Businessweek, "Merck Could Use a Few Pep Pills"

         Merck & Co. has a history of going its own way in the drug industry. It was the first big drugmaker to buy a pharmacy- benefits management business, now called Merck-Medco, back in 1994. It has pushed aggressively into risky new research fields, conducting one of the biggest projects to find an HIV vaccine. And while big rivals such as Pfizer Inc. and Bristol-Myers Squibb Co. have tried to keep their new-drug pipelines flowing by pulling off major mergers or striking expensive development deals with smaller outfits, Merck Chairman and CEO Raymond V. Gilmartin has relied largely on the company's vaunted research labs.
         Wall Street, however, is now questioning that independent streak as Merck enters a critical period. Patents on several of its blockbuster drugs have been expiring, exposing them to competition from cheap, generic knockoffs. At the same time, the company's pipeline looks alarmingly thin. Merck had counted on its second-biggest product, arthritis drug Vioxx, to help it through this rough patch, but now its fast growth is stalling.
          Part of a new class of painkillers called Cox-2 inhibitors, Vioxx was launched in 1999 on the heels of a similar drug, Celebrex, now owned by Pharmacia. Both drugs were immediate hits. Then, last year, a study by Merck showed how easy Vioxx was on stomachs, the drug's main selling point, but also indicated that patients taking Vioxx were more prone to heart attacks than patients taking an older, rival, drug. Merck believes that Vioxx doesn't cause heart problems -- that instead the older drug may actually help protect the heart -- but a study to prove that point has not been done yet. So in September the Food & Drug Administration warned the company that its marketing must acknowledge that it is unclear whether Vioxx poses a cardiac risk.

Consumer Reports on Health, "The COX-2 controversy. Are newer arthritis drugs safer?"

          The newest class of arthritis drugs, called COX-2 inhibitors, is supposedly easier on the stomach than standard medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs). That notion has made them by far the best-selling prescription pain relievers. But only one of two large, recent clinical trials clearly supported that idea - and that same trial raised the possibility that the COX-2 drugs may increase the risk of heart attack and stroke. More...