Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam

Robert sits down with Dr. Kaveh Hoda to talk about Vioxx, a pain medication released by pharmaceutical giant Merck even though they knew it caused fatal heart attacks.

(2 Part Series)

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Episode Transcript

Speaker 1 (00:01):
Also media, Welcome back to Behind the Bastards, a podcast
where Sophie is not in the room right now. So
doctor cave Hoda and I are are the foxes watching
the hen house? That is also we're we're also the hens.

Speaker 2 (00:21):
I am the producer, I am the captain.

Speaker 1 (00:24):
Now we're like hin foxes, like like a cat dog situation.
Although I imagine a hen fox. The fox is just
going to try to eat it's hin. That's part of
its butt, I imagine.

Speaker 2 (00:34):
I love your quaint country colloquialisms. It's great. I don't
know what they mean.

Speaker 1 (00:39):
But oh yeah, you're probably too young for that cartoon.
I was the right age for it.

Speaker 2 (00:44):
Now.

Speaker 1 (00:45):
Yes, doctor Hoda miser care expert legally my doctor, Do
you have any do you have any theories that you
can't prove, that are unprovable, that are probably nonsense, that
you nonetheless believe about health? About health? Yeah, yeah, I
got a lot.

Speaker 2 (01:08):
As a doctor. I feel like I should. Uh you know,
I will talk to you at great length about how
supplements are a fantastic waste of time. Uh And I
will tell you in detail, and I have on many
episodes why they're more dangerous generally than they are good
and you should only use them with strict instructions from

(01:31):
your physician. But that being said, I feel like ginger
really helps me in like a power up way that
it doesn't. I know it doesn't, but I love it,
and the placebo effect is so strong for me that,
you know, Yeah, Ginger's my magic thing, my little magic

(01:54):
creation in my mind that works more than it really does.

Speaker 1 (01:57):
Yeah, I'm not big on supplements. I do take my
doctor advised me to take for blood pressure, calcium and potassium.

Speaker 2 (02:06):
Uh so I do.

Speaker 1 (02:08):
I do. I do some of that, which I've noticed
I don't get cramps as much as I used to,
So I guess I guess I'll call that a win.
I do love looking it into the different potential side effect.
I love going on to like biohacking subreddits and seeing
people talk about like the side effects they're having with
with various weird supplements they're taking to never die. Although

(02:32):
my favorite is the Lion's Main subreddit. So Lion's Main
is like a mushroom that does have like some it
does have like an effect on your your your brain right,
Like there's there's actually some like studied benefits of Lion's maine.
But it's like it's a pretty mild supplement, but there's
this group of people who are convinced that like taking
it once has like destroyed their life in the way
that like a huge dose of psilocybin. Mushrooms might have

(02:55):
like mind alter effects. And it's like, man, everyone at people,
I don't put like it in their smoothies.

Speaker 2 (02:59):
I don't.

Speaker 1 (03:00):
I don't think it's the fucking lions main that's giving
you nightmares for the last seven years of your life.

Speaker 2 (03:06):
I mean that is that is That's the kind of
thing I hear a lot about, Like every medication you
name it out there, someone has had someone blames that
medication for their life being in shambles. Yeah, and you
know it's medication we're talking about today. Lots of risks,
It's true. They all they all do some more than others.
I think we're probably going to discuss here. But uh, yeah,

(03:29):
I don't know if Lion's maine, which I'm not familiar with,
really so it's us.

Speaker 1 (03:33):
It's a mushroom, you know, it's got you know, some
mushrooms have like, uh neurological impacts and stuff on people.
But you know, my My particular favorite medical theory, doctor
doctor Hoda is that obviously cigarettes are bad, terrible for
for almost everyone, nearly always horrible. But I think there's
a slightly less than one percent of the population that

(03:54):
have a genetic abnormality that makes cigarettes make them live forever.
Because every now and then I'll meet you know, sometimes
in like little corners of the world or whatever. I've
met f like little old ladies in Japan or like
ninety six, and they're like, yeah, I've been chainsmoking cigarette
since I was like eleven years old or something like that,
and it's like, clearly it works for you. Like there's

(04:14):
some some minority of the population that cigarettes make and vulnerable.

Speaker 2 (04:19):
I feel like this is that meme of the plane
that returns from war with the bullet holes. You're never
gonna hear me say cigarettes are okay. They know what
they've done, they know.

Speaker 1 (04:31):
I know they've killed They've killed uncountable more people than
war in the twentieth century, and war killed so many
people in the twentieth century. But every now and then
I'll meet some like ninety year old woman who smokes
four packs a day and she's doing fine. So clearly
clearly science doesn't understand everything about the maligned cigarette.

Speaker 2 (04:51):
Don't smoke cigarettes, okay enough.

Speaker 1 (04:53):
Don't vape o vape that's the one that worries I mean, like,
especially since all of my friends vape heavily. It's one
of those like, yeah, but it's got to be doing
something right, Like it's got something.

Speaker 2 (05:04):
Like oh, for sure, for sure, I'm a huge fan
of vaping. Either there is harm reduction. There's a good
argument about that, but I'm not You're not going to
see me promote vaping either.

Speaker 1 (05:14):
That said, you know, when we get into the whole
what is it responsible to tell people to do or not?
A lot of times the greatest harms are things that
people like cigarettes, were told by their doctors are great
for them. And today we're going to tell one of
those stories, a story of a drug that became the

(05:34):
lead seller for a major pharmaceutical company that was backed
by an alliance of physicians who had shall we say,
some you know, financial interest in finding that this thing worked.
Today we're talking about vox, which is I think an
infamous name now in the annals of medical science. People
tend to know what I'm talking about. But if you

(05:55):
don't this killed more Americans than the Vietnam War. Like that,
that's the story we're getting into today. What do you
know about ViOS.

Speaker 2 (06:08):
You know, I was too young to really be I
wasn't really practicing medicine when it happened, but I did
know about it, and I've heard some about it since then.
I'm really very fascinated by the story and I'm really
looking forward, yeah to getting into it today. So I'm
excited about that. I will say I think it was
It feels like a turning point in regards to how

(06:30):
people looked at pharmaceutical companies. I think it was really
like a sentinel event in that, Like I think doctors
were always skeptical of pharmaceutical companies. We still are, but
I think that was when people started to become cynical.
That change started. It's because of what happened with Viox
and VIAX.

Speaker 1 (06:51):
I think it's also important, Like Vias, the scandal hits
kind of right as you know, before we're really starting
to realize what has gone down with the h with
the prescription painkiller epidemic, like when that's starting to really
take off and we start to realize how fucked up
some of what Purdue did. And so this one two punch,

(07:12):
it really is responsible. I think that's very salient what
you said. It's really responsible for a lot of I mean,
for like RFK is about to be the director of
Health and Human Services right, Like it has a lot
to do with that, because this is hard for people
to imagine, Like folks my age, I have always grown
up with big Pharma being like the devil, right in
part because like as soon as I turned eighteen nineteen,

(07:33):
I was hanging out with a lot of hippies, but
in part because like there were a lot of like
really really high body count pharmaceutical company scandals, and it
is hard for some people to remember that, like, pharmaceutical
companies used to be very popular and well regarded in
a lot of cases, in part because the generation, the
generation that was kind of running the world in the

(07:54):
eighties and nineties had largely lived through like and we're
still close to Oh, polio is this nightmare that just
sweeps through and devastates like a generation. You know, you
have these flues and then suddenly you have half as
many friends after the flu passes and that stops being
a thing. And they're really the first generation you know,
kind of the later boomers that didn't have to deal

(08:17):
with that, but we're close enough to it to like
really appreciate, like, Wow, medical science did us as solid.

Speaker 2 (08:23):
Yeah, And we've drifted just far enough from that now
that people have forgotten and revising whole parts of history.

Speaker 1 (08:30):
And I mean part of the problem is that shit
like the Vox scandal and like the produe pharmaceutical scandals
are closer to us than for example, fucking people being
an iron lungs or whatever.

Speaker 3 (08:43):
You know.

Speaker 1 (08:44):
Recency bias is a hell of a thing. But since
time immemorial, mankind has struggled against a terrible and implacable enemy, pain.
Luckily for us, mother nature has provided a perfect painkiller, opium,
that could be used as the basis for a variety
of excellent medicines that really do exactly what they say
they're going to do. Unfortunately, these medicines come with a downside,

(09:06):
which is that when you start taking them, you might
not ever want to stop taking them. For some people,
this destroys their life and take a sip of my
cratem tea. And since all the all the health cops
out there don't like people pill popping, like doctor House
even though he made it look incredibly sexy. Did he.

Speaker 2 (09:29):
Hate that show?

Speaker 1 (09:30):
Oh man, you're not not a house fan. Huh No,
it's just so ridiculous.

Speaker 2 (09:35):
I mean, all of those shows, Scrubs is the only
one that's watchable for me.

Speaker 1 (09:40):
Scrubs. Really yeah, I mean I did rewatch. I like
to imagine that the movie Platoon is like a like
the the what you might call it the prequel, the prequel.

Speaker 2 (09:50):
Toy said it.

Speaker 1 (09:53):
Yeah, that's why doctor Cox is the way he is.
He had to spend that night hiding under his friend's
bodies in a trench line. You had to watch Willem
Dafoe die. Spoilers for the movie Platoon, which is older
than most of you, might be illder than me. I
don't remember when Blagin came out anyway. So because of

(10:16):
you know, health cops don't like people becoming horrible pill
addicts and destroying their lives. There's a market, a massive
market for anyone who could create a thing that is
an effective painkiller that doesn't also inspire people to break
into cars for drug money. Right, there's a lot of
money and a painkiller that does not have the kind
of abuse potential that opiates have. A Ceda medaphin was

(10:37):
discovered back in the eighteen eighties, but it took us
intol the nineteen forties to actually figure out how to
use it as a drug. And for reasons that are
more complex than it's really worth getting into. Because of
how it was discovered, a ceda medaphin could never be
patented right, which means pharmaceutical companies are not super attracted
to a ceda medaphin right because like, well, you know,

(10:58):
you can't only sell it for so much of every
one can make the damn thing. This meant that pharmaceutical
companies had to get creative marketing it in order to
make it profitable. As a result, tailand All became a
foundational part of the marketing drugs story. McNeil, the company
that started selling acid of metaphine in the US, initially
framed it as a painkiller for children. And the way

(11:19):
the ad campaign that they use is very weird for
some reason, and I've never found out why, but for
unclear reasons, they had a huge number of toy fire
trucks and the way that they first sold Thailand all
was they like stuffed fire trucks to the brim with
pills of tailan All and like made that. That was
their marketing ploy to like get little parents to buy

(11:39):
tilant All for their small show.

Speaker 2 (11:41):
Always love fire trucks. Kids love Thailand All too. They
love their Tilan Hall, they love their living damage, and
they love their fire trucks. This is a thing about kids.

Speaker 1 (11:51):
This is why I'm going to try to make the
chief Christmas toy of this season the little Doctor House
pill popper set where because kids, you can take as
much tilt All as you want.

Speaker 2 (12:02):
Right, you'll be like a big cane. That's dispenser, right,
and that's your little house toy for kids.

Speaker 1 (12:12):
Takes your little house toy for kids. Yeah, now this
worked better than any it had any right to work.
Advertising was easier back then. I imagine today if you
tried to sell parents on a chat, which is like
a firetruck Philip Bills, I don't know this would make
me feel good about any of this, But you have
to remember so jaded.

Speaker 2 (12:31):
Now that's a problem. We're jaded.

Speaker 1 (12:33):
We're jaded, and like, prior to Thailand All, the chief
method of dealing with pain for small children was to
give them a spoonful of heroin and hope they woke
up the next day right like. They literally sold it
as a cough medicine for children. So the fire truck
plan worked well. It worked so well that McNeil gets
bought by Johnson and Johnson. And that's actually when it
gets the name thailand All. McNeil's not selling it under

(12:54):
tiland All Johnson and Johnson, which, for whatever reason is
a great name. I don't know why. Doesn't make much
sense to me. Easier remember, Yeah, So, in subsequent decades,
tailand All was found to be useful in numerous medical
applications as a painkiller, a fever reducer, and about a
million other things. It was joined in the mild painkiller
category by Bear's aspirin, which had its roots in herbal

(13:17):
medications that had been used by peoples around the world
since time immemorial. The Assyrians and Sumerians had actually been
using willow leaves as treatments for various ailments, and a
variety of plants containing sallasitic acid have been used in
similar ways all over the globe. So Aceta metaphine and
aspirin both quickly became foundational pieces of any medicine cabinet,
but they weren't perfect. One issue that both painkillers had

(13:39):
is that they could interact with other drugs or just
interact badly with certain patients to cause substantial stomach distress.
In the most severe cases, this could result in stomach
ulcers and sometimes life threatening stomach ulcers. So, you know,
this is one of these problems, is like you want
to be able to give people as much of this
as they need because it's you know, non adict diven

(14:00):
helps with a lot of things, but there's some hard
limits based on what this does to people's stomachs well
and livers.

Speaker 2 (14:06):
I mean menafin, Yeah, you know, that's worldwide one of
the biggest causes of liver failure from people taking too
much a cedum, menaphin, and and then yeah, these other
nonstroidal anti inflammatory drugs. They're the kind of thing that
make me a gastro introologist have to go in the
middle of the night to go put a scope into
someone's stomach because they're bleeding a ton in the setting

(14:30):
of you know, somebody's who's swallowed too much advil or
something like a leave or something.

Speaker 1 (14:37):
Yeah, and I think that probably doesn't didn't make it
as much into my research, just because in the seventies
they didn't have as much data on that made sure
they all they're all focused at least on the ulcers.
But yeah, like the there's a there's a great bluegrass
song called codeine with the lyrics Codeine, Codeine, You're the
nicest thing I've seen for a while. And if you
know anything about codine, it's the worst of the painkillers

(14:57):
to get high on, which makes the song better because
if you are the kind of person for whom like
codeine is the nicest thing you've ever encountered, your life
has been a hard life.

Speaker 2 (15:06):
Yes, you have had a bad light.

Speaker 1 (15:13):
So by the late twentieth century, pharmaceutical researchers had started
poking around both compounds to try to find ways to
create new variants that didn't have any of those downsides.
They called these hypothetical medications super aspirins, because research pharmacologists
aren't great at naming things terrible, terrible, terrible. The quest
for a super aspirin seems to have really started in

(15:35):
nineteen seventy one when a gaggle of British researchers, I
think that's how you term a group of researchers tried
to unravel the mystery of why aspirin and thailand all work. Again,
we knew these things were good painkillers, and we knew
they did other stuff. The method of action was unclear
to us at this point, which is a startling amount
of the time. True with drugs. There's a lot of
medications you might be on that the doctors don't precisely

(15:59):
know why it does what it does. We have somebody,
but like a.

Speaker 2 (16:02):
Lot of this is still being you want to know. Yeah,
with a lot of things we do in medicine that
we yeah, were we just they seem to work, it doesn't.

Speaker 1 (16:12):
It definitely helps. We're not sure why. But in this case,
the research research board fruit. As author Tom NeSSI describes
in his excellent book Poison Pills quote, when an injury
takes place in the body, chemicals known as prostaglandins rush
into the wound site to deal with the swelling, heat,
and pain. Prostaglandins have important functions for human well being.
They play a part in ovulation, to protect the stomach

(16:34):
from acids and to ensure that blood clots normally. The
latter effect explains why asprom reduces heart disease. It prevents
clumps of blood from forming that can potentially block an artery.
Prostaglandins actually make nerve endings more sensitive to pain. N
s A I, d's in, SAIS and insetes.

Speaker 2 (16:52):
Yeah.

Speaker 1 (16:53):
Insades reduce the production of prostaglandin and thereby relieve the
pain associated with swelling and soreness. Unfortunately, in the process
of doing so, they irritate the stomach. Sometime after this discovery,
scientists found that a substance called cyclooxygenase or COX, was
produced as part of the mobilization of prostaglandin and was
the enzyme that actually controlled pain and inflammation.

Speaker 2 (17:15):
You're doing a fantastic job, by the way, a moment,
you're doing a really good You didn't call it Cox,
by the way, Cox.

Speaker 1 (17:21):
Yeah, I was going to because doctor Cox.

Speaker 2 (17:24):
Yeah, yeah, in his honor. But this is interesting. I
didn't expect I was going to be getting this like
trip down medical school, like memory lane. This is fantastic.
You're doing great.

Speaker 1 (17:35):
We try to be complete. Also, doctor Cox isn't born
on the fourth of July, which you can consider a
stealth sequel to Platoon if you assume that Williem Dafoe
actually survived his injuries in Platoon?

Speaker 2 (17:45):
Was he in.

Speaker 1 (17:48):
He's the crazy vet in Mexico that fucking Tom Cruise
meets when they're both like doing drugs and hanging out
with prostitutes after losing their legs. Yeah, it's great, oh Man,
that movie rules. So these researchers began to theorize that
COX might include an additional substance that was separately the
cause for stomach irritation. If someone could find an isolate

(18:09):
said substance, it might allow for the creation of a
super aspirin. But no one even knew if this theoretical
substance was real, and pharmaceutical companies didn't exactly feel an
immediate urge to jump on the matter because they had
no idea if this was even a thing. Fast forward
to nineteen ninety A pharmacologist named Needleman gets close to
isolating the COX enzyme that he believes is causing all

(18:30):
of the problems he hasn't actually doesn't actually find it,
but he's confident enough in its existence for reasons that
I'm sure makes sense to biochemists that he gives it
a name Cox.

Speaker 2 (18:41):
Two.

Speaker 1 (18:41):
Research goes on, and in July of nineteen ninety two,
several teams of researchers in Montreal announced that they have
isolated two enzymes COX two and one, of which COX
two seems to be the causal agent behind the side
effects in SAIDs provoke in some patients. Right, So nineteen
ninety two they found finally this thing they've been looking

(19:02):
for for like twenty years. Right, this is the reason
they believe why your aspirin or whatever can cause stomach olcers.
So the researchers used that if you can find a
medication that blocks COS two and you compound it with
like a painkiller with a seat of metaphine or whatever,
then you'd have a super aspirin capable of being prescribed
much more often to even more people. Aspirin sales at

(19:24):
that point are already like fifty billion tablets per year,
So the amount of money on table for the first
pharmaceutical company to figure this out is mind boggling, because
then you get to patent it. Then you are the
only one that has the aspirin that doesn't cause stomach ulcers, right,
and for like whatever twenty years, you're the only one
who gets to sell that shit. That's so much fucking money, right, Like, yeah.

Speaker 2 (19:45):
It's one of the most commonly used medications in the world.

Speaker 1 (19:47):
Yes, or this is like an unfathomable fortune. We're talking
like an oil and gas industry level fortune is on
the table here, and so a fucking race begins, right,
And the two major companies that are going to wind
up really throwing their money, throwing their hats into the
table and to get into the super aspirin ring are
our old friend Pfizer and our new friend Merk. Now, today, again,

(20:10):
any pharmaceutical company you mentioned, people tend to say, like,
fuck these guys. But in the late nineteen eighties and
early nineties, people did not feel that way about Merk.
They were very much considered to be one of the
good guys. Now, I know that kind of sounds crazy,
but I want to read a quote from an article
by David Colp and Isabelle Berry in the Journal of
Civil Rights and Economic Development. In its missions value statement,

(20:30):
the company stresses that its business is preserving and improving
human life. Merk's mission statement continues, we value above all
the ability to serve everyone who can benefit from the
appropriate use of our products and services. Throughout its history,
Mirk has often lived up to its state admission. In
the nineteen thirties, after streptomycin was developed by a Merk scientist,
Merck gave up its patent protection since it believed the

(20:52):
drug was too important a medical breakthrough to keep to itself.
Other companies were allowed to produce streptomycin, and Merk lost
potential profits. The nineteen eighties, when Merk found a cure
for river blindness caused by a parasitic worm. The company
had given away, free of charge, forty million pillars a
year to African nations to treat and cure this. So
Merks seems pretty good. Coming into the nineties, You're like, hey,

(21:14):
maybe there's a company that I actually believes what it
is they put. They gave up money, you know, a
lot of it, so that sounds pretty great. But coming
into the nineties, Murk is also staring down the barrel
of a big problem a lot of its massive wealth,
because this is a very wealthy company coming into the nineties.
Was based on a pair of cholesterol drugs, zocore and Preachol,

(21:34):
which were both about to lose their twenty year patent
protection starting in the early two thousands, so not yet
in about a decade, but a Decade's not a lot
of time in terms of like researching a new medicine. Right,
If you've only got a decade or so over your
two big profit engines are going to.

Speaker 4 (21:49):
Time from really to get to market. Yeah, you got
to start cooking. Yeah, you got to start moving. In
addition to that, five of their best selling medications, including pepsid,
were set to lose patent protection even soon in ninety nine,
so they are looking at a looming, very serious problem
for their profitability.

Speaker 2 (22:06):
This is such a recurring theme with pharmaceutical companies. I
just did an episode about a medication called Zygris, which
was like, it sounds awesome, It sounds awesome. It's this
medication that was touted as like this new breakthrough therapy
for sepsis, and it was super exciting, ended up falling

(22:27):
apart for a lot of different reasons and being withdrawn
and end up being a big marketing scandal in my opinion.
But at the end of the day, it all started
because they were losing their patent on their big like
sellings and medications like the one, The things that were
making them tons of money were about to run out
and they needed a new like cash stream as quick
as possible. So things started happening probably faster than they

(22:50):
should have.

Speaker 1 (22:51):
Yeah, yeah, yeah, And that's like that is the story
here as the story a lot of the time right
where these and I don't think this is a bad idea,
Like the idea that drugs eventually age out to get
generic is like kind of necessary in order to in
our system at least in order to make it even
have a chance of being affordable for some medications. But
it does it leads to this as well.

Speaker 2 (23:12):
I don't know.

Speaker 1 (23:13):
Again, we don't need to go on another single payer
healthcare rant, but like we have, so there's so many
little things that are fucked up about, like even the
things that seem like they make sense that also lead
to fucked up outcomes. And because of how much money
is at stake in these basins and how expensive it
is to be a pharmaceutical company, right, Like, it's not

(23:33):
cheap and most of the medications that they like, one
of the things you have to accept as a pharma
company is that most of the things you try to
make into a medicine aren't going to work, right, Like,
that's just and that's kind kind of the story. Here
is a medication that if they had done more, spent
more time, they would have realized this was not a
viable product. But they've got shareholders to please.

Speaker 2 (23:58):
Right, and when the money start to shift from research
and development in these companies to marketing, which it does
more and more, and I.

Speaker 1 (24:06):
Mean really happening in the nineties.

Speaker 2 (24:08):
Yeah right, I'm assuming that's that their problem here, That's a.

Speaker 1 (24:12):
Big part of it. Yes, so you know, murk is
coming into the nineties, not quite a five alarm fire yet,
but definitely like a serious situation. And super Aspirins seems
like it might be the salt solution to their problems
and maybe even the key to greater profits than ever before.
And speaking of greater profits than ever before, you know,
who's making money like they've never made money.

Speaker 2 (24:35):
Oh, I'm the people who deserve to the people are
the people who sponsored this podcast. They're the ones that
deserve the most of the money.

Speaker 1 (24:42):
That's right. The products and services that support this podcast
are literally the only ethical people in capitalism. And you
can just trust them. Give them your wallet, give your kids,
you know, hand with children over to our sponsors. They'll
take care of them, they'll raise them as their own.
You know better than better than we would, better than
you would. Yeah, exactly, you know, just trust them and

(25:08):
we're back. I didn't mean to imply that none of
you were good parents. It's just that our sponsors are
incredible parents, you know.

Speaker 2 (25:15):
That much better.

Speaker 1 (25:16):
They've never they've never yelled at me, never yelled at me,
never even spanked me, and I deserved it sometimes. So
you paid money for that sort of thing, I have. No,
we don't even saying shit like that. The subredit's gotta
get real uncomfortable, very fast. Okay, So super Aspirin seems

(25:37):
like it could be the solution to their to Merk's problems.
In nineteen ninety four, a new CEO takes over at Merk,
and this is we were just talking about the shift
from R and D to marketing. This is perfectly emblematic
of that because Merk's new CEO is a guy named
Raymond gil Martin. Now, the previous CEO, Raymond is an
NBA from Harvard, right, which means he doesn't know anything

(25:58):
about anything but making making money in the most sketchy
ways possible. Whereas the previous CEO of Merk had been
doctor Roy Vagelos, an actual medical scientist with a research background.

Speaker 2 (26:10):
Very famous.

Speaker 1 (26:11):
So yes, yes, yeah, so R goes from famous and
widely respected medical researcher as their CEO to a guy
with an MVA NBA from Harvard.

Speaker 2 (26:22):
Yeah. The Vagelos Award is like this award that's still
given out to like people who are like doing humanitarian
work for like in the pharmaceutical world. So yeah, like
this is a major shift, a major shift away from
somebody who was I think ostensibly a very good person
from all the towns, a very good person, good researcher. Yeah,

(26:44):
to something very different.

Speaker 1 (26:46):
Yeah. Maybe maybe the answer is, if you're going to
be the CEO of a pharmaceutical company, you should have
like watched a sick child die at a hospital. Like
I don't mean to be blunt, blunt, but it seems
like it leads you to do things like give up
patents on life saving medication.

Speaker 2 (27:03):
For rotation, a rotation in the hospital.

Speaker 1 (27:06):
I keep thinking about, like fucking the polio vaccine guy
who he was, like, I think his direct his direct
question quote when asked if he was going to patent
it was like would you patent the sun?

Speaker 2 (27:20):
Yeah?

Speaker 1 (27:20):
Sulk, yeah, real, real, real, g real Chad so Raymond's
career up to that point this is the business guy.
See new CEO Mark had included eight years as a
consultant for Arthur D. Little, which lists as run of
its great achievements, which is it. It's like Mackenzie kind of.
It's a consulting firm and it listed as one of

(27:40):
its great achievements the privatization of British rail So those
of you over in the UK, sure you love this guy. Also,
there was this time that they used a bucket of
sow's ears to make a silk purse. I don't know
why this is listed as an achievement of the Arthur D.
Little company, but it is. He worked as the CEO

(28:02):
at a medical device company after that, until he was
hired by Merck as their first outside CEO for the
express purpose of seeing them through the looming patent cliff scenario.
So he was brought in as kind of like an
emergency guy right now. It was Raymond who decided that
Merk's future would be in super aspirin. Alongside their chief scientist,
doctor Edward Skolnik, he launched a crash program to bring

(28:24):
a cox to inhibitor pain medication to market. The name
they picked for the wonder drug that did not yet exist,
but they were going to have that they were going
to hang the company's future on was Viox.

Speaker 2 (28:35):
Now.

Speaker 1 (28:35):
Time was of the essence here. Doctor Needleman, the guy
who had failed to discover Cox two but had gone
ahead and named it anyway, worked at a company called
g D. Seerle which was a division of Monsanto and
was leading research into a new inside that would eventually
be called Celebrex. And while Celebrex was under development, Pfizer
bought Seerrel from Monsanto and started throwing money into Celebrex

(28:59):
as part of what was turning into a vicious competition
to be the first pharmaceutical company to bring one of
these new super aspirints to market. And there's probably a
lot to be said about Celebrex. I am not competent
to say it. I will say that it is currently
a medication that the FDA says there's not evidence of
significant harms for There is debate about that to this day.

(29:20):
But that's all I can say on the matter because
I'm not a not an expert on this. There are
some activists who are very angry that Celebrex is still
on the market. The FDA has said it's more or
less fine. That's where we are with Celebrex.

Speaker 2 (29:33):
Yeah, it's the same family, Yes, and it does have
that comes with a warning on it that's more striking
than most other ensades. Yes, I know. Actually it's a
good question. I don't know how often it's used these days.

Speaker 1 (29:46):
I assume it's pretty rare or not as often as
it was.

Speaker 2 (29:51):
For sure.

Speaker 1 (29:51):
It's one of those things where a few years ago
there was a very scary study about heart effect like
heart problems that it could cause, and then a few
years later there was a study that suggests like, well, no,
maybe we got that one wrong. Maybe it's no worse
than other drugs in this class. Again, that's all I
can really say about Celebres because I'm not qualified to
judge a medication that there's still a lot of debate over.

Speaker 2 (30:14):
I don't have a lot more to add to it either,
But it feels like there's other ensades out there that, yes,
that we use a little frequently. It seem a little safer. Yeah.

Speaker 1 (30:22):
Yeah, But what you need to know is that Pfiser
is putting there, is putting their money into Celebres after
they acquire Merle, and you know vox is going to
be the attempt made by Mark to do the same thing.
So throughout the mid nineteen Ninetieskvet Merk scientists worked on VOCs,
rushing it through stages of medical testing, harassed by the

(30:45):
knowledge that any delay or bad finding. And when I
say bad, not in a scientific sense. It's not bad
scientifically to find out a drug doesn't work, but bad
for the company if this drug doesn't work because they're
on a timetable, would stop them from beating Pfizer and
unfortunately forever. There were signs right from the beginning that
viox might be dangerous. The first evidence of this was

(31:06):
presented in the mid nineteen nineties by doctor Garrett Fitzgerald,
a Merck consultant who was also professor of cardiovascular medicine
at the University of Pennsylvania. He warned the company that
Vyax might harm the walls of the blood vessels protecting
the human heart. I'm going to quote again from the
book Poison Pills by Tom NeSSI, which, if you're looking
for like a really good exploration of how a pharmaceutical

(31:26):
company does evil, Poison Pills is very well written. He
suggested that Mark set up a series of experiments to
test this theory, few of them wherever performed. Other scientists
cautioned that yox was related to kidney damage an increase
in blood pressure that could be linked to heart problems.
Doctor Fitzgerald also found similar problems with the drug in
the same class as vyax, called Celebres, made by rival

(31:46):
drug company Pfiser. Like Merk, Pfeiser denied the finding of
any cardiovascular problems with its drug, but cleverly began its
own campaign to portray viox as the more dangerous of
the compounds. That's smart at this point and victually warns
them the drug is not on market. He is trying
to stop it from getting to market by saying, like,
there's some real evidence. This is sketchy, you should carry

(32:06):
it more studies, and Murk is just kind of like,
but what if we didn't.

Speaker 2 (32:13):
It's like when you've.

Speaker 1 (32:14):
Been like spending like crazy all month, and you know,
you probably like you might be running down to the limit,
but you're just like going to the grocery store hoping
that like your card works this one more time or something.
So now, at this point, there was no hard evidence
of harm to the human heart, in large part because
Merk had refused to do the studies that doctor Fitzgerald advised.
This changed in nineteen ninety six, when an internal Mirk

(32:36):
study showed that people who took viox in high doses
suffered more heart problems than people given a placebo. A
MIMO was issued internally that noted the treatment period was
six weeks versus placebo. The initial dose of viox was
one hundred and seventy five milligrams, but in mid study
the dose was lowered to one hundred and twenty five milligrams.
Adverse events of most concern were in the cardiovascular system

(32:58):
i e. Heart attack, stable angina, rapid fallen hemoglobin and
hematopec crip, dangerous blood problems and some subjects. So that's bad.
Those are all really bad. Yeah, results, that's yeah.

Speaker 2 (33:10):
You're almost officially a doctor because that is correct. That
is the appropriate diagnosis is that it's all not good,
not good, not good, not good.

Speaker 1 (33:19):
It is important to underline the severity of these results, though.
These extremely serious side effects were present after just a
few weeks of medication for doses that were just about
twice the approved amount for treating acute pain, which was
fifty milligrams now twice sounds like a lot, but when
we are talking about the way people use medicines, it's
really not. People take way more, specially pain medicine than

(33:43):
they ought to.

Speaker 2 (33:45):
It keeps me in business. Yeah, people do this. This
is like almost You don't even have to take it
more than is recommended to run into problems, because sometimes
people only take a little and they run into problems
in the GI system for example, or other issues that
kid needed that can be affected for the heart. But
it is a sole underlying known fact that whatever we

(34:10):
think people are going to be taking, likely it'll be.

Speaker 1 (34:13):
More, and that is why it's standard in tests like
the one they were conducting, actually to test ten times
the effective acute dose when doing studies like this to
check for side effects, which they didn't do because they
knew that the results would be even worse. One doctor
who analyzed these results noted, I recall very clearly many
occasions where MERK scientists and doctors working with MERK were

(34:34):
claiming that viox was safe as placebo, which we've already
seen it's not.

Speaker 2 (34:40):
Now.

Speaker 1 (34:40):
The reality is that results like this were a big
warning sign and should have been taken as evidence that
biax might not be viable as a medication and certainly
needed more testing, But Merk went full speed ahead. In
November of nineteen ninety eight, they asked the FDA to
approve viviocs after testing the drug on fifty four hundred patients.
They bragged that they had conducted eight different studies which
had shown owned biox's efficacy. Now, this is where we

(35:02):
get into a complicated and uncomfortable topic, medical studies, and
why they often don't work the way that they should.
In theory, the process of conducting medical studies should identify
dangers in new drugs and accurately measure their efficacy. But
theory envisions a situation in which drugs are researched by
disinterested parties who have no vested interest in anything but

(35:22):
the truth. The reality is that studies are often funded
by pharmaceutical companies who, like Merk, might be sweating the
arrival of an upcoming patent cliff and headed by a
new CEO who lacks the same commitment to medical ethics
as his precursor. I'm going to quote now from an
article on this in the Union of Concerned Scientists to
increase the likelihood of FDA approval for its anti inflammatory

(35:44):
and arthritis drug bios. Merk used flawed methodologies biased towards
predetermined results to exaggerate the drug's private positive effects. Internal
documents made public in litigation revealed that a Merk marketing
team had developed a strategy called Advantage Assessment of Differences
between bios and to ascertain gastrointestinal tolerability and effectiveness to
skew the results of clinical trials in the drugs favor.

(36:06):
As part of the strategy, scientists manipulated the trial design
by comparing to the drug to neproxin, a pain reliever
sold under brand names such as a Leave, rather than
to a placebo. The scientists then highlighted the results that
neproxyen decreased the risk of heart attack by eighty percent
and downplayed the results that viax increased the rate the
risk of heart attack by four hundred percent. This misleading

(36:28):
presentation of the evidence made it looked like the proxen
was protecting patients from heart attacks and that vax only
looked risky by comparison. So instead of comparing this drug
to a placebo in which it would have been like Wow,
the rate of heart attacks is much higher. They compared
it to a drug that reduced the risk of heart
attacks and were like, well, of course people have more
heart attacks on this drug. This other drug reduces heart attacks,

(36:49):
but that doesn't mean this is danger. Like that's so
fucking shady.

Speaker 2 (36:54):
Is It's a bit tricky how they're doing it too,
because you know, so far, a lot of what they
have done sounds very I mean it sounds sound from
a distance. You know, the whole idea of like looking
at COX two inhibitors, like looking at medications specifically for
this and comparing it, you know, say, hey, look at
least we're better than the other medications to some degree.

(37:16):
From a high from your way back vantage point, it
all makes sense. It's when you start to like look
a little bit more closely that it's questionable, especially given
that they seem to know early on that there was
high risk of these cardiovascular injuries and that the whole
narrative is being shifted to try and take focus away

(37:36):
from that. Yeah, it's it's all. This is why it's
a difference between marketing and between like a scientist running
the program. Yeah.

Speaker 1 (37:45):
Yeah, and that's like that's really the whole story here, right.
So Merks fuckery extended to the hiring of ghostwriters to
write scientific articles reporting on clinical trials of bias to
try and convince doctors and regulators that the medication was safe.
Internal Mirk documents later revealed that in sixteen out of
twenty papers reporting on early VYAX clinical trials, a Merk

(38:07):
employee was listed as the lead author of the first draft,
but in the published versions credit for authorship was given
to an outside academic to continue in that from that
piece by the Union of Concerned Scientists. In one draft
of a Yox research study that did not yet have
a prominent outside name attached, MIRK officials listed the lead
author only as external author question mark. A MERK scientist

(38:30):
was also found to have removed the evidence of free
heart attacks among patients in a data set from the
results presented some great stuff.

Speaker 2 (38:39):
I mean, in wonder what numbers were in that paper,
but removing three can make a huge difference.

Speaker 1 (38:44):
Yes, yes, especially if you're not talking about a huge study.

Speaker 2 (38:47):
You know, did say anything about how many people were
in that study?

Speaker 1 (38:51):
I you know what, I'm sure I could have looked
into it, but I did not.

Speaker 2 (38:56):
And I'm wondering if in these studies they were talking
about the rates of ulcer bleed and gastric bleeding as well,
because I mean that's o sensibly the whole reason that.

Speaker 1 (39:05):
They're doing it was the whole thing that advantage was
supposed to show, right, is that it reduced the rate
of like peptic ulcer bleeding and stuff. And yeah, just
the whole the fact that we have drafts of them
just being like, we'll figure out who the author of
this piece is later, once we find a science, once
we find an outside doctor who you know, wants some cash.
And a lot of times these aren't direct bribes. These

(39:25):
are like, okay, you'll stick your name on this and
then this research project you want, we'll get a little
bit of funding from a from from a Papa merk.

Speaker 2 (39:33):
You know. Not even just that these are all being
published in decent journals. I'm sure that just people want
to be in good journals. They want to have another
publication and you know, New Journal and Medicine or the
Lancet or whatever.

Speaker 1 (39:46):
And you you also have to remember people think a
lot of people think this is the next big miracle drugs.
So yeah, you want you want to you want to
have a you want to have a little bit of
play in that, right of course.

Speaker 2 (39:56):
Uh so. Yeah.

Speaker 1 (39:57):
The worst piece of evidence against BIOS of this peerod
came out the same year Merk asked for FDA approval
nineteen ninety eight. Merk Study zero ninety involved nine hundred
and seventy eight patients and showed that people on BIOS
experienced serious cardiovascular events six times as often as patients
taking a different drug or a placebo for arthritis pain.
Merks shelled the study and never published it. Later that

(40:19):
same year, a group of medical researchers at the University
of Pennsylvania and by the way, thanks to that doctor
we named earlier, U of pen really tried to stop
biox from being a thing, published a study that showed
that COX two inhibitors might interfere with other enzymes that
helped prevent heart disease. Warnings were sent to Mercandfiser, who
quickly shoved them off into the circular file and kept

(40:41):
right on begging the FDA to say yes. And say yes,
the FDA did. They approved bios for use as a
painent killer in results in adults in nineteen ninety nine.
A minstrel pain medication and an anti inflammatory for people
with osteoarthritis. Despite approving the drug, FDA reviewer doctor Villalba
warned in his memorandum that there was evidence suggesting vyax

(41:02):
caused more frequent cardiovascular events and patients. So Vox goes
to market, it immediately becomes a best seller. Celebrex also
goes to market. It drives massive profits for Pfizer. And
this is in spite of the fact that particularly viox
is not great at I mean, neither drug is really
all that good at fighting pain. And I'm going to

(41:23):
quote from the New York Times here. When studies on
viox and rex became available in nineteen ninety eight nineteen
ninety nine, many doctors were disappointed. Neither drug alleviated pain
any better than the old medications, and the drugs cost
close to three dollars a pill over the counter. Pain relievers,
in contrast, cost pennies a dose, and by the way,
they weren't all that much better at preventing ulcers. Some

(41:45):
studies suggest like viox was no better at preventing ulcers,
although that seems to be unclear now. Analysts say that
the success of viox was critical to MRK. The patents
on those popular mark drugs Aspire started expiring in two
thousand and two thousand and one, which opened them up
to eric competition, and Vyox comes through and is I
mean almost immediately billions of dollars a year in profits

(42:07):
for the company. Michael krint Savage, a drug industry analyst
at the investment bank Raymond Jameson Associates, says vax was
Merk savior. It's as simple as that, like he puts
it down, as the company might have gone on or
under at least, you know, probably been acquired if it
hadn't been for a Yox.

Speaker 2 (42:23):
I mean, I remember at the time it was huge.
It was I had never seen a campaign like it
about that I remember. I think it was one of
the first times I remember really having like being conscious
of like how much a medicine was being marketed, you know.
And you know, I think it's one of these medicines

(42:44):
where it's like, you know, maybe five to ten percent
of the people who are using it maybe had some benefit,
real benefit where they maybe it did help them from
a gastric ulcer perspective, maybe they didn't have the option
of taking another medicine. But for the other ninety percent
of people there taking it, it wasn't necessary for them.
It wasn't something that they needed, and it was just

(43:04):
increasing their risk of heart attack or stroke. And I
think that this is I bet you. I mean, you
probably know this, but I bet up to this point
this was the most that ever been spent on direct marketing.

Speaker 1 (43:17):
Yeah, I mean, and that is what we're actually about
to talk about is the marketing campaign, which surprise, surprise,
involves beloved figure skater Dorothy Hamill.

Speaker 2 (43:26):
But I knew it.

Speaker 1 (43:27):
Yes, she's the great monster in this in all of
our episodes, every episode we have ever done, Dorothy Hamill
and building into this.

Speaker 2 (43:35):
She's the fanos of the behind the Bastard's world.

Speaker 1 (43:37):
That's right. Joseph Stalin would never have accomplished his greatest
crimes without Dorothy Hamill's assistance. That's obvious though. Evil historians
have been talking about that for decades. Anyway, you know
who's not Dorothy Hamill. I don't know why I'm shitting
on Dorothy Hamill. None of this is really her fault. Anyway,
here's as we're back. Okay, so we're talking the viox

(44:04):
marketing campaign. How do you sell America on this drug
that is going to get a decent percentage of America killed?
And the answer is figure skating superstar Dorothy Hamill. So yeah,
this is this is where the real villain of the
story comes into it.

Speaker 2 (44:21):
The haircut is a problem for me.

Speaker 1 (44:22):
I had Hamil's haircut.

Speaker 2 (44:24):
My first girlfriend, The first girl that really smashed my
heart into like a billion pieces, scattered them across the globe.

Speaker 1 (44:32):
Was Dorothy Hamill. That has really taking some strays in
this episode.

Speaker 2 (44:36):
Just she had Dorothy Hamill's haircut. Oh, which I don't
know why at the time didn't bother me, But so
now when I see that haircut, I'm like, oh, yeah,
that reminds.

Speaker 1 (44:47):
Me of that that lost love.

Speaker 2 (44:51):
Yeah, painful, painful. So for those of you.

Speaker 1 (44:53):
Who don't know what we're talking about, back in the
nineteen seventies, an incredible athlete named Dorothy Hamill became one
of the most famous people in the world. When she
was just nineteen. She performed at the nineteen seventy six
Innsbruck Olympics and won the gold. Time declared her America's
Sweetheart and as his customary for world class athletes, corporations
began offering her embarrassing piles of money to endorse their products.

(45:15):
Hamil's first run as a famous person didn't go great.
She married Dean Martin's kid, and then he died in
a plane crash. She fell out with her coach. She
spent all of her money buying the ice capades, and
then wound up burning out and developing a bleeding ulcer.
She had another marriage that ended badly and wound up well,
not broke, you wouldn't say, but no longer rich, and

(45:36):
she suffered from a substantial amount of pain from a
lifetime of pushing her body to athletic excess. The pain
was bad enough that at the worst Dorothy could no
longer even play with her daughter. Some days she could
barely get out of bed. And then her doctor told
her to try biox. She would later claim that it
was effectively a miracle cure for her, not only soothing
her pain, but bringing back her ability to perform on

(45:58):
the ice in a way she hadn't in years. In
August of two thousand, Hamil made an appearance on Larry
King Live with Caitlyn Jenner, and Jenner is also talking
about viox and this this. Jenner is also claiming that
like this this really helped her arthritis. She told the
audience a heart wrenching story about loss and pain and
her miraculous return to the world of the living thanks

(46:18):
to Vyos quote. I just I felt old. I felt depressed,
tired all the time. I mean, having chronic pain is exhausting.
And I got to the point this year I was
on tour and I couldn't skate, and so I went
to a doctor and we finally got to the bottom
of it, and my doctor prescribed VOX for me. And
it's as if I've been given a new life. It's
just it's been amazing. I feel twenty years younger. I

(46:39):
don't look it, and I don't skate it, but I
feel that way.

Speaker 2 (46:43):
Was this when Larry King still had some credibility?

Speaker 1 (46:45):
Oh yeah, he was big at this point. This is
like right around the turn of the century. He's still
a big, a major major. This is like before infomercial
Larry Yes, yes, okay, and this is I mean, maybe
this is part of his downfall. But people still take
the show series and they take this very seriously. And
to be clear, I'm not saying that, you know, even
Caitlin or or Hamilorthy were lying about their experiences on

(47:12):
viox because some people did gain benefits of this. Yeah,
and you know, so I'm not doubting that. The problem
again is that a single person's having a good reaction
to a drug is not evidence that the drug is safe.

Speaker 3 (47:25):
You know.

Speaker 1 (47:26):
For example, I know some people in their seventies who
have been doing heroin for fifty straight years and are
and are fine. That doesn't mean heroin is safe. It
means some people are lucky, right, Yeah, or they afore
mentioned ninety year old women doing you know.

Speaker 2 (47:44):
Those ancient people who do you get drugs and smokes
that you now with a.

Speaker 1 (47:48):
Little burning Man regionals, you run into a lot of
elderly people who have been doing drugs for forever. Some
of them are very good at it. I've been gas
stations sober for years now, Kava, that's Responlifornia sober.

Speaker 2 (48:03):
But you can only get the things you buy at
the gas station.

Speaker 1 (48:06):
I don't mess with that marijuana. That shit's dangerous. I
just take those trucker yellow jackets that they give to
keep people driving long haul awake. You know, I don't
know what's in them. They're big and yellow. That means
they're safe. Yeah, it's danger'd me red if it was dangerous.
They can't put dangerous drugs in a yellow and black
pill and call it yellow jackets and it doesn't mean dangerous.

Speaker 2 (48:28):
Yeah.

Speaker 1 (48:29):
So I never take more than like twelve in a day. Yeah,
thank god for yellow jackets.

Speaker 2 (48:35):
I just some I sometimes don't know if you're kidding,
and I just hope in my heart that you are.
And I'm just going to pretend that this is all
part of a bit.

Speaker 1 (48:45):
I do the safe thing. I like, open the pill
and I pour all the powder in the pill into
a glass, and then I pour in a bunch of
my krateion into the glass, and then I add a
banana for the potassium because your heart level.

Speaker 2 (48:56):
This level of detail is what bothers me.

Speaker 1 (49:01):
The more I don't like it's fine. It's mostly just
B twelve in caffeine and god knows what else, because
there's absolutely no no agency that looks into what gets
put into substances that are sold in gas stations in
this country.

Speaker 2 (49:14):
Oh my god, and what little oversight there is is
gonna be gone.

Speaker 1 (49:18):
Yes, thanks gone, thank god. Look, RFK Junior might ban
the HPV vaccine, but we could get legal heroin.

Speaker 2 (49:29):
It's all one big, organized end of humanity cash grab
the next couple of years. Any drug you want to
get through is gonna get through god willing.

Speaker 1 (49:41):
Look, if the world's ending, do you want heroin to
not be legal?

Speaker 2 (49:47):
That's fair, But it's not gonna be heroin. It's gonna
be like, you know, blood pressure pills that the company
just gets through and then it makes people's hearts explode,
and then the company will just say, hey, we're bank
and then they're fine, and then they just move on
with their lives, and then people are going to be
left in the wake.

Speaker 1 (50:05):
Then no, you're right, they're going to ban prozac and
replace it with like polar Bear liver pills. It's just
going to be a disaster.

Speaker 2 (50:14):
He was always doing research that in RFK.

Speaker 1 (50:16):
He's always trying something new. So the fact that this
beloved celebrity athlete has gone on Larry King and said
exactly what viox PR would want her to say was
a godsend. You know, that's the kind of pr no
money can buy. Although I have to tell you now
that moment was in fact bought and paid for by
MERK they had found out that Dorothy was a customer.

(50:39):
They had reached out to her with an idea and
a pile of money. Her life story had been used
as the basis for an entire marketing campaign, and her
appearance on Larry King was just the first step in
launching it. Tom NeSSI writes the day after Dorothy Hamill's appearance,
even Merks CEO Raymond gil Martin was smitten. He received
heart written letters from arthritis sufferers saying they were going
to immediately ask their physicians for a viox. Gil Martin

(51:02):
personally congratulated the public relations department. One marketing executive wrote
that with Dorothy telling our story, vyox sales were going
to soar and overtake celebrates and obsession within the.

Speaker 2 (51:12):
You'll slipped into like your fifties radio announcer voice. You
kind of shifted to the nineties. I saw what you
did there.

Speaker 1 (51:19):
I love it. I love it. I love it. So yeah,
patients are are coming in, They're begging doctors to write prescriptions.
Doctors are going, well, shit, how bad could it be.
It's basically just aspirin, you know, And a lot of
people are suddenly taking viox. Now the FDA does push
back a little on this campaign because Dorothy's appearance on
Larry King counted as an ad and she had not

(51:41):
mentioned that she was being paid by Merk, which you're
not supposed to do. They also had an issue that
she was kind of basically saying she had not told
people that viox was extremely dangerous if you prescribed it
to patients with the history of bleeding ulcers. In fact,
she had stated that she was taking it despite her
history of bleeding ulcers, which is kind of telling people

(52:04):
this is safe to say in the exact situation that
the FDA knows. We know it is not safe to
tell people to take it in. So the FDA gets
kind of unhappy with this, and Merk replied, she just
slipped up. We taught Hammil the proper way to sell
our product, but she went off script. They promised to
retrain her before following up with any additional advertisements. This

(52:26):
happened on September twelfth, two thousand. The next day, in
violation of their promise to the FDA, Hamill appeared on
a local TV station in Atlanta to urge people to
consider a biox. The FDA never found out about this
and might not have cared if they had, if you
wanted to get away with something. September twelfth, will actually
that was two thousand. Never mind, everything was still fine.

(52:46):
I was gonna. I was just like, did I just
go over to September twelfth and not make it?

Speaker 2 (52:49):
I feel like that. No, No, it's fine.

Speaker 1 (52:51):
Research didn't happen yet, everything was fine. Plenty of towers
in New York still at this now. The unfortunate reality
of the FDA is that it is stand and operated
by a lot of people who want to work in
the private sector of the pharmaceutical industry someday, and some
of these people feel a need to avoid making waves
and killing a golden goose that is currently injecting cash

(53:11):
into someone they want as a future employer who made
a bit of past employer that they're hoping we'll hire
them on for a lucrative consulting gig in the future.
Beyond that, the teams at the FDA who we rely
on to monitor food and drug advertising are hideously understaffed,
operating on a shoe string budget. There may not have
been anyone watching Dorothy Hamill's ad on local Atlanta TV
because no one was being paid to do so. Now,

(53:34):
MERK did change their TV ads for vyox based on
the FDA's feedback, and you can see one example of
that here. We've got to play just one of these
bad boys. Here is Dorothy Hamill's revised vyox ad.

Speaker 5 (53:46):
When I started skating at eight years old, I never
thought i'd experience the thrill of winning a medal with
all the great memories. Has come another thing I thought
I'd never experience, The pain of osteo Arthur writers.

Speaker 6 (53:58):
Yox is here. Medicine for ustioar threat is pain. With
one little pill of day, biox can provide powerful twenty
four hour relief. Biox specifically targets only the COX two enzyme.
A key source of our threat is pain. People with
allergic reactions such as asthma to aspirin or other arthreatus
medicines should not take bios. In rare cases, serious stomach

(54:19):
problems such as bleeding can occur without warning. Tell your
doctor if you have liver or kidney problems. For more information,
talk to your doctor about once daily biox for the
relief of ostio war threat is pain.

Speaker 5 (54:30):
Perhaps my biggest victory is to be able to plan
my day around my life instead of my pain after.

Speaker 6 (54:36):
Your doctor Biox is right for you, bios for everyday victories.

Speaker 2 (54:42):
First of all, I take back what I said about
her hair. I think it actually looked really good there.
I don't know, like time and the cycle change and fashion.

Speaker 1 (54:51):
I don't know it was the Viox. You don't know.
Maybe vix makes your hair look great.

Speaker 2 (54:55):
Everybody. It's a by Biox. It's a brilliant strategy. Like
the people who grew up watching her and knew who
she was and admired her are that age where they
were having lots of the osteoarthritis and joint pains looking
for medication. It's a she's the perfect spokesperson. Yeah, and
she has that innocence so that you believe, you know.

Speaker 1 (55:15):
Yeah. And the Dorothy hammel Ads are a huge success.
Millions of Americans saw their former child sweetheart skating and
skiing and living an active, healthy life thanks to this
new miracle drug, and millions of them decided I want
that for myself, And ultimately tens of thousands of them
are going to die as a result. And that's the
story we're going to tell in Part two. Kaba can't wait,

(55:37):
Yay But first off, do you have anything to plug
before we roll out here?

Speaker 2 (55:41):
I do plug is my show. That is the plug
that I want to plug is my show. I'm plugging
it now. It's called The House of Pod. It is
a humor adjacent medical podcast. If you like the subjects,
like today's subject, you'll like our show. In fact, one
of our most recent episodes is about sort of similar

(56:02):
a little bit less egregious, but similar pharmaceutical shenanigaree. I
don't know if that's a word about the medication zygris
And and there's all kinds of fun guests like Robert
and prop and all the people you know and love here, Margaret.
So check out my show, The House of Pod. And

(56:23):
if you want, you can follow me at Blue Sky,
which I'm giving a shot now. Seems a little bit
less fascist.

Speaker 1 (56:28):
Yeah, definitely less fascist. It's got its own annoyances, but
all of social media has things that annoy me. So
what are you gonna do exactly?

Speaker 2 (56:35):
You can follow me there at Cave MD.

Speaker 1 (56:37):
You can also follow me there and I write, okay,
where you can follow me on the other place too,
But you know what you could do that I would
appreciate most get off the internet. Feed somebody you know
do something good in the world. Like it online, I
like it. And to listen to podcasts. Keep listening. For
the love of God, keep listening. Do not stop listening

(56:59):
to the podcast under no circumstances.

Speaker 2 (57:01):
Stop. Will you ever stop? In fact no, just for
thinking about stopping. You should listen to extra podcasts today.

Speaker 1 (57:08):
Yeah, you know what, I'll say it right now. If
you have stomach holcers podcast on the podcast.

Speaker 2 (57:12):
Your Way Through It podcast Your Way Through.

Speaker 1 (57:14):
It, that's right.

Speaker 3 (57:19):
Behind the Bastards is a production of cool Zone Media.
For more from cool Zone Media, visit our website Coolzonemedia
dot com or check us out on the iHeartRadio app,
Apple Podcasts, or wherever you get your podcasts. Behind the
Bastards is now available on YouTube, new episodes every Wednesday
and Friday.

Speaker 1 (57:37):
Subscribe to our

Speaker 3 (57:38):
Channel YouTube dot com slash at Behind the Bastards