This is a follow up to my earlier post on Alaska, Good Friday Earthquake and Zyprexa.
In March Eli Lilly settled the Zyprexa case for $15 million, according to the New York Times. (
Bloomberg News filed a motion to unseal all the documents related to the case and was granted the motion in July. They reported:
Lilly Trained Sales Force to Ignore Drug's Risks (Update2)
“Eli Lilly & Co. trained its sales force to downplay risks for Zyprexa and encourage doctors to prescribe the drug beyond approved uses for schizophrenia and bipolar disorder, according to court documents.
“Lilly's research showed some patients on Zyprexa gained as much as 80 pounds and that the incidence of high blood sugar at diabetes levels was 3.5 times higher than for placebos, according to documents filed in a lawsuit brought by the state of Alaska.”
“We believe it is essential to weaken this link to neutralize the diabetes/hyperglycemia issue,'' the company said in the sales document, which was provided for the
Strong words indeed, sounds more like a task for Bond. Psychiatrists better watch out.
But this is not just about psychiatrists.
“Zyprexa became the company's top-selling drug, with $4.76 billion in sales last year -- about a quarter of Lilly's revenue. Company sales representatives disputed or ignored the risks and pursued primary-care and nursing-home doctors as well as psychiatrists.”
There were more than 20 million pages of submission. 20 million pages!!!
How did Bloomberg sieve through 20 million pages? Good job, Bloomberg.
Lilly faces suits by nine other states alleging failure to warn and improper marketing, separate consumer-protection investigations in about 30 other states and an investigation of off-label marketing by the U.S. Attorney in Philadelphia.
“Lilly pushed Zyprexa sales to primary care physicians and doctors in nursing homes for patients who weren't diagnosed with schizophrenia or bipolar disorder, according to complaints filed by
Those interested may like to read the full Bloomberg account.
There are some gems in the quotes:
“Zyprexa's attributes line up so beautifully in the elderly,'' Alan Breier, then-team manager for the drug, told the group. “The need for better treatment in Alzheimer's and other elderly conditions is so paramount and so key.''
But Zyprexa wasn't approved for use with Alzheimer's or for elderly conditions.
“He's talking about the characteristics of the molecule which might make it a good agent for Alzheimer's,'' Sidney Taurel, current Chairman testified. "He was not giving them instructions as to what to do the next day in the field.''
Very smart answer indeed. But that is not the end of it.
“The doctor's thinking that he does not see a schizophrenic or bipolar patient,'' Bandick said in a December 2000 internal e- mail to the marketing department. “But he probably does see patients with symptoms of behavior, mood and thought disturbances,'' he wrote. "Even if the doctor does not have diagnosis, he should treat anyway.''
It was not until October 2007 when Lilly finally added to its packaging a warning about weight gain.
Documents show that in 2002, the Zyprexa sales force was advised:
“We will NOT proactively address the diabetes concern.”
An in true Olympian spirit, they proclaimed:
“The competition wins if we are distracted into talking about diabetes.”
Let us wait and see what the judges in other States think. The earthquake in
We doctors must continue to resist being badgered, coerced and manipulated by pharmaceutical sales reps.