Merck & Co., Inc.

Rofecoxib offered meaningful gastrointestinal advantages over a traditional anti-inflammatory drug, yet its development and postmarket record also produced cardiovascular signals that were difficult to interpret and costly to leave unresolved. The Vioxx episode is an accountability test because the decisive question is not whether one result should have ended debate. It is whether the institutions with practical control converted uncertainty into timely trials, labeling, promotion limits, clinical communication, and independently verifiable drug-safety controls.