Drugs Dollars and Doctors

Got to pay for that house in Aspen somehow….

Benjamins

Suit Details How J&J Pushed Sales of Procrit – WSJ.com

Documents in a lawsuit filed against Johnson & Johnson by two former salesmen show how the pharmaceutical giant sought to boost sales of its blockbuster anti-anemia drug Procrit by offering contracts that fattened doctors’ profits and urging its salespeople to push higher-than-approved doses.

Some of Mr. [Dean] McClellan’s documents [a drug salesman for 12 years] reviewed by The Wall Street Journal indicate that Ortho Biotech created complex purchasing programs offering doctors discounts and cash rebates on Procrit, which would increase the doctors’ profits.

Procrit is an infused drug, which is administered by a doctor. Unlike pills sold by pharmacies, infused drugs offer profit opportunities for doctors, who can buy the drugs, administer the infusions in their offices, and collect the payments from insurers or the government. Drug companies can fatten the doctor’s margin using discounts and rebates to lower the price.

How are these doctors any different than a street corner drug dealer? Why doesn’t the DEA spend some time investigating these pushers too? Reminds me of Glenn Greenwald’s question as to why doctors can over-rule patients.

Mr. McClellan’s documents on the marketing of Procrit show that in 2004 — after Amgen Inc.’s competing drug Aranesp came on the market — J&J made offers that would allow buyers of Procrit to receive discounts off an already-reduced price as well as rebates. For example, an internal company memo calculates that a physician who bought nearly $1 million of Procrit over 15 months would get a check for $237,885 back, or 24%.

Another J&J program offered hospitals an incentive to buy Procrit and shun Aranesp: discounts on purchases from across Johnson & Johnson’s product line — including some huge-selling drugs and medical devices sold by different subsidiaries — if the hospital used Procrit at least 75% of the time when prescribing anti-anemia drugs.

In addition, J&J created a “Right of First Refusal” contract for doctors, requiring them to allow Ortho Biotech to make a counteroffer if Amgen’s Aranesp price undercut Procrit.

Mr. McClellan also alleges the company pushed doctors to prescribe a higher dose years before it was approved as safe and effective by the FDA. For years, the company focused on educating health care providers on Procrit’s medical benefits, he says. But in the mid-1990s at a national sales force meeting, an Ortho executive announced that the division was moving to promote what it called “QW dosing,” switching patients from three, 10,000-unit doses a week to a single, 40,000-unit dose in cancer patients, Mr. McClellan says.

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