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flashl Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 08:25 AM
Original message
Pending $1 Billion Zyprexa Settlement
Lilly Considers $1 Billion Fine to Settle Case

Eli Lilly and federal prosecutors are discussing a settlement of a civil and criminal investigation into the company’s marketing of the antipsychotic drug Zyprexa that could result in Lilly’s paying more than $1 billion to federal and state governments.

If a deal is reached, the fine would be the largest ever paid by a drug company for breaking the federal laws that govern how drug makers can promote their medicines.

Several people involved in the investigation confirmed the settlement discussions, which began last year and took on new urgency this month. The people insisted on anonymity because they have not been authorized to talk about the negotiations.

Zyprexa has serious side effects and is approved only to treat people with schizophrenia and severe bipolar disorder. But documents from Eli Lilly show that from 2000 to 2003 the company encouraged doctors to prescribe Zyprexa to people with age-related dementia, as well as people with mild bipolar disorder who had previously had a diagnosis of depression.

NY Times
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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 09:28 AM
Response to Original message
1. the elderly
This pushing of drugs for the elderly is particularly reprehensible. The elderly are basically at the mercy of their doctors and the wishes of nursing home administrators.

http://www.alexanderlaw.com/zyprexa/side-effects.html

Following is a list of terms that reflect treatment-emergent adverse events reported by patients treated with olanzapine (at multiple doses ³1 mg/day) in clinical trials (8661 patients, 4165 patient-years of exposure). This listing does not include those events already listed in previous tables or elsewhere in labeling, those events for which a drug cause was remote, those event terms which were so general as to be uninformative, and those events reported only once or twice which did not have a substantial probability of being acutely life-threatening.

Events are further categorized by body system and listed in order of decreasing frequency according to the following definitions: frequent adverse events are those occurring in at least 1/100 patients (only those not already listed in the tabulated results from placebo-controlled trials appear in this listing); infrequent adverse events are those occurring in 1/100to 1/1000patients; rare events are those occurring in fewer than 1/1000patients.

Body as a Whole — Frequent: dental pain and flu syndrome; Infrequent: abdomen enlarged, chills, face edema, intentional injury, malaise, moniliasis, neck pain, neck rigidity, pelvic pain, photosensitivity reaction, and suicide attempt; Rare: chills and fever, hangover effect, and sudden death.

Cardiovascular System — Frequent: hypotension; Infrequent: atrial fibrillation, bradycardia, cerebrovascular accident, congestive heart failure, heart arrest, hemorrhage, migraine, pallor, palpitation, vasodilatation, and ventricular extrasystoles; Rare: arteritis, heart failure, and pulmonary embolus.

Digestive System — Frequent: flatulence, increased salivation, and thirst; Infrequent: dysphagia, esophagitis, fecal impaction, fecal incontinence, gastritis, gastroenteritis, gingivitis, hepatitis, melena, mouth ulceration, nausea and vomiting, oral moniliasis, periodontal abscess, rectal hemorrhage, stomatitis, tongue edema, and tooth caries; Rare: aphthous stomatitis, enteritis, eructation, esophageal ulcer, glossitis, ileus, intestinal obstruction, liver fatty deposit, and tongue discoloration.



And more!!
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flashl Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 10:02 AM
Response to Reply #1
3. Saying that we are 'lab rats' would probably be an upgrade. nt
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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 09:41 AM
Response to Original message
2. I wish all people and groups that pushed substances and treatment...
were held to the same strict standards and subject to the same massive penalties as big pharma!
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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 10:18 AM
Response to Reply #2
4. a challenge
Please name a substance which is improperly marketed to doctors as a treatment for the elderly.

Please name a substance (improperly marketed) that has the same side effect profile as Xyprexa, or as negative even if in a different way.

Please name a substance that I pay for through my insurance premiums or taxes that is improperly marketed, even if it has no side effects.

Remember that the amount of fine has to do with the size of company and the amount of sales.

Please name a company that pushes substances improperly that has the same market capitalization as Eli Lilly.

Please name a company that pushes a substance improperly with 4.8 billion dollars in annual sales, as this drug had in 2007.

Now, name a substance with all of the above characteristics, and then, yes, a one billion dollar fine would seem cheap.

Can you do it?
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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 10:43 AM
Response to Reply #4
5. Bwah ha ha
Love the challenge. Perfectly parameterized and categorized so that no other than a large pharmaceutical company could possibly fit it. A great exercise in mental masturbation! Too bad it doesn't make any kind of relevant point.

All I want is for the makers and pushers of ALL products and treatments to be subject to reasonable regulation, oversight, and penalties.

DO YOU?
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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 10:50 AM
Response to Reply #5
6. "Reasonable"
Reasonable is related to all the factors that I named.........particularly the side effect profile and clear fraud. Fraud is always against the law and fraud should be prosecuted. But fraud with a harmless substance doesn't seem quite as bad as fraud involving a harmful substance.
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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 10:52 AM
Response to Reply #6
7. Why do you assume a substance is harmless?
Plenty of 100% all-natural things are more deadly than even Vioxx.
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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 10:59 AM
Response to Reply #7
8. I didn't assume that
Some substances could be harmful, and if marketed fraudulently, then that is a problem.

Overall, though, I would say the FDA should leave the cherry growers alone--

http://www.businessweek.com/smallbiz/content/jun2006/sb20060626_541703.htm?campaign_id=bier_smjjk
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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 11:13 AM
Response to Reply #8
9. There you go again trying to sidetrack into a specific case.
It's the only way you can avoid the tough questions, isn't it?
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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 11:23 AM
Response to Reply #9
10. not at all
That just happens to be one where the FDA has acted to issue a warning to a group re: their advertising practices.
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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 11:26 AM
Response to Reply #10
11. Do you think, in general, that an entity which manufactures a product...
should have to prove the claims they make about the benefits of said product? *Even if* the product is otherwise "harmless"?
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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 11:36 AM
Response to Reply #11
12. should not be regulated
However, if they are guilty of fraud in promoting a product, they can be prosecuted in any state of the union. Fraud is prosecutable, and rightfully so.
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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 11:45 AM
Response to Reply #12
13. So you would rather wait until after people are harmed to do something?
No precautionary actions?
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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 12:05 PM
Response to Reply #13
14. Not a significant public health problem
I do not see a significant public health problem with supplements that would warrant any additional regulation.

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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 12:14 PM
Response to Reply #14
15. Ridiculous.
Where do you draw the line with "supplements"? Who decides what is "significant"? Only you?

Let's take your cherry example. Were you aware that cherry pits contain cyanide? I kid you not, they really do. Swallowing a even a couple of pits isn't a problem, of course. But if the pits are ground up and ingested, it doesn't really take that many to be harmful or even fatal. Let's say the cherry growers were allowed to make all sorts of claims about their product curing various conditions or diseases. Since they don't have any dosage information, the obvious assumption is that more = better. However any mechanical processing of cherries is naturally going to be busting up some pits and introducing some cyanide into the product - cherry juice, dried cherries, etc. So now you have a clear case where your precious innocent "supplement" could be deadly.

But no, you have the expertise and knowledge to declare "supplements" safe. Because they're always harmless.

Riiiiight.
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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 12:39 PM
Response to Reply #15
17. I never said that all supplements are safe
It isn't always safe to cross the street or drive in a car. What I see is no significant public health risk. There don't seem to be people falling out all over the place supplements or herbs. What are you going to do about cherry juice, exactly? It seems to me that if cherry juice is harmful that is irrespective of any claims made by the manufacturer, anyway. A lot of people drink cherry juice because it tastes good. The FDA has the power to remove any supplement or food that are harmful. That is a good idea. I'm a little more concerned about e.coli, and meat processing than I am supplements. That is where there is a public health risk, and I feel that history confirms this to be the case. I would rather see additional regulation resources be put in areas that I think have a greater chance of being a problem.

Perhaps I have missed this news. Have you heard of any cases of cyanide poisoning from cherry juice recently? If it indeed is dangerous, then the FDA should not allow it to be sold, irrespective of any claims made. But I don't think the cherry growers should have to prove safety before selling it--same with apple juice. It would be a really terrible marketing idea for a company to market a product that has the potential to be recalled for safety reasons.

Again, regulation should be used where there is a significant amount of public health risk.
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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 12:56 PM
Response to Reply #17
19. Answer the question.
How do you know what is "significant"?

There don't seem to be people falling out all over the place supplements or herbs.

One of the main reasons is because no one is REQUIRED to report these adverse effects for sweet innocent "supplements or herbs." The big evil corrupt gubmint you love to hate mandates that deaths and reactions be recorded when it comes to approved substances.

There's also the problem with people taking "supplements" and eschewing evidence-based medicine until it's too late. Who gets blamed then?

You're not following the reasoning about cherries, by the way. Think food item vs. medical product intended to treat or prevent a disease. With no indications as to dosage or use.

Again, regulation should be used where there is a significant amount of public health risk.

You have an extraordinarily simple black-and-white view of health issues. "Big pharma" = TEH EVUL, "Supplements" = safe and good

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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 01:17 PM
Response to Reply #19
20. not at all
Do you propose that all food reactions be reported? Herbs are foods of course, just sometimes put in capsule form.

So do you think we need to report ALL FOOD REACTIONS--shellfish can be dangerous of course. Should it be banned and/or regulated because it is harmful for some people?

So, is cherry juice with cyanide any less poisonous when claims are not made? I would want people protected from bad cherry juice even if they are recreational users.

The goal should be to save lives--as you can see by other posts, the FDA has its hands full with real threats.

You keep thinking that there *must* be lots of problems with supplements because reactions aren't required to be reported. All that means is that you have no proof of a problem--it is in your imagination. And people report all sorts of things that aren't required to be reported.





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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 01:47 PM
Response to Reply #20
21. Herbs are *concentrated* *parts* of foods.
Technically you could grind up cherry pits (or apple seeds or apricot pits, which also contain cyanide) and sell it as an herb/supplement. You haven't been paying attention in this discussion at all.

You keep thinking that there *must* be lots of problems with supplements because reactions aren't required to be reported.

No, I'm pointing out that BECAUSE they aren't reported, YOU are making an erroneous conclusion that they are far safer than they might be. Your conclusion is based on insufficient evidence.
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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 03:34 PM
Response to Reply #21
22. For the record
I don't think it is a good idea to make/eat cyanide filled apricot pits, or cyanide filled cherry juice, whether as a food or as a medicine.

But to argue that this is a reason to regulate herbs but not food is not logical.
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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 03:37 PM
Response to Reply #22
23. Was it right to regulate/ban Ephedra? It's just an herb, you know. n/t
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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 05:28 PM
Response to Reply #23
24. perfect example
People DO report reactions to products like this, and we see that there is harm. If they didn't we wouldn't know about it, would we?

If ephedra was bad enough to ban, then why wasn't Sudafed banned, which had pseudoephedrine in it? Now, only because it is made into meth, pseudoephedrine is getting harder to get. But what made it safer than ephedra? Nothing, really.

Athletes just way overdo things, and took way too much of the stuff. That is probably a decent reason to ban it. But the ban was inconsistent, since Sudafed stayed on the market for a time after that.
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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 07:19 PM
Response to Reply #24
25. Yes, a perfect example - against your position.
It totally goes against all you've said to this point. It's just an herb. It's just food. But it was controlled and banned by the FDA. You agree it was good, so you've just completed a great argument against yourself. Thanks.
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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 07:45 PM
Response to Reply #25
26. Sure when there is a known problem
Of course they have that power. I never said anything different. But what you wanted was prior proof submitted by the manufacturer of some substance that something "worked" for a condition, even though they made no claims for it--for herbs, of all things. I do not agree to that.
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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 07:49 PM
Response to Reply #26
27. I don't even understand what you just wrote.
You agree with me, thus contradicting yourself, but you don't agree with something else, which doesn't even make sense.

But what you wanted was prior proof submitted by the manufacturer of some substance that something "worked" for a condition, even though they made no claims for it--for herbs, of all things.

Please parse this sentence for this poor stupid big pharma shill who can't make heads nor tails out of it.
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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 09:29 PM
Response to Reply #27
28. What *do* you want?
I'm confused, I guess. If what you are saying is that you want the FDA to have the power to take dangerous products off the market, then, guess what, they have that power already. I agree with that. So what is the controversy?

If you say you don't want companies to make fraudulent claims about a product, well guess what, fraud is illegal. I agree with that.

So what's your beef? It seems we already have in place the things that you want. And I am fully supporting these measures that are already in place. What are you complaining about?
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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 09:33 PM
Response to Reply #28
29. I guess now that you've abandoned everything else you've said upthread,
there's nothing left to say.
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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 10:24 PM
Response to Reply #29
30. took back nothing
But I am glad you are happy with our current laws regarding supplements and feel no need for further regulation.
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trotsky Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-01-08 08:04 AM
Response to Reply #30
31. Absolutely not.
There is insufficient protection in place to guard against dangerous and improperly manufactured products - medications, supplements, herbs, food, all of it.
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lizerdbits Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 12:28 PM
Response to Reply #14
16. Vitamin overdoses
Edited on Thu Jan-31-08 12:29 PM by lizerdbits
Fat soluble vitamins will accumulate in adipose tissue and cause serious problems. There was a case on NEJM's site late last year. Man was hospitalized and eventually they found his vitamin D supplement contained far more than what the label said. IIRC his BUN and creatinine levels were elevated for almost a year after hospitalization. Why should vitamin producers not have any regulation as to what's on the label matching what's in the capsule?
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Celebration Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jan-31-08 12:41 PM
Response to Reply #16
18. one thing that would be a good idea
Is sampling of vitamins and supplements to see that labels are accurate. I support that.
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