Behind the Bastards - Part One: The Vioxx Scandal: How Big Pharma Killed More Americans Than Vietnam

Episode Date: December 10, 2024

Robert sits down with Dr. Kaveh Hoda to talk about Vioxx, a pain medication released by pharmaceutical giant Merck even though they knew it caused fatal heart attacks. (2 Part Series)See omnystudio.com/listener for privacy information.

Welcome back to Behind the Bastards, a podcast where Sophie is not in the room right now. So Dr. Kavehoda and I are the foxes watching the hen house. That is also weird. We're also the hens. I am the producer. I am the captain now. We're like hen foxes, like a cat dog situation. Although I imagine a hen fox, the fox is just going to try to eat its hen. That's part of its butt, I imagine.

I love your quaint country colloquialisms. It's great. Don't know what they mean, but they sound folksy. You're probably too young for that cartoon. I was the right age for it. Yes. They sound folksy. You're probably too young for that cartoon. I was the right age for it. No, yes. Dr. Hoda, my healthcare expert, legally my doctor. Oh God. Do you have any theories that you can't prove that are unprovable, that are probably nonsense,

that you nonetheless believe about health? About health? Yeah. Yeah, I got a lot. That's good. You know. Yeah. Yeah, I got a lot. That's good. As a doctor, I feel like I should. I will talk to you at great length about how supplements are a fantastic waste of time. And I will tell you in detail, and I have on many episodes, why they're more dangerous generally than they are good.

And you should only use them with strict instructions from your physician. But that being said, I feel like ginger really helps me in like a power-up way that it doesn't. I know it doesn't, but I love it. And the placebo effect is so strong for me that, you know, you got to adopt. Ginger's my.

Yeah, ginger's my magic thing. My little magic creation in my mind that works more than it really does. Yeah, I I'm not big on supplements. I do take my doctor advised me to take for for blood pressure, calcium and potassium. So so so I do I do I do some, my doctor advised me to take for blood pressure, calcium and potassium. So I do some of that, which I've noticed I don't get cramps as much as I used to. So I guess I'll call that a win. I do love looking into the different potential side effects.

I love going onto like biohacking subreddits and seeing people talk about like the side effects they're having with various weird supplements they're taking to never die. Although my favorite is the lion's mane subreddit. So lion's mane is like a mushroom that does have like some, it does have like an effect on your brain, right? Like there's actually some like studied benefits of lion's mane, but it's like, it's a pretty mild supplement. But there's this group of people who are convinced that like taking it once has like destroyed their life in the way that like a huge dose of psilocybin mushrooms might have like mind altering effects. It's like, man, everyone at people I don't put

like it in their smoothies. I don't I don't think it's the fucking lion's mane that's giving you nightmares for the last seven years of your life I mean that is that is that's the kind of thing I hear a lot about like every medication Yeah, you name it out there someone has had someone blames that medication for their life being in shambles Yeah, and you know, it's medication we're talking about today lots of risks. That's true. They all they all do Some more than others. I think we're talking about today. Lots of risks. That's true. They all they all do some more than others. I think we're probably going to discuss here. But yeah, I don't know if lines mean which I'm not familiar with really. It's a mushroom.

It's a mushroom. You know, it's got you know, some mushrooms have like neurological impacts and stuff on people. But, you know, my my particular favorite medical theory doctor, Dr. Hoda, is that obviously cigarettes are bad, terrible for almost everyone, nearly always horrible. But I think there's a slightly less than 1% of the population that have a genetic abnormality that makes cigarettes make them live forever.

Because every now and then I'll meet, you know, sometimes in like little corners of the world or whatever, I've met like little old ladies in Japan or like 96 and they're like, yeah, I've been chain smoking cigarettes since I was like 11 years old or something like that. And it's like, clearly it works for you. Like there's some, some minority of the population that cigarettes make and vulnerable. I feel like this is that meme of the plane that returns from war with the bullet holes in it. You're never gonna hear me say cigarettes are okay. They know what they've done. They know.

I know, they've killed uncountable, more people than war in the 20th century. And war killed so many people in the 20th century. But every now and then I'll meet some like 90 year old woman who smokes four packs a day and she's doing fine So clearly clearly science doesn't understand everything about the maligned cigarette. No, that's okay. Don't vape That's the one that worries I mean like especially since all of my friends vape heavily It's one of those like yeah, but it's got to be doing something, right? Like, it's got to do something. Oh, for sure. For sure.

I'm not. I'm a huge fan of vaping either. There is harm reduction. There's a good argument about that. But I'm not. You're not going to see me promote vaping either. That said, you know, when we get into the whole what is it responsible to tell people to do or not? A lot of times, the greatest harms are things that people, like cigarettes, were

told by their doctors are great for them. And today we're going to tell one of those stories, a story of a drug that became the lead seller for a major pharmaceutical company that was backed by an alliance of physicians who had, shall we say, some financial interest in finding that this thing worked. Today, we're talking about Vioxx, which is, I think, an infamous name now in the annals of medical science. People tend to know what I'm talking about. But if you don't, this killed more Americans than the Vietnam War.

That's the story we're getting into today. What do you know about Vioxx? That's the story we're getting into today. What do you know about Vioxx? You know, I was too young to really be, I wasn't really practicing medicine when it happened, but I did know about it. And I've heard some about it since then. I'm really very fascinated by the story and I'm really looking forward to getting into it today.

So I'm excited about that. I will say, I think it was, it feels like a turning point in regards to how people looked at pharmaceutical companies. I think it was really like a sentinel event in that. Like I think doctors were always skeptical of pharmaceutical companies, we still are. But I think that was when people started to become cynical. That change started.

Yes. That's because of what happened with Vioxx. And Vioxx, I think it's also important. Like Vioxx, the scandal hits kind of right as, you know, before we're really starting to realize what has gone down with the prescription painkiller epidemic. Like when that's starting to really take off and we start to realize how fucked up some of what Purdue did.

And so this one, two punch, it really is responsible. I think that's very salient what you said. It's really responsible for a lot of, I mean, for like RFK is about to be the director of Health and Human Services, right? Like it has a lot to do with that because this is hard for people to imagine. Like folks my age, I have always grown up

with big pharma being like the devil, right? In part because like as soon as I turned 18, 19, I was hanging out with a lot of hippies. But in part because like there were a lot of like really, really high body count pharmaceutical companies scandals. And it is hard for some people to remember that like pharmaceutical companies used to be very popular and well regarded in a lot of cases, in part

because the generation that was kind of running the world in the 80s and 90s had largely lived through like, and we're still close to, oh, polio is this nightmare that just sweeps through and devastates like a generation. You know, you have these flus and then suddenly you have half as many friends after the flu passes. And that stops being a thing. And they're really the first generation, you know, kind of the later boomers

that didn't have to deal with that, but were close enough to it to like really appreciate like, wow, medical science did us a solid. Yeah, and we've drifted just far enough from that now that people have forgotten and are revising whole parts of history. And I mean, part of the problem is that shit, like the Vioxx scandal and like the Purdue

pharmaceutical scandals are closer to us than, for example, fucking people being in iron lungs or whatever. Recency bias is a hell of a thing. But since time immemorial, mankind has struggled against a terrible and implacable enemy, pain. Luckily for us, Mother Nature has provided a perfect painkiller, opium, that can be used as the basis for a variety of excellent medicines that really do exactly what they say they're going to do. Unfortunately, these medicines come with a downside,

which is that when you start taking them, you might not ever want to stop taking them. For some people, this destroys their lives. Let me take a sip of my kratom tea. Mm. And since all the all the health cops out there don't like people pill popping like Dr. House, even though he made it look incredibly sexy Fucking hate that show oh man. You're not not a house fan, huh? No. It's just so ridiculous. I mean all of those shows Scrubs is the only one that's watchable for me scrubs really yeah, I mean I did rewatch

I like to imagine that the movie platoon is like a like the the what you call it the prequel the prequel to John C. McGinley said it yeah That's why dr. Cox is the way he is he had to spend that night hiding under his friends bodies in a trench line He had to watch Willem Dafoe die Everyone ran away, man. He had to watch Willem Dafoe die. Yeah. Spoilers for the movie Platoon, which is older than most of you.

Might be older than me. I don't remember when Platoon came out. Anyway, so because of, you know, health cops don't like people becoming horrible pill addicts and destroying their lives, there's a market, a massive market for anyone who can create a thing that is an effective painkiller that doesn't also inspire people to break into cars for drug money, right? There's a lot of money in a painkiller that does not have the kind of abuse potential that opiates have.

Acetametafin was discovered back in the 1880s, but it took us until the 1940s to actually figure out how to use it as a drug. And for reasons that are more complex than it's really worth getting into, because of how it was discovered, acetaminophen could never be patented, right? Which means pharmaceutical companies are not super attracted to acetaminophen, right? Because like, well, you know, you can't only sell it for so much if everyone can make the damn thing. This meant that pharmaceutical companies had to get creative marketing it in order to make

it profitable. As a result, Tylenol became a foundational part of the marketing drug story. McNeil, the company that started selling acetaminophen in the US, initially framed it as a painkiller for children. And the way the ad campaign that they use is very weird for some reason, and I've never found out why, but for unclear reasons, they had a huge number of toy fire trucks. And the way that they first sold Tylenol

was they like stuffed fire trucks to the brim with pills of Tylenol and like made that, that was their marketing ploy to like get little kids, parents to buy Tylenol for their small children. Kids have always loved fire trucks. Kids love Tylenol too. They love their Tylenol. They love their liver damage and they love their small children. Kids have always loved fire trucks. Kids love Tylenol too. They love their Tylenol. They love their liver damage and they love their fire trucks.

It's just a thing about kids. This is why I'm going to try to make the chief Christmas toy of this season, the little doctor house pill popper set. Where, cause kids you can take as much Tylenol as you want, right? It'll be like a big cane. Just a big cane. With a pez dispenser at the top. With a pez dispenser at Tylenol Tylenol as you want, right? It'll be like a big cane. Just a big cane.

With a pez container at the top. And a pez dispenser at Tylenol. And that's dispenser, right? And that's your little house toy for kids. It's your little house toy for kids, yeah. Now this worked better than any, it had any right to work. Advertising was easier back then.

I imagine today if you tried to sell parents on a child, which is like a fire truck full of pills Make me feel good about any of this but you have to remember so jaded now. That's a problem We're jaded we're jaded and like prior to Tylenol The chief method of dealing with pain for small children was to give them a spoonful of heroin and hope they woke up the next Day, right like they literally sold it as a cough medicine for children hope they woke up the next day, right? Like they literally sold it as a cough medicine for children. So the fire truck plan worked well.

It worked so well that McNeil gets bought by Johnson and Johnson. And that's actually when it gets the name Tylenol. McNeil's not selling it under Tylenol, Johnson and Johnson, which for whatever reason is a great name. I don't know why. Doesn't make much sense to me. Easier to remember.

Yeah. So in subsequent decades, Tylenol was found to be useful in numerous medical applications as a painkiller, a fever reducer, and about a million other things. It was joined in the mild painkiller category by Bayer's aspirin, which had its roots in herbal medications that had been used by peoples around the world since time immemorial. The Assyrians and Sumerians had actually been using willow leaves as treatments for various ailments and a variety of plants containing salicylic acid have been used in similar ways all over the globe.

So acetaminophen and aspirin both quickly became foundational pieces of any medicine cabinet, but they weren't perfect. One issue that both painkillers had is that they could interact with other drugs or just interact badly with certain patients to cause substantial stomach distress. In the most severe cases, this could result in stomach ulcers and sometimes life threatening stomach ulcers. So this is one of these problems is like, you want to be able to give people as much

of this as they need because it's non addictive and helps with a lot of things, but there's some hard limits based on what this does to people's stomachs. And livers, I mean, acetaminophen, you know, that's worldwide one of the biggest causes of liver failure from people taking too much acetaminophen. And then, yeah, these other non-steroidal anti-inflammatory drugs, they're the kind of thing that make me, a gastroroenterologist have to go in the middle of the night To go put a scope into someone's stomach because they're bleeding a ton In the setting of you know somebody who's swallowed too much the Advil or

Something like a leaf or something yeah And I think that probably doesn't didn't make it as much into my research just because in the 70s They didn't have as much data on that maybe they Sure. They're all focused at least on the ulcers. But yeah, like the, there's a great bluegrass song called Coding with the lyrics coding, coding you're the nicest thing I've seen for a while. And if you know anything about coding, it's the worst of the painkillers to get high on. Which makes the song better because if you are the kind of person for whom like coding is the nicest thing you've ever encountered, your life has been shit. You have had a bad life.

So by the late 20th century, pharmaceutical researchers had started poking around both compounds to try to find ways to create new variants that didn't have any of those downsides. They call these hypothetical medications super aspirants because research pharmacologists aren't great at naming things. Terrible branding. Terrible. Terrible. The quest for a super aspirant seems to have really started in 1971 when a gaggle of British

researchers, I think that's how you term a group of researchers, tried to unravel the mystery of why aspirin and Tylenol work. Again, we knew these things were good painkillers and we knew they did other stuff. The method of action was unclear to us at this point, which is a startling amount of the time true with drugs. There's a lot of medications you might be on that doctors don't precisely know why it does what it does.

We have some ideas, but like a lot of this is still being figured out. More than you wanna know. Yeah. There's a lot of things we do in medicine that we, we're, we just, they seem to work. It does it, like it definitely helps. We're not sure why.

But in this case, the research bore fruit as author Tom Nessie describes in his excellent book, Poison Pills. Quote, when an injury takes place in the body, chemicals known as prostaglandins rush into the wound site to deal with the swelling, heat, and pain. Prostaglandins have important functions for human well-being. They play a part in ovulation, to protect the stomach from acids, and to ensure that

blood clots normally. The latter effect explains why aspirin reduces heart disease. It prevents clumps of blood from forming that can potentially block an artery. Prostaglandins actually make nerve endings more sensitive to pain. NSAIDs, NSAIDs, NSAIDs, NSAIDs, NSAIDs, NSAIDs, NSAIDs, NSAIDs, NSAIDs, NSAIDs, NSAIDs, NSAIDs, reduce the production of prostaglandin and thereby relieve the pain associated with swelling and soreness. Unfortunately, in the process of doing so, they irritate the stomach.

Sometime after this discovery, scientists found that a substance called cyclooxygenase, or COX, was produced as part of the mobilization of prostaglandin and was the enzyme that actually controlled pain and inflammation. You're doing a fantastic job, by the way. Thank you, thank you. I just wanted, for a moment, you're doing a really good, you can call it Cox, by the way. Cox, yeah, I was going to.

Yeah. Because Dr. Cox. Yeah, yeah. In his honor. But this is interesting. I didn't expect I was gonna be getting this like trip down medical school like memory lane. This is fantastic. You're doing great, keep it up. We try to be complete.

Also Dr. Cox is in Born on the Fourth of July. Would you can consider a stealth sequel to Platoon if you assume that Willem Dafoe actually survived his injuries in Platoon? Was he in Willem Dafoe actually survived his injuries in platoon. Was he in Willem Dafoe in 4th of July? He's the crazy vet in Mexico that fucking Tom Cruise meets when they're both like doing drugs and hanging out with prostitutes after losing their legs. Yeah, it's great. Oh man, that movie rules. So these researchers began to theorize that cox might include an additional substance

that was separately the cause for stomach irritation. If someone could find and isolate said substance, it might allow for the creation of a super aspirin. But no one even knew if this theoretical substance was real and pharmaceutical companies didn't exactly feel an immediate urge to jump on the matter because they had no idea if this was even a thing. Fast forward to 1990, a pharmacologist named Needleman gets close to isolating the Cox enzyme that he believes is causing all of

the problems. He doesn't actually find it, but he's confident enough in its existence for reasons that I'm sure make sense to biochemists that he gives it a name, Cox II. Research goes on and in July of 1992, several teams of researchers in Montreal announced that they have isolated two enzymes. One of which, COX2, seems to be the causal agent behind the side effects NSAIDs provoke in some patients. 1992, they found finally this thing they've been looking for for like 20 years, right? This is the reason they believe why your aspirin or whatever can cause stomach ulcers. So the researchers muse that if you can find a medication that blocks COX-2 and you compound

it with like a painkiller, with acetaminophen or whatever, then you'd have a super aspirin capable of being prescribed much more often to even more people. Aspirin sales at that point are already like 50 billion tablets per year. So the amount of money on table for the first pharmaceutical company to figure this out is mind boggling because then you get to patent it. Then you are the only one that has the aspirin

that doesn't cause stomach ulcers, right? And for like, whatever, 20 years, you're the only one who gets to sell that shit. That's so much fucking money, right? Like. Yeah, it's one of the most commonly used medications in the world. Yeah, of course. You're the only one who gets to sell that shit. That's so much fucking money, right? Like yeah It's one of the most commonly used medications in the world. Yes This is like an unfathomable fortune. We're talking like an oil and gas industry level fortune is on the table here Yeah, and so said so a fucking race begins, right?

And the two major companies that are going to wind up Really throwing their money throwing their hats into the table into to get the super aspirin ring are our old friend Pfizer and our new friend Merck. Now today again, any pharmaceutical company you mentioned, people tend to say like, fuck these guys. But in the late 1980s and early 90s, people did not feel that way about Merck. They were very much considered to be one of the good guys. Now I know that kind of sounds crazy, but I want to read a quote from an article by David Culp and Isabel Berry in the Journal of Civil Rights and Economic Development.

In its missions values statement, the company stresses that its business is preserving and improving human life. Merck's mission statement continues, we value above all the ability to serve everyone who can benefit from the appropriate use of our products and services. Throughout its history, Merck has often lived up to its stated mission. In the 1930s, after streptomycin was developed by a Merck scientist, Merck gave up its patent protection since it believed the drug was too important a medical breakthrough to keep to itself.

Other companies were allowed to produce streptomycin, and Merck lost potential profits. Since the 1980s, when Merck found a cure for river blindness caused by a parasitic worm, the company had given away, free of charge charge 40 million pills a year to African nations to treat and cure this. So Merck seems pretty good coming into the 90s. You're like, maybe there's a company that actually believes what it's... They gave up money, you know, a lot of it. So that sounds pretty great.

But coming into the 90s, Merck is also staring down the barrel of a big problem. A lot of its massive wealth, because this is a very wealthy company coming into the 90s, was based on a pair of cholesterol drugs, Zocor and Preyachol, which were both about to lose their 20-year patent protection starting in the early 2000s. So not yet in about a decade, but a decade's not a lot of time in terms of researching a new medicine, right? If you've only got a decade or so over your two big profit engines are going to be generic. It takes a long time. You research to get to market. Yeah, you got to start cooking.

You got to start moving. And in addition to that, five of their best selling medications, including Pepsid, were set to lose patent protection even sooner in 99. So they are looking at a looming very serious problem for their profitability. This is such a recurring theme with pharmaceutical companies. I just did an episode about a medication called Zygres, which was— Wow, it sounds like the Tigris, yeah. It sounds awesome. It sounds awesome. It's this medication that was touted as like this new breakthrough therapy for sepsis. And it was super exciting.

It ended up falling apart for a lot of different reasons and being withdrawn and ended up being a big marketing scandal, in my opinion. But at the end of the day, it all started because they were losing their patent on their big sellings and medications. The things that were making them tons of money were about to run out, they needed a new like cash stream

as quick as possible. So things started happening probably faster than they should have. Yeah, yeah, yeah. And that's like, that is the story here. It's the story a lot of the time, right? Where these, and I don't think this is a bad idea. Like the idea that drugs eventually age out to get generic

is like kind of necessary in order to, in our system at least, in order to make it even have a chance of being affordable for some medications. But it does, it leads to this as well. I don't know. Again, we don't need to go on another single payer healthcare rant, but like we have so, there's so many little things that are fucked up about like even the things that seem like they make sense that also lead to fucked up outcomes.

Because of how much money is at stake in these. How expensive it is to be a pharmaceutical company, right? It's not cheap and most of the medications that they, like one of the things you have to accept as a pharma company is that most of the things you try to make into a medicine aren't going to work. Right. Like that's just and that's kind of the story here is a medication that if they had done more, spent more time, they would have realized this was not a viable product. But right. But they've got shareholders to please.

Right. And when the money starts to shift from research and development in these companies to marketing, which it does more and more. Oh yeah, and that's really happening in the 90s. Yeah. Right. I'm assuming that's the problem here. Yeah, that's a big part of it.

Yes. So, you know, Merck is coming into the 90s, not quite a five alarm fire yet, but definitely like a serious situation. And Super Aspirin seems like it might be the solution to their problems. And maybe even the key to greater profits than ever before. And speaking of greater profits than ever before, you know who's making money like they've never made money? Oh, I know the people who deserve to.

The people are the people who sponsored this podcast. They're the ones that deserve the most of the money. That's right. The products and services that support this podcast are literally the only ethical people in capitalism. And you can just trust them. Give them your wallet. Give them your kids. You know, hand your children over to our sponsors. They'll take care of them. They'll raise them as their own, you know, better than better than we would better than you would. Yeah, exactly. You know, just trust them. 911 response, what's your emergency? My babies, please, my babies!

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The subreddit is gonna get real uncomfortable very fast. Okay, so super aspirin seems like it could be the solution to Merck's problems. In 1994, a new CEO takes over at Merck. And this is, we were just talking about the shift from R&D to marketing. This is perfectly emblematic of that. Cause Merck's new CEO is a guy named Raymond Gilmartin.

Now the previous CEO, Raymond is an MBA from Harvard, right? Which means he doesn't know anything about anything, but making money in the most sketchy ways possible. Whereas the previous CEO of Merck had been Dr. Roy Vagelos, an actual medical scientist with a research background. Very famous. Yes. Yes. So Merck goes from famous and widely respected medical researcher as their CEO to a guy with an MBA from Harvard.

Yeah. The Vagelos Award is like this award that's still given out to people who are doing humanitarian work in the pharmaceutical world. So this is a major shift, a major shift away from somebody who was, I think, ostensibly a very good person from all accounts, a very good person, a good researcher, to something very different. Yeah, maybe the answer is,

if you're going to be a CEO of a pharmaceutical company, you should have watched a sick child die at a hospital. Yeah. Like, I don't mean to be blunt, but it seems like it leads you to do things like give up patents on life-saving medication in order to make sure it saves more people. Do at least a rotation.

Do a rotation in the hospital. I keep thinking about fucking the polio vaccine guy who he was like, I think his direct quote when asked if he was going to patent it was like, would you patent the sun? Yeah. Sulk. Yeah, sulk. Yeah. Real G, real Chad.

So Raymond's career up to that point, this is the business guy, new CEO of Merck, had included eight years as a consultant for Arthur D. Little, which lists as one of its great achievements, which is it, it's like McKinsey kind of, it's a consulting firm, and it listed as one of its great achievements, the privatization of British Rail.

So those of you over in the UK, sure you love this guy. Also there was this time that they used a bucket of sow's ears to make a silk purse. I don't know why this is listed as an achievement of the Arthur D. Little Company, but it is. He worked as the CEO at a medical device company after that until he was hired by Merck as their first outside CEO for the express purpose of seeing them through the looming patent cliff scenario. So he is brought in as kind of like an emergency guy, right? Now it was Raymond who decided that Merck's future would be in super aspirin alongside

their chief scientist, Dr. Edward Skolnick. He launched a crash program to bring a COX-2 inhibitor pain medication to market. The name they picked for the wonder drug that did not yet exist, but that they were going to hang the company's future on was Vioxx. Now, time was of the essence here. Dr. Needleman, the guy who had failed to discover COX-2, but had gone ahead and named it anyway, worked at a company called G.D. Searle, which was a division of Monsanto and was leading research into a new insade that would eventually be called Celebrex. While Celebrex was under development, Pfizer bought Searle from Monsanto and started throwing

money into Celebrex as part of what was turning into a vicious competition to be the first pharmaceutical company to bring one of these new super aspirants to market. And there's probably a lot to be said about Celebrex. I am not competent to say it. I will say that it is currently a medication that the FDA says there's not evidence of significant harms for. There is debate about that to this day, but that's all I can say on the matter because I'm not an expert on this.

There are some activists who are very angry that Celebrex is still on the market the FDA has said it's it's more or less fine That's where we are with Celebrex. Yeah, it's the same family Yeah, and it does have that comes with a warning on it. Yeah, that's more striking than most other NSAIDs Yeah, I don't know actually it's a good question. I don't know how often it's used these days. I assume it's pretty rare. Yes. Or not as often as it was, for sure. It's one of those things where a few years ago

there was a very scary study about heart effect, like heart problems that it could cause, and then a few years later there was a study that suggests like, well no, maybe we got that one wrong. Right. And maybe it's no worse than other drugs in this class. Again, that's all I can really say about Celebrex, because I'm not qualified to to judge a medication that there's still a lot of debate over. I don't have a lot more to add to it either.

It feels like there's other NSAIDs out there that yes, that we use a little frequently and seem a little safer. Yeah, yeah. But what you need to know is that Pfizer is putting Pfizer is putting their money into Celebrex after they acquire Merle. And Vioxx is going to be the attempt made by Merck to do the same thing. So throughout the mid 1990s, Kava, Merck scientists worked on Vioxx, rushing it through stages of medical testing, harassed by the knowledge that any delay or bad finding, and when I say bad, not in the scientific

sense, it's not bad scientifically to find out a drug doesn't work, but bad for the company if this drug doesn't work because they're on a timetable, would stop them from beating Pfizer. And unfortunately for everybody, there were signs right from the beginning that Vioxx might be dangerous. The first evidence of this was presented in the mid 1990s by Dr. Garrett Fitzgerald, a Merck consultant who was also professor of cardiovascular medicine at the University of Pennsylvania.

He warned the company that Vioxx might harm the walls of the blood vessels protecting the human heart. I'm going to quote again from the book Poison Pills by Tom Nessie, which if you're looking for like a really good exploration of how a pharmaceutical company does evil, Poison Pills is very well written. He suggested that Merck set up a series of experiments to test this theory. Few of them were ever performed. Other scientists cautioned that Vioxx was related to kidney damage, an increase in blood pressure that could be linked to heart problems.

Dr. Fitzgerald also found similar problems with the drug in the same class as Vioxx called Celebrex made by rival drug company Pfizer. Like Merck, Pfizer denied the finding of any cardiovascular problems with its drug, but cleverly began its own campaign to portray Vioxx as the more dangerous of the compounds. That's smart. At this point, when he initially warns them, the drug is not on market, he is trying to stop it from getting to market by saying like, there's some real evidence this is sketchy, you should carry out more studies. And Merck is just kind of like, but what if we didn't?

It's like when you've been like spending like crazy all month and you know you probably like you might be running down the limit, but you're just like going to the grocery store hoping that like your card works this one more time or something. So now at this point, there was no hard evidence of harm to the human heart in large part because Merck had refused to do the studies that Dr. Fitzgerald advised. This changed in 1996 when an internal Merck study showed that people who took Vioxx in high doses suffered more heart problems than people given a placebo. A memo was issued internally that noted the treatment period was six weeks versus placebo. The initial dose of Vioxx was 175 milligrams, but in mid study, the dose was lowered to

125 milligrams. Adverse events of most concern were in the cardiovascular system, i.e. heart attack, unstable angina, rapid fall in hemoglobin, and hematocrip, dangerous blood problems in some subjects. So that's bad. Those are all really bad results. You're almost officially a doctor because that is correct. That is the appropriate diagnosis is that it's not good.

It is important to underline the severity of these results though. These extremely serious side effects were present after just a few weeks of medication for doses that were just about twice the approved amount for treating acute pain, which was 50 milligrams. Now twice sounds like a lot, but when we are talking about the way people use medicines, it's really not. People take way more specially pain medicine than they ought to. This keeps me in business that people do this. This is like almost, you don't even have to take it more than is recommended to run into problems because sometimes people only take a little and they run into problems in the GI system, for example, or other issues like kidneys that can be affected or the heart. But it is a sole underlying known fact that whatever we think people are going to be taking,

likely it'll be more. And that is why it's standard in tests like the one they were conducting actually to test 10 times the effective acute dose when doing studies like this to check for side effects, which they didn't do because they knew that the results would be even worse. One doctor who analyzed these results noted, I recall very clearly many occasions where Merck scientists and doctors working with Merck were claiming that Vioxx was safe as placebo, which we've already seen it's not. Now the reality is that results like this were a big warning sign and should have been

taken as evidence that Vioxx might not be viable as a medication and certainly needed more testing. But Merck went full speed ahead. In November of 1998, they asked the FDA to approve Vioxx after testing the drug on 5,400 patients. They bragged that they had conducted eight different studies which had shown Vioxx's efficacy. Now, this is where we get into a complicated and uncomfortable topic, medical studies and

why they often don't work the way that they should. In theory, the process of conducting medical studies should identify dangers in new drugs and accurately measure their efficacy. But theory envisions a situation in which drugs are researched by disinterested parties who have no vested interest in anything but the truth. The reality is that studies are often funded by pharmaceutical companies who, like Merck, might be sweating the arrival of an upcoming patent cliff and headed by a new CEO who lacks the same commitment to medical ethics as his precursor.

I'm going to quote now from an article on this in the Union of Concerned Scientists. To increase the likelihood of FDA approval for its anti-inflammatory and arthritis drug Vioxx, Merck used flawed methodologies biased towards predetermined results to exaggerate To increase the likelihood of FDA approval for its anti-inflammatory and arthritis drug, Vioxx, Merck used flawed methodologies biased towards predetermined results to exaggerate the drug's positive effects. Internal documents made public in litigation revealed that a Merck marketing team had developed a strategy called ADVANTAGE, assessment of differences between Vioxx and naproxen to ascertain gastrointestinal tolerability and effectiveness, to skew the results of clinical

trials in the drug's favor. As part of the strategy, scientists manipulated the trial design by comparing the drug to naproxen, a pain reliever sold under brand names such as Aleve, rather than to a placebo. The scientists then highlighted the results that naproxen decreased the risk of heart attack by 80% and downplayed the results that Vioxx increased the risk of heart attack by 400%. This misleading presentation of the evidence made it look like the Proxen was protecting patients from heart attacks and that Vioxx only looked risky by comparison.

So instead of comparing this drug to a placebo in which it would have been like, wow, the rate of heart attacks is much higher. They compared it to a drug that reduced the risk of heart attacks and we're like, well, of course people have more heart attacks on this drug. This other drug reduces heart attacks, but that doesn't mean this is dangerous. Like that's so fucking shady.

It's a bit tricky how they're doing it too, because, you know, so far a lot of what they have done sounds very, I mean, sounds sound from a distance. You know, the whole idea of like looking at COX-2 inhibitors, like looking at medications specifically for this and comparing it, say, hey, look, at least we're better than the other medications, to some degree from a high,

from your way back vantage point, it all makes sense. It's when you start to look a little bit more closely that it's questionable, especially given that they seem to know early on that there was high risk of these cardiovascular injuries and that the whole narrative is being shifted to try and take focus away from that. This is why it's a difference between marketing and between scientists running the program. Yeah. Yeah. And that's really the whole story here, right?

So Merck's fuckery extended to the hiring of ghost writers to write scientific articles reporting on clinical trials of Vioxx to try and convince doctors and regulators that the medication was safe. Internal Merck documents later revealed that in 16 out of 20 papers reporting on early Vioxx clinical trials, a Merck employee was listed as the lead author of the first draft. But in the published versions, credit for authorship was given to an outside academic. To continue from that piece by the Union of Concerned Scientists, in one draft of a Vioxx

research study that did not yet have a prominent outside name attached, Merck officials listed the lead author only as external author question mark. A Merck scientist was also found to have removed the evidence of three heart attacks among patients in a data set from the results presented. So great, great stuff. And when I mean, in one of what numbers were in that paper, but removing three can make a huge difference. Yes, yes, especially if you're not talking about a huge study, you know? Yeah, did it say anything about how many people

were in that study? I, you know what, I'm sure I could have looked into it, but I did not. And I'm wondering if in these studies, they were talking about the rates of peptic ulcer bleeding, gastric bleeding as well, because I mean, that's ostensibly the whole reason that they're doing this.

That was the whole thing that advantage was supposed to show, right? Was that it reduced the rate of like peptic ulcer bleeding and stuff. And yeah, just the whole, the fact that we have drafts of them just being like, we'll figure out who the author of this piece is later. Once we find an outside doctor who wants some cash

and a lot of these aren't direct bribes. These are like, okay, you'll stick your name on this and then this research project you want will get a little bit of funding from a Papa Merc. And not even just that, these are all being published in decent journals. I'm sure that just people wanna be in good journals. They wanna have another publication

in the New Journal of Medicine or the Lancet or whatever. You also have to remember, a lot of people think this is the next big miracle drug. So yeah, you want to have a little bit of play in that, right? Of course. Yeah. So yeah, the worst piece of evidence against Vioxx of this period came out the same year Merck asked for FDA approval, 1998. Merck studies 090, involved 978 patients

and showed that people on Vioxx experienced serious cardiovascular events six times as often as patients taking a different drug or a placebo for arthritis pain. Merck shelved the study and never published it. Later that same year, a group of medical researchers at the University of Pennsylvania, and by the way, thanks to that doctor we named earlier,

U of Penn really tried to stop Vioxx from being a thing. Published a study that showed that COX-2 inhibitors might interfere with other enzymes that help prevent heart disease. Warnings were sent to Merck and Pfizer, who quickly shoved them off into the circular file and kept right on begging the FDA to say yes. And say yes, the FDA did.

They approved Vioxx for use as a painkiller in adults in 1999, a menstrual pain medication and an anti-inflammatory for people with osteoarthritis. Despite approving the drug, FDA reviewer Dr. Villalba warned in his memorandum that there was evidence suggesting Vioxx caused more frequent cardiovascular events in patients. So Vioxx goes to market, it immediately becomes a best seller. Celebrex also goes to market, it drives massive profits for Pfizer. And this is in spite of the fact that particularly Vioxx is not great at, I mean, neither drug is really all that good at fighting pain.

And I'm going to quote from the New York Times here. When studies on Vioxx and Celebrex became available in 1998 and 1999, many doctors were disappointed. Neither drug alleviated pain any better than the old medications and the drugs cost close to $3 a pill. Over the counter pain relievers in contrast cost pennies a dose. And by the way, they weren't all that much better at preventing ulcers. Some studies suggest like Vioxx was no better at preventing ulcers, although that seems to

be unclear. Now, analysts say that the success of Vioxx was critical to Merck. The patents on those popular Merck drugs started expiring in 2000 and 2001, which opened them up to generic competition. Vioxx comes through and is almost immediately billions of dollars a year in profits for the company. Michael Crensavage, a drug industry analyst at the investment bank Raymond James & Associates says, Vioxx was Merck's savior.

It's as simple as that. He puts it down as the company might have gone under, at least probably been acquired if it hadn't have been for Vioxx. I remember at the time it was huge. I'd never seen a campaign like it. I thought that I remember. I think it was one of the first times I remember really having been conscious of how much of medicine

was being marketed. And I think it's one of these medicines where it's like, maybe five to 10% of the people who are using it maybe had some benefit, real benefit, where they maybe, it did help them from a gastric ulcer perspective. Maybe they didn't have the option of taking another medicine. But for the other 90% of people that were taking it,

it wasn't necessary for them. It wasn't something that they needed. And it was just increasing their risk of heart attack or stroke. And I think that this is, I bet you, I mean, you probably know this, but I bet up to this point, this was the most that ever been spent on direct marketing.

Yeah, I mean, and that is what we're actually about to talk about is the marketing campaign, which surprise, surprise involves beloved figure skater, Dorothy Hamill. But- Oh, it mm-hmm yes she she's the great monster in this in all of our episodes every episode we've ever done Dorothy Hamill in building up to this is the Thanos of the behind the bastards world that's right Joseph Stalin would never have accomplished his greatest crimes without Dorothy Hamill's assistance that's obvious those evil historians have been talking about that for decades anyway you know who's not Dorothy Hamill's assistance. That's obvious, though. It's an evil haircut.

Historians have been talking about that for decades. Anyway, you know who's not Dorothy Hamill? I don't know why I'm shitting on Dorothy Hamill. None of this is really her fault. Anyway, here's that. From audio up, the creators of Stephen King's Strawberry Spring comes The Unborn, a shocking true story. My babies, please, my babies.

One woman, two lives, and a secret she would kill to protect. She went crazy. She shot and killed all her farm animals. Slaughtered them in front of the kids. Tried to burn their house down. Listen to The Unborn on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. We want to speak out and we want this to stop. Wow, very powerful. I'm Ellie Flynn, an investigative journalist,

and this is my journey deep into the adult entertainment industry. I really wanted to be a playboy, my doll. He was like, I'll take you to the top, I'll make you a star. To expose an alleged predator and the rotten industry he works in. It's honestly so much worse than I had anticipated." "...we're an army in comparison to him." From Novel, listen to The Bunny Trap on the iHeart Radio app, Apple Podcasts, or wherever

you get your podcasts. Join iHeart Media chairman and CEO Bob Pitman for a special episode of the hit podcast, Math & Magic, Stories from the Frontiers of Marketing, as he interviews the iconic and prolific Martha Stewart in front of a live audience in celebration of her 100th book. Did you ever think you were going to wind up writing 100 books? Yeah. You did?

Yeah, it's just a minor goal. Listen to Math & Magic on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hey, everyone. It's John, also known as Dr. John Paul. And I'm Jordan, or Joe Ho. And we are the BlackFatFilm Podcast. A podcast where all the intersections of identity are celebrated.

Ooh, chat. This year, we have had some of our favorite people on, including Kid Fury, T.S. Madison, Amber Ruffin from the Amber and Lacey show, Angela Carras and more. Make sure you listen to the Black Fat Fam podcast on the iHeartRadio app, Alpha podcast or whatever you get your podcast girl. Oh, I know that's right. Welcome to the Criminalia podcast. I'm Maria Tremorchi Welcome to the Criminalia Podcast. I'm Maria

Tremorchi. Holly Frye And I'm Holly Frye. Together, we invite you into the dark and winding corridors of historical true crime. Maria Tremorchi Each season, we explore a new theme from poisoners to art thieves. Holly Frye We uncover the secrets of history's most interesting figures, from legal injustices to body snatching. Maria Tremorchi And tune in at the end of each episode as we indulge in cocktails and mocktails inspired by each story. Listen to Criminalia on the iHeartRadio app, Apple

podcasts, or wherever you get your podcasts. In the quiet town of Avella, Pennsylvania, Jared and Christy Akron seemed to have it all. A whirlwind romance, a new home and twins on the way. What no one knew was that Christy was hiding a secret so shocking it would tear their world apart. 911 response, what's your emergency? My babies, please, my babies! One woman, two lives, and the truth more terrifying than anyone could imagine.

They had her as one of the suspects, but they could never prove it. You're going to go to jail if you don't come with us right now. Throughout this whole thing, I kept telling myself, nobody's that crazy, crazy. Uncover the chilling mystery that will leave you questioning everything. A story of the lengths we go to protect our darkest secrets.

She went bat-shit crazy, shot and killed all her farm animals, slaughtered them in front of the kids, tried to burn her darkest secrets. She went bat shit crazy, shot and killed all her farm animals, slaughtered them in front of the kids, tried to burn their house down. AudioWeb presents the Unborn on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. We want to speak out, we want to raise awareness, and we want this to stop. Wow, very powerful. I'm Ellie awareness, and we want this to stop. Wow, very powerful. I'm Ellie Flynn, and I'm an investigative journalist.

When a group of models from the UK wanted my help, I went on a journey deep into the heart of the adult entertainment industry. I really wanted to be a Playboy model. Lingerie, topless. I said, yes, please. Because at the center of this murky world is an alleged predator. You know who he is because of his pattern of behavior?

He's just spinning the web for you to get trapped in it. He's everywhere and has been everywhere. It's so much worse and so much more widespread than I had anticipated. Together, we're going to expose him and the rotten industry he works in. It's not just me. We're an army in comparison to him. Listen to The Bunny Trap on the iHeartMedia chairman and CEO Bob Pitman for a special episode of the hit podcast, Math & Magic, Stories from the Frontiers of Marketing, as he interviews this icon in front of a live audience to celebrate her 100th book, Martha, the Cookbook, 100 Favorite Recipes, with lessons and stories from My Kitchen.

This intimate and wide-ranging conversation between friends covers the pivotal decisions in Martha's career, the philosophy that has guided her, and the source of so much of her creative inspiration. They actually looked at the July issue that I had prototyped and they said, this is fabulous. What would you do next July? And I said, well, living is a limitless subject matter. Listen to math and magic on the iHeartRadio app,

Apple podcasts, or wherever you get your podcasts. Hey everyone, it's John, also known as Dr. John Paul. And I'm Jordan or Joe Ho. And we are the Black Fat Film Podcast. A podcast where all the intersections of identity are celebrated. Oh, chat. This year we have had some of our favorite people on including Kid Fury, T.S. Madison, Amber Ruffin from the Amber and Lacey Show, Angelica Ross and more.

Make sure you listen to the Black Fat Fam podcast on the iHeartRadio app, have a podcast or whatever you get your podcast girl. Ooh, I know that's right. Welcome to the Criminalia podcast. I'm Maria Tremarchi. And I'm Holly Fry. Together we invite you into the dark and winding corridors of historical true crime.

Each season we explore a new theme, everything from poisoners and pirates to art thieves and snake oil products and those who made and sold them. We uncover the stories and secrets of some of history's most compelling criminal figures, including a man who built a submarine as a getaway vehicle. Yep, that's a fact. We also look at what kinds of societal forces were at play at the time of the crime, from legal injustices to the ethics of body snatching, to see what, if anything, might look different through today's perspective. And be sure to tune in at the end of each episode as we indulge in custom-made cocktails and mocktails inspired by the stories. There's one for every story we tell. Listen to Criminalia on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts.

We're back. Okay. So we're talking the Vioxx marketing campaign. How do you sell America on this drug that is going to get a decent percentage of America killed? And the answer is figure skating superstar, Dorothy Hamill. So yeah, this is where the real villain of the story comes into it. The haircut is a problem for me. I had my first-

Haircut, Dorothy Hamill's haircut? My first girlfriend, the first girl of the story comes into it. The haircut is a problem for me. I had my first- Haircut, Dorothy Hamill's haircut? My first girlfriend, the first girl that really smashed my heart into like a billion pieces, scattered them across the globe. Was Dorothy Hamill? Now she's really taking some strays in this episode. She had Dorothy Hamill's haircut. Which I don't know why at the time, didn't bother me.

So now when I see that haircut, I'm like, oh yeah, that reminds me of that. Lost love. Lost love. Yeah. Painful, painful. So for those of you who don't know what we're talking about, back in the 1970s, an incredible athlete, Naden Dorothy Hamill, became one of the most famous people in the world when she was just 19.

She performed at the 1976 Innsbruck Olympics and won the gold. Time declared her America's sweetheart, and as is customary for world-class athletes, corporations began offering her embarrassing piles of money to endorse their products. Hamill's first run as a famous person didn't go great. She married Dean Martin's kid, and then he died in a plane crash. She fell out with her coach. She spent all of her money buying the ice capades and then wound up burning out and developing a bleeding ulcer. She had another marriage that ended badly and wound up, well, not broke, you wouldn't say,

but no longer rich. And she suffered from a substantial amount of pain from a lifetime of pushing her body to athletic excess. The pain was bad enough that at the worst, Dorothy could no longer even play with her daughter. Someday she could barely get out of bed. And then her doctor told her to try Vioxx. She would later claim that it was effectively a miracle cure for her, not only soothing her pain but bringing back her ability to perform on the ice in a way she hadn't in years. In August of 2000, Hamill made an appearance on Larry King Live with Caitlyn Jenner. And Jenner is also talking about Vioxx and this. Jenner's also claiming that like this really helped her arthritis.

She told the audience a heart wrenching story about loss and pain and her miraculous return to the world of the living thanks to Vioxx. Quote, I just, I felt old. I felt depressed, tired all the time. I mean, having chronic pain is exhausting. And I got to the point this year, I was on tour and I couldn't skate. And so I went to a doctor and we finally got to the bottom of it and my doctor prescribed Vioxx for me.

And it's as if I've been given a new life. It's just, it's been amazing. I feel 20 years younger. I don't look it and I don't skate it, but I feel that way. Was this when Larry King still had some credibility Oh, yeah, he was big at this point This is like right around the turn of the century. He's still a big a major major This is like before infomercial Larry. Yes. Yes. Okay, and this is I mean, maybe this is part of his downfall But people still take the show serious and they take this very seriously and to be clear

I'm not saying that, you know, even Caitlin or, or, uh, uh, Hamill were lying about their experiences on Vioxx, uh, because some people did gain benefits of this. Uh, and you know, I, I, so I'm not doubting that the problem again is that a single person's having a good reaction to a drug is not evidence that the drug is safe. For example, I know some people in their 70s who have been doing heroin for 50 straight years and are fine. That doesn't mean heroin is safe.

It means some people are lucky. Or the aforementioned 90-year-old women doing. Who are these ancient people who do drugs and smoke that you hang out with all the time? You go to little Burning Man regionals, you run into a lot of elderly people who have been doing drugs for forever. Some of them are very good at it.

I've been gas station sober for years now, Cava. Yeah, it's like California sober, but you can only get inebriated with things you buy at the gas station. I don't mess with that marijuana. That shit's dangerous. I just take those trucker yellow jackets that they give to keep people driving long haul awake.

You know, I don't know what's in them. They're big and yellow. That means they're safe. It would be red. Yeah, it would be red if it was dangerous. They can't put dangerous drugs in a yellow and black pill and call it yellow jacket. It doesn't mean danger Yeah, so I never take more than like 12 in a day. Yeah Thank God for yellow jackets. I

Just I some I sometimes don't know if you're kidding and I just hope in my heart that you are And I'm just gonna pretend that this is all part of a bit I do the safe thing I like open the pill and I pour all the powder in the pill into a glass and then I pour in a bunch of My kratom into the glass and then I add a banana potassium Level this level of detail is what bothers me Like mm-hmm, it's fine

It's the part I don't like. It's fine. It's mostly just B12 and caffeine and God knows what else because there's absolutely no agency that looks into what gets put into substances that are sold in gas stations in this country. Oh my God. And what little oversight there is, is going to be gone in the next coming years. Thank God. Look, RFK Jr. might ban the HPV vaccine, but we could get legal heroin.

It's all one big organized end of humanity cash grab. The next couple years, any drug you want to get through is going to get through. God willing. Look, if the world's ending, do you want heroin to not be legal? That's fair, but it's not gonna be even heroin. It's gonna be like, you know, blood pressure pills that the company just gets through and then it makes people's hearts explode. And then the company will just say,

hey, we're bankrupt and then they're fine. And then they just move on with their lives and then people are gonna be left in the wake. And then- No, you're right. They're gonna ban Prozac and replace it with like polar bear liver pills. It's just gotta be a disaster.

He was always doing research that RFK. He's always trying something new. So the fact that this beloved celebrity athlete has gone on Larry King and said exactly what Vioxx PR would want her to say was a godsend. That's the kind of PR no money can buy. Although I have to tell you now, that moment was in fact bought and paid for by Merck. They had found out that Dorothy was a customer.

They had reached out to her with an idea and a pile of money. Her life story had been used as the basis for an entire marketing campaign, and her appearance on Larry King was just the first step in launching it. Tom Nessie writes, The day after Dorothy Hamill's appearance, even Merck's CEO Raymond Gilmartin was smitten. He had received heart-rending letters from arthritis sufferers saying they were going to immediately ask their physicians for a Vioxx. Gilmartin personally congratulated the public relations department.

One marketing executive wrote that with Dorothy telling our story, Vioxx sales were going to soar and overtake Celebrex, an obsession within the company. You almost slipped into your 50s radio announcer voice. I know. You kind of shifted to the 90s. I saw what you did there. It was nice. I love it.

I love it. I love it. So yeah, patients are coming in. They're begging doctors to write prescriptions Doctors are going well shit. How bad could it be? It's basically just aspirin You know and a lot of people are suddenly taking Vioxx now The FDA does push back a little on this campaign Because Dorothy's appearance on Larry King counted as an ad and she had not mentioned that she was being paid by Merck Which you're

not supposed to do. They also had an issue that she was basically saying she had not told people that Vioxx was extremely dangerous if you prescribed it to patients with a history of bleeding ulcers. In fact, she had stated that she was taking it despite her history of bleeding ulcers, which is kind of telling people this is safe to say in the exact situation that the FDA knows we know it is not safe to tell people to take it in. So the FDA gets kind of unhappy with this and Merck replied, she just slipped up.

We taught Hamill the proper way to sell our product, but she went off script. They promised to retrain her before following up with any additional advertisements. This happened on September 12th, 2000. The next day, in violation of their promise to the FDA, Hamill appeared on a local TV station in Atlanta to urge people to consider Vioxx. The FDA never found out about this and might not have cared if they had. If you wanted to get away with something September 12th, well actually that was 2000, nevermind, everything was still fine. I was just like, did I just go over September 12th and not make a 9-11 joke?

I feel like you would have caught that in the research. No, no, no, it's fine. Didn't happen yet. Everything was fine. Plenty of towers in New York still at this point. Now the unfortunate reality of the FDA is that it is staffed and operated by a lot of people who want to work in the private sector of the pharmaceutical industry someday. Some of these people feel a need to avoid making waves and killing a golden goose that

is currently injecting cash into someone they want as a future employer, or who made a bit of past employer that they're hoping will hire them on for a lucrative consulting gig in the future. Beyond that, the teams at the FDA who we rely on to monitor food and drug, are hideously understaffed, operating on a shoestring budget. There may not have been anyone watching Dorothy Hamill's ad on local Atlanta TV because no one was being paid to do so. Now, Merck did change their TV ads for Vioxx based on the FDA's feedback. And you can see one example of that here. We've got to play just one of these bad boys. Here is Dorothy Hamill's revised

Vioxx ad. When I started skating at eight years old, I never thought I'd experience the thrill of winning a medal. With all the great memories has come another thing I thought I'd never experience, the pain of osteoarthritis. Vioxx is here, a prescription medicine for osteoarthritis pain. With one little pill a day. Vioxx can provide powerful 24-hour relief. Vioxx specifically targets only the COX2 enzyme, a key source of arthritis pain. People with allergic reactions such as asthma to aspirin or other arthritis medicines should not take Vioxx. In rare cases, serious stomach problems such as bleeding can occur without warning. Tell your doctor if you have liver or kidney problems.

For more information, talk to your doctor about once daily Vioxx for the relief of osteoarthritis pain. Perhaps my biggest victory is to be able to plan my day around my life instead of my pain. Ask your doctor if Vioxx is right for you. Vioxx for everyday victories. First of all, I take back what I said about her hair.

I think it actually looked really good there. I don't know. Maybe it's like time and the cycle change and fashion. I don't know. Maybe it was the Vioxx. You don't know, maybe Vioxx makes your hair look great. Everybody go out and buy Vioxx. It's a brilliant strategy.

Like the people who grew up watching her and knew who she was and admired her are that age where they were having lots of osteoarthritis and joint pains looking for medication. She's the perfect spokesperson and she has that innocence that you believe. The Dorothy Hamilads are a huge success. Millions of Americans saw their former child sweetheart skating and skiing and living an active healthy life thanks to this new miracle drug. And millions of them decided, I want that for myself.

And ultimately, tens of thousands of them are going to die as a result. And that's the story we're going to tell in part two, Cava. Can't wait. Yay. But first off, do you have anything to plug before we roll out here? I do. Plug is my show. That is the plug that I want to plug is my show. I'm plugging it now. It's called the house of pod. It is a

humor adjacent medical podcast If you like the subjects like today's subject, you'll like our show. In fact, one of our most recent episodes is about a Sort of similar a little bit less egregious, but similar pharmaceutical shenanigary, I don't know if that's a word, about the medication Zygres. And there's all kinds of fun guests like Robert and Prop and all the people you know and love here, Margaret. So check out my show, The House of Pod. And if you want, you can follow me at

bluesky, which I'm giving a shot now. Seems a little bit less fascist. Yeah, definitely less fascist. It's got its own annoyances, but all of social media has things that annoy me. So what are you going to do? Exactly. You can follow me there, KaveMD. You can also follow me there at iriteok, where you can follow me on the other place too.

But you know what you could do that I would appreciate most? Go get off the internet, feed somebody, you know? Do something good in the world. Yeah, I like it. Don't be online. I like it. And take a nice- Except for to listen to podcasts.

Keep listening to podcasts. For the love of God, keep listening to podcasts. Do not stop listening to podcasts. Under no circumstances stop listening to podcasts. Will you ever stop? In fact, just for thinking about stopping, you should listen to extra podcasts today. Yeah, you know what?

I'll say it right now. If you have stomach ulcers, podcast will knock that right out. Podcast your way through it. Podcast your way through it. That's right. Agreed. Okay.

Behind the Bastards is a production of Cool Zone Media. For more from Cool Zone Media, visit our website, CoolZoneMedia.com, or check us out on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Behind the Bastards is now available on YouTube. New episodes every Wednesday and Friday. Subscribe to our channel, YouTube.com, at behind the bastards. From audio up, the creators of Stephen King's strawberry spring comes the unborn, a shocking true story. One woman, two lives and a secret she would kill to protect.

She went crazy and shot and killed all their farm animals, slaughtered them in front of the kids, tried to burn their house down. Listen to The Unborn on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts. We want to speak out and we want this to stop. Wow, very powerful. I'm Ellie Flynn, an investigative journalist,

and this is my journey deep into the adult entertainment industry. I really wanted to be a playboy, my doll. He was like, I'll take you to the top, I'll make you a star. To expose an alleged predator and the rotten industry he works in. It's honestly so much worse than I had anticipated. We're an army in comparison to him. From Novel, listen to The Bunny Trap on the iHeart Radio app, Apple Podcasts,

or wherever you get your podcasts. Join iHeart Media Chairman and CEO Bob Pittman for a special episode of the hit podcast, Math & Magic, Stories from the Frontiers of Marketing, as he interviews the iconic and prolific Martha Stewart in front of a live audience in celebration of her 100th book. Did you ever think you were going to wind up writing 100 books? Yeah. You did? Yeah, it's just a minor goal.

Listen to Math and Magic on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hey, everyone, it's John, also known as Dr. John Paul. And I'm Jordan, or Joe Ho. And we are the Black Fat Film Podcast. A podcast where all the intersections of identity are celebrated. Oh, chat.

This year we have had some of our favorite people on, including Kid Fury, T.S. Madison, Amber Ruffin from the Amber and Lacey Show, Angelica Ross, and more. Make sure you listen to the Black Fat Film Podcast on the iHeartRadio app. Have a podcast or whatever you get your podcast, girl. Make sure you listen to the Black Fat Fam podcast on the iHeartRadio app, Alpha Podcast, or whatever you get your podcast, girl. Ooh, I know that's right.

Welcome to the Criminalia Podcast. I'm Maria Tremarchi. And I'm Holly Frye. Together we invite you into the dark and winding corridors of historical true crime. Each season we explore a new theme from poisoners to art thieves. We uncover the secrets of history's most interesting figures,

from legal injustices to body snatching. And tune in at the end of each episode as we indulge in cocktails and mocktails inspired by each story. Listen to Criminalia on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts.