Merck markets our medicines and vaccines to health care professionals, providers, insurers and governments. Our professional sales representatives and other employees inform these customers about our medicines and vaccines and their appropriate use. In some countries, where permitted by law, we also inform patients and other consumers directly about diseases and available treatments that they may wish to discuss with their doctor.

We believe that our marketing, sales and advertising activities make an important contribution to medicine by informing our customers of treatment options based on the most current scientific information and findings from rigorous clinical studies. We take our responsibilities related to this seriously and evaluate our marketing, sales and advertising activities on an ongoing basis to ensure they are consistent with the laws, regulations and Merck policies and values.

Information for and Interactions with Health Care Professionals

We inform health care professionals about how our products should be used and what types of patients would benefit most based on the results of rigorous clinical studies.

We provide promotional information in several ways including:

• Directly to health care professionals through product discussions with our trained professional representatives
• Through promotional meetings sponsored and organized by Merck

In 2008, Merck implemented a more customer-centric selling model that is designed to provide a competitive advantage, help build trust with customers, and improve patient outcomes. The strategy employs the use of new marketing technologies to complement a new, customer-centered approach, and moves away from the traditional frequency-based sales and marketing approach. It also creates efficiencies by eliminating redundancies in core functions and across the sales organization.

We also provide non-promotional information through educational or scientific activities:

• Through scientific presentations at medical conferences
• Through published articles on our products and related scientific studies in peer-reviewed scientific journals
• Through internet-based tools such as MerckMedicus.com

The basis of our interactions and content must provide truthful, balanced and non-misleading information to health care professionals. These interactions are highly regulated by government through laws such as the U.S. Anti-Kickback Statute and the U.S. Foreign Corrupt Practices Act (FCPA) and anti-bribery laws in other countries. Merck has a corporate policy and procedure in place regarding anti-bribery and standards for interactions with government officials, as well as detailed guidance which provides employees with:

• A more detailed understanding of the basic principles of the FCPA and the procedures required in identifying and interacting with a foreign/government official when a benefit is to be provided
• Outlines the factors that must be considered and rigorous process to be followed in assessing whether to proceed with a particular interaction
• Highlights the importance of individual country guidance pertaining to the evaluations conducted under the FCPA and local anti-corruption regulations

Both anti-corruption/anti-bribery e-learning and face-to-face training are conducted with all employees that have the opportunity to engage with a foreign/government official.

Merck's overall ethical values and standards have been the basis of our Guiding Principles for Ethical Business Practices with the Medical and Scientific Community, which are aligned with national regulations worldwide, industry codes -- including the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) Code of Pharmaceutical Marketing Practices — and the World Health Organization's Ethical Criteria for Medicinal Drug Promotion. In June 2008, Merck implemented the principles to serve as a bridge between country laws, regulations, industry guidelines, and the Company's Values and Standards, which are articulated in Company policies, guidelines, and procedures. The principles are intended to enable interactions with the medical and scientific community that comply with our ethical and legal obligations and improve human health.

Continuing Medical Education (CME) and Continuing Education (CE)

Merck plays a strong role in sponsoring educational programs aimed at disseminating and sharing medical and/or health economic information. Merck's CME/CE Grant Program supports independent educational programs that we believe are most likely to improve health care professional performance and patient outcomes.

The environment in which we sponsor or support educational programs worldwide is a complex one, governed by a multitude of laws, regulations and medical or industry association guidelines. We seek to honor them all in the countries in which we operate.

Merck has an established policy regarding the Company's involvement in and commitment to continuing education for all types of health care professionals. We are committed to ensuring that our CME/CE programs are educational and not promotional, with the goal of increasing physician awareness of the latest scientific data relating to health care advances and patient care. Continuing Medical Education programs supported or sponsored by Merck are governed by an internal policy and must be aligned with appropriate standards such as the Accreditation Council for Continuing Medical Education (ACCME) standards for commercial support of CME in the United States, which specify independence, financial disclosure and other requirements applicable to CME programs sponsored by commercial entities, including pharmaceutical manufacturers.

In some cases, Merck provides grants to organizations for professional education initiatives, including accredited continuing medical education (CME). In October 2008, Merck began reporting grants over $500 provided by the Company's Global Human Health division to U.S. organizations in support of independent accredited educational programs for health care professionals. Over the course of 2009, we are expanding this disclosure to include other types of grants.

While disclosure of supported patient organizations became mandatory in Europe in March 2009, Merck has voluntarily disclosed support to patient organization in Europe, Middle East and Africa made by Merck offices in those regions since 2008.  In addition, in the second half of 2009, Merck plans to begin reporting payments made to patient organization by Merck operations in Canada from 2009 onward.  Also in 2009, Merck operations in Europe, Middle East, Africa and Canada plan to begin disclosing grants to other third-party institutions made beginning in January 2009.

In 2008, Merck endorsed the Physicians Payment Sunshine Act, mandating disclosure of these financial relationships. In the absence of a legislative requirement, we have begun to voluntarily disclose in the fourth quarter of 2009 all payments to US-based health care professionals who speak on behalf of Merck or our products.

For more information on our financial interactions with independent third-party groups, please click here.  

Prescription Product Samples

Where sampling is permitted, Merck has established country-specific guidance and policies regarding the provision of prescription product samples to health care professionals. This guidance specifies the appropriate distribution and use of samples to safeguard against the potential for misuse or abuse of our medicines, or diversion of our products to inappropriate channels. In accordance with the law and ethical practices, we do not provide samples for the purpose of reducing or discounting the price paid or reimbursed for Merck products, or in exchange for prescribing, purchasing, contracting for, or recommending for formulary status a Merck product.

Obtaining Services from an External Health Care Professionals

Merck is committed to ensuring that we only engage the service of an external Health Care Professional when we do not have the specialized talent or expertise internally, or an external viewpoint is critical to obtain. In addition, compensation or honoraria provided to the Health Care Professional must be based on fair market value for the service, based on where the Health Care Professional resides. An extensive cross-divisional project was undertaken to evaluate our current honoraria guidelines and practices on a global basis, and determine the fair market value amounts for such activities. Merck is confident that the compensation/honoraria provided to external Health Care Professionals is fair and reasonable and completely aligned with fair market value for the service in the home country of the Health Care Professional providing the service.

Unapproved or "Off-Label" Use of Our Medicines and Vaccines

In accordance with external requirements, internal policies and ethical practices, our professional representatives and other members of our sales and marketing team are not permitted to make product claims that are not based on the approved product label, sometimes referred to as "off label" product claims. We have policies in place to address violations and we ensure that physicians are aware that we do not encourage off-label use.

Informing Patient Choices

As advertising of prescription medicines has become more prominent in the United States during the past decade, this has contributed to questions about its value. Merck believes that direct-to-consumer (DTC) advertising can be an important and helpful way to inform patients about diseases that may be relevant to them and therapeutic options they may want to discuss with their physicians. Credible data demonstrate that DTC can have a positive impact on patient health in terms of diagnosis, treatment and adherence to prescribed therapies.^{1, 2} Under-diagnosis and under-treatment of chronic conditions remain important public health concerns. Merck medicines address many unmet medical needs such as high cholesterol and blood pressure, uncontrolled diabetes, osteoporosis and asthma. DTC advertising is one channel among many to help educate patients about these conditions and can encourage consumers to speak with their doctors about them. Ultimately, the decision of what treatment, if any, a patient receives rests with the physician, following consultation and discussion with the patient.

Merck strives to enable consumers to achieve better health outcomes by delivering accurate, relevant information on disease prevention, identification and treatment in an understandable manner. To remain true to this goal, Merck adheres to the letter and spirit of FDA regulations and guidelines governing DTC promotion, ensures all Pharmaceutical Research and Manufacturers of America (PhRMA) guidelines are met or exceeded, and follows a comprehensive set of internal policies and practices when engaging in DTC advertising. Merck has a long-standing policy to submit new DTC advertising campaigns voluntarily to the FDA for their review and comment prior to running any DTC campaign. According to our own DTC policies and practices, the information provided in our advertising campaigns must:

• Ensure that any ads with branded product information have appropriate benefit and risk information
• Be appropriately balanced consistent with FDA regulations and with appropriate 'taste and tone'
• Ensure that ads are run at appropriate times during the day and during appropriate programs
• Be approved by Merck's medical and legal departments ensuring that the view of the medical community is considered and that the content is consistent with approved labeling.

In addition, in 2008, Merck began to include in all new DTC print and television advertisements information on Merck's Patient Assistance Programs along with a toll-free phone number for more information.

In 2008, to formalize our historical practice of informing health care professionals about our products before we advertise them to the consumer, Merck adopted a policy requiring a minimum six-month time period following the approval of a new product before launching DTC broadcast advertising. In addition, Merck carries out comprehensive programs to educate physicians and other prescribers about a new product before commencing product-specific DTC broadcast advertising in the U.S. These principles and our practices are reflected in the PhRMA Guiding Principles on direct-to-consumer Advertisements About Prescription Medicines: for more information click here ( PDF*)

Disease Awareness

There are concerns that some diseases are under-diagnosed and under-treated. Merck is committed to ensuring that health care practitioners, patients and care givers are informed about diseases such as high cholesterol and blood pressure, osteoporosis and asthma, in which we have extensive knowledge and expertise. To provide answers to questions about symptoms, diagnosis and treatment options, we sometimes provide grants to organizations with specific expertise in disease areas of interest to us.

The content on this page was last modified on September 15, 2009.

Merck & Co., Inc., Whitehouse Station, NJ, USA, and Schering-Plough Corporation, Kenilworth, NJ, USA, are now one company. We have combined our global operations under the name Merck & Co., Inc. We are working to update our corporate responsibility Web site to reflect our new, combined, global organization.

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¹ Aikin K, Swasy J, Braman A. Patient and Physician Attitudes and Behaviors Associated with DTC Promotion of Prescription Drugs: Summary of FDA Survey Research Results, Final Report, U.S. Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research, 19 November 2004.

² See for example: McGlynn EA, et al. The quality of health care delivered to adults in the United States. N Engl J Med. 2003 Jun 26;348(26):2635-4.