I'm a doctor, with no ties at all to the drug industry, and I've followed this issure closely since it first came out.
Point 1
Clinical trials dont have to be hidden to be confusing. The art of clinical sscience comes in pulling the "truth" out from the mess of randomness -- i.e. "results" that look a certain way just 'cause the dice were rolled enough that a by chance a false result looks true. "Conclusions" are "significant" when the chance of randomly false results is under 5% In other words, reliable studies are randomly wrong 1 time out of 20.
IN real life, 1/3 of all scientific studies turn out to have incorrect conclusions, as a recent review found. This is exactly why one week coffee is bad for you, and the next week coffee is good for you.
So anybody honestly looking at the data can have reasonable uncertainty about the importance of the results. When lawyers say "Merck knew", it's the lawyers -- not the company -- that are twisting the truth. I doubt its the lawyers' ignorance, since they're the only really big winners.
Point 2
The media isnt worth poo when it comes to assessing science, especially in regards to relative risk. Media twerps seem to be limited to "this bad" and "this good." Life isnt that simple.
Bottom line -- the studies showing problems with the COX-2 inhibitors like Vioxx DID show that there was an increased risk of cardiac events in those taking the drugs...BUT the risk was very small. As I'm remembering off the top of my head, the study groups found like 20 heart attacks for every 1000 people NOT taking Viox, and 45 heart attacks per thousand in those TAKING viox. It's much more exciting to say "double the risk" -- so the talking heads said that -- but in reality, for every person who had an MI on Viox, 50 people took it without any problem at all. AND, almost half of the MI's in people taking the drug WERE GOING TO HAPPEN ANYWAY. Try explaining that to a jury...
And this jury awarded the money even though the guy died from arrythmia, WHICH HAS NEVER BEEN ASSOCIATED WITH A COX-2 DRUG. PERIOD.
Point 3
Every arthritis and anti-inflammatory medicine except tylenol increases risk of heart attack. Celebrex (only at high doses), probably Bextra; and the entier Motrin family includig Naproxen and others all have SOME degree of increased risk.
It comes down to taking a risk because the benefit is greater. We do it every day when we drive to get groceries or go to work -- we might get hit by a plane or a drunk driver or a dump truck tryign to merge. WE drive anyway because experience has taught us that the risk is small and the benefits are greater. We try to minimize the risk by being smart, but only a neurotic will try to live a zero risk life.
Unfortunately, the media and the plaintiff's bar act like we should have a zero risk life. The outcome may be very rich lawyers, class action victims getting $150 each, and no drugs on the market. We've already lost domestic vaccine makers.... how far will we let it go? Knee jerk anti-corporate reactions will bite us in the butt -- so unless there has been real corporate malfeisance, which has never been suggested in the COX-2 case, punitive damages are ludicrous.
