November 12, 2009 - Utah Snags $24 Million in Pharmaceutical Drug Settlement

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A four-year investigation into a pharmaceutical giant's alleged off-label marketing of an anti-psychotic drug has earned a $24 million settlement for Utah.

"This isn't just about money," Utah Attorney General Mark Shurtleff said Wednesday. "The victims were those who could least afford health care."

The Food and Drug Administration had approved Zyprexa's use for treating schizophrenia and bipolar disorders. But, Utah investigators say, Eli Lilly's sales force had been encouraging, since 1999, doctors to prescribe the drug for dementia, Alzheimer's, agitation, aggression, hostility, depression and generalized sleep disorders.

"The thing that was remarkable was how vigorously it was promoted and how much we spent in our Utah Medicaid program" -- the state's Zyprexa tab totaled $11 million since 2007, said David Sundwall, executive director of Utah's Department of Health.

"There aren't that many psychotic people in Utah," Sundwall said, noting there was clear documentation of the drug's overuse and misuse.

Shurtleff said, besides the settlement money, the state "wanted [Eli Lilly's] bad conduct to stop."

The company, founded in Indianapolis in 1876 and now marketing its products in 143 countries, denies any wrongdoing, said spokeswoman Marni Lemons.

"We have always lived by the highest standards in promoting our drugs," Lemons said. "We reached the point where it was time to put these issues behind us."

The company -- which also makes the well-known Cialis, Cymbalta and Prozac -- has battled Zyprexa litigation since 2003. Last year, a 32-state lawsuit ended in a $62 million settlement. Utah was one of 13 states that chose to file separately.

Zyprexa's side effects include significant weight gain and obesity -- part of a metabolic syndrome, Sundwall said, that can lead to diabetes, hypertension and stroke.

According to Utah's investigation, 1,769 Utah Medicaid patients over age 65 took Zyprexa without the proper diagnosis.

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