Eli Lilly (NYSE:LLY) Chairman and CEO John Lechleiter’s op-ed piece on “Health-Care Reform and the ‘Innovation Test’” in yesterday’s Wall Street Journal is yet another anti-consumer big pharma industry rant. Mr. Lechleiter does not want Americans to have the ability to choose between a public or private option for health insurance. And he’s against the government conducting cost benefit comparisons of medications and medical treatments so consumers can save money by using the most effective treatment at the lowest price.
Lechleiter reiterates big pharma’s party line, threatening that any tampering by government to bring down the costs of pharmaceutical drugs in America means “innovation may be written out of the script.” “U.S.-based private industry is the heart and soul of this innovation drama, investing $58 billion in research and development for new medicines in 2007 alone.”
Yet turning to the front page of yesterday’s Journal (“A Celebrity Backing Turns Sour for Drug Firm”) describes a different “innovation drama” taking place at big pharma. And the only thing being pushed out of this “innovation script” is the $60 billion per year drug companies spend marketing their products. This is twice the amount big pharma spends on research and development, according to a study published by the Public Library of Science.
Bristol-Myers Squibb’s (NYSE:BMY) innovation script for its “disease awareness” efforts marketing campaign is straight out of a Hollywood casting call. People who recovered from illness audition for a part in the campaign. If they pass the audition, they receive a callback where they’re given a script based on their talk during the audition. If selected, they’re paid to appear in TV commercials and give speeches at internal marketing events.
In early 2004, Bristol-Myers was seeking FDA approval to expand the use of its schizophrenia drug Abilify to treat bipolar disorder. According to the National Institutes of Health, bipolar disorder affects 5.7 million Americans. It is characterized by “mood episodes” that go from a depressive episode to a euphoric high called a "mania." Sometimes a person can exhibit a combination of both (a “mixed state”). Over half of all cases of bipolar disorder start before age 25.
A Bristol-Myers employee contacted Andy Behrman about promoting Abilify for bipolar after reading Behrman’s book, “Electroboy: A Memoir of Mania” chronicling his mood episodes and describing his drug use and electroshock therapy, his time as a stripper, and running an art forgery ring (which landed him in jail for five months).
Between February 2004 and December 2005, Bristol-Myers paid Behrman a total of $400,000 to appear in a promotional video and give speeches to Bristol-Myers sales reps at marketing events about his experiences using Abilify. In the video Behrman says: “Since I switched to Abilify, almost all the side effects have gone away. In fact, all of them have gone away.”
Behrman had been taking Abilify just four days before the video was shot, and within weeks of taking the drug he told the Journal he “developed stiffness and agitation in his legs” and that Abilify “clouded his thinking.”
Behrman was not contractually obligated to take Abilify, and stopped taking the drug in early 2005. He claims he privately complained to Bristol-Myers about its side effects. Bristol-Myers acknowledged to the Journal that “the appearance and onset of side effects depends on a number of variables,” but claims it has no record of Behrman’s complaint.
Behrman continued to speak at Bristol-Myers internal marketing events, where he praised Abilify as the only medication he took that didn’t have side effects. To prepare for these events, Behrman was regularly coached by a communications consultant and a PR firm employed by Bristol-Myers. Behrman said he was instructed to:
- Reiterate the drug has no side effects.
- Say that Abilify had “saved” him.
- Avoid mentioning (but if pressed respond truthfully) that he was being paid by Bristol-Myers.
Bristol-Myers even hired Andy Behrman’s psychiatrist, Mark Frye as a consultant, funding physician education videos featuring the two men.
The collaboration between Behrman and Bristol-Myers ended when Bristol-Myers offered to renew his contract for $150,000 a year for three years, but Behrman rejected the offer. (Behrman disputes Bristol-Myers’ assertion he asked for $7.5 million.)
Perhaps Behrman should have taken a cue from the Hollywood playbook he attempted to emulate and have asked for a low salary and a share of Abilify’s profits. (Abilify’s sales were $2.8 billion in 2008, making it Bristol-Myers’ second biggest selling drug.) Since his confidentiality agreement expired at the end of 2008, Behrman has been unsuccessful in acquiring a new speaking gig with another drug company.