx test results to the
FDA dummied-up, falsified? How long ago did Merck really know
they had a problem and what was the decision-making process
that led to not taking the drug off the market sooner? Was
this one of those Ford Pinto capers where a decision was made
that it was better to let a few folks die and pay off their
survivors in court, versus doing a recall that could save
For those of you too young to understand what I am talking
about, here's a primer. About 30 years or so ago, many people
died when the Ford Pintos they were driving or riding in were
rear-ended and the gas tanks exploded. It turns out Ford knew
about the problems for some time, but a bean counter did the
math and figured out it was cheaper to pay off the families
of a couple of hundred dead Pinto victims than pay for a recall
of all the dangerous cars and repair them. In other words,
it was more cost efficient to pay for dead people than to
fix the bad Pintos. What a business decision!!
It's one of the ugly tales of the corporate world, where the
almighty dollar IS the bottom line, above human lives, above
all else. I'm not suggesting Merck has done that, but the
question still has to be asked because worldwide sales of
Vioxx totaled $2.55 billion last year. Since the introduction
of the drug in 1999, more than 91 million Vioxx prescriptions
have been written in the United States alone. Someone has
to ask the tough questions about Merck's motives and who better
to ask those types of questions than the media.
Ninety One MILLION prescriptions!! Have you ever wondered
what prompts a doctor to recommend one medicine over another?
Does he/she just reach into the medicine sample drawer and
recommend whatever comes up in his/her hand? Hardly. Doctors
are pitched medicines by cute young chicks and cute guys.
The science of marketing medicine is more about the science
of hormones and pheromones between pharmaceutical reps and
the M.D. than anything else in too many cases.
When you get old enough to pay regular visits to multiple
doctors, as I have, you learn some things you never knew nor
ever wanted to know about the health field. I have spoken
with these pill reps because I see them making their "cold
calls" and I feel for them. I have never been a good
cold caller and I empathize with them. They have, in turn,
told me some of the tricks of the trade, the dress codes,
the "doctor etiquette," the whole nine yards. Knowing
the chemical technicalities of the drugs they peddle is a
given. But as we have come to see in many products, it's the
clean smile, the wink, the cleavage, the spiked hair, whatever,
that closes the sale.
I tell you all this because I often wonder, and question,
why one of my medical professionals may prescribe a certain
cure for me. What makes a doctor decide to tell a patient,
Vioxx versus Celebrex? The drug makers have it down to a system
and in the very competitive world of prescription drugs, there
is no margin for error.
The most important point here is that your average audience
member who hears the Vioxx story is immediately going to freak
and wonder if a heart attack or stroke is right around the
corner. For those of us who have arthritis, we never considered
the pain reliever the doctor gave us could lead to the final
curtain call. After all, whether it was Vioxx or Celebrex,
we took it to take away the joint pain. Nothing more, nothing
less. People RELY on the media to get the facts, not conjecture
or corporate spin. JUST THE FACTS, PLEASE! My life depends
It is not easy. But interview a few local doctors and ask
them what causes them to prescribe one drug over the other.
Ask them what Celebrex users should do now that Vioxx has
been pulled and there are suggestions that ANY "Cox inhibitors"
(used in Vioxx, Celebrex, and Bextra) are the problem. Are
there alternatives to Cox inhibitors? These are important
and very timely questions because the people who take these
drugs sometimes cannot even walk without the pain relief they
receive from these drugs. They can't afford to wait a few
months for the next New England Journal of Medicine study
or an article in JAMA (Journal of the American Medical Association)
to tell them if they can go to the store, visit a friend,
or simply go to work. Pain relief is a "here and now"
kind of issue and that's why your ACCUARTE reporting is so
key to Americans on such a major story.
An internet search will tell you that "Pfizer (the manufacturer)
says Celebrex is safe for long-term use." Another site
tells you that "Celebrex is safe unless you are allergic
to celecoxib, aspirin or other non-steroidal anti-inflammatory
drugs, sulfas, or any other drugs." Wow, you need a dictionary
to figure that one out and a lie detector to feel safe about
what you swallow in the name of pain relief.
I asked my doctor if I should keep taking the Celebrex he
prescribed for the pain in my overloaded knees because of
what I was reading and hearing from the media. He didn't hesitate
to tell me it was the best choice for me, and that despite
what I was hearing in the media, there were tests done years
ago on the safety of the drug and he had decided it was a
better choice for me than Vioxx. He told me his research was
a key factor in his decision-making on my prescription.
Just to seal my satisfaction in my doctor's decision-making
process, and to validate for myself that he was right and
too many media reports I was seeing were wrong, I asked him
about the Pfizer and Merck pharmaceutical reps he deals with
from time to time. He told me he thinks one is a "wannabe
cop" working his way through the college and the other
guy is a "biology geek." Neither description sounds
like someone that could trick, seduce, or unduly influence
my doctor into prescribing one drug over another because of
tricks of the trade. And "too much cleavage" doesn't
seem to be a factor here either.