A VULTURE’S TALE 46

In 2005 vultures in the form of trial lawyers not only circled, but drew a beady eye on their prey, drug company Merck, the makers of Vioxx. In the Dallas Morning News ads from law firms exhorting victims of Vioxx to contact them appeared and one even offered a free medical/legal seminar in case Vioxx patients needed coaching to formulate their maladies. This process was repeated in newspapers all across this broad land - and on television and the internet as well.

A dozen nonsteroidal anti-inflammatory drugs (NSAIDs) are available by prescription with the best known, because of extensive advertising, being Vioxx (rofecoxib) and Celebrex (celecoxib). Over-the-counter NSAID medications include aspirin (Bayer & Ecotrin), ibuprofen (Advil & Motrin), and naproxen (Aleve). Acetaminophen (Tylenol) is not technically an NSAID, but is considered an analgesic (pain reliever).

Why are these drugs called “nonsteroidal” and “anti-inflammatory?” Because they are not steroids which treat inflammation by suppressing the immune system; rather they inhibit the body’s ability to synthesize prostaglandins (fatty acids) which contribute to inflammation, pain, muscle cramps, and fever.

The main inflammatory diseases which are treated with these drugs are osteoarthritis (a degenerative joint disease) and rheumatoid arthritis (an autoimmune disease). Of the people who are treated for these diseases in the United States, circa 60% are women and 40% men. Rheumatoid arthritis occurs in about 1% of the U.S.A. population and is three times more prevalent in women than men. Perhaps some consolation for women can be extracted from knowing that a secondary disease, gout, which is treated with NSAIDs, mostly afflicts men.

Essentially what are the differences between the prescription and over-the-counter drugs used to treat arthritis? The answers are drug strength and price. To equal the potency of one tablet of one of the prescription drugs a person would have to take several of the over-the-counter drugs. An increased risk of heart attack or stroke seems to occur with long term (years or at least many months) use of either prescription or over-the-counter drugs.

Whether a person takes one of the prescription or several over-the-counter pills daily, long term, the health risks are the same. Therein lays the artificiality of the liability claims against Vioxx. Given that hundreds of millions of people in this country have taken aspirin or ibuprofen or naproxen over the many decades (aspirin has been around for more than 100 years) these drugs have been available it is practically a certainty there are and have been many people who have taken large doses for years and have suffered increased mortality or disability from heart attacks or strokes yet how many lawsuits have resulted? None that I know of – at least none that were successful. Perhaps Merck can be faulted for not making public sooner the measured long term risk of Vioxx. It appears that although the long term risk of Vioxx is low, it is twice the risk of people not taking the drug. Still who possesses such naiveté as not to believe that the birds-of-prey (lawyers) would not swoop down in a frenetic feeding fury even if Merck had been timelier in its disclosure?

It is interesting that in a speech during the 2004 presidential political campaign, the world renowned homeopathic physician Dr. Teresa Heinz-Kerry of Mozambique weighed in on the issue of treating osteoarthritis by the use of gin & raisins. Her formula, dating back to the era of old wives tales, is to soak nine white raisins (only white raisins; dark raisins simply will not do – even for an African) in a large glass of gin for two weeks then throw away the raisins and gulp down the gin or some such procedure. We should all take comfort in the knowledge that such an ingénue as Mrs. Heinz-Kerry is in the forefront of our political, social, scientific, and medical life.

As an aside, the reason for the past shortages of influenza vaccine can be largely attributable to these aforementioned rapacious trial lawyers of which Sen. John Edwards is an archetypical example. John Kerry even had the temerity to launch a jeremiad against George Bush, blaming him for the then flu vaccine shortage. If Kerry wants to assign culpability for the lack of flu vaccine he would do well to look at his partner in crime the egregiously greedy Johnny Edwards who compiled his fortune by foisting junk science arguments on gullible juries.

A generation ago there were a dozen pharmaceutical companies in the United States making flu vaccine – today there are only two or three. Why? The answer is tied up in the concept of capitalism. Manufacturing flu vaccine was never a highly profitable enterprise in the first place then when lawsuits were filed because there are always some bad reactions in any medical intervention the companies logically decided just to get out of the business.

For the uninformed who believe the answer to this problem is to have the federal government produce flu vaccines I would suggest the following: I made five trips to the old Soviet Union in 1990-91 and I saw what a socialist society wrought in the sphere of economics. They were a half century behind us in all sorts of consumer products and services and the people I talked to knew it. So for those Americans who would opt for government medical services I would paraphrase the words of John F. Kennedy from a speech on June 26, 1963 in West Berlin if it were possible to go backwards in time: “Let them come to the Soviet Union!”