Eli Lilly Posts its Grand Deception

Eli Lilly has recently posted the Grand Deception which it is calling the "Lilly Faculty Registry." You can inspect it here. Why do I call it the "Grand Deception?" Because the doctors listed as "faculty" are not really faculty at all. They are salesmen and saleswomen, with MDs after their names.

The Wall Street Journal reported that over the first three months of 2009, Lilly pumped $22 million into doctors' pockets, and most of this was categorized as "Healthcare Professional Education." This is the same kind of education you'll get if you go to a Toyota dealership and ask the salesman to educate you about which hybrid to buy. You will get some education, most of it accurate, about the Toyota Prius. You'll hear about its gas mileage, its cubic footage and its GPS system. But you won't hear anything about Honda hybrids or Ford hybrids or Chrysler hybrids. You won't be getting "car-buying professional education." You'll be getting a marketing pitch.

Lilly's Healthcare Professional Education events are no different. Doctors who go to a Lilly-sponsored talk on depression, for example, will hear plenty of information about Lilly's blockbuster Cymbalta, most of it accurate. But they'll hear nothing about Zoloft, or Celexa, or Paxil, or Effexor, or Remeron, or Nardil, or any of the dozens of other antidepressants that are as effective as Cymbalta.

Here's how Lilly defines Healthcare Professional Education: "Speaker programs are intended to enhance a healthcare professional's knowledge and patient care expertise." Excuse my calling a spade a spade here, but that's simply a lie, and every speaker on the registry list (many of whom are friends and colleagues) knows it. The speakers are required to use Lilly's slides, and are required to say what Lilly wants them to say. And what Lilly wants them to say are things that will get the doctors in the audience to prescribe more Lilly drugs.

Aren't I insulting the intelligence of doctors? Don't the doctors who go to these talks understand that it is a hard sell? Of course they do. But this knowledge does not make them impervious to the effects of marketing. Everybody knows that the billboards for Bud Light are paid for by Anheuser Busch. But that doesn't make them any less effective.

The question is, do we want our doctors to get their medical education this way? To be plied with good food, plentiful wine, and a free ticket to a colleague's joke-filled presentation singing the praises of the company's drug? Of course not.

Most importantly, do these talks lead to patients being harmed? Almost certainly. Lilly's top-selling drug, Zyprexa, led to an average weight gain of 37 pounds in a year in one study (Strassnig M et al. Schizophr Res 2007 Jul; 93:90-8.). Now that's not a study you'll be hearing much about during Lilly's Healthcare Professional Education talks!