16 ms·

When half a million Americans died and nobody noticed

293 points by gruseom 15y ago

Alex3917 15y ago
Still happening today with sedative hypnotics (e.g. xanax, ambien), where a recent study estimated that these drugs were killing 300,000 - 500,000 Americans each year: http://www.medicaldaily.com/news/20120228/9190/sleeping-pill-cancer-premature-death-barbiturates-research.htm http://www.medicaldaily.com/news/20120228/9190/sleeping-pill... This is despite the fact that the government recommends against prescribing them for longterm use since all the research shows that these drugs have zero efficacy (in fact negative efficacy) after the first ten days or so. And yet most doctors hand out longterm prescriptions for these drugs like candy since they either have no idea about this research or simply don't care. In fact they are some of the most widely prescribed drugs in the US. (Note that it's not entirely clear that they really are killing 300 - 500k Americans each year, as other studies find no excess deaths, but what is clear is that the longterm use of them is terrible for you and that they have zero longterm efficacy in the first place.)
- sliverstorm 15y ago
  they either have no idea about this research or simply don't care Alternatively, perhaps their patients have no idea about the research (or simply don't care)? Of course, a doctor does not have to bend to his patients' demands, but perhaps if they are pestered enough...
- DanBC 15y ago
  The world health organisation has some information about the Z drugs. People in France steal prescription pads - zopiclone is in the top ten list for medications that are obtained with stolen pads. Dublin drug and alcohol clinics are reporting more people having trouble with zopiclone. People suggest that zopiclone is as addictive as diazepam (valium). "Addiction" is a technical term, and zopiclone doesn't meet that definition, but people should be a bit careful when taking these meds. Especially if they're taking them long term. Sleep hygiene is important, and even though there's plenty of information about it anecdote suggests people aren't often given that information. Also, unfortunately, the best (evidence based) treatment for most insomnia -cognitive behaviour therapy (tailored for insomnia)- is hard to find.
- Estragon 15y ago
  > a recent study estimated that these drugs were killing > 300,000 - 500,000 Americans each year Looks like sloppy epidemiology to me. The only way to nail a claim like that down would be to establish a control group with very similar life stressors, something you couldn't do from medical records. People take sleeping pills because they're under stress bad enough to keep them from sleeping, and that has an impact on survival rates. > what is clear is that the longterm use of them is terrible > for you and that they have zero longterm efficacy in the > first place.) This is interesting. What's the evidence?
  - DanBC 15y ago
    > This is interesting. What's the evidence? I'd be interested to see the evidence for "terrible for you". Hypnotics just make you sleep - they don't treat the cause of the insomnia. (For some people they're great at kicking you back into a routine.) There's evidence that long term use can create rebound insomnia. Here's a guide for general public stating the need for using the meds short term:- (http://www.nice.org.uk/nicemedia/pdf/TA077publicinfoenglish.pdf http://www.nice.org.uk/nicemedia/pdf/TA077publicinfoenglish....) Here's a slightly more technical document with links to the evidence that they used: (http://www.nice.org.uk/nicemedia/pdf/TA077fullguidance.pdf http://www.nice.org.uk/nicemedia/pdf/TA077fullguidance.pdf) Here's a guide aimed at clinicians with many links to good evidence: (http://www.cks.nhs.uk/insomnia/evidence http://www.cks.nhs.uk/insomnia/evidence)
  - Alex3917 15y ago
    "This is interesting. What's the evidence?" http://www.madinamerica.com/2011/11/anxiety/ http://www.madinamerica.com/2011/11/anxiety/ The actual book (Anatomy of an Epidemic) explains it better, but those are just some quick links. They're also vastly more addictive than heroin. While the worst of heroin withdrawals are over in less than a week, benzo withdrawals can literally last over a year, with people unable to sleep and in severe pain that entire time: http://en.wikipedia.org/wiki/Benzodiazepine_withdrawal_syndrome http://en.wikipedia.org/wiki/Benzodiazepine_withdrawal_syndr...
    - delackner 15y ago
- jsdalton 15y ago
  Just over 2.4 million Americans died in 2010 (source: http://www.cdc.gov/nchs/fastats/deaths.htm http://www.cdc.gov/nchs/fastats/deaths.htm). So basically, this study is making the claim that prescription sleeping pills are responsible for 12-20% of all deaths in the U.S. That sounds like a rather extraordinary, and probably exaggerated, claim.
mikeash 15y ago
The US death rate is about 2.5 million/year. Seems like somebody would have noticed a 20% jump due to a single drug. Can this 500,000 deaths/year number really be close to correct? Edit: duh, not per year. Oh well, there may still be some little nugget of validity in there somewhere.
- haberdasher 15y ago
  It's 500,000 in total, not per year.
- RandallBrown 15y ago
  it was 100,000 per year for five years. The article mentions that people did notice when it was dropped down, but doesn't mention anything about when deaths/year went up.
  - gruseom 15y ago
    "We find the largest rise in American mortality rates occurred in 1999, the year Vioxx was introduced, while the largest drop occurred in 2004, the year it was withdrawn" Moreover: "Vioxx was almost entirely marketed to the elderly, and these substantial changes in the national death-rate were completely concentrated within the 65-plus population." And: "The FDA studies had proven that use of Vioxx led to deaths from cardiovascular diseases such as heart attacks and strokes, and these were exactly the factors driving the changes in national mortality rates."
    - RandallBrown 15y ago
      yes, but those were noticed years later. As far as I know, no "Mysterious death spike" articles were published in 2000 because of the extra deaths in 1999.
      - Retric 15y ago
        The drug did not gain widespread adoption in a single year.
joejohnson 15y ago
"Besides," says Unz laughing, "it shows the stupidity of our political leaders that they didn't seize upon this great opportunity. They should have just renamed Vioxx the 'Save Social Security Drug,' and distributed it free in very large doses to everyone, starting on their 65th birthday. Maybe they should have even made it mandatory, three times per day. At sufficiently large levels of national consumption, Vioxx could have almost singlehandedly eliminated all our serious budget deficit problems. 'Vioxx - The Miracle Anti-Deficit Drug'." That's so morbid. This is the kind of dangerous idea that I'm sure many people have, but are afraid to voice publicly.
- EvilTerran 15y ago
  Yeah, that's morbid all right. I'm reminded of "Quietus" in Children of Men.
  - mortenjorck 15y ago
    Truly the best sci-fi movie of the past decade. Not only the lifting of taboo, but the commercialization of euthanasia was perhaps the film's most hauntingly powerful sign of how despairing society had become without reproduction.
    - excuse-me 15y ago
      A lot of religions object to contraception - there aren't many that object to killing people.
      - bdunbar 15y ago
        Every religion objects to killing folk. Every religion has exceptions to the rule. This is a rational accommodation. Religions that don't make those exceptions run out of followers real quick.
        excuse-me 15y ago
        "Every religion has exceptions to the rule." Typically = the set of people that don't belong to that religion!
reasonattlm 15y ago
Half a million Americans died in the last 80 days, most due to aging. Nobody really paid much attention to that either - or the same number in the preceding 80 days, and the 80 days prior to that, and so on. One can ponder what that says about humans.
- josefresco 15y ago
  If we could pull "aging" off the market than we would. Unlike aging, this one drug can be removed from public consumption. Aging, while some day "curable" is nowhere near that today.
nkoren 15y ago
I can actually see how this would be difficult to spot. Look at the graph of American death rates from the CDC: http://www.cdc.gov/nchs/data/databriefs/db88_fig1.png http://www.cdc.gov/nchs/data/databriefs/db88_fig1.png If you know where to look, there is indeed a small spike from 2000-2005, corresponding with the availability of Vioxx. The rise in 2000 is barely noticeable, but the drop in 2005 is fairly striking. This makes sense: the drug would have been taken up gradually by the market, but its cessation was virtually overnight. The reason this would be difficult to spot, however, is because death rates did not really increase. Rather, they stayed more or less constant, when they might otherwise have gradually decreased. In hindsight, this looks plausible -- but at the time, saying that death rates would be decreasing were it not for Vioxx would have been an extremely difficult counterfactual argument to make.
- planetguy 15y ago
  I think you've seriously gotta squint to make the data you're talking about look like anything other than noise.
  - ajross 15y ago
    That's not right. Correlations with data this large can be proven quite conclusively even if the signal is low. There are a lot of deaths every year, so even fairly small relative signals are resolvable. What's interesting here though is that this is not a small signal, precisely because it shows up against the background without any correlation work at all. FTA: > "We find the largest rise in American mortality rates [in the last 15 years] occurred in 1999, the year Vioxx was introduced, while the largest drop occurred in 2004, the year it was withdrawn," says Unz.
    - nkoren 15y ago
      That statement, however, doesn't seem to correspond with the CDC's graph, which shows a much larger rise in death rates occurring in 1993. (Source article for that graph: http://www.cdc.gov/nchs/data/databriefs/db88.htm http://www.cdc.gov/nchs/data/databriefs/db88.htm -- would that they distributed the actual datasets behind the graphs!)
Duff 15y ago
I don't agree with the conclusions in this article at all. Also consider that Celebrex (same drug family) is still on the market. If these drugs were truly a grim reaper, I don't think Celebrex would still be around. If anything, this should be seen as a reason to not allow the pervasive advertising of prescription drugs and aggressive peddling of drug swag - Vioxx was peddled in the most ostentatious way -- my doctor STILL has Vioxx clipboards and other junk in his office. I'm sure that this constant brand awareness and patient nagging helped drive sales (ie. encourage potentially unnecessary or inappropriate scripts). The other thing to consider is quality of life. I began suffering by a sudden onset of what was eventually diagnosed as a degenerated disc in my back -- at age 25. I went through some intensive physical therapy to try to avoid surgery (ultimately an unsuccessful effort), and Vioxx was the only thing that allowed me to function without narcotic pain relief (which I refused to take for more than a week at a time). It was that good at reducing chronic inflammation. If I were a 75 year old man with severe, debilitating arthritis having difficulty walking or living a decent life, I'd happily volunteer to take a drug like Vioxx to improve the quality of my remaining time here, even knowing that I was at a higher risk of a heart attack.
- ajross 15y ago
  Your argument seems to be one of simple personal disbelief, that one drug "in a family" can have effects that others don't? That doesn't seem to be borne out by history or logic... Even your own anecdote seems to argue against it: Vioxx worked for you pain, but Celebrex doesn't.
  - Duff 15y ago
    I never tried Celebrex, as I had surgery in early 2004 that eliminated the need for any medication. I'm not a pharmacist, but the story regarding this drug is more nuanced. Doctors prescribed the two drugs differently, as folks with other drug sensitivities were not good celebrex candidates, and the risk factors associated with vioxx were not known. Vioxx was the more heavily marketed, "safe" choice.
- liber8 15y ago
  I've heard this from countless other people as well (including many doctors). Apparently, it was a fantastic pain drug for many people. Should Merck have disclosed the increased risk of heart attack and stroke? Absolutely. But, part of the problem is the incentives fostered by a bureaucracy like the FDA. If you know that your new wonderfully effective pain medication increases the risk of heart attacks from 4% to 6% (or whatever the numbers were), are you going to disclose that to the FDA, knowing it essentially spells doom for the billion dollars plus you spent on development?
randomfool 15y ago
Worth noting that Celebrex is very similar to Vioxx (COX-2 inhibitor), and that researchers do not know if Celebrex has the same issues as Vioxx- they've avoided repeating this study. http://en.wikipedia.org/wiki/COX-2_inhibitor#Adverse_effects http://en.wikipedia.org/wiki/COX-2_inhibitor#Adverse_effects
- refurb 15y ago
  This isn't true. When the FDA held their hearing about Vioxx, they also evaluated Celebrex as well. Vioxx was found to have serious CV risks associated with it at ALL recommended doses. Celebrex was found to have CV risks associated with only the highest dose. The FDA made the call that Vioxx should be gone and that Celebrex can stay (with an updated label that describes the risks). Same with Naproxen.
wtracy 15y ago
I would suggest that it's not that American lives are cheaper, it's that old people's lives are cheaper. (I don't think it should be that way, just that it is that way.) That, and the public has a much more visceral reaction to food and beverages that kill people than medications that kill people.
jorleif 15y ago
I find the value of human life comparison between China and the US somewhat ludicrous, since societies obviously tend to react much more strongly to babies with strange acute symptoms (kidney stones), than to elderly people passing away from typical reasons (heart disease).
- Vadoff 15y ago
  Oh yes, because 6 dead babies have more "value" than half a million dead elderly. How dare the author make such a comparison!
leoh 15y ago
Very interesting. I am very passionate about this topic, and I happen to know the author of the paper that took on Merck. The statistics in that paper are exceedingly convincing, since the study was conducted on a controlled set of patients, some whom received Vioxx, and some whom did not (a control group). This article points out a very interesting correlation between Vioxx being taken off the market, and a drop in death rates. Yet proving Vioxx as the causative agent will be very difficult.
- gruseom 15y ago
  Since you know the author of that paper, could you find out for us what he/she thinks of this new information about death rates? Proving causation would be a high bar, of course, if not impossible. But I'm curious to know what further investigation could be done with this.
herbivore 15y ago
And yet the majority of HN users still trust big pharma that vaccines are safe. You are being lied to over and over and just never learn.
- tokenadult 15y ago
  I can't speak for the majority of HN users, but I can speak for people who read serious medical research about vaccine safety and effectiveness (as I am one such person), and I can say for the record that there is plenty of evidence that vaccines have consistently resulted in reduced mortality and morbidity from a variety of diseases. Childhood death is now rare (it was once commonplace) largely because of improved sanitation and other public health measures around the globe but also because of vaccines. http://www.sciencebasedmedicine.org/index.php/category/vaccines/ http://www.sciencebasedmedicine.org/index.php/category/vacci...
  - Alex3917 15y ago
    The problem is that: - The safety standards for getting new drugs approved are incredibly lax. All you need to show is that it helps the person in some measurable way for the first six weeks. You don't need to show that the drug is safe or effective for longterm use, even if the drug is designed for longterm use. And you don't need to show that the person's overall health and wellbeing is improved, just the one condition the drug is designed to treat. So if an acne drug causes liver failure it will still get approved as long as it's effective at treating acne. - The government has been caught many times injecting political dissidents and others with fake vaccines, most recently in the case of the Bin Laden family. - Most academics believe that the US government was responsible for starting the AIDS epidemic by running vaccination programs in Africa. [1] [2] - The government has repeatedly shown that they don't take evidence of safety and quality problems seriously at best, and actively prosecute whistleblowers at worst. [1] http://www.theglobeandmail.com/life/health/new-health/health-news/canadian-researcher-traces-aids-to-single-bush-hunter-from-1921/article2210046/ http://www.theglobeandmail.com/life/health/new-health/health... [2] http://www.amazon.com/The-River-Journey-Source-AIDS/dp/0316372617 http://www.amazon.com/The-River-Journey-Source-AIDS/dp/03163...
jeffdavis 15y ago
There is a big difference between premeditated adulteration of a product people already use, like milk; and sweeping studies under the rug[1] about a new product. If nothing else, a huge amount more people needed to know about the malamine scandal. How are we shipping so much milk with so few cows? Why am I dumping this unmarked 50lb bag of powder into the milk? [1]: After looking at http://en.wikipedia.org/wiki/Vioxx http://en.wikipedia.org/wiki/Vioxx, I don't see any allegation that Merck actually withheld raw data from the FDA, or provided it with false raw data. That's the great thing about a vague analogy like "sweeping under the rug": you can imply that something happened that didn't, without actually lying.
- herbivore 15y ago
  In a 2030 version of Hackernews someone will point out that a lot of people must have known about coordinated efforts to dump fluoride into our water and everyday products, pasteurize cow's milk to produce a liquid substance that does not exist in nature and then push it as healthy and essential. That thousands of people sprayed produce with toxic chemicals. That thousands of people stood behind a counter and sold people a product that kills half a million of them every year along with 50,000 of their acquaintances (cigarettes) and that America's greatest investor pushed Coke and its evil twin Diet Coke to millions of people who later abused it as part of their path to obesity and heart attack.
  - wordplay 15y ago
    There's a difference, subtle though it may be to some, between common legal practices in food and drug production and conspiring to criminally poison consumers for profit. Many of the items you mention are likely bad for the long term health of our species--but I would compare them more readily to medical practices in the dark ages than the short sighted and improperly structured health / regulatory environment we have today. I'm deeply concerned about the world my children will inherit, but it's difficult for educated mainstream individuals to take the issues you point out seriously if they are presented from a paranoid and conspiracy theory embracing perspective. Even taking a giant leap and supposing any of the conspiracies exist to the extent some claim, the presentation still suffers because of a lack of willingness by the populace to embrace such a dark view of a society that they participate in.
vixen99 15y ago
The article tells us that lives in the US were valued at $4.85 billion. So what was the payoff for victims in China that permits the conclusion that 'American lives are quite cheap unlike those in China'?
- bilbo0s 15y ago
  Uhhh... The fact that NO AMOUNT OF MONEY could save you from prosecution in China maybe? In fact, the American Conservative can point to several dead Chinese 'Boardroom types' to make a quite convincing argument that no amount of money could even save them from execution in China.
  - tsotha 15y ago
    Or maybe the people who were executed are the ones who didn't have enough money. Anti-corruption campaigns are very common in China. They'll go through and execute a few hundred people at a time. But they don't make a dent in actual corruption, because the only people to get executed are the ones without connections.
Tloewald 15y ago
I wonder if the blowout in the rate of healthcare cost expansion under Bush and the deceleration of late can both be ascribed, at least in part, to the end of Vioxx.
jackfoxy 15y ago
It's worth calling-out the original article http://www.theamericanconservative.com/blog/chinese-melamine-and-american-vioxx-a-comparison/ http://www.theamericanconservative.com/blog/chinese-melamine... (Oh my gosh! A nasty right-wing publication.) You need a right-wing and a left-wing to fly. Or, to go from the abstract to the concrete, you should inform yourself from a wide range of sources. Another notable health scandal (in California) first exposed by the conservative, aka right wing, press was MTBE. See http://www.calnews.com/archives/morgan03.htm http://www.calnews.com/archives/morgan03.htm and http://www.nature.nps.gov/hazardssafety/toxic/mtbe.pdf http://www.nature.nps.gov/hazardssafety/toxic/mtbe.pdf (search for KSFO). These kinds of scandals are not consequences of the free-market. This is crony-capitalism. It could just as easily happen under crony-socialism. And as the MTBE scandal demonstrated, progressive politicians are perfectly capable of foisting this kind of stuff on the public.
- gruseom 15y ago
  I hesitated over whether to post Unz's original piece or Cockburn's linkbaity rehash. In the end the rehash won, because I don't think the comparison to China is the interesting part and because it would likely have sparked a dumb political argument.
seanp2k2 15y ago
Liked the article up until the point at the end where he attributes our deficit to Medicare and not the wars.
- tsotha 15y ago
  He's right: http://www.americanthinker.com/2010/08/iraq_the_war_that_broke_us_not.html http://www.americanthinker.com/2010/08/iraq_the_war_that_bro...
seanp2k2 15y ago
Liked the article up until the point at the end where he attributes our deficit to Medicare and not the wars.
seanp2k2 15y ago
Liked the article up until the point at the end where he attributes our deficit to Medicare and not the wars.
seanp2k2 15y ago
Sick that a country that most people would agree doesn't have strong human rights values /executed/ people for a similar scandal while we don't even slap their wrists. Money over positively everything.
- jeffdavis 15y ago
  "a similar scandal" It was not similar. In my opinion, it's so different that it's not even worth comparing. An analogy is not an argument. It only illustrates your argument, if you have one.
12uu45dd 15y ago
I'm sure their loved ones noticed.
jgamman 15y ago
post hoc ergo proctor hoc
- revolutions 15y ago
  'Correlation does not imply causation, but it does waggle its eyebrows suggestively and gesture furtively while mouthing "look over there".'
kristianp 15y ago
One point no-one else has raised here, is that (as far as I can tell) no employee of Merck was punished for this. How can Merck the company plead guilty to a misdemeanor, but no individual be held even partly responsible? "Under separate criminal proceedings, Merck plead guilty to a federal misdemeanor charge relating to the marketing of the drug across state lines, incurring a fine of $321.6 million." From http://en.wikipedia.org/wiki/Rofecoxib http://en.wikipedia.org/wiki/Rofecoxib . It frustrates me that people in big companies have no deterrent from acting unlawfully. The same thing happened in Wall Street companies in the GFC.
- josephcooney 15y ago
  Contrast that with what happened in China.
rsanchez1 14y ago
So the American media lied. What's new? I bet the only people who really cared are those that you would have written off as "conspiracy theorists" before you came to realize the grisly truth.

293 points by gruseom 15y ago

Still happening today with sedative hypnotics (e.g. xanax, ambien), where a recent study estimated that these drugs were killing 300,000 - 500,000 Americans each year: http://www.medicaldaily.com/news/20120228/9190/sleeping-pill-cancer-premature-death-barbiturates-research.htm http://www.medicaldaily.com/news/20120228/9190/sleeping-pill... This is despite the fact that the government recommends against prescribing them for longterm use since all the research shows that these drugs have zero efficacy (in fact negative efficacy) after the first ten days or so. And yet most doctors hand out longterm prescriptions for these drugs like candy since they either have no idea about this research or simply don't care. In fact they are some of the most widely prescribed drugs in the US. (Note that it's not entirely clear that they really are killing 300 - 500k Americans each year, as other studies find no excess deaths, but what is clear is that the longterm use of them is terrible for you and that they have zero longterm efficacy in the first place.)

sliverstorm 15y ago
they either have no idea about this research or simply don't care Alternatively, perhaps their patients have no idea about the research (or simply don't care)? Of course, a doctor does not have to bend to his patients' demands, but perhaps if they are pestered enough...
DanBC 15y ago
The world health organisation has some information about the Z drugs. People in France steal prescription pads - zopiclone is in the top ten list for medications that are obtained with stolen pads. Dublin drug and alcohol clinics are reporting more people having trouble with zopiclone. People suggest that zopiclone is as addictive as diazepam (valium). "Addiction" is a technical term, and zopiclone doesn't meet that definition, but people should be a bit careful when taking these meds. Especially if they're taking them long term. Sleep hygiene is important, and even though there's plenty of information about it anecdote suggests people aren't often given that information. Also, unfortunately, the best (evidence based) treatment for most insomnia -cognitive behaviour therapy (tailored for insomnia)- is hard to find.
Estragon 15y ago
> a recent study estimated that these drugs were killing > 300,000 - 500,000 Americans each year Looks like sloppy epidemiology to me. The only way to nail a claim like that down would be to establish a control group with very similar life stressors, something you couldn't do from medical records. People take sleeping pills because they're under stress bad enough to keep them from sleeping, and that has an impact on survival rates. > what is clear is that the longterm use of them is terrible > for you and that they have zero longterm efficacy in the > first place.) This is interesting. What's the evidence?
- DanBC 15y ago
  > This is interesting. What's the evidence? I'd be interested to see the evidence for "terrible for you". Hypnotics just make you sleep - they don't treat the cause of the insomnia. (For some people they're great at kicking you back into a routine.) There's evidence that long term use can create rebound insomnia. Here's a guide for general public stating the need for using the meds short term:- (http://www.nice.org.uk/nicemedia/pdf/TA077publicinfoenglish.pdf http://www.nice.org.uk/nicemedia/pdf/TA077publicinfoenglish....) Here's a slightly more technical document with links to the evidence that they used: (http://www.nice.org.uk/nicemedia/pdf/TA077fullguidance.pdf http://www.nice.org.uk/nicemedia/pdf/TA077fullguidance.pdf) Here's a guide aimed at clinicians with many links to good evidence: (http://www.cks.nhs.uk/insomnia/evidence http://www.cks.nhs.uk/insomnia/evidence)
- Alex3917 15y ago
  "This is interesting. What's the evidence?" http://www.madinamerica.com/2011/11/anxiety/ http://www.madinamerica.com/2011/11/anxiety/ The actual book (Anatomy of an Epidemic) explains it better, but those are just some quick links. They're also vastly more addictive than heroin. While the worst of heroin withdrawals are over in less than a week, benzo withdrawals can literally last over a year, with people unable to sleep and in severe pain that entire time: http://en.wikipedia.org/wiki/Benzodiazepine_withdrawal_syndrome http://en.wikipedia.org/wiki/Benzodiazepine_withdrawal_syndr...
  - delackner 15y ago
jsdalton 15y ago
Just over 2.4 million Americans died in 2010 (source: http://www.cdc.gov/nchs/fastats/deaths.htm http://www.cdc.gov/nchs/fastats/deaths.htm). So basically, this study is making the claim that prescription sleeping pills are responsible for 12-20% of all deaths in the U.S. That sounds like a rather extraordinary, and probably exaggerated, claim.

mikeash 15y ago

The US death rate is about 2.5 million/year. Seems like somebody would have noticed a 20% jump due to a single drug. Can this 500,000 deaths/year number really be close to correct? Edit: duh, not per year. Oh well, there may still be some little nugget of validity in there somewhere.

haberdasher 15y ago
It's 500,000 in total, not per year.
RandallBrown 15y ago
it was 100,000 per year for five years. The article mentions that people did notice when it was dropped down, but doesn't mention anything about when deaths/year went up.
- gruseom 15y ago
  "We find the largest rise in American mortality rates occurred in 1999, the year Vioxx was introduced, while the largest drop occurred in 2004, the year it was withdrawn" Moreover: "Vioxx was almost entirely marketed to the elderly, and these substantial changes in the national death-rate were completely concentrated within the 65-plus population." And: "The FDA studies had proven that use of Vioxx led to deaths from cardiovascular diseases such as heart attacks and strokes, and these were exactly the factors driving the changes in national mortality rates."
  - RandallBrown 15y ago
    yes, but those were noticed years later. As far as I know, no "Mysterious death spike" articles were published in 2000 because of the extra deaths in 1999.
    - Retric 15y ago
      The drug did not gain widespread adoption in a single year.

joejohnson 15y ago

"Besides," says Unz laughing, "it shows the stupidity of our political leaders that they didn't seize upon this great opportunity. They should have just renamed Vioxx the 'Save Social Security Drug,' and distributed it free in very large doses to everyone, starting on their 65th birthday. Maybe they should have even made it mandatory, three times per day. At sufficiently large levels of national consumption, Vioxx could have almost singlehandedly eliminated all our serious budget deficit problems. 'Vioxx - The Miracle Anti-Deficit Drug'." That's so morbid. This is the kind of dangerous idea that I'm sure many people have, but are afraid to voice publicly.

EvilTerran 15y ago
Yeah, that's morbid all right. I'm reminded of "Quietus" in Children of Men.
- mortenjorck 15y ago
  Truly the best sci-fi movie of the past decade. Not only the lifting of taboo, but the commercialization of euthanasia was perhaps the film's most hauntingly powerful sign of how despairing society had become without reproduction.
  - excuse-me 15y ago
    A lot of religions object to contraception - there aren't many that object to killing people.
    - bdunbar 15y ago
      Every religion objects to killing folk. Every religion has exceptions to the rule. This is a rational accommodation. Religions that don't make those exceptions run out of followers real quick.
      - excuse-me 15y ago
        "Every religion has exceptions to the rule." Typically = the set of people that don't belong to that religion!

reasonattlm 15y ago

Half a million Americans died in the last 80 days, most due to aging. Nobody really paid much attention to that either - or the same number in the preceding 80 days, and the 80 days prior to that, and so on. One can ponder what that says about humans.

josefresco 15y ago
If we could pull "aging" off the market than we would. Unlike aging, this one drug can be removed from public consumption. Aging, while some day "curable" is nowhere near that today.

nkoren 15y ago

I can actually see how this would be difficult to spot. Look at the graph of American death rates from the CDC: http://www.cdc.gov/nchs/data/databriefs/db88_fig1.png http://www.cdc.gov/nchs/data/databriefs/db88_fig1.png If you know where to look, there is indeed a small spike from 2000-2005, corresponding with the availability of Vioxx. The rise in 2000 is barely noticeable, but the drop in 2005 is fairly striking. This makes sense: the drug would have been taken up gradually by the market, but its cessation was virtually overnight. The reason this would be difficult to spot, however, is because death rates did not really increase. Rather, they stayed more or less constant, when they might otherwise have gradually decreased. In hindsight, this looks plausible -- but at the time, saying that death rates would be decreasing were it not for Vioxx would have been an extremely difficult counterfactual argument to make.

planetguy 15y ago
I think you've seriously gotta squint to make the data you're talking about look like anything other than noise.
- ajross 15y ago
  That's not right. Correlations with data this large can be proven quite conclusively even if the signal is low. There are a lot of deaths every year, so even fairly small relative signals are resolvable. What's interesting here though is that this is not a small signal, precisely because it shows up against the background without any correlation work at all. FTA: > "We find the largest rise in American mortality rates [in the last 15 years] occurred in 1999, the year Vioxx was introduced, while the largest drop occurred in 2004, the year it was withdrawn," says Unz.
  - nkoren 15y ago
    That statement, however, doesn't seem to correspond with the CDC's graph, which shows a much larger rise in death rates occurring in 1993. (Source article for that graph: http://www.cdc.gov/nchs/data/databriefs/db88.htm http://www.cdc.gov/nchs/data/databriefs/db88.htm -- would that they distributed the actual datasets behind the graphs!)

Duff 15y ago

I don't agree with the conclusions in this article at all. Also consider that Celebrex (same drug family) is still on the market. If these drugs were truly a grim reaper, I don't think Celebrex would still be around. If anything, this should be seen as a reason to not allow the pervasive advertising of prescription drugs and aggressive peddling of drug swag - Vioxx was peddled in the most ostentatious way -- my doctor STILL has Vioxx clipboards and other junk in his office. I'm sure that this constant brand awareness and patient nagging helped drive sales (ie. encourage potentially unnecessary or inappropriate scripts). The other thing to consider is quality of life. I began suffering by a sudden onset of what was eventually diagnosed as a degenerated disc in my back -- at age 25. I went through some intensive physical therapy to try to avoid surgery (ultimately an unsuccessful effort), and Vioxx was the only thing that allowed me to function without narcotic pain relief (which I refused to take for more than a week at a time). It was that good at reducing chronic inflammation. If I were a 75 year old man with severe, debilitating arthritis having difficulty walking or living a decent life, I'd happily volunteer to take a drug like Vioxx to improve the quality of my remaining time here, even knowing that I was at a higher risk of a heart attack.

ajross 15y ago
Your argument seems to be one of simple personal disbelief, that one drug "in a family" can have effects that others don't? That doesn't seem to be borne out by history or logic... Even your own anecdote seems to argue against it: Vioxx worked for you pain, but Celebrex doesn't.
- Duff 15y ago
  I never tried Celebrex, as I had surgery in early 2004 that eliminated the need for any medication. I'm not a pharmacist, but the story regarding this drug is more nuanced. Doctors prescribed the two drugs differently, as folks with other drug sensitivities were not good celebrex candidates, and the risk factors associated with vioxx were not known. Vioxx was the more heavily marketed, "safe" choice.
liber8 15y ago
I've heard this from countless other people as well (including many doctors). Apparently, it was a fantastic pain drug for many people. Should Merck have disclosed the increased risk of heart attack and stroke? Absolutely. But, part of the problem is the incentives fostered by a bureaucracy like the FDA. If you know that your new wonderfully effective pain medication increases the risk of heart attacks from 4% to 6% (or whatever the numbers were), are you going to disclose that to the FDA, knowing it essentially spells doom for the billion dollars plus you spent on development?

randomfool 15y ago

Worth noting that Celebrex is very similar to Vioxx (COX-2 inhibitor), and that researchers do not know if Celebrex has the same issues as Vioxx- they've avoided repeating this study. http://en.wikipedia.org/wiki/COX-2_inhibitor#Adverse_effects http://en.wikipedia.org/wiki/COX-2_inhibitor#Adverse_effects

refurb 15y ago
This isn't true. When the FDA held their hearing about Vioxx, they also evaluated Celebrex as well. Vioxx was found to have serious CV risks associated with it at ALL recommended doses. Celebrex was found to have CV risks associated with only the highest dose. The FDA made the call that Vioxx should be gone and that Celebrex can stay (with an updated label that describes the risks). Same with Naproxen.

wtracy 15y ago

I would suggest that it's not that American lives are cheaper, it's that old people's lives are cheaper. (I don't think it should be that way, just that it is that way.) That, and the public has a much more visceral reaction to food and beverages that kill people than medications that kill people.

jorleif 15y ago

I find the value of human life comparison between China and the US somewhat ludicrous, since societies obviously tend to react much more strongly to babies with strange acute symptoms (kidney stones), than to elderly people passing away from typical reasons (heart disease).

Vadoff 15y ago
Oh yes, because 6 dead babies have more "value" than half a million dead elderly. How dare the author make such a comparison!

leoh 15y ago

Very interesting. I am very passionate about this topic, and I happen to know the author of the paper that took on Merck. The statistics in that paper are exceedingly convincing, since the study was conducted on a controlled set of patients, some whom received Vioxx, and some whom did not (a control group). This article points out a very interesting correlation between Vioxx being taken off the market, and a drop in death rates. Yet proving Vioxx as the causative agent will be very difficult.

gruseom 15y ago
Since you know the author of that paper, could you find out for us what he/she thinks of this new information about death rates? Proving causation would be a high bar, of course, if not impossible. But I'm curious to know what further investigation could be done with this.

herbivore 15y ago

And yet the majority of HN users still trust big pharma that vaccines are safe. You are being lied to over and over and just never learn.

tokenadult 15y ago
I can't speak for the majority of HN users, but I can speak for people who read serious medical research about vaccine safety and effectiveness (as I am one such person), and I can say for the record that there is plenty of evidence that vaccines have consistently resulted in reduced mortality and morbidity from a variety of diseases. Childhood death is now rare (it was once commonplace) largely because of improved sanitation and other public health measures around the globe but also because of vaccines. http://www.sciencebasedmedicine.org/index.php/category/vaccines/ http://www.sciencebasedmedicine.org/index.php/category/vacci...
- Alex3917 15y ago
  The problem is that: - The safety standards for getting new drugs approved are incredibly lax. All you need to show is that it helps the person in some measurable way for the first six weeks. You don't need to show that the drug is safe or effective for longterm use, even if the drug is designed for longterm use. And you don't need to show that the person's overall health and wellbeing is improved, just the one condition the drug is designed to treat. So if an acne drug causes liver failure it will still get approved as long as it's effective at treating acne. - The government has been caught many times injecting political dissidents and others with fake vaccines, most recently in the case of the Bin Laden family. - Most academics believe that the US government was responsible for starting the AIDS epidemic by running vaccination programs in Africa. [1] [2] - The government has repeatedly shown that they don't take evidence of safety and quality problems seriously at best, and actively prosecute whistleblowers at worst. [1] http://www.theglobeandmail.com/life/health/new-health/health-news/canadian-researcher-traces-aids-to-single-bush-hunter-from-1921/article2210046/ http://www.theglobeandmail.com/life/health/new-health/health... [2] http://www.amazon.com/The-River-Journey-Source-AIDS/dp/0316372617 http://www.amazon.com/The-River-Journey-Source-AIDS/dp/03163...

jeffdavis 15y ago

There is a big difference between premeditated adulteration of a product people already use, like milk; and sweeping studies under the rug[1] about a new product. If nothing else, a huge amount more people needed to know about the malamine scandal. How are we shipping so much milk with so few cows? Why am I dumping this unmarked 50lb bag of powder into the milk? [1]: After looking at http://en.wikipedia.org/wiki/Vioxx http://en.wikipedia.org/wiki/Vioxx, I don't see any allegation that Merck actually withheld raw data from the FDA, or provided it with false raw data. That's the great thing about a vague analogy like "sweeping under the rug": you can imply that something happened that didn't, without actually lying.

herbivore 15y ago
In a 2030 version of Hackernews someone will point out that a lot of people must have known about coordinated efforts to dump fluoride into our water and everyday products, pasteurize cow's milk to produce a liquid substance that does not exist in nature and then push it as healthy and essential. That thousands of people sprayed produce with toxic chemicals. That thousands of people stood behind a counter and sold people a product that kills half a million of them every year along with 50,000 of their acquaintances (cigarettes) and that America's greatest investor pushed Coke and its evil twin Diet Coke to millions of people who later abused it as part of their path to obesity and heart attack.
- wordplay 15y ago
  There's a difference, subtle though it may be to some, between common legal practices in food and drug production and conspiring to criminally poison consumers for profit. Many of the items you mention are likely bad for the long term health of our species--but I would compare them more readily to medical practices in the dark ages than the short sighted and improperly structured health / regulatory environment we have today. I'm deeply concerned about the world my children will inherit, but it's difficult for educated mainstream individuals to take the issues you point out seriously if they are presented from a paranoid and conspiracy theory embracing perspective. Even taking a giant leap and supposing any of the conspiracies exist to the extent some claim, the presentation still suffers because of a lack of willingness by the populace to embrace such a dark view of a society that they participate in.

vixen99 15y ago

The article tells us that lives in the US were valued at $4.85 billion. So what was the payoff for victims in China that permits the conclusion that 'American lives are quite cheap unlike those in China'?

bilbo0s 15y ago
Uhhh... The fact that NO AMOUNT OF MONEY could save you from prosecution in China maybe? In fact, the American Conservative can point to several dead Chinese 'Boardroom types' to make a quite convincing argument that no amount of money could even save them from execution in China.
- tsotha 15y ago
  Or maybe the people who were executed are the ones who didn't have enough money. Anti-corruption campaigns are very common in China. They'll go through and execute a few hundred people at a time. But they don't make a dent in actual corruption, because the only people to get executed are the ones without connections.

Tloewald 15y ago

I wonder if the blowout in the rate of healthcare cost expansion under Bush and the deceleration of late can both be ascribed, at least in part, to the end of Vioxx.

jackfoxy 15y ago

It's worth calling-out the original article http://www.theamericanconservative.com/blog/chinese-melamine-and-american-vioxx-a-comparison/ http://www.theamericanconservative.com/blog/chinese-melamine... (Oh my gosh! A nasty right-wing publication.) You need a right-wing and a left-wing to fly. Or, to go from the abstract to the concrete, you should inform yourself from a wide range of sources. Another notable health scandal (in California) first exposed by the conservative, aka right wing, press was MTBE. See http://www.calnews.com/archives/morgan03.htm http://www.calnews.com/archives/morgan03.htm and http://www.nature.nps.gov/hazardssafety/toxic/mtbe.pdf http://www.nature.nps.gov/hazardssafety/toxic/mtbe.pdf (search for KSFO). These kinds of scandals are not consequences of the free-market. This is crony-capitalism. It could just as easily happen under crony-socialism. And as the MTBE scandal demonstrated, progressive politicians are perfectly capable of foisting this kind of stuff on the public.

gruseom 15y ago
I hesitated over whether to post Unz's original piece or Cockburn's linkbaity rehash. In the end the rehash won, because I don't think the comparison to China is the interesting part and because it would likely have sparked a dumb political argument.

seanp2k2 15y ago

Liked the article up until the point at the end where he attributes our deficit to Medicare and not the wars.

tsotha 15y ago
He's right: http://www.americanthinker.com/2010/08/iraq_the_war_that_broke_us_not.html http://www.americanthinker.com/2010/08/iraq_the_war_that_bro...

seanp2k2 15y ago

Liked the article up until the point at the end where he attributes our deficit to Medicare and not the wars.

seanp2k2 15y ago

Liked the article up until the point at the end where he attributes our deficit to Medicare and not the wars.

seanp2k2 15y ago

Sick that a country that most people would agree doesn't have strong human rights values /executed/ people for a similar scandal while we don't even slap their wrists. Money over positively everything.

jeffdavis 15y ago
"a similar scandal" It was not similar. In my opinion, it's so different that it's not even worth comparing. An analogy is not an argument. It only illustrates your argument, if you have one.

12uu45dd 15y ago

I'm sure their loved ones noticed.

jgamman 15y ago

post hoc ergo proctor hoc

revolutions 15y ago
'Correlation does not imply causation, but it does waggle its eyebrows suggestively and gesture furtively while mouthing "look over there".'

kristianp 15y ago

One point no-one else has raised here, is that (as far as I can tell) no employee of Merck was punished for this. How can Merck the company plead guilty to a misdemeanor, but no individual be held even partly responsible? "Under separate criminal proceedings, Merck plead guilty to a federal misdemeanor charge relating to the marketing of the drug across state lines, incurring a fine of $321.6 million." From http://en.wikipedia.org/wiki/Rofecoxib http://en.wikipedia.org/wiki/Rofecoxib . It frustrates me that people in big companies have no deterrent from acting unlawfully. The same thing happened in Wall Street companies in the GFC.

josephcooney 15y ago
Contrast that with what happened in China.

rsanchez1 14y ago

So the American media lied. What's new? I bet the only people who really cared are those that you would have written off as "conspiracy theorists" before you came to realize the grisly truth.