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Eli Lilly Pays a Record $1.4 Billion to Settle Federal and State Fraud Investigations into Illegal Zyprexa Off-Label Marketing Practices
Date:1/15/2009

sentative far exceeded the revenues generated per representative in any other Zyprexa sales division.

According to Deming, Lilly had no legitimate purpose in creating a sales force to call upon nursing homes and other elder care facilities because Zyprexa is not approved for any use in that patient population in addition to the fact that the typical residents of these homes were not schizophrenic or bipolar. "Our clients questioned their superiors about the legality of Lilly's Zyprexa marketing practices," explained Deming, "but they were instructed that as long as they adhered to Lilly's LTC marketing message, the LTC marketing tactics were not illegal."

Because of the lack of any FDA-approved use in the LTC demographic, LTC sales representatives were instructed to focus on "behavior treatment," i.e., Zyprexa's efficacy in treating disruptive and combative patients and patients exhibiting signs of anxiety, depression, and loss of concentration who were demanding of caregiver time and effort. Lilly's Zyprexa marketing arm, the Zyprexa Brand Team, created marketing tools tailored to the LTC symptom-based sales message, such as colorful visual detail aids that stressed Zyprexa's ability to "restore calm" in elderly patients.

Because one of Zyprexa's primary side effects is somnolence or drowsiness, Zyprexa was often used to sedate patients, a practice that was commonly referred to as "snowing." According to Kenney, "Lilly even devised a LTC sales slogan used nationwide - '5 at 5 pm,' which was shorthand for dosing elderly patients with 5 milligrams of Zyprexa at 5 pm to keep patients calm throughout the night." "It's particularly disturbing that such a potent drug, with so many serious adverse side effects, was so blatantly abused in a vulnerable patient population whose health is already at risk," stated Kenney. Kenney added that "at many nursing homes this potent antipsychotic was essentially used as a 'c
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SOURCE Kenney, Egan, McCafferty & Young
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