American Addict Page #10

HAD BEEN DIAGNOSED WITH BIPOLAR

DISORDER OR SCHIZOPHRENIA.

IN OTHER WORDS. THEY HAD NO

CLINICAL CONDITION IN THEIR PAS THAT WOULD INDICATE WHY THEY

SHOULD GET ZYPREXA.

SECONDLY IS. IS THESE PEOPLE HAD

A INCREASED PROPENSITY FOR

GETTING DIABETES.

I LOOKED. THEN. AT WHAT THE COS WOULD BE TO OUR PROGRAM AND

NOTED THAT. BESIDES THE PILL

COSTS. THERE WERE ADDITIONAL

HEALTH CARE COSTS. MAYBE UP TO

$70 MILLION FOR OUR PARTICULAR

STATE FOR THE USE OF THIS

MEDICATION.

THESE ARE PRIMARY CARE

PHYSICIANS THAT THEY'RE SELLING

ZYPREXA TO.

THEY'RE NOT GOING TO

PSYCHIATRISTS WHO ARE TREATING

THE PEOPLE THE FDA HAS APPROVED

ZYPREXA FOR.

ONLY PSYCHIATRISTS ARE TREATING

PEOPLE WITH BIPOLAR DISORDER

AND SCHIZOPHRENIA.

THE JUSTICE DEPARTMENT THA PROSECUTES THESE CASES HASN' FINED THE COMPANIES ANYWHERE

NEAR AS MUCH AS THEY SHOULD.

IN OTHER WORDS. AS MUCH AS THEY

MADE. NOR HAS ANYONE EVER GONE

TO JAIL.

IF YOU JUST THINK ABOUT THE

CONSEQUENCES OF THIS CRIMINAL

ACTIVITY. A DOCTOR GETS

ILLEGALLY PROMOTED BY THE

COMPANY TO PRESCRIBE A DRUG THA THE DOCTOR MAY THINK HAS

BENEFITS THAT OUTWEIGH THE RISK.

THERE ISN'T ANY EVIDENCE FOR

THAT AT ALL.

THE DOCTOR PRESCRIBES THE DRUG.

A PERSON DIES BECAUSE THERE

REALLY WASN'T ANY EVIDENCE THA IT EVEN WORKED FOR THAT.

AND THERE WERE--THERE'S EVIDENCE

OF DANGERS.

ONE COMPANY. PFIZER. ONE OF THE

BIGGEST DRUG COMPANIES IN THE

WORLD. SOLD $1 BILLION A YEAR OF

A PARTICULAR DRUG. AND 90% OF

THE SALES WERE FOR OFF-LABEL

USE.

ILLEGAL. THEY WERE CRIMINALLY

PROSECUTED FOR IT BACK ABOU FIVE OR SIX YEARS AGO. BUT THE

FINE THEY PAID. WHICH SEEMED

LARGE--HUNDREDS OF MILLIONS OF

DOLLARS--WASN'T BIG ENOUGH TO

DETER THEM FROM DOING IT AGAIN.

AND IN SEPTEMBER OF 2009.

THE SAME COMPANY PAID THE

LARGEST CRIMINAL PENALTY EVER

PAID BY ANY UNITED STATES

COMPANY:
OVER $1.2 BILLION FOR

ILLEGAL. CRIMINAL OFF-LABEL

PROMOTION.

THIS WAS A DELIBERATE SCHEME.

THEY KNOW HOW DEFENSELESS

MEDICAID AND MEDICARE ARE WHEN

IT COMES TO PAYING DRUG

PRESCRIPTIONS.

THERE'S SUCH AN ELABORATE

COMPUTER ORIENTED SYSTEM SET UP

FOR PAYMENT OF THESE MILLIONS

AND MILLIONS OF PRESCRIPTIONS

ACROSS THE COUNTRY BY PEOPLE ON

MEDICAID AND MEDICARE THAT I CAN'T BE INTERRUPTED.

THERE'S NO WAY FOR ANY WATCHDOG

TO SAY. "OH. WELL, YOU'VE

PRESCRIBED THIS TO SOMEBODY WHO

HAS NO BUSINESS TAKING IT."

MEDICAID WILL PAY WHATEVER I IS THEY CHOOSE TO CHARGE FOR

THEIR DRUGS.

SO ZYPREXA PRESCRIPTIONS COS SOMEWHERE BETWEEN $500

AND $1.000 A MONTH PER PERSON.

IT'S AN EXTRAORDINARILY

EXPENSIVE DRUG.

WHEN WE LOOKED AT THIS.

WE NOTICED THAT THERE WAS

A CONSIDERABLE INCREASE IN COST.

IN ADDITION TO THE COST OF

THE MEDICINE ITSELF.

NOW. THIS WAS PARTICULARLY

FRUSTRATING TO ME. BECAUSE

RECENTLY THERE'S BEEN EVIDENCE

THAT SOME OF THE OLDER

ANTIPSYCHOTICS--

ANTIPSYCHOTICS HAD BEEN AROUND

FOR 40 OR 50 YEARS--

WORK ALMOST AS WELL AS ZYPREXA.

SO HERE WE HAVE A GROUP OF

PEOPLE OVER 65 WHO ARE GETTING

A MEDICATION FOR ANXIETY OR TO

CALM THEM DOWN FOR WHICH

THE MEDICINE WAS NOT APPROVED.

AND IT'S COSTING A LOT OF MONEY.

INCREASING THE LIKELIHOOD

THAT THEY'LL HAVE DIABETES.

AND IN ADDITION TO THAT. THERE

ARE OTHER MEDICINES THAT THEY

COULD'VE USED THAT SEEM TO WORK

AS EFFECTIVELY.

BUT THE STATE IS PAYING FOR

IT. SO IT DOESN'T MATTER THA IT'S EXPENSIVE. AND IT DOESN' MATTER THAT THERE ARE OTHER

THINGS THAT ARE BETTER.

IT'S SORT OF LIKE A MODERN FORM

OF LOBOTOMY.

WHILE THE NURSES ARE COMPLAINING

LESS BECAUSE THE OLD PEOPLE ARE

LESS ACTIVE. IT'S KILLING THEM.

AND IT'S EXTREMELY EXPENSIVE.

OUR LOOK AT THE DATA SAID IT'S

EXTREMELY EXPENSIVE TO DIE.

SO WHAT HAPPENS IS. MEDICAID

WINDS UP PAYING FOR THE PERSON'S

FINAL ILLNESS.

SO IT'S A WIN-WIN FOR LILLY AND

FOR THE DOCTORS. BUT IT IS

A TERRIBLE LOSING PROPOSITION

FOR THE STATE.

WHAT WE FOUND OUT THROUGH THE

MEDICAID DATABASES OF THE STATES

THAT WE REPRESENTED WAS THA OVER 50% OF THE DRUG ZYPREXA WAS

PRESCRIBED OFF-LABEL FOR

UNAPPROVED USES BY THE FDA.

THIS IS OVER 50% OF THE DRUG

JUST IN THE MEDICAID POPULATION.

THERE'S NO DOUBT THAT AT LEAS THAT MUCH OF THE DRUG WAS

PRESCRIBED OFF-LABEL FOR PEOPLE

OUTSIDE THE MEDICAID POPULATION.

ALL RIGHT. NOW WE'RE GONNA

GET BACK TO OUR EARNINGS.

SPECIFICALLY DRUG EARNINGS.

ELI LILLY BEATING ANALYS ESTIMATES BY TWO PENNIES A SHARE

NOT COUNTING MONEY SET ASIDE FOR

FUTURE LEGAL SETTLEMENTS LINKED

TO THE ANTIPSYCHOTIC DRUG

ZYPREXA.

JOINING US FOR A CLOSER LOOK A THE COMPANY'S NUMBERS IS

JOHN LECHLEITER. CHIEF EXECUTIVE

OFFICER AT ELI LILLY.

HE COMES TO US FROM THE

COMPANY'S HEADQUARTERS IN

INDIANAPOLIS THIS MORNING.

JOHN. GOOD MORNING.

GOOD TO HAVE YOU BACK ON

MORNING CALL.

THANKS. CAROL. GOOD MORNING.

SO WHAT ARE THE HIGHLIGHTS

FROM THE QUARTER?

CAROL. WE HAD A VERY STRONG

QUARTER.

WE GREW OUR SALES 14%.

WE GREW OUR EXPENSES LESS THAN

THAT.

WE EXPANDED OUR GROSS MARGIN.

OUR NON GAP QUARTER TO QUARTER

COMPARISON. 14% GROWTH IN

EARNINGS PER SHARE.

MAKE IT TOO EXPENSIVE TO DO

IT IN THE UNSAFE WAY.

IF YOU SAY TO THE DRUG COMPANY.

"HEY. LOOK. YOU CAN MAKE

$4 BILLION WORTH OF PROFIT OU OF THIS IF YOU DO IT IN THE

UNSAFE WAY. BUT I'M ONLY GONNA

FINE YOU $1 BILLION."

WELL. THAT'S $3 BILLION WORTH OF

PROFIT.

WELL. IT CAN'T WORK THAT WAY.

IT'S GOT TO BE TOO EXPENSIVE TO

DO IT IN THE UNSAFE WAY.

THE FDA. THEY DON'T HAVE

THE MANPOWER.

THEY NEVER WILL.

THEY DO IT--THEY DO THE BEST JOB

THAT THEY CAN WITH WHAT THEY

HAVE. BUT AS ONE OF OUR EXPERTS

SAID. NOBODY CAN REVIEW A NEW

DRUG APPLICATION AT THE FDA.

BECAUSE NO HUMAN BEING CAN READ

THE WHOLE THING.

YOU CAN HIDE THE STUFF IN THERE.

BUT WHAT THE DRUG COMPANY NEEDS

TO KNOW BEFORE THEY EVER SUBMI THAT APPLICATION IS. THAT IF I

HIDE THINGS IN THERE AND THE

TRUTH COMES OUT. IT'S GOING TO

BE MORE EXPENSE THAN IT IS

WORTH.

OTHERWISE. NONE OF US ARE GONNA

BE SAFE FROM THIS BEHAVIOR.

YOU CAN'T LET THEM MAKE A NE PROFIT ON LYING.

YOU MAKE A NET PROFIT ON LYING.

YOU'RE GOING TO LIE.

AND IT'S THE LAWYER'S FAULT.

OKAY?

IT'S THE LAWYER'S FAULT.

WE INVENTED CORPORATIONS.

AND WHEN WE INVENTED IT.

WE DIDN'T GIVE IT A CONSCIENCE.

WE DIDN'T GIVE IT A SOUL.

YOU CAN'T PUT IT IN JAIL.

IT'S NOT A HUMAN BEING.

IT'S A MACHINE.

IT'S A LEGAL MACHINE.

WE INVENTED IT.

IT'S OUR FAULT.

BUT THE ONLY WAY TO KEEP THA MACHINE IN CHECK IS TO MAKE I TOO EXPENSIVE FOR THAT MACHINE

TO DO IT. BECAUSE THAT'S ALL THE

MACHINE UNDERSTANDS. AND THAT'LL

SOLVE THE PROBLEM.

I MEAN. WE--WE ARE SPENDING

FOR A LEVEL OF HEALTH CARE THA WE SHOULD BE ABLE TO HAVE I ALL.

INSTEAD. WHAT WE SPEND ON HEALTH

CARE BENEFITS THE INSURANCE

COMPANIES AND THE PHARMACEUTICAL

COMPANIES.

I THINK WE NEED TO CHANGE

MEDICAL EDUCATION.

WE NEED TO TRAIN MEDICAL

STUDENTS IN RESIDENCE SO THA THEY THINK ABOUT ADVERSE

EFFECTS. PROBABLY EVEN BEFORE

THEY THINK ABOUT THE DESIRED

EFFECT. BECAUSE ADVERSE EFFECTS

CAUSE PROBLEMS IN PATIENTS.

AND THAT'S COUNTER TO THE

PRINCIPLE THAT WE ALL HAVE

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