As Election Day draws nearer, one of those hot button issues
we keep hearing about are the evils or drug companies: they
"gouge" prices, step on the backs of the poor and infirm and
lack a single shread of humanity. Steadfastly refusing
Africa much needed AIDs medication while stabbing Grandma
and Grandpa in the back, they are the embodiement of evil,
right?
Wrong. Don't be fooled by the rhetoric: because the
drug companies have to care about the bottom line, we, as a
society are better off. Proft is an incentive for innovation
and the threat of losing it is an incentive for safety. My
favorite instance of the invisible hand smacking around some
irresponsible drug company broke last week: Merck pulled Vioxx.
Vioxx, a drug used to lessen the pain from arthritis, turns
out to double the risk of heart attack if taken too long.
While the company denied this was the case for years, after
an independent panel reached this conclusion, the company
pulled the product. Shortly thereafter, they lost $28
billion as their stock plummented.
Some people may point to this as proof of the need for
government to have a greater role in health care but that
level of faith in the state is sadly misplaced. Let's
suppose, for argument's sake, that the government, not
private companies, were responsible for new drugs. Thus we
would avoid the heartless refusal to acknowledge the drug
may have problems. Governments look out for the people.
At least in theory. I find it highly unlikely that a
government organization could create a drug as sophisicated
as Vioxx--they lack the incentive. Even if they did, they
would have to learn that the drug has flaws (considering how
subtle it is, that's unlikely also). THEN, they would have
to admit they were wrong. If the Bush Administration has
taught us anything, it's that accountability is a foreign
word in Washington.
Governments lack incentive to be good at their job. Sure,
there's re-election (which doesn't apply to some figures)
but considering how much governments do, it's easy to bury
one big thing under a pile of good-sounding stuff. This is
why the Administration doesn't have to fire anyone over the
intelligence failures; they just have to say "oops." What
are you going to do about it? Sell stock?
Firms, on the other hand, have to do well. They have to
balance public safety and medical progress as best they can.
Too much in one direction is not only bad for the company,
it's bad from society. The reward of profits is what makes
capitalism work. Give it to all those who do well, take it
away from all the failures. It may seem heartless, but it's
the best way; it's exactly what socialism lacked. Proper
motivation is how progress is made. Merck's value fell so
much, some investors say it's poised for a takeover,
something the higher-ups were vehemently trying to aviod
(and still are trying to avoid). Every employee at Merck,
especially these higher-ups, is now at risk of losing their
job.
That's what I call incentive.
Monday, October 04, 2004
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22 comments:
I'm having a hard time understanding the points you two are making. Chris, you say that there are several life saving drugs that would be on the market if not for government intervention. I could be wrong here, but I believe that most drugs deal with non-life threatening illnesses. We are balancing the risk posed by untested drugs against the risk of specific diseases specific drugs are designed to treat. I don't believe the government is doing us a disservice on this one unless your disease is worse than any possible drug side affects.
Here's an argument on the C vs. S side of things. We have drugs today that treat our health problems with varying degrees of success. With the exception of bleeding edge research areas like Cancer and Neurological/Nervous System Disorders we've basically tackled all of the major "Disease Markets". Sure, we might be able to cure Cystic Fibrosis, or Schizophrenia but the cost of research might outweigh the benefit.
So why not just take all of the current medicines, and have the government spew out generic brand versions that everyone can afford? A lot of S countries do that, and some would call those countries more humane than pure C ones.
Sorry, I could not resist responding to this one:
"Every employee at Merck, especially these higher-ups, is now at risk of losing their job."
Sure the higher ups "might" be losing their jobs, but what kind of severance package do you think they'll get, and don't you think their worker bee humanoids will be the one bearing the most of this burden?
First of all, Chris: I was imagining a scenario inwhich governments were responsible for creating new drugs, not approving them (though I agree, the FDA is rather unneeded).
Second, Anonymous, you noted Chris said, "there are several life saving drugs that would be on the market if not for government intervention," and responded, "I could be wrong here, but I believe that most drugs deal with non-life threatening illnesses." Those are two completely unrelated sentances. Of course most drugs aren't life saving (though it depends on how you define "life saving"--if you never get into a car crash, selts don't do jack squat). But there are some drugs that DO save lives and government HAS denied people options, mostly because the options are still expirmental.
Third, your idea about government suppling drugs may sound like a good one at first but be careful; there's a great deal more that goes into a drug besides research. The world changes all the time and when faced with dynamic markets in transportation, chemical manufacuturing, container manufacturing, packaging and on and on and on, governments are nortoriously bad at adapting.
That's not the end of it, either. You're assuming an apex of research, but no drug is perfect and all of them have side effects. Some people have adverse reactions, such as allergies, and some people have cases so bad, the current medications may not be good enough. Bodies are complicated; to assume they are all the same and let government handle handing out the medication gives them an incentive to build barriers to entry, denying someone else from improving the standard. (Besides, generic brands exist without the government producing them.)
Finally, (and I'm assuming you are the same Anonymous) you're criticism of the the punishment of the higher-ups lacks economic sense. You said, "Sure the higher ups "might" be losing their jobs, but what kind of severance package do you think they'll get, and don't you think their worker bee humanoids will be the one bearing the most of this burden?"
1) You bet your ass they are getting great severence packages; I'd bet the farm it's written in their contract. But, for them, it's still undesirable. Otherwise they would have drove the company into the ground a long time ago. They are being punished because they are being fired. They are getting rewarded because they had the foresight to plan for the worst-case scenario (like getting fired).
2) For your second critique on the "worker bees" (I have no idea what that means, by the way), be careful. Neither of us know the structure of the company so we're not in a position to judge the reprucusions of something that hasn't even happened yet. But if it DOES land on "their backs," like in the form of a pay cut, that'll harm the company, too (loss of productivity). No one forces them to work there and today's frustrated employees can easily turn into tomorrow's competition.
Amusingly enough, most "hot" drugs are either discovered or isolated with the monetary assistance of grants by evil monolithic government entities like the National Science Foundation. Quite a bit of drug development goes on in institiutions of higher learning, which have a high likelihood of being at least partially drawing funding from public sources. True, profit is an incentive for innovation, but the incentive for innovation as far as drug discovery goes is often quite different. Remember, the people who actually discover or synthesize the drugs often get no financial benefits (at least not on the order of what Mama Pharma gets) from doing so. They do these jobs in part to help people, in part to experience the intellectual challenge of science, and partly to gain acclaim and recognition in their field.
Oh, and the pay isn't so bad.
I really don't think that the government taking control of drug development and discovery would really affect innovation at all.
As for the safety issue, it was an independent commission that uncovered the issue with Vioxx, and I'm sure it would be no different if it were Uncle Sam and not Merck that chose to ignore the results. Remember, officials in government have just as much to lose (money, positions, respect) as those in corporate power.
If that's not the case, then it could be argued that Merck would have a far greater motivation to cover up negative data than the government would. Remember, "Proft is an incentive for innovation
and the threat of losing it is an incentive for safety." It's not only an incentive for safety. I know I've blamed things on my little brother, or swept things under the rug so I wouldn't be damaged. Why do you think the government would do this, but good ole boy Merck wouldn't?
Anonymous-
I wasn't suggesting that government entities aren't or can't produce useful knowledge. I'm just saying that private organization, where real results are more important than who your friends are, are better at it.
"I really don't think that the government taking control of drug development and discovery would really affect innovation at all."
Then you really need to think about it more. Congress already funds hundreds, thousands, of organizations. Their incentive to find the best balance of monies between all these departments is low. Their capacity to even know what the best balance to be is lower still.
And yes, it was an independent commission that announced Vioxx was dangerous; and it was Merck that followed suit. Immediately. The fact of that matter is that government officials don't have as much to lose as corporate big wigs because it's near immpossible to blame anyone for anything. My God, look at the White House now. No one has gotten fired for the intelligence blunder. Speaking of which, if Merck hides data, people can find out about it (and often do find out about it). When the government hides data, they take a black marker to it and there's no one to tell them to remove it.
Right on smarter anonymous.
"Second, Anonymous, you noted Chris said, "there are several life saving drugs that would be on the market if not for government intervention," and responded, "I could be wrong here, but I believe that most drugs deal with non-life threatening illnesses." Those are two completely unrelated sentances. Of course most drugs aren't life saving (though it depends on how you define "life saving"--if you never get into a car crash, selts don't do jack squat). But there are some drugs that DO save lives and government HAS denied people options, mostly because the options are still expirmental. "
What Chris actually said was: "Sadly, the government is involved in the application of new drugs, the FDA. Unfortunately, many drugs have been either delayed or outright prevented from entering the market due to the FDA's overly-stringent rules for new drug testing."
My response to Chris' comment tried to address his concern that a) The FDA is bad on the whole and b) the government is killing people by being too restrictive in what drugs it will and will not allow on the market. My response was "What if the cure is worse than the disease?" That's why I talked about drugs concerning non fatal illnesses. In this case, stringent measures of acceptance might be wise. I agree that if someone is going to die in 4 months, it might be the time to use the experimental treatment, but the government does have a hard time with letting people kill themselves on a mass scale, even for the sake of science(Much less letting companies market such experimental treatments on a mass scale).
Reguarding the Socialist practice of spewing out generic drugs on a massive scale to treat patients humanely, it's already occurring in Brazil. I saw a documentary on AIDS in Brazil(funded by mondo-capitalist Bill Gates) which followed a young man with advanced AIDS living within the socialist system. His treatment was free(he couldn't afford it otherwise) and was improving both the length and the quality of his life. I thought that would mean Socialism would get at least one point in the great C vs. S soccer match. Anyway that's just the context of my point.
The content of my point was that perhaps we've reached an optimal level of technology(Reffering to the tradeoff between the benefit from future R&D vs. the benefit of treating patients today), at the moment such that the proposed system would yield a net benefit to Society. I know you won't even consider this trade off, but I wish you would just take one minute to weigh the cost(better future treatment) vs the benefit(treating the humans who can't afford it today). Of course, in your mind, everyone who buys anything can afford it, and being in debt up to one's eyeballs is a fine way to live, so we obviously disagree on some basic level here.
Reguarding the government's distribution and creation methods: I figure they'd put the pills in plastic bottles and ship them Fed Ex?
As smarter anonymous said, markets aren't the only way to reach medical breakthroughs. In fact, my dad is the head of UW madison's Oncology department, so I think I'll email him and ask him to respond on the blog.
As far as your saying that my CEO point made poor economic sense, when the CEO walks off with 3 million dollars and five hundred workers get laid off, it's hardly a ringing endorsement for a CEO's desire to be responsible. I find it illogical that you think "3 million dollars and a slap on the wrist is a great economic punishment." Isn't economic sense all about dollars and cents. Also, how much net benifit does the CEO get from another 3 million? He'll probably be able to find another lucrative job elsewhere anyway.
-DW
It's me again, Anonymous #3.
Pardon me for inserting previous comments, but I find it's the easiest way to keep track with all the anonymity flying about in here.
[b]David: I wasn't suggesting that government entities aren't or can't produce useful knowledge. I'm just saying that private organization, where real results are more important than who your friends are, are better at it.[/b]
I take issue with the idea that "real results" are somehow more important in industrial drug development than they would be in governmental drug development. Remember, the people doing the actual work are not doing this to curry favor in the eyes of some higher-up. Think of them as independent contractors: so long as they get paid, it doesn't matter who is doing the paying. For the developers of the drugs (the men in the trrenches), it's a battle to come up with the most effective drug with the least side effects first. To the victor go the publications. The government [i]would not be producing anything[/i] here. All the innovation, all the work, would still be done by people who are doing what they love. All the motivations would still be there for them.
[b]Scientist 1:[/b] Hey, I think I can cure cancer/AIDS/indigestion.
[b]Scientist 2:[/b] No, I think I can cure cancer/AIDS/indigestion.
[i]Scientists get money thrown at them from somewhere[/i]
[b]Scientist 1:[/b] Ha! I have done it! I have found a drug which seems to be effective in curing cancer/AIDS/indigestion. I will be cited for decades!
[b]Scientist 2:[/b] Damn you, Scientist 1! I will continue work on alternate pathways, and attempt to make a better drug!
As my extremely indepth skit goes, the source of the money is relatively uninvolved in the actual innovation.
As another way to think about it, do you think the fight for the X Prize would have been any less intense had the money come from the government? Last time I checked, cash is cash, and winning is everything.
-Anonymous #3
Chris, per our privacy policy, anonymity is respected. While having some sense of continuity between posts is good (keeping track of Anonymous 1, 2, and 3 is a pain), there really is no need to attach name to argument.
As a corollary to my previous comment...
Chris, I realize you were probably just joking. The point did need to be made, though.
Wow. So many points to address, so little time.
1) If the cure is worse than the disease, then people won't use it. I don't know how you'd respond if you found out you had a terminal illness, but in my case (and most people, one can only assume) they wouldn't willy-nilly pick some drug. They talk to their doctors, do research and get 2nd and 3rd opinions. Governments don't need to hold people's hands; it's not just unnecessary, it contrains options. John Stossel once did a report on a family that couldn't use an expiremental treatment because the FDA said it was too dangerous. (Though later they were able to turn the FDA around to their side, after much time and money.)
2) Don't get me wrong; donating cures for needy people is great stuff. But the government is by no means the only source of charity. And because government are far less adaptable and take that money by force, I hardly call it the favorable solution. Also understand that government action crowds out potential private charity. If Brazil didn't have the program, it's reason to think that Gates would have funded some like it himself instead of making a documentary. Wouldn't have costed Brazilians a dime, either. Just because it works doesn't mean it's the best solution.
3) The phrase "optimal level of technology" is meaningless. For years, people thought that trains were the "optimal level of technology" for travel, then cars, then planes, now, thanks to the Ansari X Prize, spaceships. I say again, assuming that anything is the apex of techology and locking it in as the best solution denies the populace something even better. (The new thing might not even be created because you just removed the incentive to investigate it.) Sure, at first locking it in seems like a good idea): we don't know what we could be missing. But in a few years what once was a net benifit becomes more than a burden than a boon (and I'm including opportunity cost in that, of course).
4) Great. And so when it turns out that Fed Ex isn't the cheapest or most efficient option, how quickly will the government change? Not very (governments are notoriously slow at virtually all things). What if UPs has better lobbists but not better service? What if there's some national issue of overwhelming attention (like there always is) and it distracts from some inevitable conflict involving the government, the company and/or the public? These are real questions which come up everyday. These represent the millions of tiny adjusts firms do all the time. Governments lack the knowledge and incentive to pull these adjustments off well.
5) Of course markets aren't the only source for technology (any type). Soviet Russia made some huge advances, especially in space travel and nuclear explosions. But that doesn't mean they are the best way. I could get to the other end of the hall by traveling north for a few seconds or traveling south for several years. When living in a world of scarcity (in time and money and patience), lots of options will technically work, but few will be worth doing and one will be the best solution. (By the way, I'd love to have your dad respond on the blog. We love new ideas.)
6) When you said, "I find it illogical that you think '3 million dollars and a slap on the wrist is a great economic punishment,'" I resent the implication you are quoting me; I never mentioned a dollar amount and I NEVER said getting fired was a slap on the wrist. And yes, he'll probably find another job somewhere else, but not without merit. He has skills others don't. Plain and simple (and yes part of it is about who you know, but a) that's not irrelevant and b) if you pick an idiot to run your company because he's your daughter's husband, you will privately reap the punishment for that stupidity). By the way, I hope you're not suggesting that the rich burn their money when they make it; that hypothetical three million goes other places. For more information, read my posts called Alphabet Soup (on 9/22) and The Magic Yacht (on 8/16).
7) Unfortunetly, governments are more prone to politics and favoritism than real results. Case in point. The Hydrogen Futures Act of 1996 costs the taxpayers millions of dollars every year. One of its goals? To create a power plant that draws in water, seperates it through electrolysis and combines the hydrogen with oyxgen to produce water and electricity. The problem? The Law of the Conservation of Energy says that you can't get more out of a system than you put into it. The same amount of energy you'll get out of the reaction is the same amount you'd need to extract the hydrogen from the oxygen. Less, actually, because no machine is 100% efficient. It SOUNDS like a good idea if you don't know the conservation law (thus it was passed) but it will never yield real results. The real difference is, governments are more prone to stupid hype than firms. If a firm was funding this kind of thing, it would have gone out of business by now (at no cost to the taxpayer). But because it's government, that's millions everyone pays each year. The law festers.
8) In the skit, you left a HUGE part out: why does scientist one get the money? How is that decided? For a private individual, they have a towering incentive to make sure this person is the best one for the job--they loose their money if they don't. For a lawmaker, they have far less incentive (not their money) and less time because they have to give funding to thousands of other causes, too, while incorporating that budget into a giant one of hundreds of billions of dollars. You're also assume that the best person was chosen. That's the hardest part, especially for laymen. (See the Hydrogen Futures Act, above.)
9) The X Prize wouldn't have been less intense if it was government funded, but it would have been less likely. NASA didn't consider using prizes until the success of Ansari. (Though I could agrue that because governments are far less efficent, there would be less money left over for the prize, thus dampening competition that way.)
Over these points, I've seen a common error. People seem to think that because government is the first thing they think of when they need a problem solve, they think it's the best one. Ask yourself the tough questions, like where wealth comes from, and challenge your assumptions, like governments should provide the basics. Just because you can make it work or it's the first thing you thought of, doesn't mean it's the best solution.
You say that I am off track in thinking that government would be the best institution to research solutions to health problems. That could be true. But the market is failing America right now when it comes to health care. The interplay between insurers, hospitals and doctors that favors a bottom line, hurts us in the long run because people can't get preventative treatment that would curb health costs later. I fear the same phenomenon is occuring within the pharmaceutical industry, in that their profit motives don't mesh with good health care.
When it comes to industrialized socialist-leaning health care systems, do you think that they work well? Or perhaps they are merely "Charity" systems that could easily be replaced by bill gateses accross the globe.
I still don't understand how you think that a CEO walking away with a 3 million dollar severance package makes for "incentive" for the CEO to not screw up. Even if he invests and helps us all with his 3mill, it's still pretty good for the CEO. The 200 people who got laid off on the otherhand, are our middle class. I offer that 200 people maintaining middle class status is more important for our economy and society than putting all that wealth into one person for making a mess of things no less. I'd like to hear your valuation between these two sides.
I hope to see my dad's response on the blog soon. He seems to agree with smarter anonymous in general terms, and should hopefully be able to address:
"8) In the skit, you left a HUGE part out: why does scientist one get the money?"
as he does a lot of grant reviewing and writing.
-DW
DW:
Whenever we talk about the activity of a particular industry, it's helpful to take a minute and untangle all the components of it; some of the industry is inherently free-market (not all of which is good, btw) and some of it is government. For example, insurance is not a wholy market industry. Thousands of laws across the fifty states govern what insurers should cover, even if the company and their clients have no interest in doing so. Forcing coverage of birth control, cancer treatments, hurricanes and hunderds of other possibilities make insurance cost more for everyone. As a man, I don't have to worry about birth control, but my insurance costs go up because the company has to do the research to figure out how much to charge its female patients. And some people don't want their insurance to cover certain things, yet they still have to pay for it. All industries are more complicated than you think.
"When it comes to industrialized socialist-leaning health care systems, do you think that they work well? Or perhaps they are merely "Charity" systems that could easily be replaced by bill gateses accross the globe."
Yes, I do. Check the amount of private donations during the Reagan years (of cut backs). It skyrocketed.
For the CEO, you are only looking at a snapshop, not the big picture. For you and me, the hypothetical three million is an incredible incentive to get fired. But for the CEO, the stock options and the 4 million salary he gets by not being fired is too good to lose nilly-willy. Big picture, DW. Think Big Picture.
http://www.npr.org/templates/story/story.php?storyId=4073351
|<) Fresh Air Audio
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Once again, why pay the bastard to screw you up. While it would be better for mr. CEO to make twice as many millions, 3 millions is about as much as he needs to get a personal Ball washer for life and a $10,000 deck chair. Why not just say "If you screw us up, we'll only give you $500,000(that would really scare the bejesus out of the man).
Because the company agreed to pay him a severence package if he is fired under certain conditions. It's one thing if they did it just for fun; it's quite another if it's a contract. Denying him payment (assuming the criteria in the contract were met) would be un ethical and illegal. By the way, contract enforcement is one of the few things I think government should do.
Very well, it's in his contract, but he's getting fired. Hence, why not put in less money in the next guy's severance package?
I don't know; I'm not in the industry. I imagine the reason why they do that in the first place is as an incentive for the person in question to work for the company in the first place. CEOs are in high demand right now.
(sorry, i may be anonymous 4) i'm not sure that i have as much faith in the free market as you do. about....5 to ten years ago, i forget exactly when, my father was serving on a board at a major pharmaceutical company that may or may not have been mentioned by name in your article. at the time, they were considering suspending the majority of their aids research because it was not profitable. ultimately, they didn't (and i think bad press was obviously a concern), but as the majority of crucial discoveries in that field have been made by industry and not government, i feel it's rather important to have some governmental involvement.
i suppose a great deal of this had to do with the aids crisis in africa, and i'm curious to know how you would think of that.
Excellent. I love questions.
So in economics we have this thing called the Broken Window Fallacy, originally described by Frederic
Bastiat and explored in great detail in Henry Haslitt's Economics in One Lesson. Here's how it goes.
So this kids comes up to your house with a rock and chucks it at one of your windows, smashing it. As people gather, they say that in light of the problem there's a ray of sun-shiney happiness: it helps the economy. You, on the other hand, know better. The $100 you were going to spend to buy a leather coat has to go to replace the window. If the kid didn't have a prospenity to throw hunks of the earth at stuff, you would have a coat and a window. Because he does, you have just a (new) window. Seeing only the most obvious activity (purchasing the new window) and not the unseen activity (purchasing the new coat) is the cornerstone of the fallacy.
The Broken Window Fallacy has many guises, but in more common economics-speak, it reminds us of opportunity cost-the benefit of of a lost opportunity. Engaging in one activity denies us the ability to use those same resources to engage in another activity (one that we might value more).
Here's where your comment comes in. Governments are nortoriously bad at doing most everything. They are subject to lobbyists and non-economic incentives (like building a new school instead of raising teacher salaries because the latter looks better in the paper--ever tried getting your picture taken while next to a check? It's not very impressive.) They are awful at gathering knowledge, especially local and tacit knowledge. They are slow, ineffiecent bureacracy--by their very nature. While they can pull off amazing things, the chances are that the private sector can do it far better.
Ask yourself, what the lost opportunity is. What's unseen? While I don't doubt they added some great stuff in fighting AIDS, I have a hard time believing that they were the best or only option.
Andrew,
Still alive. I didn't post because I didn't have time to do it in a
thoughtful way, and it really seemed best left to the younger crowd.
Several posters including you made my points anyway. For example, the idea
that government sponsored research is not generally done be the govt., but
essentially by independent individuals. More to the
point, the market doesn't work in the absence of regulation. Merck would
never have done the randomized clinical trial that led to the adverse CV
results without such data being required by the FDA in order for them to
sell the drug as prevention of colon cancer. The FDA was slow on the uptake
(see http://www.fda.gov/bbs/topics/news/2004/NEW01122.html ) --there was
substantial information indicating a safety issue as early as 2000. But, no
FDA, no safety studies and it would have taken years before the risk would
have been uncovered.
^ N. Drinkwater's response to the topic. As I said, he agreed with anonymous number 3.
Well, first let me thank DW's dad for lending his opinion to the site and let me ask him to post on the site anyway; all opinions are welcome. (You'll also notice that your son just copied/pasted your e-mail so you might as well comment directly.)
Now you say "government sponsored research is not generally done be the govt., but essentially by independent individuals." I'm sorry to disappoint but by defintion, government sponsored research IS done by the government. Oh sure my congressman isn't in the lab with beakers but they have a heavy hand in the process: they boughtt he beakers, as well as everything else. They approved the funding, they denied others funding; they control the purse. I'm sure you know that no small deal. And because they don't bear the costs for failure, they are far more prone to politicking over science. Surely you never heard of a good idea being shot down over politics? Surely you never heard of a bad idea being embraced simply because it sounded good?
By the way, telling me the FDA was slow on the uptake isn't exactly making me put a lot of faith in the government for this. You're also assuming that if the government didn't do it, no one else would. I highly doubt that people wouldn't be willing to pay to have new drugs tested. In fact, I'd be astonished and amazed if there was just one company that would be willing to provide this service. Instead of one entity (the FDA) providing studies, numerous ones would be, making it harder for Merck to silence them, especially since they would be less prone to bribery/corruption. Of course we don't have that because we are being forced to pay for the FDA. Again, read my post on the Broken Window: what are we losing? What's unseen?
News, Resources and Information on Vioxx and its Effectsvioxx settlement
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Vioxx health - Merck Earns Fall After Vioxx Withdrawal NEW YORK (Reuters) -
Merck Earns Fall After Vioxx Withdrawal
NEW YORK (Reuters) - Merck & Co. MRK.N on Thursday said first-quarter profit fell 15 percent following the withdrawal of its arthritis drug Vioxx last year. Link to original article
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