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 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

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 and anti-bribery laws in other countries. 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.

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). We plan to begin reporting such grants provided to U.S. organizations by Merck's Human Health division on a quarterly basis, starting with 3Q08 data in October 2008 on this website.

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.

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.

Starting later in 2008, all new Merck DTC advertisements will also include information on Merck's Patient Assistance Programs and 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. 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

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 October 24, 2008.

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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.