The Associated Press, "Vioxx aggressively marketed despite concerns; Merck used code-named projects to boost sales, report finds"

          Merck & Co. sales personnel, using projects code-named "Offense" and "XXceleration," took extensive measures to boost sales of the painkiller Vioxx amid brewing safety concerns.
          Documents released Thursday at a congressional hearing detail how a sales army of 3,000 turned the drug into a multibillion-dollar blockbuster before it was pulled from the market last fall because of an increased risk of heart attack and stroke.
          A Merck official told the House Government Reform Committee that the company was talking to federal health officials about what it could do to return the drug to pharmacy shelves. But the hearing’s focus was on the extraordinary glimpse into the marketing of drugs to doctors.
          Instructions were as detailed as how long to shake a physician’s hand -- three seconds -- and how to eat bread when dining with doctors -- "one small bitesize piece at a time."
          One memo, on Feb. 9, 2001, told sales reps, "Do not initiate discussions" on a study that raised heart concerns. Another document describes "obstacle handling" to overcome physician concerns.
          "When it comes to the one thing doctors most needed to know about Vioxx -- its health risks -- Merck’s answer seems to be disinformation and censorship," said Rep. Henry Waxman, D-Calif.
          Merck pulled Vioxx after a study showed it doubled the risk of heart attacks and strokes in patients using the drug for more than 18 months. Merck is facing more than 2,300 lawsuits from customers, and on Thursday its chief executive, Raymond V. Gilmartin, stepped down. Merck named Richard T. Clark to replace him.