Vioxx was heavily marketed as the safest and most effective drug for
arthritis and related conditions when it was launched in the UK six
years ago. Arthritis Care, one of the biggest charities in the field,
received ?26,000 from Merck in 2004 alone.
Other recipients included the National Rheumatoid Arthritis Society,
the National Osteoporosis Society and the British Society for
Rheumatology.
Experts said that the relationship between Merck and arthritis
groups was merely a small part of a bigger problem, with millions of
pounds being spent by drugs companies in return for their corporate
logo and name being featured on websites and literature created by
respected and influential charities.
Sapna Malik, a solicitor representing more than 50 patients who are
suing Merck over Vioxx, said: "I am sure the charities would say that
they act independently of the companies that give them money, but it is
an unhealthy relationship.
"How can a charity that has taken money from Merck and features its
logo, then offer impartial advice if something goes wrong? Drugs
companies want to get something for their money, and the emerging
situation surrounding Merck has brought the way in which this can prove
to be a conflict of interest to the fore."
Vioxx was launched in the UK in 1999 and it was aggressively
marketed to GPs, hospital consultants and patient groups as a new type
of painkiller that was more effective and safer than old-style
anti-inflammatory drugs. It promised to be particularly useful for
arthritis sufferers.
But it was withdrawn in September last year after it emerged that it
was linked to a doubling of heart attacks and strokes in patients.
Merck is now facing legal action from more than 4,000 patients around
the world, including 300 in Britain, who claim that they or their
relatives suffered or died as a result of Vioxx.
It is estimated to have contributed to the deaths of around 60,000 people.
Merck has also been hit by allegations that it knew as early as 1998
that the drug carried increased risks of cardiovascular problems, but
withheld the information from both the US Food and Drugs Administration
and the UK's Medicines and Healthcare Products Regulatory Agency (MHRA)
when applying for licences.
The Independent has now learnt that many of the biggest arthritis
charities have been long-standing recipients of sponsorship and
donations from Merck's UK subsidiary, Merck Sharp and Dohme (MSD). The
website for Arthritis Care says its creation was "made possible with
support from Merck Sharp and Dohme".
Arthritis Care was one of several organisations that submitted
evidence to the NHS drugs assessment body, the National Institute for
Clinical Excellence (Nice), in 2000 when it was investigating how
widely Vioxx should be prescribed in Britain. Since the scandal
surrounding Vioxx emerged, Arthritis Care has said it cannot comment
until the MHRA has concluded its investigations. The charity accepted
?10,000 from MSD in 2003 and ?26,000 last year, a spokesman said.
He added: "Arthritis Care does not advise or recommend specific
medications to people with arthritis. As a patient representative body
we provide factual information on living with arthritis. Arthritis Care
does not moderate its messages according to the wishes of external
agencies."
A report by the National Rheumatoid Arthritis Society in 2003,The
Painful Truth, called for faster access to new medication and was
sponsored by MSD, which it names on the title page. A spokeswoman said
the charity had "clear rules" about how it accepted money from the
industry and that it would refuse to work with any company that acted
deceitfully.
The British Rheumatology Society, which represents clinicians and
scientists, also has MSD as a commercial sponsor. David Isenberg, the
BRS's president, said it did not accept money for endorsing drugs or
companies.
Other organisations were unwilling to publicly criticise the
arthritis charities. One insider said: "It can be difficult as you
desperately need the money and these drugs companies come offering it
on a plate, but I think it's more trouble than it's worth getting into
bed with the pharma industry ... And it's not just arthritis charities
- it's going on everywhere in the voluntary sector, although it's not
shouted about. That tells you how murky it can be."
MSD was asked to comment on its donations and links to charities, but the company did not respond.
'Company should be in dock'
Donald Clark, 69, husband of Vioxx taker
Irene Clark was a fit and healthy grandmother who spent every
lunchtime supervising children in the playground of a nearby primary
school.
Yet within two months of being prescribed Vioxx, the 62-year-old suffered a massive heart attack and died.
It was only when the drug was withdrawn in September last year that
her husband, Donald, made the link with his wife's death. Mr Clark, 69,
from Gillingham, Kent, has now joined the legal action against Merck,
with hundreds of other British people.
He said: "I blame myself because I suggested she went to the doctor
and asked for different medication because the old drugs weren't doing
her any good. It's a nightmare. The drugs company should be up in the
dock for murder."
Mrs Clark had suffered from rheumatoid arthritis in her knees and
shoulders for some years. Her GP prescribed her Vioxx, in a liquid
rather than tablet form. It worked well, and Mrs Clark obtained a
repeat prescription.
On 1 August 2003, Mr Clarkfound her slumped at the top of the stairs
in their home. "The doctor said she had had a massive heart attack.
Irene had never had any heart trouble," he said.
A year after Mrs Clark's death, Merck voluntarily withdrew Vioxx from the market. It was only then that Mr Clark made the link.