On Sept. 30 global drug maker Merck pulled its blockbuster arthritis drug Vioxx off the market after studies showed that using the drug could lead to increased risk of
heart attack and stroke. On November 5, more than a month later--amid a torrent of negative press--the front page of Vioxx.com still consisted of a single document: The
original Sept. 30 press release announcing the Vioxx withdrawal, with additional links to PDF files containing doctor and patient information.
"The PR response hasn't been great," says Alan Weiss, president of organizational-consulting firm Summit Consulting Group (East Greenwich, R.I.). Without getting in
front of the story, Merck has started to pay a severe price, as its stock dropped to $26 a share from $45 in a five-week period.
What's more, Merck's credit rating was recently lowered (for the first time in a decade) by Moody's Investor Service amid Wall Street's growing discomfort with Merck's
potential liability from pulling Vioxx.
There's little surprise that PR execs see more than a few elements missing in Merck's efforts to stop the bleeding.
Peter Morrisey, president-CEO of PR firm Morrisey & Co. (Boston), worked on the Tylenol-poisoning crisis in the early 1980s. When he compares that event to the
Merck debacle he sees a glaring difference. Merck, he says, is not talking enough. "You need things like patient hotlines, Web sites, chat rooms, which show consumers that you are
serious about communications."
While saying it acted responsibly as it developed and marketed Vioxx, Merck's Web site on Nov. 15 was less than forthcoming. "Merck does not intend at this time to address
specific documents, as many continue to be subject to court orders that prohibit their disclosure," says the site. "Merck also believes that the appropriate place to try legal
proceedings against the company is in a court of law, not through the news media." Fine, but try telling that to reporters chomping at the bit for fresh information. (Merck's PR
executives did not return repeated telephone calls to comment for this story.)
Even if Merck executives are reluctant to talk directly to the press they still could shape the story through outside commentary, says Jack Gutt, a principal at the New York
City-based communications advisory Vistance Group. "Who is out there talking about you? Where are the third-party friends who are going to give you credibility? These could
be people from the medical profession or the civic world, people like former regulators talking about what you have done right historically."
And Merck has been recognized in the past for good corporate citizenship, including efforts to keep drugs affordable and make medicines available in impoverished areas
throughout the world.
Today, however, the company's reputation is at a low tide, with calls increasing for Merck CEO Ray Gilmartin to step down. Pulling Vioxx off the shelf was one thing, but now
Merck is dealing with allegations that the company knew early on that the drug could cause medical problems. Indeed, healthcare experts allege that Merck's PR efforts pushed the
drug too hard, even after an internal study in 2000 showed potentially serious side effects.
Merck's official line is that it withdrew the drug as soon as it knew there was a problem. Maybe so, but it is up to PR to prove it to the satisfaction of the public and
media reps. "You want to be as candid as you can: What you know right now, and when you knew it," Morrisey says. "And if there is a disconnect in the timing, you have to spend the
time to reconstruct it and explain it."
It is a complicated story to tell, but it still has to be told, especially in the face of what many see as contradictory evidence. Even before the FDA approved the drug,
there were indications of increased cardiac risk, says Marybeth Belsito, CEO of Manhattan-based communications firm Belsito & Co. This would seem to belie the company's
present claim that it knew nothing until the day the drug was pulled. "There is no way they didn't know something," Belsito says.
To reconcile the discrepancy PR executives at Merck need to give a more detailed accounting of the manner in which its drugs go to market. "With any drug there is an inherent
risk. [Merck] knew there was an increased risk of heart attack with this compound, but the magnitude was not understood," Belsito adds.
Others say PR should have taken the lead in letting consumers know about potential risks from the very start, and not just when the product was pulled.
"As more studies came out someone should have said, 'Look, we have a potentially very serious problem. Let's let people know what we know and put the appropriate warnings in
our literature,'" says Mark Pruner, VP of marketing for RD Legal Funding, an Englewood, N.J. firm involved in handling payment of legal settlements. "PR does not have the
primary responsibility for this decision, but they should not just be bystanders in the corporate decision-making process."
The lack of communication often leads to what many see as the bigger lesson for PR executives who deal in the Big Pharma/healthcare arena.
"We need to get some well-spoken pharmacists front-and-center to explain to the lay public how drugs work," says Patricia Raymond, a gastroenterologist in Chesapeake, Va. and
host of "Housecalls" on National Public Radio (NPR). "The peril that the pharmaceutical companies are facing is that the patients' expectations are of a drug that has no
side effects, is fast in onset, doesn't require commitment to compliance, and is almost free."
PR in support of pharmaceuticals has helped to foster that expectation, and it is now up to healthcare PR professionals to steer public opinion in a more realistic direction
if the industry is to avoid the kind of massive blowback that Merck is now incurring. "The PR folks have been hoisted on their own petard," Raymond says. "We need to glorify the
science, not simplify, simplify, simplify."
In the short-term, Merck can only dig itself out of this one by swift action. "The only serious PR strategy here is for some heads to start rolling," Weiss says. "If I were
PR, I would be telling the board that the key here is accountability, and it cannot be a broad corporate accountability. There has to be some personal, individual
accountability."
Others will say that finding a scapegoat does not satisfy the public, which will see the problem as more systemic. But Weiss makes a compelling case for the need to allay the
public's sense of outrage. "Nobody is really interested in somebody apologizing on behalf of some corporate entity," he says. "They want somebody to say: I, personally, am
sorry."
Contacts: Marybeth Belsito, 212.981.5665, [email protected]; Jack Gutt, 212.935.2071, [email protected]; Peter Morrisey, 617.523.4141, [email protected]; Mark Pruner,
800.565.5177, [email protected]; Patricia Raymond, 757.547.2673, [email protected]; Alan Weiss, 401.884.2778, [email protected].