Uechi-Ryu.com

This frosts my butt. But anyone who knows me knows how I feel...

Cute.... Ignore the science, and damn the facts. We have a dead dude, and a big, bad drug company with lots of money. Let's screw the bastard!

The problems here are the following.

1) The biggest winners are the lawyers - every single time. No matter who loses and who wins, everyone loses but the lawyers who smell money. The plaintiff will see damn little of the verdict money - if any.

2) This heart attack had absolutely nothing to do with Vioxx. This reminds me a lot of two other events in history.

* Multiple class action suits filed against Dow Corning for their silicone breat implants allegedly causing connective tissue disease. The lawyers collected billions and temporarily put Dow Corning into near bankruptcy status. Science proved that these breast implants didn't cause the disorders, but the lawyers didn't give a penny of their ill-gotten gains back to Dow Corning.

* Lawyers (including that A-hole John Edwards) filing suits against obstetricians for allegedly causing mothers to deliver cerebral palsy babies. The science proved that there was no connection. Meanwhile, the lawyers made fame and fortune, and didn't give a penny back to the doctors whose lives and careers they ruined. And now we have a health care crisis in rural areas because OBs cannot afford to practice there with their $200K per year malpractice insurance premiums. Instead, these rural moms are left on their own.

Yes, every treatment has risks.

I'm shocked!!!

But actually we shouldn't be. There are likely as many if not more risks to taking aspirin as there are to taking any of these Cox II inhibitor drugs.

Meanwhile, now we have millions of elderly suffering from chronic pain, and fewer drugs on the market to help them deal with it. Not everyone can take aspirin or ibuprofen (Motrin, Advil, Nuprin), and acetaminophen (Tylenol) isn't an anti-inflammatory.

And if you have a 401K and/or own any mutual fund, chances are you just took a big hit. Merck stock is in more places than you think. And now all YOUR retirement money is going to those lawyers.

But wait, there's more!

They advertise every day on our local television for people having taken Celebrex, Vioxx, Aleve, etc. who happen also to have had a heart attack. There's money to be made, you know...

This has nothing to do with justice. When these scumbags make all the money and the rest of us are left with fewer options and more expensive medicine, we all are being hurt by this activity. When lawyers knowingly prey on the emotions and ignorance of the common person in rural America to make money, my mind tells me that there's something seriously wrong.

And I know I will get multiple posts after this about Big Business, the Big Bad Drug companies, corporate greed, etc., etc. The problem is, it's the consumers of health care who are both screaming for more new treatments and then wanting to hire one of these ambulance chasing scumbags whenever they encounter a bad outcome. And it is the consumers of health care who in the end get hurt by the retribution. The only winners are the lawyers.

Living involves taking risks - period. Get over it.



And there are better ways to dealing with these kinds of issues, not the least of which is re-examining this direct-to-consumer drug advertising. It didn't used to be this way.

Do yourself a favor. Do not ever elect anyone associated with this kind of legal activity to political office. And if you don't like jobs going overseas where the issue of corporate liability isn't the same as it is here, think twice before you decide what American Corporations "deserve." In the end, punishing American Corporations in such fashion only hurts Americans. The "Big Bad Corporations" are just going to pass the bill on to you, and the job over to a 3rd world country.

- Bill

Good for them. They took on a huge case, probably with nothing but an expense agreement, which they may or may not enforce at the end of the day.



The jury decided otherwise, and they get to make the decision in this case. Don't like it? Write your congressman and get the law changed.



But in this case, and in legions of others, the risks of Vioxx therapy were minimized, underplayed or lied about in order to increase market share. If Merck had come clean from the beginning (like they were supposed to)about the risks of Vioxx, and if the prescriber had done his/her job when warning the deceased about the risks of Vioxx (like he/she is supposed to), then there would be no case, even if there was causation.



If Merck, Pfizer, etc can advertise their goods and services, how come lawyers can't advertise their goods and services either?



I'm sure the judge would be surprised. He/she probably had multiple opportunites to dismiss this case, but didn't. Does Texas have a tribunal system?



And I'm sure the lies and deceptions by the drug companeis have nothing to do wth that...



You mean like when the drug companies use their slick advertisements to get people to convince their doctors to prescribe drugs for conditiions the afflicted never knew they had? That doesn't drive up the costs of healthcare for all?



And the drug companies do an honorable job in advancing the science of drug therapy to treat our afflictions. But time and time again they accentuate the positives of their drugs and don't even want to discuss the negatives. You have to pry it out of them, and use other, more reliable sources of info to get the true story.

When the companies lie, trick and deceive, they deserve to get sued.



In modern jurisprudence, no plaintiff ever won a malpractice suit that was held up on appeal where just a bad outcome was involved. Give me examples and prove me wrong. And for every example cited, I'm willing to bet there was an informed consent, learned intermediary or duty violation that was the defendant's undoing.

This is not a post about Big Business, the Big Bad Drug companies, corporate greed, etc., etc. My only issue with drug companies is the method and manner they market their wares. Most, if not all, have treated me and my colleagues well.

If Merck had just come clean from the beginning they would not be in this mess. They are not the first drug company to suffer the fate of hubris, and I'm sick and tired of waiting for them to get the damn message.

Gene

Just a few nickels falling out of their bucket of gold.
They'll hardly feel it.
One of many companies they own.

Personally I'm proud to say I use "0" prescriptions.
They are not getting rich off me.

F.

_________________
Sans Peur Ne Obliviscaris
www.hinghamkarate.com

And herein lays one of the major problems - people equating jury verdicts with the truth.

A physician mentor of mine often was called as an expert witness for the defense in physician malpractice cases. As he used to tell me back when I would get angry about such cases, "The first thing you need to realize is that the court system has little to do with the truth." Just ask OJ's in-laws. Just ask the decedents of any black lynched back when it was fashionable to do so.

Oh trust me - I'm doing plenty about it. The more you argue with me, the more you bring the disinfecting light of day to the surface.

Did you know, Gene, that the scumbag lawyer John Edwards did not carry either his state of birth of South Carolina, or the state he represented of North Carolina in the presidential election? Ever wonder how that could have happened? The truth shall set you free.

Surely you believe in justice, right Gene? There was no causation - period.

I thought you defended the role of lawyers in society, Gene. It doesn't matter whether or not you like or don't like the way Merck does business, or what doctors told patients. That doesn't give ambulance chasers the right to steal money from people who do real work - just because the money is there. The end should not justify the means.

But if you prefer a society where people can take money whenever they feel entitled to it and the rule of law does not matter, I'm sure I can give you a few suggestions.

The problem is that we as a society got what we asked for. And when it didn't turn out right, folks want to blame someone.

There's always someone ELSE to blame, right? That's the American way, right?

The FDA was pressured by our society and by Congress to speed the approval process. The FDA was asked to get drugs to the market faster because HIV and cancer patients were dieing and they needed new treatments fast. The process was streamlined for the benefit of the consumer. And without more long-term studies, guess what? More drugs get on the market with unknown long-term effects. Should we be surprised? Should we as a society blame the drug companies that we just enabled to do exactly what we asked them to do? Should we feel a right to take money from them? That money, after all, will never kill or "punish" Merck. Merck will survive just fine. Instead, it will increase the cost of healthcare, and lower the value of retirement accounts of people living on relatively fixed incomes.

You're listening to and regurgitating lawyer language designed to rationalize their thievery. Science is a peer-reviewed process with point and counterpoint from step one to the retirement of a drug. We NEED a free and open process to debate the efficacy, effectiveness, and safety of products. As soon as the scumbags come in and use pieces and parts of the scientific debate out of context as an excuse to steal money, guess what happens? Drug companies will hide negative findings. I'm shocked!!!

This kind of argument reminds me of a spouse who throws private communication up into the face of their partner as ammunition when they argue, and then wonders why they never communicate any more.

All these lawsuits are going to do is increase the secrecy of the research. That unintended consequence is a disservice to society. The consumer loses in the end. The litigation is not the solution; it is a ROOT CAUSE of the problem.

I'm all for it, Gene, as long as the networks will give equal time to lawyers who sue other lawyers for malpractice or for filing a suit against an innocent party. But that NEVER happens, does it, Gene?

It's honor amongst thieves. I know racketeering when I see it. So do the lawyers. They know a good idea when they steal it.

Yea, yea.... Former lawyers watching out for misbehavior amongst lawyers. In my book, that's the fox guarding the chicken coop.

Why not let industry peers decide when a suit would be thrown out? But that'll never happen as long as there's money to be stolen. It's Sutton's law, you know.

Can you say Cerebral Palsy? Can you say silicone implants?

Sorry, Gene, science has long ago proven you wrong. Ask John Edwards how much of the ill-gotten gains he has given back. And check out how many careers were ruined, and how many poor women in rural areas have reduced access to proper neonatal and delivery care.

Furthermore, the appeals process just perpetuates the problem - lawyers earning money off of people doing real work. You obviously take society to be as ill-informed as you are on the subject.

I'm happy you have lots of time and emotional energy and a limitless bank account to fight in court for years. I'm happy for you that you don't mind writing those checks to the lawyers who make money fighting other lawyers making money.

Go ahead, Gene. Move to a rural area, and see if you can find an OB to deliver your wife's baby. It isn't going to happen in many places in this country today because of the very thing you say could NEVER happen.

In the end, it's the little guy who takes it in the tush.

Oh they most definitely got the message, Gene. It's their response to this "message" that will continue to frustrate you (unless you are part of the meal ticket).

Merck, and Dow Corning, and Philip Morris, and every other company that the victim-minded in this society want to "get" are going to do just fine.

Meanwhile... Don't complain to the rest of the world when:

* There's MORE secrecy in research

* The price of healthcare goes up

* More employers elect not to offer healthcare as a benefit

* More families - even insured ones - are forced to declare bankruptcy when there is an episode of chronic or serious illness in the family.

* The value of your retirement account goes down

* The price of all products and services - especially American made - goes up

* Jobs go overseas because there's less litigation there and the smart people take on careers that actually produce something

* The healthcare system orders tests you don't really need (a.k.a. defensive medicine)

* Your doctor spends more time filling out paperwork, and less time seeing you

* Your physician refuses to do risky treatments that might save your life

* Drug companies refuse to do research for treatment of rare conditions

* You'll rarely see a politician you (Gene) like make it into the White House

- Bill

In Virginia they do. I see them every evening durong the news hours.

Rich

_________________
Member of the world's premier gun club, the USMC!

... lies the truth.

It's funny that people on both sides of this argument dislike each other so much, when the drug makers and lawers have so much in common: they are looking to make a quick buck off our pain and suffering.


chewy

I must take issue with this. The drug companies spend billions$ annually to come up with the great drugs that they do. And it takes years to get approval. And when the patents expire the generic companies junp in to take the market. And if the FDA approves a drug that should of been better scrutinized, they do not pay for any bad outcomes, the drug company does.

No, nothing quick about the bucks they make.

Also, drug companies create wealth, build manufacturing facilities, and truly make life saving products.

Celebrex was a god send for me. I doubt that I would have continued martial arts and my Marine Corps relationship without it. I am aware of the risks associated with it and accept them.

Attorney's on the other hand create no wealth... they merely redistribute it. The net impact on the economy is negative.

Rich

_________________
Member of the world's premier gun club, the USMC!

If it wasn't for those evil drug companies my mom would be dead instead of meeting us down in Disney. So a big thanks to those fat cats from my family.

Does anybody remember when a drunk did an auger job with his Cessna and the lawyer filed against everybody including the company that made the bolts on the plane. That was really a high point for the law industry.

_________________
I was dreaming of the past...

chewy

It's clear that there is incentive in the system. Economic reward and personal ethics are what drive the system. The issue I and others have is with perversion of the incentives, and the law of unintended consequences.

What we argue about at the end of the day is over philosophical approaches to the problem. And these are not insignificant issues. It's not just related to whether we want a nanny state, or prefer more individual responsibility and accountability. In the end, the chosen approach determines our national and individual economic success in a global economy, the quality of our lives, and the freedom we as individuals and economic entities have to pursue the good life on a level playing field.

- Bill

The job of drug company executives and drug reps is to make money. Not to be nice. This is exactly the same as it is with tobacco companies. Their job isn't to accurately represent their products to people; their ob is to make money so that's what they do, hiding and distorting facts if they need to. Drug companies aren't out to make your life better as a primary aim. Here are some examples:

1) eflornithine. Great drug. Cures sleeping sickness. Poor africans can't afford it. USA stopped making it outright. Guess what--eflornithine is also effective for facial hair. And now its back--lucky africans eh? We stopped making the equivalent of penicillin because it wasn't cost effective!
http://www.grahamazon.com/2004/09/the-s ... lornithine

2) Me too drugs. Omeprazole, lansoprazole, rabeprazole, pantoprazole--these 4 drugs are essentially interchangeable, and the last three were invented ONLY for money. We didn't need them. They helped only in that they brought competition to the market, they did not advance medicine.

3) BS patent extensions. Omeprazole made us billions and is running out of its patent?! Switch ALL patients to ESomeprazole, which is basically the same stuff, and will be on patent another 10 years. Contract with hospitals to get esomep super cheap so they'll use it--and all the unwitting interns will prescribe it on discharge, inadevertently switching patients with trouble making rent off cheaper drugs. How about Sarafem? This is prozac with a new indication--PMS--that they deliberately waited to seek because they could extent their patent life. Hey doc, order the exact same chemical generic!

4) Crap with ribbons on it. Alprazolam is a crummy drug. There are many other agents in its class with better side effect profiles which are not as addictive (valium, librium, klonopin, ativan, you name it) YET the manufacturer, aware that it is crummy, creates "Xanax XR" and the whole marketing scheme is, "Wow, our old drug ran out real fast and induced patients to take more and more... now the drug is less horrible and more like the better drugs which can be had far more cheaply!" Are any physicians stupid enough to prescribe this stuff?

5) Bogus ads. Call your doctor about this thing when you don't even know what its for. Or, watch this old guy run around and play chess with his kids because he took an alzheimers drug... watch the lady garden with butterflies because of the arthritis drug... we'll play happy music and show smiling people while we blur through discussion on the risk of death and injury, and we'll gloss over the fact the alzheimers drug raises your mental exam oh, 1 point out of 30 with no meaningful clinical effect at high cost.

6) Every last dollar. Did GCSF or epo shorten the stay of a cancer patient by 2 days, leading to cost savings of several thousand for the hospital? Price the drug at that exact price minus a buck. Oh, are those drugs now indicated for large numbers of uninsured patients NOT in a situation to save $ by using them? Too bad, good luck finding coverage! Pegfilgrastim costs about 4k per shot--not priced by R+D, but by figuring out the most $ they could bring in. Nesiritide: convinced doctors to create "heart failure infusion clinics" where they could charge big $$$ to medicare (Scios has a guide on how for you to read!) even though that drug's endpoints were measured only out to hours in studies, and it was never shown to be better than cheaper alternatives, and may cause more renal failure and death!

7) Lie and conceal. Nesiritide covered up its flaws. It's reps pretended they weren't there with me. Azithromycin reps tried to convince me it works for asthma and bronchitis (it doesn't). Spectracef people wanted me to use their drug for strep throat when it causes more side effects, wastes valuable antibiotics, costs much more--and isn't needed because penicillin can do the job for a dollar. And yes--Merck. Merck instructed its drug reps to conceal heart risks, and it failed to be as forthcoming as it could have been with company data about heart risks. It did not behave as it would if its job was to make us feel better--it behaved as if its job was to make money. Which is no coincidence.

Bill, how'd you determine this man didn't die because of Vioxx? From what i can tell, vioxx increases the risk of death by heart attack--barely--and when faced with an individual case, who can tell? I say Vioxx is responsible for a few percent of each death among its users who have cardiac deaths. In this case, lost wages should have been reduced to a few percent of the total because that's the small fraction caused by vioxx.

I don't blame snakes for acting like snakes. Lawyers are snakes. Drug companies are snakes. And snakes do not empathize, they just do their job; if presented with lunch, they strike. If attacked, they defend. Put lunch in front of Merck or the ambulance chasers, and they bit. Big surprise.

What we need to do is get snakes out of healthcare. Lawyers should not be making millions off bullsheit and Vioxx should be making decisions about their drug with patients in mind rather than dollars. Have a physician panel with no vested interest in vioxx make decisions about the labels and markets--I believe this organization, if created, could be called "the food and drug administration"--with 100% transparency from Merck and Co. If Merck lies, those involved should be fined and jailed. If Merck complies, than it should be EXEMPT from lawyersnake attacks. Every therapy contains effects and side effects; if companies are honest about both, they can make decisions with patients as a partnership of a physician, a patient, and a drug company together seeking wellness and prosperity. This is not possible when parties have conflicts of interest--whether the physician (who might make a buck referring to a center s/he has a stake in). the patient (who not that uncommonly comes to score narcotics or file bogus disability paperwork), or the drug company (who wants to conceal risks to maximize profits).

And yes Bill, while the three are talking, lock the F'ing layers out of the room permanently.

Anyone remember the vaccine compensation fund? To remove lawyerly disincentives to making these wonderful therapies, we created funds to compensate the few injured and to keep the lawyersnakes out of the process. Recently, the lawyers are looking for cracks in this well functioning happy machine, in order to improve patient care, i mean, ruin things for money.

_________________
--Ian

I'm confused about something Bill:

Was John Edwards involved in this Vioxx trial?

Is John Edwards involved in any Vioxx trial?

If you start a thread about John Edwards - his past and his present - , then maybe we can have adiscussion on that, but not here.

It confirms my suspicions about voters the Carolinas, and the South in general, that more people didn't vote for Kerry/Edwards. But that's just me.

Gene

Ian

I mostly agree with you.

However, on the issue of "me too drugs"... With Cox II inhibitors, there first was Celebrex, then Vioxx, then Bextra. With nonsedating antihistamines, there first was Claratin, then Allegra, then Zyrtec. Competition is good, Ian. Whenever you have a monopoly on the market, this raises prices. Competition creates choices, and choices drive the unit price of services down.

It's the 3rd party payment system in healthcare and some of the other practices (like cute drug reps giving docs free lunch) that create perversions of a true free market system. Don't blame it all on the drug companies. And when managed care tries to put market pressures on, patients bitch. If they had to pay for it out of their own pocket, the free market would be just fine. More and more, healthcare benefits are putting skin in the game for the consumer. For many elective drugs, that's a good thing.

Yes, I agree with your bitching about slight tweaks on an off-patent formula, and suddenly you have a new drug patent that doctors MUST prescribe because obviously it's new and better. Not... It's a quirk in the system that needs to be fixed.

Some of these incremental changes are for the better. Anti-depression drugs are getting better and better (with fewer side effects).


Several things to consider here, Ian.

First, most heart attacks are a multifactorial proposition. No one thing (hypertension, age, gender, hyperlipidemia, stress, family history, homocysteine level, obesity, etc.) is going to kill you. It's the mix of it all that kills you.

Second, heart attack is the number one killer of both men and women. The likelihood that Vioxx was the sole cause for any one person who happened to have taken Vioxx is slim to none.

Third, best I can tell an arrhythmia as this man had is atypical of the type of death that Vioxx is likely associated with.

Nobody can prove that Vioxx did it. If you want to try a Vioxx class action lawsuit and have everyone (basically one out of every three individuals in the population) who dies of a heart attack and happen to have take an NSAID sue, well maybe you give a penny or so per person and you might have it about right in terms of average economic compensation.

The whole thing is nuts, Ian. The jury was stirred up because they found someone within Merck who hypothesized (without sufficient data to prove) that there might be an increased risk of heart attack from taking the drug. Now that we have tens of thousands who have taken these drugs for long periods of time, we're starting to see the slightly increased risk. The lawyers made this internal debate out to be a coverup. Bullsheet! I'm paid to speak my mind on my job, but I also make sure I put my best foot forward out to the customer. That's not telling a lie; that's being smart.

NOBODY can prove that Vioxx caused their heart attack.

Meanwhile, who is sueing Bayer because they have stomach bleeding from taking aspirin, or died from a hemmoragic stroke from the same? Or lost their kidney from taking a lifetime of aspirin? Nobody.

I like your proposed solutions, BTW. I think full disclosure with no penalty for the same is a good thing. Encourage more open research. Encourage (perhaps require) 3rd party evaluation of drugs with freedom to publish. More information is better. Informed risk is a good thing.

And if 2 parties happen to disagree about whether or not a drug has a risk, well let them friggin disagree without the lawyers getting into it. Debate is healthy. Using parts of a debate out of context in a punitive fashion serves no useful purpose.

- Bill

Gene

John Edwards is the poster boy of the ugly American ambulance chasing lawyer turned politico. When you think of examples of truly wrong lawsuits in medicine with 20/20 hindsight, silicone breast implants and cerebral palsy babies are the gold standard classics. The Cox II inhibitors and soon-to-be NSAID suits are damn close... It's a very good comparison indeed.

And politics has everything to do with it. In fact... Many of these lawsuits filed in the wrong places may end up having punitive damages limited to 2 million. That's the law in Texas, and tort reform has been a major political issue that W has used to his advantage.

Yes, Kerry really screwed up in picking Edwards. It bought him nothing, and quite possibly actually cost him votes. Just take a gander at the red and blue map. It reminded me of George HW Bush picking Dan Quayle. I could think of a few Democrats Kerry could have chosen that would have made the election very interesting indeed.

Remember who JFK picked as a running mate? He hated LBJ; the Kennedy brothers secretly called him "Uncle Cornpone." But it probably won him the election. And it cost NASA in Hampton, VA the honor of being mission control for the space program. That's politics!

- Bill

Agreed... Some of those "me too" drugs are helpful in that they're:

1) actually better (the newer statins do a better job lowering cholesterol, although the newest and most efficient one has more side effects and interactions
2) cheaper. Competition IS good, yes... my point here is that the snakes are neither good nor bad, they're just being snakes. And the snakes want money. Me too drugs are not to help patients. Might a me too drug help? Yes, but that's not what a purely giving drug company would look after, they'd try to find a new class not an incremental difference. Like right now, we need a NEW kind of car, not an H3. That's just a gas wasting turd on wheels grabbing market share.

I'm not sure drug lunches are a perversion of the free market. They're selling their wares... its propaganda, the american way. I would prefer it if all products had to come in gray boxes with no flash and had to win market share on merit, but what can you do...

_________________
--Ian

And the truth is what, exactly? Just because you say it Bill, doesn’t make it so.



Well, I am taking the LSAT this Fall…..

I complain to the drug companies if there's MORE secrecy in research and not use their products. Not direction they should go. If they continue to violate informed consent and the learned intermediary doctrine, they deserve to loose.

I’ll just find another job, when more employers elect not to offer healthcare as a benefit

I’ll fight to have the Big Business Bonanza that is Pres. Bush’s bankruptrcy reform bill overturned when more families - even insured ones - are forced to declare bankruptcy when there is an episode of chronic or serious illness in the family.

I won’t complain when the value of your retirement account goes down. I have an excellent financial advisor.

I’ll work to change US foreign and domestic commerce policy when the price of all products and services - especially American made - goes up, and when jobs go overseas because there's less litigation there and the smart people take on careers that actually produce something

I’ll blame moron doctors who continue to refuse to follow clinical, evidence-based guidelines when diagnosing and treating when the healthcare system orders tests you don't really need (a.k.a. defensive medicine). Defensive medicine? What a laugh! Doctors who aren’t up to speed is more like it.

I blame doctors of old who ordered useless tests of questionable utility and prescribed the newer and more expensive drugs (and therefore better) and making payors pay so much. Those same payors now require approval before hand for needed tests and drugs. These doctors of yore didn’t do their jobs as watchdogs, so now we are paying the price. Maybe that’s the reason why my doctor spends more time filling out paperwork, and less time seeing me.

Or maybe I should blame insurance companies, who are finding every way they can to squeeze their nickels?

I’ll just sue so the pants off my physician who refuses to do risky treatments that might save your life. She should get out of medicine if she’s so gun shy. Lots of Third World countries need good doctors who want to screw up and not get sued.

Drug companies refuse to do research for treatment of rare conditions? Always been thus and so.

I blame the far-right religious wackos in charge of the Republican party and the head-in-the-clouds Democrats when I rarely see a politician I (Gene) like make it into the White House.

Gene