Podcast Summary: Behind the Bastards – Part Two: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam

Introduction to the Vioxx Scandal

In this compelling episode of Behind the Bastards, hosts Robert Evans and Dr. Kaveh Hoda delve deep into one of the most infamous pharmaceutical scandals in history: the Vioxx debacle. Released on December 12, 2024, this episode meticulously unpacks how Merck's aggressive marketing and deceptive practices led to widespread harm, ultimately claiming more American lives than the Vietnam War.

Merck’s Deceptive Practices and the Rise of Vioxx

The episode opens with a critique of pharmaceutical advertising, notably criticizing the use of celebrity endorsements like Dorothy Hamill’s promotion of Vioxx without proper vetting or understanding of the drug's risks. Evans emphasizes the irresponsibility of leveraging trusted figures to market potentially dangerous medications:

"We just shouldn't have pharmaceutical ads like the way that we have them, because you can't. Dorothy Hamill was a great figure skater. Nothing in her life prepared her to adequately vet whether or not Vioxx was a safe medication to advertise." [04:23]

Merck's Vioxx, a COX2 inhibitor designed as a "super aspirin," was heavily promoted as a breakthrough with minimal side effects. However, internal studies revealed significant cardiovascular risks, which Merck chose to obscure rather than address.

Key Figures and Manipulation of Scientific Research

Evans introduces Dr. Jerome Grupman, a Harvard Medical School professor who authored a misleading article in The New Yorker promoting Celebrex, a drug similar to Vioxx. Grupman's failure to disclose conflicts of interest and reliance on anecdotal evidence raised significant ethical concerns:

"He described Celebrex as incredible and told Dr. Grupman that unique among all other medications ever created, it had no side effects whatsoever." [11:42]

Another pivotal figure discussed is Dr. Scott Rubin, an anesthesiologist whose fraudulent research bolstered the false safety claims of Vioxx and Celebrex. Rubin's manipulation of data and publication of 21 falsified studies under Pfizer’s funding highlight the systemic issues within Big Pharma:

"He completely falsified at least 21 of his published papers, all of which claim to show how well super aspirins could benefit postoperative healing." [58:04]

The Legal Battle and Public Backlash

The narrative shifts to the personal story of Carol Ernst, whose husband Bob died of a heart attack linked to Vioxx use. Her pursuit of justice led to a landmark lawsuit against Merck, resulting in a substantial financial verdict:

"In August of 2005, a Texas state jury awarded almost $25 million to Carol Ernst in compensatory damages and more than $200 million in punitive damages." [24:19]

Despite the victory, Merck's defense painted the lawsuit as another example of frivolous litigation, akin to the infamous McDonald’s coffee spill case. This portrayal contributed to public skepticism and backlash against the victims seeking justice.

Impact on the FDA and Public Trust

Evans and Hoda critically examine the FDA’s role, highlighting failures in oversight and the agency's inability to swiftly act on emerging evidence of Vioxx's dangers. Internal Merck communications revealed a blatant disregard for safety in favor of profits, sowing distrust in regulatory bodies:

"Internal Merck analyses in 2000, 2001, and 2002 showed that Merck was worried about lost profits if warnings or precautions were put on its label." [30:25]

Hoda expresses deep concern over the future of the FDA, fearing increased deregulation could lead to more pharmaceutical malfeasance:

"It's terrifying to me to see what's going to happen to our FDA. It's going to be the golden age of diarrhea." [31:26]

Concluding Reflections and Broader Implications

In their concluding remarks, Evans and Hoda reflect on the broader implications of the Vioxx scandal for the pharmaceutical industry and public health. They lament the loss of trust in medical institutions and the enduring impact of corporate greed on patient safety:

"They are trading lives for dollars. The longer they know, the more they get to sell this stuff without a warning is worth it to us, right?" [40:22]

Hoda acknowledges the duality of Big Pharma's role, recognizing their critical contributions to medical advancements while condemning their unethical practices:

"I have a lot of mixed emotions about pharmaceutical companies in general. We need to continue to pick at them, analyze them, be super critical of them, but also be fair about what they can do." [60:24]

Notable Quotes with Timestamps

• Robert Evans [04:23]: "We just shouldn't have pharmaceutical ads like the way that we have them, because you can't. Dorothy Hamill was a great figure skater. Nothing in her life prepared her to adequately vet whether or not Vioxx was a safe medication to advertise."

• Dr. Kaveh Hoda [31:26]: "It's terrifying to me to see what's going to happen to our FDA. It's going to be the golden age of diarrhea."

• Robert Evans [40:22]: "They are trading lives for dollars. The longer they know, the more they get to sell this stuff without a warning is worth it to us, right?"

• Dr. Kaveh Hoda [60:24]: "I have a lot of mixed emotions about pharmaceutical companies in general. We need to continue to pick at them, analyze them, be super critical of them, but also be fair about what they can do."

Conclusion

Part Two: The Vioxx Scandal serves as a sobering exposé of the lengths to which pharmaceutical companies like Merck will go to maximize profits at the expense of public health. Through thorough analysis and poignant discussions, Evans and Hoda shed light on the critical need for transparency, accountability, and stringent regulatory oversight in the pharmaceutical industry to prevent such tragedies in the future.