Thursday, January 31, 2008

Cliches and the Definition of Insanity

My mind is cliche-driven this morning as I read about Eli Lilly and the potential one billion dollar criminal and civil settlement for the drug company's tactics in marketing its antipsychotic drug Zyprexa. "You can't teach an old dog new tricks" and "Deja vu all over again" keep percolating through my mind. Way back in the 1980s, i.e. less than twenty years ago, Lilly was indicted and prosecuted for its outrageous conduct in producing and selling a new arthritis product, Oraflex, that was marketed in the United States for a brief eleven weeks while nearly four thousand (not a misprint, 4000) elderly Americans died. Please try to focus on the points I am trying to make here and don't get side tracked by comparing the loss of life in the Oraflex fiasco with the Word Trade Center disaster. It wouldn't be fair to the Oraflex victims who all died slow and painful deaths over weeks because of combined liver and kidney failure. At least the WTC victims had the advantage of sudden death, or at most a few minutes of terror. (Please don't read this as any attempt on my part to minimize the horror of that event). It turns out that more than four hundred citizens of the British Isles took Oraflex and died, a fact which was known to Lilly BEFORE it was FDA-approved and sold to an unsuspecting American public. Lilly claimed that it didn't understand that it needed to report these known incidents to the FDA. The real outrage was that Lilly was allowed to subsequently plead guilty to 25 misdemeanor counts and pay a $25,000 fine, prompting the federal prosecutor to resign out of frustration and disgust. Before the Oraflex incident there was Lilly's sale and promotion of DES, a synthetic estrogen made from coal tar and a known carcinogen, to millions of pregnant women in the fifties and sixties. Virtually 100% of the female offspring of these pregnancies suffered cancer or structural deformities of their reproductive tracts thereby confirming what was observed when the drug was administered to pregnant animals in the 1930s. Of course, it is only incidental that the drug by the early 1940s had caused cancer in every organ system in every animal species it had been administered in hundreds of different scientific studies. What's that definition of insanity? Expecting different results from the same behavior?

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