Comments on: Lilly Backs Bill Requiring Payment Disclosure http://www.pharmalot.com/2008/05/lilly-backs-bill-requiring-payment-disclosure/ News, Comment and Conversation Sat, 20 Mar 2010 14:56:46 +0000 http://wordpress.org/?v=2.6.2 By: M Helm, MD http://www.pharmalot.com/2008/05/lilly-backs-bill-requiring-payment-disclosure/#comment-356756 M Helm, MD Wed, 14 May 2008 21:41:57 +0000 http://www.pharmalot.com/?p=13613#comment-356756 Nathan, I agree with your assessment here, and I too commend Lilly on this move whatever their motive - assuming that it is not to water the bill down so the risk analysis makes it easier to go ahead and do whatever they want. I think it may simply be an issue where one law is better than fifty. I have to wonder about the term "gifts" and what will constitute "payments" though. If a company pays for "consultation" work is that a gift or compensation? I would assume a plane ticket to a conference would be a gift, but what about payments to a practice to defray research project expenses for those undisclosed Phase IV trials? There is a lot that can be done to a bill to dilute it's intent beyond what is reported here. Let us not forget that Lilly has an aggressive stance public policy even down to the state level. In several states, Lilly has sponsored and passed legislation which limits public and private payors ability to ensure appropriate use of the medications they produce. These have been promoted as "open access" laws, but the actual intent is to prohibit Drug Utilization Review activities, step therapy (which if you believe the STAR-D results, may be entirely reasonable for antidepressants), or any need for prior approval or review on everything from ADD medications to atypical antipsychotics (even in children or institutionalized frail elderly - where there should be more caution). Lilly also infiltrated and ran the National Alliance for Mental Illness for a number of years. On cafepharma, even their own reps call the company "We Lie" Lilly. Poor Eli, he left a fine legacy for a long time. Not so much anymore. Nathan,

I agree with your assessment here, and I too commend Lilly on this move whatever their motive - assuming that it is not to water the bill down so the risk analysis makes it easier to go ahead and do whatever they want. I think it may simply be an issue where one law is better than fifty.

I have to wonder about the term “gifts” and what will constitute “payments” though. If a company pays for “consultation” work is that a gift or compensation? I would assume a plane ticket to a conference would be a gift, but what about payments to a practice to defray research project expenses for those undisclosed Phase IV trials? There is a lot that can be done to a bill to dilute it’s intent beyond what is reported here.

Let us not forget that Lilly has an aggressive stance public policy even down to the state level. In several states, Lilly has sponsored and passed legislation which limits public and private payors ability to ensure appropriate use of the medications they produce. These have been promoted as “open access” laws, but the actual intent is to prohibit Drug Utilization Review activities, step therapy (which if you believe the STAR-D results, may be entirely reasonable for antidepressants), or any need for prior approval or review on everything from ADD medications to atypical antipsychotics (even in children or institutionalized frail elderly - where there should be more caution).

Lilly also infiltrated and ran the National Alliance for Mental Illness for a number of years. On cafepharma, even their own reps call the company “We Lie” Lilly. Poor Eli, he left a fine legacy for a long time. Not so much anymore.

]]> By: Cynical http://www.pharmalot.com/2008/05/lilly-backs-bill-requiring-payment-disclosure/#comment-356686 Cynical Wed, 14 May 2008 14:34:53 +0000 http://www.pharmalot.com/?p=13613#comment-356686 Good attempt at positive PR, but probably will not fundamentally change the way they do business. They have been on the edge too long. That's probably why they won't reveal the past activities. It would be too much of a risk. The Big Pharma companies are all about trying to build trust at this point, but they have a long, long way to go. Too many misdeeds over too many years to rake in too much money. Who's going to make sure that they've really turned obver a new leaf? We can't yet trust them to. Good attempt at positive PR, but probably will not fundamentally change the way they do business. They have been on the edge too long. That’s probably why they won’t reveal the past activities. It would be too much of a risk. The Big Pharma companies are all about trying to build trust at this point, but they have a long, long way to go. Too many misdeeds over too many years to rake in too much money. Who’s going to make sure that they’ve really turned obver a new leaf? We can’t yet trust them to.

]]> By: Nathan http://www.pharmalot.com/2008/05/lilly-backs-bill-requiring-payment-disclosure/#comment-356673 Nathan Wed, 14 May 2008 12:44:38 +0000 http://www.pharmalot.com/?p=13613#comment-356673 Tim -- While I continue to applaud Lilly's decision, I completely agree with your cynisism. This goes back to a discussion we were having a couple weeks ago. Companies frequently face choices between profit and ethics. Which will they choose? Unless there is a big stick or a big carrot, they will choose profit. Therefore, I can only assume that one of the following is true: 1) They figured that these laws were coming anyway, so they might as well look like the "good guy" and jump on board early. 2) They really were beginning to feel financial pressure from lawsuits, shareholder demands, fines, etc. 3) They really took a "long-term" view of the industry and figured that continuing down the current path would lead to long-term lower valuation of our industry (due to #2). 4) I was wrong about the “big stick/big carrot” approach and Lilly execs really do put ethics before profits. Tim — While I continue to applaud Lilly’s decision, I completely agree with your cynisism. This goes back to a discussion we were having a couple weeks ago. Companies frequently face choices between profit and ethics. Which will they choose? Unless there is a big stick or a big carrot, they will choose profit. Therefore, I can only assume that one of the following is true:
1) They figured that these laws were coming anyway, so they might as well look like the “good guy” and jump on board early.
2) They really were beginning to feel financial pressure from lawsuits, shareholder demands, fines, etc.
3) They really took a “long-term” view of the industry and figured that continuing down the current path would lead to long-term lower valuation of our industry (due to #2).
4) I was wrong about the “big stick/big carrot” approach and Lilly execs really do put ethics before profits.

]]> By: Tim http://www.pharmalot.com/2008/05/lilly-backs-bill-requiring-payment-disclosure/#comment-356666 Tim Wed, 14 May 2008 11:24:40 +0000 http://www.pharmalot.com/?p=13613#comment-356666 It wouldn't surprise me at all to find out that even though Lilly backs this bill publicly, behind the scenes they are paying off politicians and everyone else in their way to keep it from getting past. This stance is great PR for the company, but ultimately it would only hinder their company goals and affect their profits. I don't believe lilly or any other big Pharma company would honestly support this type of legislation. It wouldn’t surprise me at all to find out that even though Lilly backs this bill publicly, behind the scenes they are paying off politicians and everyone else in their way to keep it from getting past.

This stance is great PR for the company, but ultimately it would only hinder their company goals and affect their profits.

I don’t believe lilly or any other big Pharma company would honestly support this type of legislation.

]]> By: Matthew Holford http://www.pharmalot.com/2008/05/lilly-backs-bill-requiring-payment-disclosure/#comment-356665 Matthew Holford Wed, 14 May 2008 10:25:57 +0000 http://www.pharmalot.com/?p=13613#comment-356665 Self-regulation doesn't tend to be very efficient regulation, on the whole - we still don't have access to negative trials' data, after all, whatever one's position on that may be. There's a culture, here, that is anything but transparent. Can an opaque culture conduct a transparent act, in a transparent way? I'm not sure that it can. Incidentally, it always amuses me greatly to point out that Eli is the company that made LSD for the CIA's Mind Control programme. To what extent does Eli still think like that? Matt Self-regulation doesn’t tend to be very efficient regulation, on the whole - we still don’t have access to negative trials’ data, after all, whatever one’s position on that may be. There’s a culture, here, that is anything but transparent. Can an opaque culture conduct a transparent act, in a transparent way? I’m not sure that it can.

Incidentally, it always amuses me greatly to point out that Eli is the company that made LSD for the CIA’s Mind Control programme. To what extent does Eli still think like that?

Matt

]]> By: Paul http://www.pharmalot.com/2008/05/lilly-backs-bill-requiring-payment-disclosure/#comment-356664 Paul Wed, 14 May 2008 04:03:30 +0000 http://www.pharmalot.com/?p=13613#comment-356664 Skeptical, I get your point, what do you want? We keep criticizing companies and demanding things from them. When they do them or give them to us we still want to shoot them down. How can we ever get beyond this. If in your mind it is a lost cause then don't waste your time blogging or your nerves worrying about it. On the other hand, there are enough of us in these blogs who see that there is a way forward. Skeptical,

I get your point, what do you want? We keep criticizing companies and demanding things from them. When they do them or give them to us we still want to shoot them down.

How can we ever get beyond this. If in your mind it is a lost cause then don’t waste your time blogging or your nerves worrying about it. On the other hand, there are enough of us in these blogs who see that there is a way forward.

]]> By: Skeptical http://www.pharmalot.com/2008/05/lilly-backs-bill-requiring-payment-disclosure/#comment-356661 Skeptical Wed, 14 May 2008 03:24:16 +0000 http://www.pharmalot.com/?p=13613#comment-356661 Give me a break! The company that used piles of money to sell Zyprexa to thousands of people that didn't need it. The same company that used oodles of cash to push Prozac for years. Too little too late. They won't be able to weasel their way out of the Zyprexa mess! Give me a break! The company that used piles of money to sell Zyprexa to thousands of people that didn’t need it. The same company that used oodles of cash to push Prozac for years. Too little too late. They won’t be able to weasel their way out of the Zyprexa mess!

]]> By: Paul http://www.pharmalot.com/2008/05/lilly-backs-bill-requiring-payment-disclosure/#comment-356659 Paul Wed, 14 May 2008 02:55:01 +0000 http://www.pharmalot.com/?p=13613#comment-356659 I think everyone will jump on board now, they have no choice; who wants to stick out with a big bullseye? Good for Lilly to being the first. I et all the other big ones are kicking themselves for being too slow. I also think that this is a good thing. Sounds like there was some coming together of minds to do something that everyone can live with and bring some reason to this stupid debate. Can this be an example of things to come? I think everyone will jump on board now, they have no choice; who wants to stick out with a big bullseye?

Good for Lilly to being the first. I et all the other big ones are kicking themselves for being too slow.

I also think that this is a good thing. Sounds like there was some coming together of minds to do something that everyone can live with and bring some reason to this stupid debate.

Can this be an example of things to come?

]]> By: Justice in Michigan http://www.pharmalot.com/2008/05/lilly-backs-bill-requiring-payment-disclosure/#comment-356658 Justice in Michigan Wed, 14 May 2008 02:50:01 +0000 http://www.pharmalot.com/?p=13613#comment-356658 It's very heartening to hear these responses. They don't surprise me, but it's good to hear directly. Thanks for that! It’s very heartening to hear these responses. They don’t surprise me, but it’s good to hear directly. Thanks for that!

]]> By: Phrma Doc II http://www.pharmalot.com/2008/05/lilly-backs-bill-requiring-payment-disclosure/#comment-356657 Phrma Doc II Wed, 14 May 2008 02:33:34 +0000 http://www.pharmalot.com/?p=13613#comment-356657 Agreed. Would love to see my company support this but what I hear instead is that we are fighting it like crazy behind the scenes. Very disappointing. If our payments to physicians for speaking and consulting cannot be defended then we probably shouldn't be doing it. But rather than participate in necessary change we will fight and fight until we are pulled into it with our last gasping breath. Again, what we lack is leadership. I never would have expected it to be Lilly to take a leadership position like that but the industry certainly needs it. I think Lilly might just be trying to get out in front because they will probably be announcing a huge settlement with the government. But there's nothing wrong with a turn-around as long as the new direction is the right one. We certainly can't expect leadership from Merck, Schering, BMS, Novartis, Pfizer or Sanofi/Aventis. Agreed. Would love to see my company support this but what I hear instead is that we are fighting it like crazy behind the scenes. Very disappointing. If our payments to physicians for speaking and consulting cannot be defended then we probably shouldn’t be doing it. But rather than participate in necessary change we will fight and fight until we are pulled into it with our last gasping breath. Again, what we lack is leadership. I never would have expected it to be Lilly to take a leadership position like that but the industry certainly needs it. I think Lilly might just be trying to get out in front because they will probably be announcing a huge settlement with the government. But there’s nothing wrong with a turn-around as long as the new direction is the right one. We certainly can’t expect leadership from Merck, Schering, BMS, Novartis, Pfizer or Sanofi/Aventis.

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