An example of drug sales run amok

As I write this, over 81,000 pharmaceutical representatives or 1 for every 7.9 physicians are fanning out across the United States trying to make their sales quotas. The more they sell, the bigger their bonuses.

In a book titled Blood Medicine: Blowing the Whistle on one of the Deadliest Prescription Drugs Ever, author Kathleen Sharpe provides an inside look into how Ortho, a division of Johnson and Johnson, sought to increase profits at the expense of patients. In this case, the drug they are pushing is called Procrit. The book was inspired by a whistle-blower lawsuit by two company employees, one of whom stated, “I want to be a millionaire.”

Even though the book focuses Ortho/Johnson & Johnson, I have no doubt that nearly all—if not all—of the big drug companies use many of the sales tactics described in the book, which include giving good deals to buyers (including free samples), plying them with gifts and “grants,” getting them to prescribe a lot, getting them to prescribe higher than recommended doses—whatever it takes. Here are a couple of quotes to give you the idea of the salespeople’s tactics:

“[McCellan, a salesman] started the day by bringing his boss along on a visit to Dr. Suresh Katakkar, who was set to buy $900,000 worth of Procrit that year. The doctor warmly greeted McClellan. A few weeks earlier, on April 12, McClellan had given him an Ortho check for $19,278.73—the physician’s bonus for exceeding his first-quarter purchase agreement.”

A dialogue between one salesman, named Duxbury, and his boss, goes like this: “’We’re giving them free Procrit, knowing they’re going to file for government reimbursement,’ he said. ‘Isn’t that Medicare fraud?’ ‘No,’ his boss replied. ‘All you’re doing is giving them Procrit. If they want to bill for the drug, that’s their business.’ …[Later they learn] the administrator had filed a Medicare claim based on its retail price, and presto! The federal government had actually paid for the free drugs at 95 percent of the inflated AWP [average wholesale price] price. That was pure profit, the administrator exclaimed. Duxbury reported back to Nelson, ‘They’re very happy to be making such good money on Procrit.’”

“[Duxbury] figured epo [the generic term for Procrit] had killed half a million people over the years, yet he couldn’t comprehend why the drug was still on the market approaching $100 billion in global sales… paying hundreds of millions to doctors every year to pump anemic patients with unsafe doses. In fact a cancer clinic near Seattle had received $2.7 million from Amgen [another company selling the drug] just for prescribing $9 million worth of its drug in 2006 alone.”

Next week: More reasons to be skeptical about drugs

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