In this case the Golden eggs are new pharmaceuticals that keep us healthier longer. I am not ashamed to admit that I would like to live to a ripe, old age, and reamin healthy for as long as possible. Among other things, the Pharmaceutical industry has done its part to ensure that I, and many other people, remain healthy and age more slowly than our parents or their parents, yet the greed of liability lawyers and lottery-hopefuls bringing law suits, is threatening to destroy an entire industry and at best, will slow down the development of new life-saving and age-slowing drugs.
Merck is firing ~11% of their workforce and the entire industry has been contracting. Vioxx is not the only problem Merck is facing, but the lawsuits over Vioxx are emblematic of the convergence of greed, entitlement mentality, and the nanny state that is threatening our Pharmaceutical industry:
Merck's cutbacks were the latest in a string of firings throughout the troubled industry, and could bring the industry's worst bloodbath ever with as many as 30,000 pharmaceutical employees thrown out of work, experts said.
"Recalls, legal troubles and the lack of new blockbuster drugs have forced pharmaceutical employers to adjust payrolls," said John Challenger, CEO of global outplacement firm Challenger, Gray & Christmas Inc.
"Merck's troubles go beyond the Vioxx debacle. Throughout the industry, we are seeing an all-out search for the next big prescription drug that will become a profit blockbuster," he said.
The liability crisis is self-explanatory; people who have been harmed by a product essentially find a lawyer who will help them play the lottery, which is our court system, in order to make a fortune out of their injury. Depending on the venue, the choice of jurors (who rarely have any expertise in understanding the complicated physiology involved in medication reactions, and the trade-offs involved in taking medicines, all of which have side effects that can be life threatening for some unlucky people.)
The entitlement philosophy and Nanny state are less obvious offenders. In both cases, people are implicitly given the message that they are never to be held responsible for the misfortunes which befall them. Additionally, the philosophical foundation of the Nanny state, which are Utopian, holds out the idea that all needs and desires should be fulfilled by someone else (the Nanny state, deep pocketed corporations, the "rich"). When people are injured or even disappointed, someone must be held responsible.
I suppose it is possible that Merck knew that Vioxx caused heart attacks and kept it on the market for venal reasons, but that is nonsensical. In our litigious climate, what company is going to risk being destroyed for some short term gain, when they know the trial lawyers are just waiting to get a crack at them.
Much more likely is that in post marketing surveys, an uptick in heart attacks was noticed at some point; in the situation of a new drug, when it comes onto the market and large numbers of people take them, treatment emergent side effects are the rule, not the exception. It is never clear at first, with small sample sizes, whether an effect is real or an artifact, so the usual practice is to wait until the data become clearer. In the case of Vioxx, it did become clear that after 18 months of high dose use, the risk of a heart attack doubled (from 1% to 2% in the older population who are most likely to need Vioxx.) In response Merck panicked (they have lawyers, too) and pulled it off the market. Their action, rather than helping them, did not protect them from an avalanche of lawsuits. They are currently 1 for 2 in lawsuit verdicts.
[I wrote about the issue of litigation concerns from the viewpoint of a Physician in The Doctor's Dilemma: Risks, benefits, and liabilities. In our current climate, malpractice is the assumption when outcomes are not happy ones; this is a constant background concern of Doctors today and leads to defensive medicine, unnecessary tests, and avoidance of risky treatments even when they may be indicated. And just to preempt the usual comments about the ubiquity of genuine malpractice, I would respectfully suggest that malpractice cases have more to do with the lawyers than the Doctors; most malpractice is missed and never brought into the legal system, which is why I call it a lottery.]
In the real world, rather than the fantasy world of perfect lives and perfect safety where people can win big money for bad luck, patients would be treated like adults, told the risks and benefits, and decide for themselves whether to take, or continue, the drug or not. Instead, we have lawyers sewing terror among executives at the very companies we rely on to discover new drugs to keep us healthy longer. Except for those few lawyers and injured plaintiffs who benefit financially, we all lose in this climate.
Obviously, we must always balance risks and benefits, yet the pendulum has swung, under the influence of the fantasy wish of perfect safety in life, too far to one side. We have lost sight of the fact that all medications have risks along with benefits; ultimately, the only way to reduce the risk to zero is to reduce the benefits to zero, as well.
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