Opinion: Merck deserves fair treatment on Vioxx

Merck began building its reputation for ethics shortly after World War II when the company generously gave streptomycin to Japan to combat a tuberculosis epidemic.

Merck’s business ethics gained widespread public recognition almost 20 years ago when the company launched a program to wipe out river blindness disease. For decades, the disease threatened millions of Africans.

A small, black fly that breeds along rivers and streams carries a parasite that causes river blindness. The fly transfers the parasite to a human host when the fly bites its victim. The parasite multiplies while spreading throughout the host’s body. Gradually, the infected victim goes blind.

When developing Ivermectin to treat animal parasites, Merck scientists discovered that Mectizan, the compound used to create Ivermectin, would kill the parasite that causes river blindness.

Yearly, more than 30 million people in 36 African countries needed Mectizan to prevent or cure river blindness when Merck’s scientists made their discovery. No commercial market existed, however, for Mectizan. The people and the governments of the countries most threatened by river blindness were too poor to buy the drug. Regardless of cost, the countries lacked the means to deliver the drug to people living in disease-threatened rural areas.

Selflessly, Merck spent hundreds of millions of dollars to develop Mectizan and gave it to those at risk from river blindness. Merck also paid road building and other delivery costs to get the drug to people living in remote areas.

Recently, Merck expanded the program to treat elephantiasis, a disfiguring disease caused by a different parasite found in the same regions as the river blindness parasite.

Today, however, Merck faces serious ethics questions over sales of its pain-relieving arthritis drug, Vioxx. The drug reduces pain without causing harmful stomach and intestinal irritations common to many arthritis drugs. Merck’s critics, however, accuse Merck of hiding test results linking Vioxx with heart disease. Merck’s detractors accuse the company of pressuring the Food and Drug Administration to approve the drug prematurely and of training salespersons to dismiss doctors’ concerns about the drug.

Two juries recently differed on Merck’s conduct. A Texas jury awarded $253.5 million in damages to the family of a man who allegedly suffered a fatal heart attack from taking Vioxx. The jury found that Merck intentionally failed to warn Vioxx users of the drug’s risks. The judgment included $229 million in punitive damages.

A New Jersey jury came to an opposite conclusion in a case involving a former postal worker. He claimed Vioxx caused him to have a heart attack in 2001. The jury ruled for Merck in rejecting the plaintiff’s claims that Merck failed to warn him and others about the dangers of taking Vioxx.

So, what is Merck? Is it an unethical company that put profits ahead of the welfare of patients, or a company wrongfully accused of intentionally endangering people?

Possibly, the truth lies between the two extremes. Perhaps Merck is an ethical company whose leadership became too enthusiastic about a profitable, new arthritis pain-reliever that was free of the usual harmful complications. As a result, Merck’s executives underestimated the drug’s cardiovascular risks.

An estimated 20 million people used Vioxx. Plaintiffs’ lawyers will question whether Merck’s current leadership is as ethical as its predecessors and describe Merck’s previous generosity as self-serving business strategy to gain long-term market share.

As plaintiffs’ lawyers advertise for possible claimants, and try their cases in the media, too many people will assume that Merck is in the wrong. Merck deserves fair consideration.

No medication is risk-free. The FDA approved the drug’s use, and Vioxx is effective against pain. Although Merck voluntarily withdrew the drug from the market, millions of arthritis patients want it back.

Decades of evidence show Merck to be an ethical, even generous, corporate citizen.

The Vioxx lawsuits place Merck, its employees and investors at financial risk. More important, the lawsuits impact the health of millions of people dependent on Merck’s medications and the company’s generosity.

John D. Copeland, J.D., L.L.M., Ed.D., is an executive in residence at the Donald G. Soderquist Center for Business Leadership and Ethics and professor of business at John Brown University in Arkansas.