According to internal Merck documents uncovered during legal
preparation for the recent Vioxx lawsuits, a 1999 Merck & Co. study of the
drug, ostensibly designed to test its effects on the stomach, was actually
designed as a marketing strategy.
Vioxx, the blockbuster painkiller that Merck introduced in
June 1999, was withdrawn from the market on September 30, 2004 after it caused
thousands of heart attacks and strokes.
The Merck mock-study, called ADVANTAGE, recruited over 600
family doctors who were inexperienced in clinical research to help in the
testing of Vioxx. Each doctor in the
trial received a stipend for participating, and additional fees for prescribing
the drug to a few of their patients.
To a trained eye, this study’s design might look suspicious
on its own. Normally, clinical trials
are conducted by a small number of specialists at major hospitals who each test
a product on hundreds of consenting patients.
Moreover, clinical trials are typically designed and carried out by a
company’s research and development department.
As Dr. Kevin P. Hill and colleagues discovered while perusing Merck
documents on behalf of plantiffs in the Vioxx lawsuits, ADVANTAGE was designed and
carried out by Merck’s marketing
While Merck told doctors and patients in the study that they
were contributing to the scientific research on Vioxx, the real purpose of the
study, as described in Merck marketing documents, was to get doctors and
patients in the habit of using Vioxx just as the product was being launched to
As a marketing technique, the study was wildly successful,
so much so that two top Merck executives nominated it for an internal marketing
award. At its peak, Vioxx brought Merck
about $2.5 billion a year.
As part of the $4.85 billion settlement of all Vioxx claims,
Merck began payments to some of the nearly 50,000 claimants on August 28, 2008.
Payments are scheduled to be completed
by the end of 2009.