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There are two remarkable things about the painkiller Vioxx. One was its disastrous impact on those who took it. Before it was pulled from the market in September 2004, Vioxx probably did more harm than any other modern prescription medicine. Critics of the drug have estimated that up to 140,000 Americans suffered heart attacks or strokes and about a third died as a result of taking it—and that is not counting those who died in the other countries where the drug was sold. It was as if a full jumbo jet dropped from the sky every week for five years, yet no one noticed.
The other notable aspect of Vioxx followed its withdrawal. Big pharma does not like to go to court, in part because liability trials can involve public washing of dirty corporate linen. But when the victims of Vioxx started legal action, Merck, the drug’s manufacturers, decided not to settle privately. As a result, the company’s internal deliberations over Vioxx—the emails, memos, reports—have been made public. For anyone who ever visits a doctor, these documents matter. There are 20m pages of them. They constitute a warts-and-all record of what Merck’s staff were telling each other—but not necessarily anyone else—about Vioxx. It’s all there: bad tempers, bad spelling, back-slapping, back-stabbing. We trust drugs companies to be able to do things: look objectively at data, make decisions about people’s safety, gauge what patients need to know in order to stay alive. The documents show that this self-regulation can simply dissolve when big profits are at stake.
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