Will you take Vioxx on its return?

Will you ever take Vioxx again? You will be surprised with what you hear. A relatively small number of people worldwide who have taken Vioxx in the past are actually ready to take it again despite the serious side effects that are now known. The pain relief that Vioxx provided to them is almost "addictive." But what about those arthritis patients who have been closely following the Vioxx recall news. But will doctors prescribe Vioxx again if its sales are allowed to resume in the US? That is a tricky question since not only do doctors have deeper understanding of risks, their decisions also tend to be more "clinical" rather than "emotional." (Related article: Doctors lose trust in FDA after Vioxx recall mess)

But a recent survey by NOP World Health has some interesting findings. New FDA Advisory Committee recommendations around COX-2 inhibitor drugs are likely to lead to prescribing gains for Bextra and Celebrex, though both physicians and patients will continue to shy away from Vioxx, even if it returns to market. The research shows that physicians, particularly general and family practitioners, anticipate increasing their Bextra prescribing, while internists, rheumatologists and orthopedic surgeons expect to boost their Celebrex prescribing. (Related article: Bextra safety)

Patients taking Celebrex or Bextra are loyal to those products and plan to continue taking them. Vioxx, however, will experience ongoing difficulties, even if Merck decides to reintroduce it. If Vioxx returns to market, most patients indicated they would be unwilling to take it-and most physicians would use it primarily as a second-line treatment, after Celebrex and Bextra. Rheumatologists are most likely to return to Vioxx, if it once again becomes available. In contrast, a third of orthopedic surgeons say they will not prescribe Vioxx, if it is reintroduced. (Related article: Americans abandon Vioxx, Celebrex, and Bextra)

"If Vioxx comes back to market, lingering concerns about cardiovascular risks may limit its potential," according to Keith Loehlein, Senior Vice President of NOP World Health's Market Assessment Practice. "To re-establish the product, Merck will have to ease fears about cardiovascular side effects. A good promotional starting point would be marketing first to rheumatologists-who are most receptive to a Vioxx return-before targeting primary care physicians or other specialists.

Physicians and Patients Remain Uncertain about COX-2s

Both physicians and patients remain cautious about COX-2s. Overall, physicians are still undecided about whether the benefits of COX-2s outweigh their drawbacks. Patients echo the concerns of many physicians. Former Vioxx users are particularly skeptical and unlikely to be swayed by the FDA's recommendations. Patients taking pain medications other than COX-2s also are highly suspicious of the category-and findings indicate that manufacturers will have to make significant efforts to change those negative perceptions. (Related article: Is Mobic a good alternative to Vioxx, Celebrex, and Bextra?)

Unsure about COX-2s, many patients are turning to their doctors for answers. Rheumatologists report that 2 out of 3 patients have inquired about the Vioxx return. Questions tend to focus on comparisons between the COX-2s and the cardiovascular risks surrounding Vioxx.

NOP World Health conducted its research after an FDA Advisory Committee issued new recommendations on February 18, 2005, about the marketing of COX-2 Inhibitors. The FDA decided that Celebrex and Bextra could remain on the market-and that Vioxx could potentially return. All three products, however, must now carry a black box warning about the increased risk of cardiovascular events. Overall, the committee agreed that, while the cardiovascular risk is a class effect, variations in that risk-based on specific drugs and dosages-necessitate a case-by-case consideration of COX-2 agents.

NOP World Health's research provides an early read on physician and patient reactions to the panel's recommendations. NOP World Health is a supplier of primary research in the global healthcare market.

Recommended articles

Non-English speakers not told of Vioxx risks

Vioxx litigation may bankrupt Merck

Merck manipulated FDA in Vioxx recall case

Natural alternatives to Vioxx, Celebrex, and Bextra

Source: NOP Health