Big Pharma Marketing Directly To Judges, Which Is Terrifying

These judges have the power to order people to take drugs. So naturally Big Pharma is right there to work them over.

There are few entities in the American landscape who draw more widespread suspicion than major pharmaceutical companies. Age, race, gender, political persuasion — it doesn’t matter. People are pretty sure pharmaceutical companies are up to something. Walk into any Hollywood writers’ room and ask them to concoct a shadowy villainous corporation and 9 times out of 10, they’ll make up a pharma company.

To some extent, this suspicion is well-founded. People like Martin Shkreli may be outliers but what’s troubling to most people is the fear that he’s not that much of an outlier. Not long ago, federal prosecutors were all over companies giving doctors handouts that looked troublingly like an effort to get doctors to bill Medicare for unnecessary products. Drugs once prescribed by the bushel are now the subject of massive settlements as people learn the price of clear skin is stage three tonsil failure or something. And the companies are working overtime to make sure those victims don’t see the inside of the courtroom — and the Supreme Court is happy to help in this regard. The atmosphere of distrust is so bad it’s easy to see how the anti-vaccination narrative gets traction with some people despite, you know, science.

Instead of trying to mend this public relations fail, pharma companies are doubling down. This time, they’re marketing directly to drug court judges. That should scare you.

Jake Harper of NPR reported on one pharmaceutical company that’s growing market share by working over judges charged with sentencing drug users. If it was unsettling to know pharma was lobbying people with medical degrees to prescribe their wares when it might not be medically necessary, then it should be genitals on fire terrifying that they’re sending “Pharma Girls” to get judges to force drugs on convicts.

Some courts offer participants a full range of evidence-based treatment, including medication-assisted treatment. Others don’t allow addiction medications at all. And some permit just one: Vivitrol.

One reason for this preference is that Alkermes, the drug’s manufacturer, is doing something nearly unheard of for a pharmaceutical company: It is marketing directly to drug court judges and other officials.

No. No, no, no, no, no. Judges, it may say “juris doctor” on your résumé but you are not, in fact, a doctor. Look, Vivitrol may be the best goddamned opioid addiction treatment in the world, but there’s nothing morally sound about giving a drug sales pitch to people who have no medical training to persuade them to use the awesome power of the state to force someone to take a drug.

Oh, and Vivitrol may not be the ideal treatment:

Sponsored

“I had sinus problems, chest problems for the whole month I was on it,” [Philip] Kirby says. “I couldn’t shake it.”

He says he also got a rash — another possible reaction to Vivitrol, according to the product’s warnings. Months after he had the shot, he still had white splotches on his arms, which he attributed to the drug. But even with those symptoms, Kirby says the court urged him to stick with the medication for a couple of more months. “They were way too pushy about it,” he says.

I wonder why? Oh, and Alkermes did the testing for the drug in Russia and, as the White House keeps assuring us, there’s absolutely nothing shady about doing business in Russia.

A sales representative sometimes sits in on the court’s treatment team meetings, [Judge Lewis] Gregory says.

The f**k? How is it appropriate to have a sales rep involved in anyone’s treatment. Like, I wouldn’t feel comfortable with a sales rep hanging out with my doctor discussing my blood work and I’m not about to be forced to take something by a court.

Well, maybe we shouldn’t say “forced”:

Sponsored

“We encourage it, but we never force anybody,” says Judge Gail Bardach of the Hamilton County, Ind., drug court, where Philip Kirby was a participant.

But facing potential jail time and court officials who really believe in Vivitrol, participants say getting the shot doesn’t always feel like a choice.

“They made it seem like they were forcing it upon me, like I couldn’t come into the program until I got it,” Kirby says.

Paging Doctor Hobson! How can someone with a straight face think this presents as a real “choice” to an addict?

And Alkermes is in the process of expanding its sales push to more Midwestern states afflicted by opioid abuse. Why not? A Pro Publica report suggests this strategy is working pretty well for Alkermes:

Thanks in great part to these judges, and to an explosive epidemic that only seems to be accelerating, some 30,000 people are now receiving Vivitrol shots. In the first quarter of 2017, sales totaled $58 million, a 33 percent increase over the year before. The company is ramping up manufacturing capacity, enough so that it could soon handle $800 million in annual sales, which it projects it will reach by 2020.

There’s not much to stop drug court judges from taking these sales meetings. As of now there’s no law or regulation on point to address this.

But, you know, maybe judges could proactively exercise a little discretion? Just a thought.

To Grow Market Share, A Drugmaker Pitches Its Product To Judges [NPR]
The Last Shot [Pro Publica]


HeadshotJoe Patrice is an editor at Above the Law and co-host of Thinking Like A Lawyer. Feel free to email any tips, questions, or comments. Follow him on Twitter if you’re interested in law, politics, and a healthy dose of college sports news.