The increase in baseline risk that I mention as a possibility in Prialt's future is not a product of my imagination. It was precisely this shift in Vioxx's baseline threat that transformed it into a matter of hysteria in the press. In the study that indicted Vioxx, the number of cardiovascular events per 1,000 was 15 for the group using Vioxx in large dosages and for 18 months. The number of cardiovascular events per 1,000 was 7.5 for the group using a placebo.
Rather than bringing in the Feds and the trial lawyers, I think such findings should leave it to doctors and patients to decide whether they wanted a slight increase in danger or enduring pain.
Instead, we now have journalistic hysteria over the Giant Pharmaceuticals and their alleged reckless pursuit of profit. The trial lawyers' pursuit of profit will get little attention. Witnesses will turn up who will insist that they recognized the painkiller's dangers all along. They will claim Vioxx's producer did, too.
Let me say it now. I seriously doubt that in litigious America any pharmaceutical company would risk putting a drug on the market knowing it was dangerous. All medications have side effects, some quite serious. The important question is over the severity and frequency of the side effects.
My guess is that Vioxx's severity and frequency are within the bounds of the tolerable. The suffering of patients no longer allowed to use Vioxx has gotten little attention in the news stories. Certainly suffering can lead to death.
The Wall Street Journal points out ironically that it might be a good thing that a growing list of painkillers is being attacked in the press. Suffering Americans need painkillers. As the list of painkillers with side effects lengthens, the public may be moved to a sensible conclusion.
Powerful medications have side effects. The afflicted and their doctors can decide what is best for them -- in the case of Vioxx, more pain or a slight increase in the chance of cardiovascular disease. The answer to the current hysteria over painkillers is more information and more consumer freedom -- nothing more.