May 13, 2009

Merck: A Case of Deadly Marketing

Can bad marketing decisions be deathly? I am not talking metaphorically as in "can they ruin your brand?" (we already know they can), I am talking about "can they actually result in deaths?" After reading what is going on with Merck in Australia, I say yes, it can.

In the context of a civil suit filed by Graeme Peterson, who suffered a heart attack in 2003 while on Vioxx, against Merck and its Australian subsidiary, it was first published that "The Federal Court has heard that Merck & Co 'prepared and gathered' doctors and academics to write the company's own research on Vioxx, which was then published in prestigious medical journals as independent studies. The drug company also allegedly produced an entire journal -- called The Australasian Journal of Bone and Joint Medicine -- and passed it off as an independent peer review publication."

I find just the idea of something like this happening, appalling. Even when by default I do not trust big companies, I couldn't wrap my mind around something like this: the consequences of such action can be devastating as doctors need to trust peer reviewed medical journals as an unbiased source for information. They simply can't test by themselves each new drug in the market. So I decided to keep an eye open for more news on the matter.

Up to that point it was allegedly but on April 30th, The Scientist published that "Merck paid an undisclosed sum to Elsevier to produce several volumes of a publication that had the look of a peer-reviewed medical journal, but contained only reprinted or summarized articles--most of which presented data favorable to Merck products--that appeared to act solely as marketing tools with no disclosure of company sponsorship. "

The Scientist report that they were able to get two issues of the journal: Volume 2, Issues 1 and 2, both dated 2003.

After that, in May 7th the same publication followed up on this matter, this time focusing in the scientific publishing giant Elsevier. The company admitted that they put out a total of six publications between 2000 and 2005 that were sponsored by unnamed pharmaceutical companies and looked like peer reviewed medical journals, without diclosing that they were in fact sponsored publications.

"It has recently come to my attention that from 2000 to 2005, our Australia office published a series of sponsored article compilation publications, on behalf of pharmaceutical clients, that were made to look like journals and lacked the proper disclosures," said Michael Hansen, CEO of Elsevier's Health Sciences Division, in a statement issued by the company. "This was an unacceptable practice, and we regret that it took place."

To make things worse, on May 8th an arthritis specialist, Dr James Bertouch, told the Federal Court of his surprise after picking up a copy of a "medical journal" created by drug company Merck and seeing his name listed as a member of its editorial board. He was never invited to be a member of any such board and first became aware of his supposed involvement when he saw his name listed prominently on the journal's first page.

WAToday, reports that Dr. Bertouch was listed as a member of the journal's "honorary editorial board", along with 13 other doctors, in a 2003 issue. His name was removed from a 2004 issue that lists eight doctors as members of the board.

That later issue did carrie a small disclaimer reading: "The content of this publication is primarily made up of company-sponsored articles … The members of the honorary editorial board have not reviewed the content of the articles, and as such the contents do not reflect their views" but there was no reference to which company sponsored the articles.

Another witness, Professor George Jelinek, a medical journal editor with an interest in publication processes, previously gave evidence that the journal was designed to resemble a peer-reviewed publication.

I believe that even if this happened in Australia it should be reported all over the world. Merck is a worldwide company and Vioxx was sold everywhere (so far, here in the US, a class action lawsuit against the company was already denied in California and NJ).

Here in the US we may not have found (yet) fake journals but legitimate medical journals have been asked to retract drug studies involving Vioxx, Celebrex, Lyrica, and other drugs that were conducted by Dr. Scott S. Reuben of Baystate Medical Center after a full-scale investigation by the hospital, uncovered 21 published papers over 13 years in which Reuben made up some or all of the data. It seems clear that big pharma companies are willing to do what it takes to sell more, no matter what.

Nevertheless I don't think this is about Vioxx anymore nor about a "bad decision" when it comes to marketing. The decision to publish fake journals is an unethical one I am not sure if it is not also an illegal one. From my point of view it merits a lawsuit by itself, against the the publishing company and the pharmaceutical companies sponsoring these publications.

Peter Lurie -a deputy director of the public health research group at the consumer advocacy nonprofit Public Citizen- said "I've seen no shortage of creativity emanating from the marketing departments of drug companies, but even for someone as jaded as me, this is a new wrinkle."

I find it ironic that in some places in Australia the Merck logo appears as it is shown at the beginning of this posting, with a tagline that reads "Finding better ways". No one can deny they found a different way to market their product. I guess the "better" part depends on who is talking, if the pharmaceutical company making the profits or the doctors and patients cheated into believe that the information they received was unbiased.

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