New York Times
Risperdal is a billion-dollar antipsychotic medicine with real benefits — and a few unfortunate side effects
It can cause strokes among the elderly. And it can cause boys to grow large, pendulous breasts; one boy developed a 46DD bust.
Yet Johnson & Johnson marketed Risperdal aggressively to the elderly and to boys while allegedly manipulating and hiding the data about breast development.
The company also turned to corporate welfare: It paid doctors and others consulting fees and successfully lobbied for Texas to adopt Risperdal in place of generics. This meant that the state paid $3,000 a year for each Medicaid patient taking it, rather than $250 a year for each, Brill says.
J&J got caught, pleaded guilty to a crime and has paid more than $2 billion in penalties and settlements. But that pales next to some $30 billion in sales of Risperdal around the world.
Oh, and the person who was in charge of marketing the drug in these ways? He is Alex Gorsky, who was rewarded by being elevated to C.E.O. of J&J. He earned $25 million last year.
The company also turned to corporate welfare: It paid doctors and others consulting fees and successfully lobbied for Texas to adopt Risperdal in place of generics. This meant that the state paid $3,000 a year for each Medicaid patient taking it, rather than $250 a year for each
Building on that, J&J reached out to Omnicare, a company that provided pharmaceutical services in nursing homes. The two companies cut a deal so that Omnicare doctors would prescribe Risperdal, and the profits would be shared with Omnicare. (Yes, that’s called a kickback.)
Even though Risperdal wasn’t approved for the elderly, J&J formed a sales force, called ElderCare, with 136 people to market it to seniors. The F.D.A. protested and noted that there were “an excess number of deaths” among the elderly who took the drug.
At the same time, J&J was also expanding into another forbidden market: children. The company began peddling the drug to pediatricians, so that by 2000, more than one-fifth of Risperdal was going to children and adolescents.
In 2003, the company had a “back to school” marketing campaign for Risperdal, and a manager discussed including “lollipops and small toys” in sample packages
All this was great for business, and by 2004 Risperdal was a $3-billion-a-year drug.
One challenge was that a J&J study had found that Risperdal led 5.5 percent of boys to develop large breasts, a condition known as gynecomastia. J&J covered this up
I asked J&J and Gorsky for comment. In particular, I wanted to understand why an executive who presided for years over conduct that the company conceded was criminal had been elevated to CEO
Gorsky declined to comment