Zyprexa

Zyprexa is drug made by Eli Lilly and used for the treatment of schizophrenia and bipolar mania. (The generic name of the drug is olanzapine.)

Zyprexa was approved for use by the U.S. Food and Drug Administration (FDA) in 1996. In 2006 Zprexa was Lilly's top selling drug, earing $4.2 billion for the company, a 4% increase on sales in 2005. Of the gobal sales, $2.1 billion was from the US and $US2.257 billion from the rest of the world. Sales of Zyprexa are critical to the company. In 2006 Zprexa generated revenues over three times as much as the company's next biggest drug, Gemzar.

In August 2006, Lilly registered the domain name Zyprexafacts.com, a site for use in crisis management campaigns.

Lilly seeks to suppress public access to internal documents
According to internal marketing documents, "Eli Lilly encouraged primary care physicians to use Zyprexa, a powerful drug for schizophrenia and bipolar disorder, in patients who did not have either condition." Under U.S. law, companies can't promote "prescription drugs for conditions for which they have not been approved ... although doctors can prescribe drugs to any patient they wish." Yet documents leaked to the New York Times describe "a multiyear promotional campaign" called "Viva Zyprexa," in which "Lilly told its sales representatives to suggest that doctors prescribe Zyprexa to older patients with symptoms of dementia." One document states "dementia should be first message" for primary care doctors, since they "do not treat bipolar" or schizophrenia, but "do treat dementia." Three months after its launch, the Zyprexa campaign "led to 49,000 new prescriptions. ... In 2002, the company changed the name of the primary care campaign to 'Zyprexa Limitless' and began to focus on people with mild bipolar disorder who had previously been diagnosed as depressed -- even though Zyprexa has been approved only for the treatment of mania in bipolar disorder, not depression." 

Federal district Judge Jack B. Weinstein has rejected a request to vary a gag order he made on January 4 blocking publication of material that would "facilitate dissemination" of leaked documents from the drug company, Eli Lilly [2]. The Electronic Frontier Foundation, representing an anonymous citizen journalist, argued that banning the addition of a link to the documents on the wiki-based website, Zyprexa Kills, is a breach of the individual's right to free speech. The documents about side-effects of Zyprexa [4], a drug used to treat schizophrenia and bipolar disorder, were cited in a series  of articles  in the New York Times in mid-December. The articles allege Eli Lilly "engaged in a decade-long effort to play down the health risks of Zyprexa."

A U.S. federal court judge has extended an injunction banning groups in the U.S. from adding a weblink to leaked internal documents on Eli Lilly's schizophrenia and bipolar disorder drug, Zyprexa. Despite the injunction, the documents have been distributed around the world from websites outside the U.S. Lilly also has problems on another front. The New York Times reports that "lawyers from the consumer protection division of the Illinois attorney general's office demanded that Lilly hand over marketing materials, e-mail messages, and other documents with information about promotion" of the drug. Vermont government investigators have made a similar order. At issue is whether Lilly hid information on weight gain and the associated risk of diabetes and also promoted the use of the drug for patients who didn't have schizophrenia or bipolar disorder. 

Preferential treatment by state plans
To "cut costs and reduce questionable prescriptions," 20 U.S. states contract with Comprehensive NeuroScience (CNS). CNS "identifies doctors who are prescribing psychiatric drugs outside of recommended guidelines. ... The states then send warning letters to doctors." 

In Minnesota, the CNS contract is funded by the drug company Eli Lilly. Minnesota spent $28 million on Lilly's drug Zyprexa for poor and disabled residents in 2005. Unlike other states, Minnesota does not require prior authorization for antipsychotic drugs, a practice that Lilly opposes. "In fact," reports the Pioneer Press, "none of the states with Lilly partnerships use prior authorization to manage antipsychotic drugs. ... Wisconsin had a contract with Lilly last year, when the state's Medicaid agency placed antipsychotic drugs, including Zyprexa, on the prior authorization list. State officials were informed shortly thereafter that Lilly was canceling the program." Minnesota also requires "dose optimization" -- often resulting in less profit for drug manufacturers -- for other antipsychotic medications, but not for Zyprexa. 

Contact details

 * Eli Lilly's Official Zyprexa website: http://www.zyprexa.com/index.jsp
 * Eli Lilly's Crisis Management Zyprexa website: http://www.zyprexafacts.com/

SourceWatch resources

 * Drug industry
 * Eli Lilly

Lilly media releases

 * Eli Lilly, "Eli Lilly and Company Responds to New York Times Article of December 17, 2006", Media Release, December 16, 2006.
 * Eli Lilly, "Response to The New York Times Article from December 18, 2006", Media Release, December 18, 2006.
 * Eli Lilly, "Eli Lilly and Company Statement Regarding Today's New York Times Article - December 21, 2006", Media Release, December 21, 2006
 * Eli Lilly, "Eli Lilly and Company Statement Regarding Today's New York Times Article - January 4, 2007", Media Release, January 4, 2007.
 * Eli Lilly, "Judge Grants Lilly’s Request for a Permanent Injunction Involving Misleading Selection of Illegally Leaked Lilly Documents", Media Release, February 14, 2007.

General articles

 * Alex Berenson, "Eli Lilly Said to Play Down Risk of Top Pill", New York Times, December 17, 2006.
 * Alex Berenson, "Drug Files Show Maker Promoted Unapproved Use", New York Times, December 18, 2006.
 * Alex Berenson, "Disparity Emerges in Lilly Data on Schizophrenia Drug", New York Times, December 21, 2006.
 * Tom Zeller Jr. "Documents Borne by Winds of Free Speech", New York Times, January 15, 2007.
 * Alex Berenson, "Leaked Documents On Lily Drug Marketing Prompt Investigation: States Study Marketing of Lilly Pill", New York Times, January 20, 2007.
 * Michael Muskal, "Judge says Internet documents fall outside injunctions' reach", Los Angeles Times, February 13, 2007.
 * Landon Thomas Jr. "Judge Rules Drug Documents Must Be Returned to Eli Lilly", New York Times, February 14, 2007.
 * Jeremy Olson, "Minnesota / Lilly link to state program questioned: Critics see a conflict of interest in drugmaker's health plan role," Pioneer Press (St Paul, MN), August 20, 2007.
 * Margaret Cronin Fisk and Elizabeth Lopatto, "Lilly Trained Sales Force to Ignore Drug's Risks (Update2)", Bloomberg, July 31, 2008.