Last night while channel surfing, I watched about 10 minutes of a PBS show
on channel 13 that was practically kissing the feet of Merck, a huge drug
company, for making some medicine that fights river blindness free to
Subsaharan Africans. I said to myself, "This fucking show has to be funded
by Merck."

I was right.

http://www.pbs.org/wgbh/rxforsurvival/about-project.html
About the Rx for Survival Project

During the twentieth century, the world lived through a golden era in
public health: vaccines were discovered, diseases were cured, and the
average life expectancy rose by many years. In recent decades, however,
this stunning progress has declined dramatically. Although life expectancy
remains high in developed nations, in many countries of the developing
world it has actually fallen.

The march to better world health has been slowed by the emergence of new
and devastating diseases such as AIDS, SARS and West Nile virus, by
microbial resistance to many modern drugs and by a global travel network
that can turn a local disease into an international outbreak in a matter of
hours.

Recognizing the impact of both the slow down in medical advances and the
speeding up of new and stronger diseases, the award-winning documentary
team of WGBH's NOVA Science Unit and Vulcan Productions, Inc., is
co-producing a groundbreaking multimedia project to address what makes us
sick, what keeps us healthy and what it would take to give good health the
upper hand...

Funded by the Bill & Melinda Gates Foundation and The Merck Company
Foundation, Rx for Survival and Rx for Child Survival have been developed
in partnership with the Global Health Council and with the advice of other
leading global health experts and organizations.

===

My guess is that any free medicine that Merck is handing out now is part of
a calculated PR effort to deflect attention from the bad publicity the
company received in the aftermath of the Vioxx affair.

washingtonpost.com
Merck CEO Resigns as Drug Probe Continues
House Panel Critical Of Vioxx Sales Tactics

By Marc Kaufman
Washington Post Staff Writer
Friday, May 6, 2005; A01

Merck & Co.'s longtime leader Raymond V. Gilmartin abruptly resigned
yesterday on the same day congressional investigators released a slew of
documents detailing how the company continued to aggressively promote its
arthritis drug Vioxx after it knew of potentially serious safety concerns.

The documents made public by the House Committee on Government Reform
showed that Merck directed its 3,000-person Vioxx sales force to avoid
discussions with doctors about the cardiovascular risks identified in a
major clinical trial of the drug in 2000. Sales representatives were told
instead to rely on a "Cardiovascular Card" that said Vioxx was protecting
the heart rather than potentially harming it.

Vioxx was withdrawn from the market last September after another clinical
trial found that people who had taken the drug for 18 months were five
times more likely to have heart attacks and strokes than those on a
placebo. The withdrawal tarnished Merck's reputation and cost the firm
billions in sales, stock value and legal fees.

The company, which had earlier said Gilmartin, 64, would stay in place
until his scheduled retirement next year, said his sudden departure as
chairman, president and chief executive officer had nothing to do with the
Vioxx controversy. Merck named its president for manufacturing, Richard T.
Clark, to replace Gilmartin as chief executive officer and president.

The resignation of Gilmartin, after he spent 11 years at the helm, came on
a day when Merck was sharply criticized in a hearing into how the company
and the Food and Drug Administration had handled the safety concerns
surrounding Vioxx.

Merck and other drug companies say their "detailers" act as neutral
educators to guide physicians in prescribing drugs, but the more than
20,000 pages of documents released yesterday showed that Merck's
representatives were coached to be aggressive salesmen.

They were trained how to smile, speak and position themselves most
effectively when talking with doctors, and were exhorted to sell Vioxx and
other Merck drugs using the Rev. Martin Luther King Jr.'s "I Have a Dream"
speech.

Rep. Elijah E. Cummings (D-Md.) read from a Merck training manual that
directed instructors to play a recording of the speech and then say to the
sales force: "King was someone with goal-focus -- he kept getting shut down
but kept going. . . . Just as with a physician, you must keep repeating the
compelling message and at some point, the physician will be 'free at last'
when he or she prescribes the Merck drug, if that is most appropriate for
the patient."

"Merck says the mission of its sales force is to educate doctors," said
Rep. Henry A. Waxman (Calif.), the panel's ranking Democrat. "This sales
force is given extraordinary training so that it can capitalize on
virtually every interaction with doctors. Yet when it comes to the one
thing doctors most need to know about Vioxx -- its health risks -- Merck's
answer seems to be disinformation and censorship."

Dennis Erb, Merck's vice president for global regulatory development, said
that company's actions were timely and appropriate, and that detailers were
trained to be "accurate and balanced" in presenting information. He said
Merck has conducted 70 clinical trials on Vioxx involving more than 40,000
patients, and the company is discussing with the FDA whether to apply for
approval to resume marketing the drug.

"We believe Merck acted appropriately and responsibly to extensively study
Vioxx after it was approved for marketing to gain more clinical information
about the medicine," he said. "And we promptly disclosed the results of
these studies to the FDA, physicians, the scientific community and the media."

Erb defended Merck's policy of instructing its representatives not to tell
doctors about the troubling cardiovascular results from a large 2000
clinical trial called Vigor. Until it withdrew Vioxx, Merck had argued that
naproxen -- the control drug in the 2000 trial -- lowered cardiovascular
risks, not that Vioxx raised them.

Erb said the FDA had not approved adding the trial results to the drug
label and so they could not be discussed except by senior officials. But
Erb acknowledged that the company did allow drug representatives to say
that the 2000 trial had established that Vioxx helped reduce
gastrointestinal bleeding. That policy led some congressmen to accuse Merck
of disclosing the good news about Vioxx but hiding the bad.

Rep. Gil Gutknecht (R-Minn.) joined Democrats on the committee in sharply
questioning Merck and the FDA. "It seems to me there's a disconnect here,"
he said. "You're saying your policies are legal, but are they ethical?
Isn't this the scandal?"

A 2004 study by FDA safety officer David Graham and others estimated that
Vioxx caused as many as 140,000 heart attacks and strokes and killed as
many as 55,000 people. Vioxx, which was approved by the FDA in May 1999,
reached $2 billion in sales in two years, faster than any drug in Merck's
history.

The FDA's Steven Galson, acting director of the Center for Drug Evaluation
and Research, also came under criticism for the agency's handling of the
Vioxx case, especially for the substantial lag time before the worrisome
cardiovascular data from the 2000 trial were added to the drug's label.
Galson said the agency had learned through the Vioxx episode that it should
give doctors and patients more information about drugs as the incomplete
research results come in.

"The most important lesson . . . is that the American public, practitioners
and patients want to get clear and accurate information as early as
possible so they can participate in their own health care decisions,"
Galson said.

The hearing also explored previously reported efforts by Merck to
"neutralize" doctors who had concerns about Vioxx's safety by paying them
to take part in clinical trials and offering grants and consultancies.
Merck officials said their efforts were designed to dispel misinformation
about their product.

Until the Vioxx debacle, Gilmartin and Merck were highly regarded in the
pharmaceutical industry. Gilmartin was a pioneer in providing cheap or free
AIDS drugs to Africa, and Merck was long considered one of the most ethical
-- and profitable -- companies. Since Sept. 30, the company has lost
one-third of its stock value.

In a conference call yesterday, Lawrence A. Bossidy, the new chairman of
the Merck board's executive committee, said of Gilmartin, "In no way did we
push him out." He said the company decided it was "time for change."

Gilmartin's successor, Clark, 59, has been president of Merck's
manufacturing division, which operates plants in 25 countries. Clark also
served as chief executive of Medco Health Solutions Inc., one of the
country's biggest managers of prescription drug programs.







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