Safety should come before marketing

The Food and Drug Administration should listen to one of the nation's leading cardiologists, who recently warned about the dangers of allowing pharmaceutical companies to aggressively market drugs, such as Vioxx, directly to consumers - before the long-term effects of the medicine are understood.

"These drugs were mass-marketed from the moment they were commercially available in the new world of direct-to-consumer advertising, with unrealistic expectations about pain relief, marked gastrointestinal protection, and safety," wrote Dr. Eric J. Topol, chairman of cardiovascular medicine at the Cleveland Clinic, in an article published on the Web site of the Journal of the American Medical Association.

"Rather than a sufficient waiting period after approval to firmly establish safety in the large, representative 'real world' population, the unbridled promotion exacerbated the public health problem."

The pain-relieving drug Vioxx was pulled from the market after research showed it increased chances of heart attacks and strokes. The drug is believed to have contributed to the deaths of tens of thousands of patients. Other similar pain relievers are under more scrutiny. ...