Cvs Unit Played Both Sides, Lilly Zyprexa Lawsuit Files Show
The subsidiary of CVS, the largest U.S. drug-store chain, touted Zyprexa starting in 2003, according to e-mails made public by lawyers suing Lilly for overpayment. CVSs AdvancePCS, a pharmacy benefit manager, or PBM, offered to send 120,000 letters to doctors promoting the drug, Lillys top-seller with $4.7 billion in sales last year, according to a confidential 2004 proposal. The CVS unit said it would charge $5 per letter.
CVSs contracts with insurers and pensions meanwhile place it in an adversarial posture with Lilly, requiring it to use its buying power as leverage in drug-price negotiations.
“The problem is that PBMs are negotiating these hidden deals while at the same time telling employers that they represent them at the negotiating table,” said Gerry Purcell, a former PBM executive who advises companies on their drug plans. “These documents will add fuel to the perception that the companies and the PBMs are in cahoots with each other.”
AdvancePCS, acquired by CVS in 2007, said in the documents that the direct-mail campaign was “designed to influence key prescribers” as part of a “tactical plan for Zyprexa.”
Financial Relationships
CVS, which isnt a defendant in the Lilly suit, said in a statement that it tells doctors when it has “financial relationships” with drugmakers and that they are free to opt out of mailings.
The insurers suing Lilly, the biggest maker of psychiatric drugs, contend the drugmaker should pay as much as $6.8 billion in damages for downplaying Zyprexas health risks and marketing it for unapproved uses to increase profits. About 10,000 pages of internal Lilly documents were unsealed as part of the suits.
“This is the kind of stuff the drug companies and the PBMs hate to see get out,” said Purcell.
Lilly fell 9 cents to $34.29 in New York Stock Exchange composite trading yesterday. CVS rose 8 cents to $30.35.
Lilly declined to comment on whether it accepted CVSs $5-per-letter offer. CVS rival Express Scripts Inc. also sent out Zyprexa marketing letters, according to the unsealed documents. It isnt named as a defendant in the suits.
“To engage in a point/counterpoint in a media outlet rather than in court would not be productive,” said Marni Lemons, a Lilly spokeswoman. “Lilly remains prepared to defend ourselves against all of these allegations.”
Lemons declined to answer specific queries about the CVS or Express Scripts letters, whether Lilly paid for the practice or other questions raised by the unsealed documents, including the “ghostwriting” of medical articles by the drugmaker and the marketing of Zyprexa to the elderly.
CVS said in its e-mailed statement that it has “no active educational programs” related to Zyprexa.
“CVS Caremark discloses to its PBM clients that it may have financial relationships with pharmaceutical manufacturers in connection with these educational programs,” said Christine Cramer, a spokeswoman for the chain. “CVS Caremarks PBM clients are aware of these programs and have the opportunity to opt out.” She said AdvancePCS also had a policy of disclosing drugmaker relationships since before its 2004 acquisition by Caremark Rx Inc.
Woonsocket, Rhode Island-based CVS Corp. acquired Caremark and its AdvancePCS unit in 2007 for $27.2 billion. It topped a bid by St. Louis-based Express Scripts.
Maria Palumbo, a spokeswoman for Express-Scripts, didnt respond to eight telephone and e-mail requests seeking comment.
Best Selling Drug
Antipsychotics have become the U.S.s best-selling class of drugs with 2008 sales of $14.6 billion, according to IMS Health, a health-care consulting firm.