Changing our view of prescription drugs
FROM THE ECONOMIST
August 26, 2005
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Since Merck withdrew Vioxx from sale late last year because of its association with an increased risk of nasty cardiovascular side-effects, sharp questions have been asked about how big drug firms communicate risks to the wider world, how they market their wares and how effective government regulators are in policing the industry. The American public now seems to distrust the very firms that are supposed to be helping to lead the fight against disease.
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The jurors were outraged at evidence that Merck may have known of the risks of Vioxx years before it revealed them. The Texas case is only one of more than 4,000 filed against Merck on Vioxx. Whatever happens in those cases, Merck, like all big drug firms, now faces closer scrutiny and, probably, tighter regulation in America.
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Part of the drug firms' problem is that they have not, in fact, been generating enough new drugs. As the flow of genuinely original treatments has slowed to a trickle, the new drugs they have brought to market have tended to resemble those already on sale. The firms have pushed these with massive marketing efforts, aimed at both doctors and patients, reaching the latter with direct-to-consumer advertising on prime-time television and other media.
The irony of Vioxx is that such blockbuster marketing, intended to bring the drug to as many people as possible, has taken it out of the reach of all. Vioxx is not a bad medicine – in fact it is a useful drug for certain patients who suffer dangerous side-effects from other painkillers. But aggressive marketing meant that those who could have found relief on other drugs were given Vioxx and exposed to its risks.
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And in the longer term the drug industry will have to exploit the trend in medicine toward more personalized treatments. These are being driven by advances in genetics, which will make possible much more accurate diagnoses, and more tailored drugs, for much smaller groups of people. For these kinds of drugs, mass-consumer marketing will be even more inappropriate than it was for Vioxx. The days of the blockbuster drug are numbered.
In the wake of Vioxx and other controversial episodes, the big drug firms not only have to find a better way to market their wares, but also to rebuild their reputations with growing numbers of skeptical Americans. The best way to do that is to refocus their resources on research rather than marketing, and to come up with genuinely new treatments and more appropriate advice about how to use them. The future of pharmaceuticals lies in drugs that treat not just symptoms, but the underlying cause of a disorder. The pharmaceutical industry should settle for no less a remedy for its own condition.
The Economist is a weekly international news magazine based in London.
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http://www.signonsandiego.com/uniontrib/20050826/news_lz1e26drugs.html 
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