What are we now learning about how drugs like Vioxx are marketed?

The recent examination into the marketing of Vioxx by pharmaceutical giant Merck has provided a rare glimpse into how drugs are presented to physicians. Papers released by a congressional House committee show that marketing instructions were as detailed as how long to shake a physician's hand -- three seconds -- and how to eat bread when dining with doctors -- "one small bitesize piece at a time." One memo, on Feb. 9, 2001, told sales reps, "Do not initiate discussions" on a study that raised heart concerns. Another document describes "obstacle handling" to overcome physician concerns.

How does Vioxx work?

Vioxx (Rofecoxib) is often referred to as a 'COX II inhibitor' and is one of the new non-steroidal anti-inflammatory drugs (NSAIDs) prescribed to decrease pain and inflammation in rheumatoid arthritis. Other NSAIDS are also prescribed but they come with warnings that they may cause digestive side effects such as ulcers, bleeds and perforations that can be serious. Vioxx was developed to be safer on the stomach than other NSAIDS.

When was Vioxx first approved by the FDA?

Vioxx, approved in June 1999, is a non-steroidal, anti-inflammatory drug, and is in a class of drugs commonly referred to as a "Cox-2 Inhibitors." Cox-2 Inhibitors include Vioxx, Celebrex and Bextra. Vioxx comes in liquid or pill form and is manufactured by Merck & Co. Vioxx was prescribed to relieve the symptoms of osteoarthritis. It can also be used to treat acute pain in adults such as those patients who experience severe pain associated with menstruation. Vioxx works by blocking COX-2 enzymes in the body that trigger pain and inflammation.

What are the supposed advantages of COX 2 inhibitors like Vioxx?

Vioxx was a medicine created and marketed by Merck. Vioxx was prescribed as a medicine that could treat pain due to osteoarthritis, menstruation caused pain in women and acute pain in adults. It belonged to a class of drugs known as COX-2 inhibitors. COX-2 inhibitors were thought to be much more effective in treating pain and inflammation without the gastrointestinal side effects such as stomach ulcers and bleeding. These types of problems were thought to be much more prevalent in users of other NSAIDs such as ibuprofen and naproxen. Before it was taken off the market, Vioxx was one of the most popular anti-inflammatory drugs in the world. It is estimated that 84 million people worldwide have used the drug, including 20 million in the United States.