Celebrex and Vioxx: Why Two Cox-2 Inhibitors for Pain Relief?

By J. Donald Capra | THE JOURNAL RECORD, September 29, 1999 | Go to article overview

Celebrex and Vioxx: Why Two Cox-2 Inhibitors for Pain Relief?


J. Donald Capra, THE JOURNAL RECORD


There is an enormous market in the United States and abroad ($10 billion a year) in pain relief medications, both over-the-counter medications such as aspirin, Tylenol, Motrin, Advil, as well as prescription drugs.

Almost 20 years ago biomedical scientists discovered an entirely different pathway -- the cox-2 pathway -- for signaling in cells. After considerable experimentation, it was determined that the most likely pharmacological benefit of this knowledge was for the relief of pain. Several large pharmaceutical firms generated independent patents on the cox-2 inhibitors.

Two companies had the lead: Merck, with Vioxx, and Monsanto (marketed by Pfizer) with Celebrex. These pharmaceutical giants guessed that a new anti-inflammatory drug, particularly one that had the promise of working by an entirely different mechanism, as well as showing in preliminary tests that they caused less stomach upset, were potential blockbusters. Celebrex hit the market first, and did not let Monsanto/Pfizer down. Now Vioxx is on the market, and in the first few months it has taken over about 25 percent of the market share!

These two companies are masters at marketing their drugs. Pfizer made history in the way they marketed Viagra. Not only do we have discussions of "erectile dysfunction" during the nightly news, we see happy couples touting the benefits of "a new life." This is termed "marketing over the heads of physicians" -- directly appealing to the public to request medication from their physicians. Viagra appeared in millions of medicine cabinets overnight and became a household word, as well as being the butt of countless jokes on late-night talk shows. …

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