Marcia Angell in the New York Review of Books:
On April 5, 2006, a New Jersey jury found that Merck’s arthritis drug Vioxx caused John McDarby, a seventy-seven-year-old retired insurance agent, to suffer the heart attack that left him debilitated in 2004. (The drug was not blamed for the heart attack of a second plaintiff in the same case.) The jury also found Merck guilty of consumer fraud for not warning doctors and the public of the drug’s cardiovascular risks. McDarby and his wife were awarded $4.5 million, plus another $9 million in punitive damages because the company was found to have misled the US Food and Drug Administration (FDA). Merck now faces about ten thousand similar lawsuits, and has vowed to fight every one of them. So far, there have been verdicts in four cases—two for Merck and two against (the McDarby case and an earlier one in Texas, in which the plaintiff was awarded $253.5 million, which under Texas law must be cut to $26.1 million). If there are more losses, and the chances are there will be, Merck, despite its defiant talk, may ultimately have to try to reach a settlement instead of fighting each case.
The defeat was not just a loss for Merck, but for the industry as a whole, which has seen its reputation plummet in the past few years. Polls show that among American businesses, the pharmaceutical industry now ranks near the bottom in public approval—above tobacco and oil companies, but well below airlines and banks and even insurance companies. This situation contrasts sharply with the generally high regard in which the industry was held just a few years ago.