Viewing the Vioxx verdict: suits become sole protection against big pharma firms.

PATIENTS used to assume that the drugs they had been prescribed were tested by pharmaceutical companies, approved by regulators and vetted by doctors. But Vioxx and its maker Merck & Co. remind us that the drug industry's lust for profit has eviscerated all levels of security, except one: the court of law.

Last week a Texas jury declared a $253 million verdict for the widow of a man who died 'after taking Merck's signature painkiller, Vioxx. The first of the Vioxx lawsuits revealed that Merck knew, yet kept secret, that use of the drug led to increased risk of heart attacks.

Much of the problem lies with the Food and Drug Administration and other government agencies that are infected by deep conflicts-of-interest between regulators and the drug companies themselves. The breadth of these conflicts suggests that regulators have become accomplices of an industry whose only motive is increased profitability.

For example, 10 of the 32 FDA scientists who approved Vioxx and other Cox-2 inhibitors (Celebrex & Bextra) had financial ties to the manufacturers of those drugs. Had scientists with conflicts of interest been excluded from the vote, Vioxx would have been removed from the market.

Drug companies have also been successful in buying off politicians. In the run-up to the 2004 presidential elections, the drug industry contributed $1 million to President Bush, $570,000 to Sen. John Kerry and $16 million to members of Congress.

With the politicians and bureaucrats in their pockets, drug manufacturers amassed profits four to seven times greater than the average Fortune 500 company. Vioxx generated $2.5 billion in sales for Merck last year alone.

If the government isn't looking out for you, surely your doctor will tell you if a drug is dangerous, right? Think again. In 2000, drug companies spent $13.2 billion in advertising drugs to doctors. That includes $4.8 billion to send armies of salespeople into doctors' offices to convince them to prescribe their products.

Only when drug companies are brought to court are they forced to clean up their act. A lawsuit brought by private attorneys prompted the U.S. Attorney General to intervene and settle a case that alleged Pfizer Inc. had fraudulently promoted its seizure medication, Neurontin, for treatments not approved by the FDA. Neurontin, erroneously promoted as a painkiller, has been linked to depression and suicide.

Among other things, government prosecutors alleged that Pfizer paid doctors more that $250,000 each to promote non-FDA-approved uses of the drug to other doctors. Most of Neurontin's $2.7 billion in sales in 2003 were for non-approved uses.

With regulators as accomplices, doctors out of the loop, and heartless corporations in pursuit of profit at any cost, the legal system is the only tool left to protect us from corporate malfeasance. However, judicial oversight is threatened by a blistering attack from insurers and companies like Merck.

In Congress, legislation is pending that would limit to $250,000 the damages for pain and suffering that victims of dangerous drugs can recover. Industry-backed limitations are already in place in Texas, which will likely slash the Vioxx verdict by 90 percent.

Drug companies might try to evoke sympathy from future jurors by claiming that big verdicts will cut into research and development funds. But that would be another cover-up. An analysis of drug company SEC filings shows that they spend two to three times more on marketing and administration than on developing new drugs. Merck spent just 5 percent of its $47 billion revenue on research and development in 2001.

Will the first Vioxx settlement be enough to scare the drug industry straight? No, but it's a good start.

Jerry Flanagan is health care policy director for the Foundation for Taxpayer and Consumer Rights.