In an online article for CNN Money by Gregory Wallace and Evan Perez (November 4, 2013), entitled: “Johnson & Johnson to pay $2 billion for false marketing,” we are again introduced to the world of kick-backs, unethical medical practices 
and blatant Medicare fraud. How or why the pharmaceutical industry has trouble in maintaining ethical values has become increasingly mysterious to me. What’s up with this ethical misconduct?
According to the article:
“The penalties announced Monday by the Justice Department involve fines and forfeiture to the federal government and several states. It involves the schizophrenia drugs Risperdal and Invega, and the heart failure drug Natrecor.”
At the core of the story, the drug Risperdal was marketed to physicians for uses other than uses for which it was approved. Though approved for schizophrenia, it was also sold to physicians for patients suffering from dementia and related diseases. An additional wrinkle is that Johnson & Johnson knew that the drug could put patients at a higher risk for diabetes, but they never publicly acknowledged the fact.
The pharmaceutical company also aggressively marketed their cardiac medication for conditions less severe than for what they were intended.
Johnson & Johnson promoted the unapproved uses for these drugs by sending paid pharmacists into nursing homes to review patient records and to make recommendations to physicians for treatment.
Though the pharmacists posed as independent consultants they were, in fact, paid by the pharmaceutical company to make those recommendations. The unnecessary medications were, of course, paid for by you – the taxpayer.
Where to start?
Maybe I could start with the victims; to the elderly patients themselves. I can recall the people I have known who lived out the last years of their lives in nursing homes trusting those who were younger and smarter to care for them when they were unable to care for themselves. Did the elderly patients not deserve better? Were they an inconvenience to the drug company or a number to which a medical bill could be attached? It leads me to wonder if anyone at Johnson & Johnson has a relative in a nursing home. Just saying.
Taxpayers were also victims; we footed the bills through Medicare. When we paid for one of those unauthorized drugs did anyone ask us if we would have wished these drugs on our parents, aunts, uncles and friends? Would I have wanted my tax dollars to subsidize harming another human being?
Does Johnson & Johnson’s think I would not understand that my tax dollars funded the unauthorized and unnecessary use of a drug? Do they not think that I would have felt badly knowing an elderly patient might have developed diabetes because my tax dollars indirectly enabled them to get the disease? Again, just asking.
The Spotlight
Though I am upset at the ethical misconduct of Johnson & Johnson, I am even more upset at the ethical misconduct of the licensed pharmacists. I cannot imagine a pharmacology college in North America (make that anywhere) that would condone one of its graduates pushing a drug for a use for which it was not intended. It leads me to wonder if the pharmacists were intentionally misled by the pharmaceutical company or if they willingly fronted for the company in an exchange for a salary. Have the ethical values of the pharmaceutical business slid that far off of the charts?
This case is one more example of how a lack of ethical controls and an absence of ethical training, combined with the opportunity to take the wrong ethical road can lead to dire consequences.
On one hand, we might say the unethical conduct lead to a two billion dollar consequence. I suppose it stings them a bit; I also suppose it won’t sting them for long. On the other hand, we might wonder if their practices led to the premature death of just one, unsuspecting patient. Maybe someone we loved and treasured.
It is the second possibility that really eats at me as I write this blog.