Merck Documents Show Vioxx® Sales Tactics

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In a recent Congressional hearing, lawmakers released confidential Merck documents that detail how the sales force of 3,000 aggressively pushed Vioxx® before it was pulled from the market last fall because of heart attack risks.

Sales tactics from managers were so detailed that they told the sales representatives how long to shake a physician's hand (3 seconds) and how to eat bread when dining with doctors ("one small bitesize piece at a time").

The following are some of aggressive sales tactics found in Merck documents sent to sales representatives to dodge and deflect any safety concerns over Vioxx®.

No. COX 00-021
April 05, 2000
Bulletin for Vioxx®: The 200 Field Incentive Plan for Vioxx®

Sales representatives received a $2,000 bonus for attaining 55 percent and 61 percent monthly new Rx share of Vioxx® for there sales region. Business Managers also earned a bonus for each region that achieved the 55 percent and/or 61 percent goals.
Hospital sales representatives also received a bonus of $2,000 for attaining 55 percent and 61 percent monthly new Rx share of Vioxx®. Hospital business managers earned a bonus for each of their territories that achieved the 55 percent and/or 61 percent goals.

No. COX 00-028
Apr 28, 2000
Bulletin for Vioxx®: New Resource: Cardiovascular Card

The disconcerting document spelled out how the representatives were to respond to doctor's questions regarding the cardiovascular risks of Vioxx®. Merck created a "Cardiovascular Card" to make sure the representatives were "well prepared to respond to questions about the cardiovascular effects of Vioxx®."
The document goes on to say:
- "The Cardiovascular Card will allow you to set the record straight with your physicians regarding the cardiovascular profile of Vioxx® and how this profile compared to other NSAIDs in OA clinical trials with Vioxx®. The Cardiovascular Card is an obstacle handling piece and should only be used with physicians in response to their questions regarding the cardiovascular effects of Vioxx®. This is for your background only. You may not use the Cardiovascular Card with your physicians."

No. COX 00-029
May 01, 2000
Bulletin for Vioxx®: New Obstacle Response

Purpose:

"To provide you (the sales rep) with a new obstacle response relating to the press release and Searle/Pfizer's promotion that Vioxx® has an increased incidence of heart attacks compared to Celebrex®, based on the Vioxx® GI Outcomes Trial compared to Celebrex® in the CLASS trial."

Obstacle Response 38:

Doctor"s Question: I just read (or heard a news story) stating that Vioxx® has a higher incidence of heart attacks than Celebrex®. Is that true?

Sales Rep's Response: "Doctor, there are no head-to-head studies comparing the cardiovascular profile of the two drugs. As a result, you cannot compare the drugs and conclude that one drug had fewer events than the other."

Merck MEMO
TO: All RBG VPs and Senior Business Directors
From: MIT for Vioxx®
Subject: Offensive Positioning for Vioxx®
Date: 07/28/00

Documents states:

"In order to win the on-going Coxib battle, many of you agree our sales force needs to STOP defending Vioxx® against the outrageous claims from our competitors, and START offensively selling the core benefit of this product... EFFICACY."
"It is evident that Pharmacia/Pfizer will continue to concentrate their selling efforts on building a perception around renal and hypertension issues with Vioxx®. In order to put these issues into perspective so that our Representatives can transition their discussion to our Top 5 messages for Vioxx®."
"The components of a quick hit proactive Vioxx® discussion should include the following:
- A 'quick hit' response to the renal/hypertension obstacles
- Top 5 Messages for Vioxx®
- A STRONG close to prescribe Vioxx® - Dr., based on the efficacy, safety and convenience of Vioxx®, is there any reason why you wouldn't chose Vioxx® FIRST for your appropriate OA and acute pain patients?
- A 'closing question' to put the Celebrex® Representative on the defensive - Doctor, one last thing, ask your Celebrex® Representative in the AE table of Celebrex® prescribing information, doesn't it state that the rate of edema with Celebrex® was more than double that of ibuprofen 800?"

No. COX 01-007
Feb 09, 2001
Bulletin for Vioxx®: FDA Arthritis Advisory Committee Meeting for Vioxx®

"Do not initiate discussions on the FDA Arthritis Advisory Committee review or the results Vioxx® GI Outcomes Research (VIGOR) Study. You may respond to customer inquires only as outline below.
- Stay focused on the EFFICACY messages for Vioxx®
- Utilize the PIR system to respond to unsolicited physician inquires
- Review the updated background Q&A
- Review the updated obstacles and responses for your physicians
- Do not initiate discussions or respond to questions."

MVX for Vioxx®
From - Jo Jerman
Audience"Field Sales
April 27, 2001
Topic - Project A & A XXceleration
Length - 1 min 30 sec

Jo's voicemail pointed out the following items:

"Now, some people might be satisfied with little increases at a time, but as you've heard, we need to give Vioxx® a real boost to keep ourselves on track and make our goals for 2001."
"By, now, I bet you are tired of cleaning up after the competition on territory. So, it's high time that we hit the offensive with confidence in our messages, our selves and most of all, the efficacy of Vioxx®."

No. COX 01-031
May 24, 2001
Bulleting for Vioxx®: Action Required: REVISED Response to New York Times Article

"Do not initiate discussions on the results of the Vioxx® GI Outcomes Research (VIGOR) Study, or any of the recent articles in the press on Vioxx®."
"Do not proactively discuss any of the recent press stories. Respond to questions by requesting a PIR and in accordance with the obstacle handling guide."

MVX for Vioxx®
To - Sales - USHH
From - Jo Jerman
August 21, 2001
"JAMA article"
Length - 4 minutes

Jo's voicemail pointed out the following items:

"Merck stands firmly behind overall and CV safety profile and favorable GI profile of Vioxx®. Keep in mind that both Vioxx® and celecoxib were under review in this article."
"Keep in perspective the many benefits of Vioxx® and stay confident in the balanced information that you have to take to our customers. Did you know that to date, more than 30 million patients have benefited from taking Vioxx® in the US this year alone? So, use your resources - stay calm and stay cool."

MVX for Vioxx®
To - Field Sales - USHH
From - Jo Jerman
November 5, 2001
"November Project Offensive Update"

Jo's voicemail stated that at that point in time Vioxx® "had grown over 10,000 scripts in the Coxib market since the launch of our new initiative... Now that is magnificent... Talk about getting on the offense."

MVX for Vioxx®
To - Field Sales - USHH
From - Jo Jerman
December 11, 2001
"Bextra® follow-up and CV Outcomes Trial"

Jo's voicemail pointed out the following items:

"Bextra® has not one, but two tenacious sales forces behind it and a dissatisfied market in front of it. There will definitely be challenges for us ahead."
"Keep your eye on the following steps:
- Focus promotion on the efficacy data for Vioxx®, both with our acute pain in adults data and our OA data and use it to make balanced presentations.
- Continue to enroll targeted accounts for VIP and pull through business at VIP institutions.
- Prepare to confidently address obstacles by reviewing the Bextra® product profile and upcoming obstacle guide.
- Use your 'Project Offensive' Tactical Plan as your Tactical Plan for Bextra®."

The Vioxx® documents can also be viewed in their entirety at:

http://www.democrats.reform.house.gov/features/vioxx/documents.asp.

If you believe that you or a relative were injured by taking Vioxx® please use the form below to contact our law firm.

References