American Addict Page #9

WORK HAS NOT LED TO POSITIVE

CHANGE OVER MY LIFETIME.

THE OBAMA ADMINISTRATION'S

HEALTH CARE POLICY STILL LEF THE INSURANCE COMPANIES IN

CHARGE.

IT WAS REFORMED WITHIN THE

CONTEXT OF A FOR-PROFIT SYSTEM.

INSURANCE COMPANIES ARE STILL

RAISING THEIR RATES TO THE ROOF.

IT ALSO DIDN'T DO ANYTHING TO

TOUCH THE PHARMACEUTICAL

INDUSTRY. BECAUSE. ESSENTIALLY,

WITH MEDICARE PART D STILL

INTACT. THE PHARMACEUTICAL

COMPANIES CAN CONTINUE TO NAME

THEIR PRICE FOR PRESCRIPTION

DRUGS AND GET IT.

SO THE GOVERNMENT. THEN. HAS

A DUAL BURDEN. WHICH IS MORE

PRESSURE ON THE MEDICARE BUDGE THROUGH THE PHARMACEUTICAL

COMPANIES TAKING A BIG CHUNK OU OF IT AND GREATER PRESSURE ON

THE ENTIRE HEALTH CARE SYSTEM

THROUGH ABOUT ONE OUT OF EVERY

THREE DOLLARS GOING FOR THE

ACTIVITIES OF THE FOR-PROFI SYSTEM--CORPORATE PROFITS. STOCK

OPTIONS. EXECUTIVE SALARIES.

ADVERTISING. MARKETING. THE COS OF PAPERWORK.

I SPOKE ABOUT THE URGENT NEED

FOR HEALTH CARE REFORM AND WHA WILL BE REQUIRED TO ACHIEVE IT.

AND ONE OF THE THINGS THAT WILL

BE REQUIRED. I SAID. WAS THA EVERYONE IN OUR HEALTH CARE

COMMUNITY IS GONNA HAVE TO COME

TOGETHER AND DO THEIR PART.

IN RECENT DAYS.

CHAIRMAN MAX BAUCUS. WHO'S BEEN

DOING AN OUTSTANDING JOB LEADING

THE FINANCE COMMITTEE ON THIS

ISSUE...

WHAT I'M HOLDING IS A BOTTLE

OF ZYPREXA.

ZYPREXA IS AN ANTI-PSYCHOTIC

MEDICATION.

IT'S VERY POPULAR. AND IT'S VERY

EXPENSIVE.

THIS AMONG SOME OF THE OTHERS.

ABILIFY. CIALIS--ERECTILE

DYSFUNCTION DRUGS--ARE VERY

COMMONLY DIVERTED.

THE REASON BEING IS. AGAIN. THE

MEDICAL PROGRAMS AND INSURANCE

PROGRAMS PAY A LOT OF MONEY FOR

THESE DRUGS.

I'M A SALES REP FOR

A PHARMACEUTICAL COMPANY.

BEEN DOING IT FOR ABOUT A YEAR.

AND MY JOB IS ESSENTIALLY TO

SELL OUR PRODUCTS TO PHYSICIANS.

YOU CAN BE FIRED FOR TALKING TO

PHYSICIANS OFF-LABELING.

NOW. DOES IT HAPPEN?

IT HAPPENS OFTEN. AND IT HAPPENS

FREQUENTLY.

OFF-LABEL PROMOTION IN

ATTEMPTING TO SELL A DRUG FOR

A DISEASE THAT THE FDA HASN' APPROVED IT FOR.

LET'S SAY A DRUG GETS APPROVED

BY THE FDA FOR ONE PURPOSE.

AND IT DOESN'T SELL VERY MUCH.

SO THE COMPANY SAYS. "HMM. MAYBE

WE CAN PRETEND. BY ADVERTISING

AND PROMOTION AND BUYING UP

DOCTORS TO SPREAD THE BUZZ.

THAT THIS DRUG IS ALSO GOOD FOR

THE SECOND AND THIRD AND FOURTH

AND FIFTH DISEASE."

THEIR MARKETING IS INGENIOUS.

IT IS SO ILLEGAL. IT MAKES THE

COLOMBIAN CARTEL LOOK LIKE

CHILD'S PLAY.

ELI LILLY KNOWS HOW LONG IT'S

DRUG IS PATENTED AND HOW LONG

THEY'RE GONNA CHARGE A PREMIUM

PRICE FOR THAT DRUG.

AND AS SOON AS THAT DRUG GOES

GENERIC. THEY NEED ANOTHER DRUG

TO REPLACE IT TO REPLACE THOSE

PROFITS. BECAUSE SHAREHOLDERS

EXPECT PROFITS AND A RETURN ON

THEIR INVESTMENT.

SO PROZAC IS GOING OFF PATENT.

AND THEY NEED TO REPLACE THOSE

PROFITS.

SO THEY TAKE ZYPREXA. AND THEY

DEVELOP THIS ELABORATE SCHEME TO

MARKET ZYPREXA TO THE ELDERLY

AND TO THE CHILDREN. TO ANYBODY

OFF-LABEL.

THIS IS A CRIMINAL ACT ON THE

PART OF A COMPANY.

IF THEY DO THIS. THEY'RE

ESSENTIALLY MAKING IT SEEM AS

THOUGH THIS DRUG IS SAFE ENOUGH.

RELATIVE TO ITS BENEFITS.

TO BE PROMOTED.

THE FACT IS. IF IT HASN'T BEEN

APPROVED AT ALL FOR THA OFF-LABEL OR SECOND PURPOSE.

WE DON'T KNOW WHETHER THE

BENEFITS OUTWEIGH THE RISK

OR WHETHER THE RISKS OUTWEIGH

THE BENEFITS.

IF THERE WAS ENOUGH EVIDENCE OF

THAT. IT WOULD BE ON-LABEL.

THE FDA WOULD GET THE EVIDENCE

AND WOULD APPROVE IT.

SO THE ELDERLY THAT WERE

PLACED ON ZYPREXA DIED TERRIBLY

PAINFUL DEATHS.

ELI LILLY HAD PSYCHIATRISTS IN

THEIR STAFF DEVELOP

A PSYCHOLOGICAL PROFILE OF THE

DOCTORS PRESCRIBING ZYPREXA.

THEY WOULD DIRECT THE MARKER TO

SAY. "NO MATTER HOW DUMB YOUR

DOCTOR IS. DON'T TALK DOWN TO

HIM."

PHARMACEUTICAL:

REPRESENTATIVES ARE UNIVERSALLY

ATTRACTIVE.

THEY GET RECRUITED FROM PLACES

LIKE CHEERLEADING SQUADS AT BIG

TEN SCHOOLS. IN THE CASE OF

WOMEN. AND IT'S QUITE CLEAR THA PART OF THEIR HIRING PROCESS IS

THE ATTRACTIVENESS OF

THE PEOPLE.

THEY DON'T PARTICULARLY HAVE

A LOT OF MEDICAL BACKGROUND.

YOU KNOW. THEY ARE MARKETERS.

BUT THEY GO TO SORT OF BOOT CAMP

TO LEARN ABOUT THEIR DRUG.

THEY'RE GOING TO PRIMARY CARE

PHYSICIANS. WHO ARE TREATING

YOU AND I. AND TELLING THEM HOW

TO MANAGE THEIR PATIENTS.

WHO MIGHT JUST HAVE A SLEEP

DISORDER.

AND I GUESS THE MOS FRUSTRATING THING TO ME TO FIND

OUT IS THAT 20% OF THE PEOPLE

GETTING ZYPREXA. AT LEAST IN OUR

CLAIMS DATA. WERE PEOPLE THA WERE OVER 65. FOR WHOM IT WAS

OFF-LABELED.

NOT ONLY THAT.

MOST OF THESE PEOPLE HAD NEVER.

IN THE DATA THAT WE HAD.

HAD EVIDENCE THAT THEY WERE

SCHIZOPHRENIC OR BIPOLAR.

THEY TAUGHT THEM TO SAY.

"DOCTOR. WELL. DON'T YOU HAVE

ANY PEOPLE THAT COME IN AND

COMPLAIN. 'WELL. YOU KNOW,

FINANCIALLY. WE'RE DOING--WE'RE

HAVING A DIFFICULT TIME. AND I'M

JUST STRESSED OUT RIGHT NOW'?

ANYBODY WHO SAYS THAT WHO USES

THESE MAGIC WORDS LIKE "STRESS."

YOU CAN CONVERT THAT WORD INTO

"DELUSIONAL." OKAY?

YOU CAN CONVERT ANY ANXIETY THEY

HAVE INTO A DELUSIONAL BEHAVIOR.

AND AS LONG AS YOU PU "DELUSIONAL" IN YOUR RECORD.

THEN YOU CAN QUALIFY FOR PAYMEN BY A GOVERNMENT ENTITY LIKE

MEDICAID AND MEDICARE."

THE REASON THAT DRUG

COMPANIES PRAY ON MEDICAID IS

THE SAME REASON THAT BANK

ROBBERS ROB BANKS.

THAT'S WHERE THE MONEY IS.

AND THERE'S HUNDREDS OF MILLIONS

OF DOLLARS IN EVEN A RELATIVELY

SMALL STATE LIKE UTAH. WITH ITS

POPULATION OF 2.5 MILLION

PEOPLE.

"IF YOU DO THAT. WE WILL PAY

YOU TO GO ON A SPEAKING CIRCUI TO TELL OTHER DOCTORS HOW

EFFECTIVE THIS DRUG IS FOR YOUR

REGULAR PATIENTS."

WHAT QUALIFIES AS A SPEAKER IS.

IF THAT DOCTOR GOT ON THE PHONE

AND TALKED TO EVEN ONE OTHER

DOCTOR WHO WAS SCHEDULED TO TAKE

PART IN A TELEPHONIC CONFERENCE.

THEY WOULD GET A CHECK.

AND THERE WERE DOCTORS WHO WERE

GETTING A LOT OF CHECKS FOR

THAT.

I SUE DRUG COMPANIES.

I SUE THEM ON BEHALF OF

ATTORNEYS GENERAL.

I SUE THEM ON BEHALF OF

MEDICAID.

I'VE BEEN DOING THAT FOR ABOU SIX YEARS.

WE WERE REALLY THE FIRST SET OF

LAWYERS TO BRING AN ATTORNEY

GENERAL CASE TO TRIAL.

WE BOUGHT--BROUGHT THAT CASE TO

TRIAL IN ALASKA.

TWO WEEKS INTO TRIAL AND SHORTLY

BEFORE THE JURY OUT--WENT OUT.

WE SETTLED THE CASE FOR

$15 MILLION.

I SETTLED UTAH'S CASE AGAINS THE SAME DEFENDANT.

WHICH IS ELI LILLY. MAKER OF THE

DRUG ZYPREXA.

I SETTLED THE UTAH CASE FOR

$24 MILLION. IDAHO CASE FOR

$13 MILLION. WEST VIRGINIA

VERSUS ELI LILLY. WHICH SETTLED

FOR ABOUT $24 MILLION.

MANY OF THE ATTORNEY GENERALS

TURNED US AWAY BECAUSE IT'S

UNPOPULAR FOR THEM TO SUE BIG

BUSINESS.

NOT ONLY IS IT UNPOPULAR.

BUT IT'S VERY EXPENSIVE.

THE GOVERNMENT PURSE WAS BEING

DEPLETED IN ENORMOUS AMOUNTS

BY THESE DRUG COMPANIES THA WEREN'T PLAYING FAIR AND THE

GOVERNMENT HAD THE RIGH TO RECOVER THAT MONEY.

THE ISSUE WAS--IT'S WHETHER

OR NOT THERE WAS EXCESSIVE COSTS

OR EXCESSIVE INAPPROPRIATE USES

OF ZYPREXA IN THE MEDICAID

POPULATION.

THE FDA APPROVED THE USE OF

THAT DRUG FOR PEOPLE BETWEEN THE

AGES OF 18 AND 65 ONLY IF THEY

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