September 17, 2015 — America’s Most Admired Law Breaker continues with the story of how Johnson & Johnson used illegal marketing tactics in Texas to convince doctors around the world to prescribe Risperdal “off-label” for children and the elderly.
The story begins in Texas, where J&J worked with state Medicaid and health officials (some of whom were paid “consulting fees”) to develop “Expert Consensus Guidelines” listing Risperdal as the first-line treatment for psychotic illness.
Nevermind that J&J’s own studies comparing Risperdal to Haldol, an inexpensive generic antipsychotic, showed that the two drugs worked equally well. By 1999, taxpayers in Texas were paying $3,000 per patient on Risperdal, compared to $250 for generic Haldol.
J&J worked out a kickback scheme for doctors, paying higher “speaking fees” for more prescriptions. Those doctors traveled around the country talking to colleagues about Risperdal.
J&J also worked out an illegal kickback scheme with Omnicare, a company that provided pharmaceutical services to nursing homes.
Pharmaceuticals companies are not allowed to prescribe medications for anything other than what the FDA has explicitly allowed. When those approved indications don’t jibe with billions of dollars in potential profits, illegal marketing campaigns are born.
The FDA explicitly warned J&J not to market Risperdal in children and the elderly. Today, Risperdal carries a “Black Box” warning that it increases the risk of death for elderly dementia patients. It has also been linked to gynecomastia — growth of massive female breasts on young boys.
One young boy was recently awarded $2.5 million for his injuries. J&J may end up paying $6 billion to resolve lawsuits and government investigations, including a $2.2 billion penalty ripping off taxpayers and the government.
But that pales next to the estimated $30 billion in global sales for Risperdal, or the $25 million salary Alex Gorsky raked in last year as C.E.O of J&J. Before Gorsky was promoted, he headed the marketing campaign for Risperdal.