Sunday, June 10, 2012

Atypical Antipsychotics - Robert Whitaker says it all!

Black Hats, White Hats, and Financial Reckonings

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It is clear now that the marketing of ayptical antipsychotics over the past 20 years was, in essence, a criminal enterprise, as the makers of these medications regularly violated the law governing the selling of new drugs. The manufacturers hid side effects and marketed the atypicals for off-label purposes, targeting in particular children and the elderly, and this led to legal actions by both state attorney generals and the U.S. Department of Justice. States sued the manufacturers to recover the millions of dollars their Medicaid programs shelled out for medically unwarranted prescriptions, while the U.S. Department of Justice charged Eli Lilly and other manufacturers with health care fraud under the False Claims Act.
As these legal actions have been settled, the manufacturers have paid large fines. I haven’t kept track of all the settlements, but even a quick Google search tells of Astra Zeneca paying a $500 million fine for its illegal marketing of Seroquel; Bristol Myers Squibb paying $515 million for its illegal marketing of Ability; Pfizer paying $301 million for its illegal marketing of Geodon; and Eli Lilly paying $1.4 billion for its illegal marketing of Zyprexa.
It should be noted, of course, that this illegal marketing of atypicals caused considerable harm. It resulted in millions of Americans, young and old, being prescribed powerful drugs that could cause diabetes and other harmful side effects, even though there was an absence of scientific reason to believe the drugs—when prescribed off-label—would provide a benefit.
However, while the companies have paid these fines for their illegal actions, the executives of these firms have gone unscathed. Instead, during the past 15 years, they were rewarded with stock options and bonuses worth billions of dollars. For instance, when I was researchingAnatomy of an Epidemic, I reviewed the profits earned by Eli Lilly executives and employees on stock options from 1987 to 2000 (when the company brought Prozac and then Zyprexa to market), and determined that they netted around $3.1 billion during that period.
Thus, from a financial standpoint, the moral of the atypical story appears to be this: crime pays. The executives at the pharmaceutical companies prospered, and so too the companies. Their illegal marketing of the atypicals turned these drugs into the top revenue-generating class of drugs in the country in 2009, with prescription sales totaling $14.6 billion. The fines could be seen as just a cost of doing business, and actually, as money well spent given that the illegal marketing worked so well.

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