March 14, 2007

The Zyprexa Chronicles: Montana Alleges Kickbacks And Off-Label Marketing

As I noted the other day, the State of Montana has sued Eli Lilly for its marketing of Zyprexa. I obtained a copy of the complaint yesterday (1 MB .pdf here) and the allegations are intense and mostly revolve around off-label marketing of the drug for use among elderly patients. Here are some key portions of the complaint:

Lilly "put users at risk for developing severe and harmful health conditions including, but not limited to, hyperglycemia, acute weight gain, diabetes mellitus, exacerbation of of diabetes mellitus, pancreatitis, cardiac problems and death. Furthermore, Defendant has been aware of studies linking Zyprexa to these conditions since 1996 and has known since at least 1999 that Olanzapine causes diabetes at a rate far in excess o fthe risk of most atypical antipsychotics, yet has failed to fully and adequately warn the State, physicians, and consumers of these risks."

The state further accuses Lilly of off-label marketing of Zyprexa for Alzheimer's, dementia, Tourette's, pervasive developmental delay, autism, anorexia nervosa and general depression. And there's more:

"Lilly's sales force concentrated on primary care physicians, rather than pyschiaitrsts, and focused upon marketing and selling the drug as treatment for depression and anxiety, rather than the psychotic conditions for which Zyprexa had been approved."

The state also alleges that Lilly "created a 280-person sales force exclusively for off-label uses especially for long-term care facilities." And:

"Lilly gave promises of financial benefits, in cash and in kind, to numerous physicians who attended the elderly to cement this unlawful marketing of Zyprexa."

And:

"Lilly management participated, encouraged and authorized the unlawful payment of illegal kickbacks to physicians in order to continue generating sales of Zyprexa."

The state also alleges that Lilly paid off the long-term care sales manager in Florida in 2006 (page 12 of complaint), who had apparently threatened to go public with what he knew of the company's marketing activities, in order to keep him quiet. Also, according to the complaint, Lilly budgeted $100,00 annually for a sales rep to spend on speaker fees and honoraria. The company paid huge amounts for speakers' travel, first-class lodging, extravagant meals and entertainment for doctors and their spouses.

The complaint states that Lilly gave gifts to doctors in the form of chartered fishing trips for doctors and their friends, sporting events, expensive dinners and entertaining in order to induce doctors to write off-label prescriptions of Zyprexa among the elderly.

Wow. More to come, you can be sure of that.

Posted by Philip Dawdy at March 14, 2007 12:52 AM
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Comments

"The complaint states that Lilly gave gifts to doctors in the form of chartered fishing trips for doctors and their friends, sporting events, expensive dinners and entertaining in order to induce doctors to write off-label prescriptions of Zyprexa among the elderly."

Not surprising. What IS surprising, however, is the depth of the allegations and what Montana has discovered. Perhaps I've missed a couple of things, but I don't remember reading about this in conjunction with the New York Times article.

A Google News search for "montana eli lilly" (sans quotations) yields two relevant results (out of an unrelated five) from the Indianapolis Star and the Indianapolis Business Journal. The funny thing is Bloomberg News originally reported the story. News like this gets hidden in the business section only because it affects the company's stocks.

Posted by: Marissa Miller at March 14, 2007 05:25 AM

Lilly "put users at risk for developing severe and harmful health conditions including, but not limited to, hyperglycemia, acute weight gain, diabetes mellitus, exacerbation of of diabetes mellitus, pancreatitis, cardiac problems and death.

No one has reported on one remarkable irony here. When Lilly's product causes weight gain, diabetes, or exacerbates diabetes, where does an individual experiencing these manifestations turn? Answer: To "the leader/expert in diabetes health care in the U.S.--Eli Lilly!" Of course, many other "diabusinesses" along the way will profit, too. Everyone from the doctor who manages/prescribes for his diabetic patients to laboratories to the many diabetes-related enterprises (meter makers, specialty foods, etc.)--all see increased revenues. Meanwhile, the hapless, helpless patient is captive in a system outside his control.

Zyprexa--what a perfect medicine. It's a gift that just keeps on giving! If you thought bipolar/schizophrenia was bad, just wait till you have the opportunity to deal with bipolar/schizophrenia PLUS diabetes!

Posted by: Melody at March 14, 2007 06:00 AM

,,"has known since at least 1999 that Olanzapine causes diabetes at a rate far in excess o fthe risk of most atypical antipsychotics, yet has failed to fully and adequately warn the State, physicians, and consumers of these risks."

1999 is the year my daughter was placed on Zyprexa at age 11.

Excuse me, while I walk away from the computer and add up how much $$$, loss of a home, near-bankrupt, I am now; as a result of the reckless covert actions of Eli Lilly, and the resulting prescribing of Zyprexa to an 11 year old, who was not has never been diagnosed with Schizophrenia, and who also has diabetes in her Father's side of the family.


I cannot even finish reading this entry; it makes me livid.

Eli Lilly, and the reckless endangerment of my daughter's life; how about this: I will see YOU in court.

Posted by: Stephany at March 14, 2007 11:16 AM

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