AN
international drug company made a hit list of doctors who had to be
“neutralised” or discredited because they criticised the anti-arthritis
drug the pharmaceutical giant produced.
Staff
at US company Merck &Co emailed each other about the list of
doctors – mainly researchers and academics – who had been negative
about the drug Vioxx or Merck and a recommended course of action.
IN-DEPTH COVERAGE: The Vioxx Trial
The email, which came out in the Federal Court in Melbourne
yesterday as part of a class action against the drug company, included
the words “neutralise”, “neutralised” or “discredit” against some of
the doctors’ names.
It is also alleged the company used intimidation tactics against
critical researchers, including dropping hints it would stop funding to
institutions and claims it interfered with academic appointments.
“We may need to seek them out and destroy them where they live,” a
Merck employee wrote, according to an email excerpt read to the court
by Julian Burnside QC, acting for the plaintiff.
Merck & Co and its Australian subsidiary, Merck, Sharpe and
Dohme, are being sued for compensation by more than 1000 Australians,
who claim they suffered heart attacks or strokes as a result of Vioxx.
The drug was launched in 1999 and at its height of popularity was
used by 80 million people worldwide because it did not cause stomach
problems as did traditional anti-inflammatory drugs.
It was voluntarily withdrawn from sale in 2004 after concerns were
raised that it caused heart attacks and strokes and a clinical trial
testing these potential side affects was aborted for safety reasons.
Lead plaintiff Graeme Peterson, 58, claims the drug caused him to
have a heart attack in 2003 after he took it for back pain and
arthritis every day from May 2001.
Merck last year settled thousands of lawsuits in the US over the
effects of Vioxx for $US4.85billion ($7.14 billion) but made no
admission of guilt.
The company is fighting the class action in Australia.
The Federal Court was told yesterday that Merck wanted to gain the
backing of researchers and doctors – or “opinion leaders” – in the
fields of arthritis to help promote the drug to medical professionals
when it was launched in 1999.
Mr Burnside said internal emails in April 1999 from Merck staff
showed the company was not happy with what some researchers and doctors
were saying about the drug.
“It gives you the dark side of the use of key opinion leaders and
thought leaders … if (they) say things you don’t like to hear, you
have to neutralise them,” he said. “It does suggest a certain culture
within the organisation about how to deal with your opponents and those
who disagree with you.”
The court was told that James Fries, professor of medicine at
Stanford University, wrote to the then Merck head Ray Gilmartin in
October 2000 to complain about the treatment of some of his researchers
who had criticised the drug.
“Even worse were allegations of Merck damage control by intimidation,” he wrote, according to Mr Burnside.
“This has happened to at least eight (clinical) investigators … I
suppose I was mildly threatened myself but I never have spoken or
written on these issues.”
Mr Burnside told the court Dr Fries went on to describe instances of
intimidation, including one colleague who thought his academic
appointment had been jeopardised and another who received phone calls
alleging “anti-Merck” bias.
Dr Fries said in the letter that Merck had been systematically
playing down the side effects of Vioxx and said the company’s behaviour
“seriously impinges on academic freedom”. The court was also told a
rheumatologist on Merck’s Australian arthritis advisory board was angry
he did not find out about Merck’s decision to withdraw Vioxx until an
ABC journalist rang to tell him. Mr Burnside said James Bertouch wrote
to other members of the board saying he was “extremely disillusioned”
with the company.
“In every possible way the company exerted itself to present the
impression to the world at large that Vioxx did not provide any
increased cardio risk … when (a) it probably would and (b) it
probably did,” he wrote, according to Mr Burnside.
Peter Garling, acting for Merck, accused Mr Peterson of not taking
the drug Vioxx in the months leading up to his heart attack in December
2003.
He said Pharmaceutical Benefits Scheme figures showed he did not
fill a Vioxx prescription for the drug in the two months before his
heart attack.
Mr Garling put to Mr Peterson during his cross-examination that this
was because he had retired from his job as a safety consultant and
therefore he did not need to take Vioxx because his back pain lessened.
Mr Peterson denied this meant he was not taking the drug.
“No, I wouldn’t accept that at all,” he said. “I can remember taking Vioxx regularly.”
The trial, before Justice Chris Jessop, continues.
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