Matt's piece is well thought out, and certainly makes many a cogent point -- but I think his conclusion is not really supported by the examples he offers (see my last few sentences at bottom) -- do go read all of Matt's:
. . . .In the grand cholesterol-drug tradition of shooting oneself in the foot, this study ranks nowhere near the worst. Timothy 
Anderson, an analyst at Sanford C. Bernstein, had compared this study, called SATURN, to a trial of Merck’s Vytorin called ENHANCE. But ENHANCE showed not a hint of benefit for Vytorin over the older Zocor, and there were no clinical trials proving the new ingredient in the drug, ezetimibe (also sold as Zetia) had any impact on heart attacks and strokes. Usage of Vytorin plummeted. In 2004, a study funded by Bristol-Myers Squibb showed Lipitor worked far better at preventing heart attacks than its own Pravachol.
For all their tendency to look like car crashes, these trials should be somewhat comforting: they show that at the end of the day the drug business isn’t just about sales-and-marketing brinksmanship, but that science – and the surprise of failure — play a role. . . .
Except, of course, that in the ENHANCE case, legacy Schering-Plough executives (allegedly) conspired to
delay the release of the disappointing scientific data -- on the futility of Vytorin
® use,
for almost 18 months. During that period, over $3.8 billion in perhaps unwarranted revenue was raked in by legacy Scheirng-Plough. That's what I'd call
brinksmanship -- plain and true.
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