A majority of the patients who were persuaded to use prescription arthritis drugs Celebrex and Vioxx would have done just as well on older, cheaper medications and would have avoided the potential heart and stroke risks now linked to those blockbuster drugs, according to a study of how they were marketed.
The two COX-2 inhibitors were promoted with aggressive direct-to-consumer advertising campaigns after their approvals in 1998 and 1999, and the researchers conclude that the marketing played a significant role in leading both doctors and patients to overuse them.
Merck & Co.’s Vioxx was withdrawn last September after a clinical trial linked it to an increased risk of serious heart attacks and strokes, and Pfizer Inc.’s Celebrex remains under a cloud following similar, though less dramatic, reports of the same problem.
The new study finds more than 70 percent of patients prescribed the COX-2 drugs in the first three years they were available were at low or very low risk of ulcers and gastrointestinal problems the conditions the COX-2 drugs were designed to prevent.
“The fast growth of the COX-2 market took place to a significant extent with patients who could have used” nonprescription alternatives, said study author G. Caleb Alexander of the University of Chicago. “In fact, there are clinical reasons to say they should have been using the alternatives.” The COX-2 drugs “were heavily marketed to physicians and the public, and both are known to be susceptible to the impression that newer is better when it comes to medications,” he said. “But we know that is not always the case.”
A Merck spokeswoman responded that clear policies govern the company’s sales and marketing activities, and that “those policies are aimed at ensuring that our product communications are fair and balanced and consistent with FDA labeling.” She said the company has training programs in place to make sure that promotions are “consistent with both our standards and our policies.”
The new study was published in the journal Archives of Internal Medicine.