But there's another question worth asking: Did Merck do enough to study Vioxx's effect on the heart?
' I say, 'Isn't that exactly what the world wants a company like Merck to do?
In theory, all Merck had to do was to show that the combination did not have some unforeseen issues.
Do Merck's legal problems merit the punishment that the stockmarket has dished out?
What can MIT biologist Peter Kim do at Merck that he couldn't in academia?
Next year's earnings-per-share numbers have little to do with Merck's future.
FORBES: Vioxx and Diclofenac: Why Are Two Heart Risky Pain Drugs Viewed Differently?
Peto writes that "any competent trial statistician" would back his conclusions and says that Vytorin's makers, Merck and Schering-Plough, do not pay his salary and had no impact on the decision to conduct his analysis or on how the analysis was conducted (see Peto's letter).
And Merck and Schering-Plough scrapped plans to do a Vytorin imaging trial with him.
The results highlight the difficult times that led Merck to drop its aversion to megamergers and do the Schering deal.
Both Merck and Aventis have picked similar bits of DNA to do the job.
From the 2005 announcement of Cordaptive's existence on, Merck seems to have fatally misjudged what it needed to do to get the drug approved.
In ENHANCE, Vytorin, a combo pill of Schering-Plough's Zetia and Merck's now-generic Zocor, failed to do better than Zocor alone in preventing atherosclerosis, leading to the sales decline and big drops in the stock prices of both companies.
More important, the new earnings numbers do not take into account Vioxx lawsuits, and these will determine Merck's future.
But the current study cannot rule out that the Merck drug increases other causes of death, as the Pfizer drug appeared to do.
Merck could have found enough of the kind of patients who take Zetia to do a study that would have been more likely to have a positive result.
FORBES: Merck's Big Vytorin Study Could Change Rules For New Cholesterol Drugs
"You can't just decide to do this based on somebody else's work and then expect to do it in a timely manner, " says Larry Hirsch, Merck's vice president of public affairs.
Later this year, Merck expects to refile Arcoxia in the U.S. and either spin off or do an initial public offering for its pharmacy-benefits manager unit, Medco.
Frazier chose to do something no other pharmaceutical chief has done: he withdrew the earnings guidance Merck has given through 2013, when it and the drug industry as a whole will face the loss of U.S. sales from big sellers invented in the 1990s.
"We do not plan on rolling over in these cases where people bring insubstantial cases against Merck, " he promised.
But Krumholz's speech drew applause, and accounts of it in the media don't do it justice. (See "The Speech That Maimed Schering And Merck").
Still, while there is a magnifying glass on the first case, one lawyer familiar with such litigation says, it is the first several cases, taken together, that could have a big impact on whether Merck eventually decides to settle--and winds up paying tens of billions of dollars to do so.
For cholesterol lowering, brand-name Lipitor from Pfizer and Crestor from AstraZeneca are the most potent "statin" medications, but generic versions of Zocor and Mevacor from Merck, or Pravachol from Bristol-Myers Squibb are all proven to prevent heart attacks and may do just fine for you.
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