Here is more information regarding Vioxx and the drug companies sales tactics.

The Lessons of Vioxx--- Drug Safety and Sales
N Engl J Med. 2005 Jun 23;352(25):2576-8. PMID: 15972862
Henry A. Waxman, J.D.

Waxman writes about his thoughts while he was sitting on the May 5, 2005 Government Reform Committee of the U.S. House of Representatives, which focused on Merck, Vioxx, and how "drugs with serious safety issues, such as rofecoxib, can remain so popular for so long."

This NEJM article references Merck documents which show how Merck taught pushed their reps to market the drug to doctors despite safety concerns. For example, inquiring physicians who sought additional information about the cardiovascular effects of rofecoxib were given Merck Cardiovascular cards which cited studies less powerful than one in NEJM (2001 v.343:1520-1528) to make it look as if Vioxx was associated with fewer heart attacks rather than more.
Merck's Cardiovascular Card memo.
Many others documents on the drug industry's practices are available at http://www.democrats.reform.house.gov/features/vioxx/documents.asp.

Unfortunately the article does not mention the drug industry's secretive database which is able to track every physician's prescription ever ordered. Prescriber reports can show the names of the doctors in a rep's territory and what each doctor prescribed and how much of it. Reports provide reps with up-to-date feedback on just how effective their marketing has been.

In my May 31, 2005 blog, I reference the article, Spin Doctored: How drug companies keep tabs on physicians which details how the database works and the fact drug companies buy the physician ID numbers to doctors' names from the federal government or the American Medical Association, (earns about $20 million a year selling its "physician master file" database).

In the age of online information and privacy fears, I am amazed that more physicians aren't upset about their prescription ID information being sold. I now find it ironic when physicians freak out about providing me (the library) with their contact information if they want to check out a book.

I agree with Waxman when he says, "Legislative reform will not be successful, however, without attention to this issue in hospitals and doctors' offices. Practicing physicians, journal editors, and leaders of associations of medical professionals may find these documents useful as they develop new strategies to keep promotional efforts from distorting clinical care."