In this NY Times Business article, it appears that Eli Lilly is going to agree to pay $1.4 BILLION to settle criminal and civil charges that it engaged in questionable marketing campaigns for the antipsychotic drug Zyprexa.
According to court documents, Lilly suggested that doctors use Zyprexa to sedate unruly nursing home patients and to treat disruptive children, even though it is FDA approved to treat schizophrenia and agitation associated with bipolar disorder.
The article states that Lilly wanted to settle the case so that Lilly isn’t barred from the Medicare and Medicaid programs – which account for a large portion of its income.
In 2007, Zyprexa had sales of $4.8 billion. In 2008, prescriptions for Zyprexa declined, but the sales increased because Lilly raised the prices on Zyprexa. Depending on the dose, the drug can cost up to $25/pill.
“Off label” use of any drug is entirely acceptable under FDA guidelines – manufacturers just can’t “officially” market their products for those uses (wink wink).
Doing “napkin” mathematics, $4.8 billion in sales divided by $15 per pill is about 320 million doses of medication. Divide that by each person getting 365 doses of Zyprexa in a year and there are about 900,000 patients on this medication each year. Yet, according to the article, “a series of landmark studies in recent years have cast doubt on that long-held view and suggested that Zyprexa is no better than older drugs that sell for far less.”
Why are doctors prescribing this stuff?