PHARMACY

Eli Lilly mulls $1 billion Zyprexa settlement

BY Drew Buono

INDIANAPOLIS Eli Lilly is trying to avoid civil and criminal prosecution by discussing with federal prosecutors a settlement regarding the company’s marketing practices of the antipsychotic drug Zyprexa that could result in Lilly’s paying a fine more than $1 billion to federal and state governments, according to The New York Times.

Zyprexa is approved to treat people with schizophrenia and severe bipolar disorder. However, documents from Eli Lilly show that from 2000 to 2003 the company encouraged doctors to prescribe Zyprexa to people with age-related dementia, as well as people with mild bipolar disorder who had previously had a diagnosis of depression.

Lilly may also plead guilty to a misdemeanor criminal charge as part of the agreement, people involved with the investigation said. But the company would be allowed to keep selling Zyprexa to Medicare and Medicaid, the government programs that are the biggest customers of the drug.

The Lilly fine would be distributed among federal and state governments, which spend about $1.5 billion on Zyprexa each year through Medicare and Medicaid. The fine would be in addition to $1.2 billion that Lilly has already paid to settle 30,000 lawsuits from people who claim that Zyprexa caused them to develop diabetes or other diseases. Zyprexa can cause severe weight gain in many patients and has been linked to diabetes by the American Diabetes Association.

Federal prosecutors have been investigating Lilly for its marketing of Zyprexa since 2004, and state attorneys general have been doing so since 2005. The people involved in the investigations said the inquiries gained momentum after December 2006, when the New York Times published articles describing Lilly’s years-long efforts to play down Zyprexa’s side effects and to promote the drug for conditions other than schizophrenia and severe bipolar disorder.

Internal Lilly marketing documents and e-mail messages showed that Lilly wanted to persuade doctors to prescribe Zyprexa for patients with age-related dementia or relatively mild bipolar disorder.

In one document, an unidentified Eli Lilly marketing executive wrote that primary care doctors “do treat dementia” but leave schizophrenia and bipolar disorder to psychiatrists. As a result, sales representatives should discuss dementia with primary care doctors, according to the document, which appears to be part of a larger marketing presentation but is not marked more specifically. Later, the same document says that some primary care doctors “might prescribe outside of label.”

Zyprexa is Lilly’s best selling drug, with worldwide sales of $4.8 billion in 2007.

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Aetna sues Express Scripts over specialty pharmacy

BY Drew Buono

PHILADELPHIA Last month, in the U.S. District Court in Philadelphia, Aetna filed a lawsuit accusing Express Scripts of “knowing, malicious, willful, deliberate and bad faith misrepresentations and outrageous misconduct” in allegedly interfering with pacts between Aetna and Priority Healthcare in the specialty pharmacy market, according to the Associated Press.

Express Scripts acquired Priority Healthcare in 2005, the year after Aetna and Priority had joined together to start a specialty pharmacy venture, Aetna Specialty Pharmacy. After Express Scripts acquired Priority, Aetna exercised its option to buy out Priority’s stake in the joint venture for $75 million, making Aetna Specialty Pharmacy a subsidiary of the health insurer.

Now, Aetna is looking to recover that $75 million plus punitive damages and injunctive relief to make Express Scripts honor the original agreement between Priority and Aetna.

Aetna alleges that Express Scripts, by violating the law and the agreements for the Aetna-Priority joint venture, has “gained an unfair competitive advantage” that precludes the health insurer and its specialty pharmacy business from “prospective advantageous relationships and markets.” Among its claims, Aetna says that its special pharmacy business has been wrongly denied access to certain limited-availability drugs, which has limited its opportunities to develop new markets.

Aetna also alleges that even before the pharmacy benefits manager announced its acquisition of Priority Healthcare in 2005, Express Scripts aimed to injure or destroy Aetna’s efforts to establish a “best of class,” standalone, independent specialty pharmaceutical business by depriving it of best-pricing guarantees in Aetna’s joint-venture agreements with Priority and the benefit of Priority’s supplier and vendor contracts.

Express Scripts has not yet filed a response.

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New Mexico disallows second-party prescription pickups without I.D.

BY Drew Buono

GALLUP, N.M. On Jan. 1, a law originated by the New Mexico state pharmacy board was put into effect that required anyone who picked up a prescription for someone else had to present a government issued photo identification, such as a driver’s license or an ID card, according to published reports. The law was created to stop fraudulent prescriptions from being filled.

One of the first people to be arrested under this new law was Michelle Florene Roan, who had attempted this stunt many times and had previously gotten away with it. She was arrested at a Wal-Mart pharmacy after coming in with a fake prescription for a narcotic.

Tom Ortega, a pharmacist at Trust Pharmacy is on the state pharmacy board that enacted this law. “We are a small pharmacy here in Grants, I know everyone who comes in,” Ortega said.

“If I don’t know them, or if they have a prescription from an out-of-state doctor, I contact the doctor’s office to see if it is good,” he said. The reason Roan probably selected Wal-Mart to try to get the drugs is it is located right next to Interstate 40 and is accessible to all the traffic and is very busy, Ortega said.

The new law is working so far; people trying to pick up prescriptions for other people has dropped by 70 percent.

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