Since the US medical marijuana program allowed the use of cannabis in the alleviation of chronic pain across 12 states, chronic arthritis sufferers have been able to apply to their doctor for a prescription certificate, which would allow them to use marijuana to ease their debilitating symptoms, turning the relief of pain, into an unfair and unjust, postal-code lottery.

If you were fortunate enough to reside in the state of California, New Mexico or Oregon perhaps, you were able to grow and consume marijuana, well known as one of nature's anti-inflammatories, which would ease pain, help restore use to the inflamed joints, and help you get through the day. 

Alas, if you were unfortunate enough to live in a state which is not covered by the medical marijuana program, it was prescription drugs such as Arcoxia, Celebrex , Vioxx , or nothing, as marijuana, (according to Rudy Giuliani and Barack Obama amongst others) is not recognised for having any medical benefits at all.

Ordinarily this would pose no problem. We would be in the hands of the medical experts and after-all, they know best right?

Wrong. 

In another blatant case which see's a medically prescribed drug licensed for public use before the full risks with its use are investigated and evaluated, pharmaceutical giants Merck , the third largest drug manufacturer in the US, foisted their product, Vioxx, onto an otherwise unsuspecting American public and as a result, will pay out more than $4.85 billion in settlement claims with patients who have had the drug prescribed, and have gone on to suffer further, cardio-vascular illness as a result, or died.

In 1999, the United States Food and Drug Administration ("FDA") approved Vioxx® (known generically as rofecoxib) a Merck product that became widely used for treating arthritis. Vioxx was stronger than existing medications, while easier on the stomach than established anti-inflammatory drugs such as Naproxen.

Vioxx became one of the most prescribed drugs in history.

Thereafter, studies by Merck and by others found an increased risk of heart attack associated with Vioxx use when compared with Naproxen.

There was no indication of this risk in the original placebo-controlled safety trials, and it was possible that the effect was more related to Naproxen decreasing the risk of heart attacks than one of Vioxx increasing the risk.

Nonetheless, in 2002 Merck adjusted the labeling of Vioxx to reflect possible cardiovascular risks.

On September 23, 2004, Merck received information about results from a clinical trial it was conducting that included findings of increased risk of heart attacks among Vioxx users who had been using the medication for over eighteen months.

On September 28, Merck notified the FDA that it was withdrawing Vioxx from the market, and it publicly announced the withdrawal on September 30.

The FDA has since recommended that Vioxx be put back on the market, but with a more prominent warning regarding cardiovascular risks on its label.

On November 5, 2004 the medical journal The Lancet published the results of its analysis of the available studies. It concluded that “the unacceptable cardiovascular risks of Vioxx (rofecoxib) were evident as early as 2000.” 

The Lancet condemned Merck for having kept the drug on the market, despite its knowledge of the risks, and also criticized the FDA for its failure of regulatory oversight.

On August 19, 2005, Merck was found liable in the death of a man who took Vioxx.

The plaintiff was awarded $253.4 million in damages, which were subsequently reduced to $20 million, the maximum allowed by Texas statute.

In a followup case in New Jersey, Merck was found not liable. A third case is pending in Louisiana.

Merck's stock fell $2.35 to $28.06/share (7.73%) in the minutes after the verdict was announced and three months later 7,000 Merck employees were laid off.

At the time of the verdict, there were over 4,000 other lawsuits pending against Merck regarding Vioxx, and several thousand against Pfizer, the maker of a similar, and also withdrawn (USA), anti-inflammatory drug Bextra, which, in some cases, caused an adverse skin reaction. 

In November 2007 the New York Times  published an article with the headline; "Merck Agrees to Pay $4.85 Billion in Vioxx Claims".

Three years after withdrawing its pain medication Vioxx from the market, Merck announced that it will pay $4.85 billion to settle 27,000 lawsuits by people who contend they or their family members suffered injury or died after taking the drug.

The settlement, one of the largest ever in civil litigation, comes after nearly 20 Vioxx civil trials over the last two years from New Jersey to California.

After losing a $253 million verdict in the first case, Merck has won most of the rest of the cases that reached juries, giving plaintiffs little choice but to settle.

The settlement will help put Vioxx behind Merck, as well as sharply reduce its Vioxx-related legal defense fees, which are now running at more than $600 million annually. 

The settlement does not end the government investigations that Merck faces, which include both civil and criminal inquires from several states and the Justice Department.

But for Merck, which has already spent more than $1.2 billion on Vioxx-related legal fees, the settlement will put to rest any fears that Vioxx lawsuits might bankrupt the company, or even have a significant financial impact.

While eye-popping in its magnitude, the settlement payment represents less than one year’s profits for the company, the third-largest American drug maker.

Investors evidently consider it a good outcome for Merck, sending its shares up more than 2 percent in today’s trading, while many other stocks were down for the day.

But the agreement is far smaller than Wall Street analysts and lawyers predicted when Merck withdrew Vioxx, and especially after the verdict in the first case.

In 2005, most analysts estimated that Merck’s ultimate liability in Vioxx would be between $10 billion and $25 billion.

The settlement vindicates Merck’s risky decision to take cases to trial rather than agree to a quick, early settlement.

By aggressively defending itself, Merck, or rather its lawyers, exposed the weaknesses in many plaintiffs’ cases. Some plaintiffs could not prove they had taken the drug, and others were overweight, smoked, or had other risk factors for heart attacks. 

That strategy looked as though it had badly backfired in August 2005, when a jury in Angleton, Tex., returned a verdict of $253.5 million on behalf of Carol Ernst, whose husband, Robert, had died after taking Vioxx for less than a year.

But Merck decided to stick to its strategy, continuing to insist it would not settle cases. And in a series of cases in 2006 and 2007, Merck defeated plaintiffs in California, Florida, New Jersey, Illinois and Louisiana, while losing only a handful of cases.