The Zyprexa Chronicles: Lilly Helps Police State MedicAid Programs

The New York Times is out today with an article concerning Eli Lilly's advisory role to doctors seeing MedicAid patients in various state programs around the country. The gist is that, in order to keep Zyprexa from being pushed out of state formularies (ie, what drugs a state program will cover), Lilly devised a program in which the company monitored the prescribing patterns of doctors and sent them a warning letter if they prescribed Zyprexa outside of normal patterns. Whatever normal might be. And you'd trust a company such as Lilly to help hold down costs in exchange for giving it an intimate look-see into how doctors prescribe to patients?

"“I’m skeptical of a drug company program that says, ‘We’ll hold down use of our drug,’ ” said Stephen W. Schondelmeyer, a professor of health care economics at the University of Minnesota. He described such programs as thinly disguised marketing."

The idea is that the program would help states control costs. But some states took a pass on the program, while some liked the program.

"Lilly’s pitch in 2005 was, “ ‘we’ll fund this program if you put our product on the preferred-drug list,’ ” said David Beshara, chief pharmacy officer for Tennessee Medicaid.

Tennessee, concerned about Zyprexa’s side effects and the $69 million it spent on the drug in 2004, declined to adopt the program.

Mr. Beshara said the potential savings from the program were unclear. And he cited another concern: the program has been offered in lieu of rebates that companies often pay to states that place their drugs on preferred lists.

In Pennsylvania, the former state deputy secretary for medical assistance, James L. Hardy, said Lilly had offered to pay for a prescription-monitoring program instead of rebates before the state developed its preferred-drug list in 2005. He declined to go along.

“I didn’t like that commingling of service and rebates,” Mr. Hardy said. “I want to manage the benefit, and I want to get the best rebate deal I can. I don’t want to settle for half a loaf.”

Mr. Hardy said Pennsylvania eventually placed Zyprexa on a list of restricted drugs.

Some states, notably Michigan and Missouri, have publicized results showing that the Lilly program helped save money. And they generally praise the program.

“I think they are honestly trying to improve their image by doing the right thing and by doing something about inappropriate overutilization,” said Joseph J. Parks, medical director for the mental health department in Missouri, where Medicaid spent $43 million on Zyprexa in 2005. "

No matter what, why is a pharma company this deeply-intertwined with how states run their MedicAid programs? And, why is it, as I've noted before, that some pharma companies know details of doctors' prescribing patterns without said doctors permission? Creepy.

Credit to Pharmalot, and CL Psych all of whom had this story up before I dragged my butt out of bed.