On November 5, 2013, Attorney General Eric Holder, announced that the Justice Department had reached $2.2 billion settlement with Johnson & Johnson. The amount covers both criminal and civil fines for illegally marketing Risperdal, an antipsychotic drug, to older patients with dementia.
Originally, the drug was intended for patients with Schizophrenia, but it didn’t take long for Johnson & Johnson to start trying to expand the use of the drug. Despite the Federal Drug Administration’s efforts to rein in the scope of the drug, Johnson & Johnson continued to pursue efforts to market the drug to elderly patients. They even went so far as to create a special sales team whose sole responsibility was to market the drugs to nursing homes and other medical professionals who specialized in treating the elderly.
Sales materials stated that the drug would help address symptoms of agitation, confusion, and hostility, especially among dementia patients in nursing homes. This is despite the fact that it had only been approved to treat patients with Schizophrenia and actually posed dangerous health risks, including strokes.
The Justice Department maintains that Johnson & Johnson marketed drugs as a way to sedate difficult dementia patients. From 1999-2005, Risperdal was one of the company’s biggest sellers. During that period the drug was heavily promoted for unapproved uses and the company reportedly illegal monetary kickbacks to doctors and pharmacists who were willing to prescribe Risperdal more often.
While reports of the lawsuit don’t go so far as to claim that J.&J., was suggesting that doctors use the drug to sedate difficult patients, it certainly sounds like that is exactly what the company had in mind. This disturbing marketing strategy eventually expanded and began being aimed at child psychologists and children with attention deficit disorder. It seems that the medicine was meant to treat symptoms and make life easier on caregivers, without much concern for the well-being of the patient.
Not only did J.&J. participate in corrupt practices, they specifically targeted vulnerable segments of the population: seniors and children who are already suffering from cognitive diseases.[i] J.&J. worked closely with Omnicare, which caters to nursing homes. They paid Omnicare millions of dollars to promote Reprisal while also downplaying potential risks.
Unfortunately, while a $2.2 billion fine certainly sends the message that the Justice Department is not afraid to prosecute large pharmaceutical companies, it doesn’t come close to placing a financial burden on the company.[ii] While J.&J. should be held responsible for reckless and illegal marketing practices, it is important to remember that they are only one part in a more complicated network of corruption. They wouldn’t have been able to turn Risperdal into a flagship drug without the help of physicians who were willing to ignore harmful side effects and prescribe drugs in return for kickbacks.
Another stipulation of the settlement requires J.&J. to be more transparent about the findings of their research. Unfortunately, regulating transparency is a difficult and somewhat abstract endeavor. If it was a more straightforward process, J&J wouldn’t have been allowed to employ corrupt marketing practices in the first place.
Other piece of this puzzle involves a society that is willing to exploit the most vulnerable portions of our population and overmedicate those will difficult illnesses. J&J is responsible for marketing a potentially dangerous drug to people who would not benefit from its use, yet they are only one player in a much larger problem. Solving the problem of corruption in the pharmaceutical and healthcare industries is a daunting task. Where do you think we should start?