A new paper, written by Glen Spielmans and Peter Parry and published in the journal Bioethical Inquiry, shows how various drug companies, particularly Eli Lilly and AstraZeneca, manipulated science and lied to doctors in order to sell their drugs. While this is not exactly news, the intriguing aspect of this article is that the authors reproduce e-mails and slides that are the smoking guns of deceptive sales practices. And let me tell you, these gun barrels are hot and you can still smell the gun powder.
"The data don't look good."
That's what John Tumas, an AstraZeneca publications manager, wrote in an email to a brand manager and a scientist. He was referring to an AstraZeneca-funded study showing that Haldol was superior to Seroquel (oops!). The fact that AZ officials knew about this data didn't prevent them from sending one of their hired guns to an APA meeting two months later to claim that Seroquel was "significantly superior" to Haldol.
When AZ didn't have the stomach to lie about unfavorable study results, they did the next best thing--they buried them. "Thus far," wrote Mr. Tumas in a different email, "we have buried Trials 15, 31, 56 and are now considering COSTAR."
Zyprexa and Weight Gain: "Don't introduce the issue!"
Eli Lilly knew that Zyprexa caused enormous weight gain as far back as 1995, and knew that it was worse than competing atypical antipsychotics as of, at the latest, 1999--we know this because Alan Breier (now Lilly's Chief Medical Officer) admitted to senior executives in an email that "Fact: the order of weight gain among antipsychotics is: Clozapine>olanzapine [Zyprexa]>seroquel>risperidone>traditional neuroleptics."
But in 2001 Lilly sales reps were being trained to "neutralize" physicians' concerns about weight gain by pushing what managers were calling a "comparable rates message." Most of all, reps were instructed to follow the "don't ask, don't tell" policy favored by the U.S. Army regarding a different inconvenient issue.
There are many other zingers in this comprehensive description of what the authors call "Marketing-based Medicine" as opposed to "Evidence-based Medicine." The entire paper is required reading for those interested in the realities of pharmaceutical marketing in the modern age.
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