ALICE IN "VIOXX" LAND

* “Curiouser and Curiouser! cried Alice”

By now the news of VIOXX (Rofecoxib) voluntary withdrawal by Merck is history. In fact, this will go down as one of the most interesting events in the history of pharmaceutical industry. This event is a telling commentary on the pressures managements of pharma companies bear to perform in the marketplace.

* “ You’re nothing but a pack of cards! ” On 30th September 2004 Merck & Co. announced a voluntary worldwide withdrawal of Vioxx (Rofecoxib), its arthritis and acute pain medication. The company’s decision, effective immediately, was based on new, three-year data from a prospective, randomized, placebo-controlled clinical trial, the APPROVe (Adenomatous Polyp Prevention on Vioxx) trial. In this study, there was an increased relative risk for confirmed cardiovascular events, such as heart attack and stroke, beginning after 18 months of treatment in the patients taking Vioxx compared to those taking placebo.

The withdrawal was done despite the drug doing a blockbuster sales crossing of 2.5 billion dollars globally. In India too, Cox – 2 inhibitors are a losing market. Now with the Rofecoxib controversy, the entire COX-2 inhibitor market is highly uncomfortable. Due to patient empowerment through media and risk free prescribing behaviour of the doctor, a strong prescribing shift in favour of older molecules like Diclofenac, Paracetamol, and Ibuprofen can be expected. Thus, there is a void created by the dying market of the COX-2 inhibitors.

The CEO of Merck who was responsible for the launch of Vioxx, Mr. Raymond Gillmartin is out. (*Quote : “ The queen had one way of settling all difficulties…. “ Off with his head!” “)

* End quote: Alice: “ Would you tell me, please, which way I ought to go from here?”
“ That depends a good deal on where you want to get to,” said the Cat.