Two studies appearing today in the Journal of the American
Medical Association have prompted the journal’s editors to call for “drastic
action” to prevent drug manufacturers from misleading patients by
misrepresenting data from clinical trials.
The two papers, based on internal Merck documents that
surfaced during litigation over its withdrawn painkiller Vioxx, accuse the
company of questionable practices over the drug. Vioxx was one of the biggest
selling and most heavily promoted drugs Merck withdrew in 2004 after it was
linked to a higher rate of heart attacks.
Bruce Psaty and Richard Kronmal, of the
Merck reported in the first place that Vioxx was “well
tolerated,” according to Psaty and Kronmal, but internal company documents
revealed that patients given the drug in one trial had been more than four
times as likely to die as those given a placebo, and 2.5 times as likely to die
in a second trial. The two trials resulted in 34 deaths among about 1,000
patients given Vioxx and 12 deaths among a similar number given a placebo.
“These mortality analyses were neither provided to the U.S.
Food and Drug Administration nor made public in a timely fashion. There was a
threefold increase in the risk of death for these patients. Our study raises
questions about the wisdom of allowing drug study sponsors like Merck to
control the data and analyses,” the two authors concluded in their report.
“The drug industry appears to treat scientific data as if
they were a marketing tool. That’s not appropriate,” Psaty added.
The second paper accusing Merck involved a team led by
Joseph Ross of Mount Sinai School of Medicine in
“This is a very serious transgression and the medical
community needs to agree that it’s wrong…and figure out a way to discourage it,”
Dr. Ross said.
Merck officials denied the accusations that the company
misrepresented data. Peter Kim, Merck’s research chief criticized the JAMA
reports saying, “the allegation that Merck is misrepresenting mortality data from
our Alzheimer’s studies is just plain wrong. We are disappointed that such
false and misleading statements about Merck from trial lawyers have made their
way into a medical journal,” Kim said in a statement, according to Reuters.
Merck’s lawyer James Fitzpatrick of Hughes, Hubbard &
Reed called the allegations a “trial brief masquerading as scientific debate.”
“These are allegations that haven been made and rebutted in
the litigation. Merck thoroughly disclosed these data both to the FDA and to
the scientific literature. And, in fact, Merck looked carefully at the
mortality data from all of its studies and concluded across the body of data
they didn't see any difference in mortality related to Vioxx,” Fitzpatrick
said.
Sen. Charles Grassley, R-Iowa, as chairperson of the Senate
Committee on Finance personally addressed a letter to Merck on Tuesday in which
he demanded answers to his questions about the trials.
“These reports reveal just how far a drug maker might go to market its product and try to bury information that might hurt sales when that information directly affected the health and safety of the people taking their medicine,” Grassley said, according to USA Today.