When Half a Million Americans Died and Nobody Noticed

Alexander Cockburn
Wed, 25 Apr 2012 21:00:00 -0700
Opinion

Are American lives cheaper than those of the Chinese? It's a question raised by Ron Unz, publisher of The American Conservative, who has just published a compelling comparison between the way the Chinese dealt with one of their drug scandals — melamine in baby formula — and how the U.S. handled the Vioxx disaster.

In September 2004, Merck, one of America's largest pharmaceutical companies, issued a sudden recall of Vioxx, its anti-pain medication widely used to treat arthritis-related ailments.

There was a fair amount of news coverage after the recall, but it was pretty slim considering the alleged 55,000 death toll. A big class-action lawsuit dragged its way through the courts for years, eventually being settled for $4.85 billion in 2007.

Senior FDA officials apologized for their lack of effective oversight and promised to do better in the future. The Vioxx scandal began to sink into the vast marsh of semi-forgotten international pharmaceutical scandals.

The year after Vioxx was pulled from the market, The New York Times and other media outlets ran minor news items, usually down column, noting that American death rates had undergone a striking and completely unexpected decline.

Typical was the headline on a short article that ran in the April 19, 2006, edition of USA Today: "USA Records Largest Drop in Annual Deaths in at Least 60 Years." During that one year, American deaths fell by 50,000 despite the growth in both the size and the age of the nation's population. Government health experts were quoted as being greatly "surprised" and "scratching (their) heads" over this strange anomaly, which was led by a sharp drop in fatal heart attacks.

For his melamine/Vioxx comparison, Unz went back to those 2005 stories. Quick scrutiny of the most recent 15 years worth of national mortality data provided on the U.S. government's Centers for Disease Control and Prevention website offered Unz some useful clues.

"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rates occurred in 1999, the year Vioxx was introduced, while the largest drop occurred in 2004, the year it was withdrawn," says Unz. "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.

"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."

"Patterns of cause and effect cannot easily be proven," Unz continues. "But if we hypothesize a direct connection between the recall of a class of very popular drugs proven to cause fatal heart attacks and other deadly illnesses with an immediate drop in the national rate of fatal heart attacks and other deadly illnesses, then the statistical implications are quite serious."

Unz makes the point that the users of Vioxx were almost all elderly, and it was not possible to determine whether a particular victim's heart attack had been caused by Vioxx or other factors. But he concludes: "Perhaps 500,000 or more premature American deaths may have resulted from Vioxx (emphasis added), a figure substantially larger than the 3,468 deaths of named individuals acknowledged by Merck during the settlement of its lawsuit. And almost no one among our political or media elites seems to know or care about this possibility."

I remarked to Unz that it seemed truly incredible that a greater than expected death rate of this dimension should scarcely have caused a ripple.

"I'm just as astonished," he said. "One might conjecture that the mainstream media and the government officials were all bribed or intimidated by Merck's lawyers, lobbyists and advertising budget into averting their eyes or holding their tongues. But from 2004 onwards, huge numbers of America's toughest trial lawyers were suing Merck for billions based on Vioxx casualties — didn't they notice the dramatic drop in the national death rate?

"The inescapable conclusion is that in today's world and in the opinion of our own media, American lives are quite cheap, unlike those in China."