Paul Alper writes:
Gorsky, it seems to me, dwarfs the villains you often write about.
Here’s the background, from New York Times columnist Nicholas Kristof:
Risperdal is a billion-dollar antipsychotic medicine with real benefits — and a few unfortunate side effects.
It can cause strokes among the elderly. And it can cause boys to grow large, pendulous breasts; one boy developed a 46DD bust.
Yet Johnson & Johnson marketed Risperdal aggressively to the elderly and to boys while allegedly manipulating and hiding the data about breast development. J&J got caught, pleaded guilty to a crime and has paid more than $2 billion in penalties and settlements. But that pales next to some $30 billion in sales of Risperdal around the world.
In short, crime pays, if you’re a major corporation.
But there’s more:
Oh, and the person who was in charge of marketing the drug in these ways? He is Alex Gorsky, who was rewarded by being elevated to C.E.O. of J&J. He earned $25 million last year.
How did this happen?
J&J’s previous antipsychotic medicine ended its patent life, so sales plunged as generics gained market share. In 1994, J&J released Risperdal as a successor, but the Food and Drug Administration said it wasn’t necessarily better than the previous version and in any case was effective primarily for schizophrenia in adults. That’s a small market, and J&J was more ambitious. It wanted a blockbuster with annual revenues of at least $1 billion.
So J&J reinvented Risperdal as a drug for a broad range of problems, targeting everyone from seniors with dementia to children with autism. . . . Even though Risperdal wasn’t approved for the elderly, J&J formed a sales force, called ElderCare, with 136 people to market it to seniors. . . . The company began peddling the drug to pediatricians, so that by 2000, more than one-fifth of Risperdal was going to children and adolescents. . . . In 2003, the company had a “back to school” marketing campaign for Risperdal, and a manager discussed including “lollipops and small toys” in sample packages . . .
One challenge was that a J&J study had found that Risperdal led 5.5 percent of boys to develop large breasts, a condition known as gynecomastia. J&J covered this up . . .
Last week the Appeal of Conscience Foundation, an interfaith organization, announced it would honor Gorsky with an award as a “man of integrity” and a “corporate leader with a sense of social responsibility.”
I guess Mark Hauser and Dr. Anil Potti were unavailable.
2 sides to the story?
OK, so here’s my question. Is there another side to this story? Kristof writes, “Risperdal is a good drug that helps people. But it was marketed too broadly, and the system failed to protect consumers.” It seems that Gorsky did behave unethically, and people have certainly been fired for much less—at the very least, he might want to veer clear of the Stockton Police Department. But here’s my question: Has Risperdal been an overall net benefit to seniors and kids? That is, do the pluses when Riseprdal has worked outweigh the minuses of the strokes it’s caused among some elders and the body distortions it’s caused among some kids?
I have no idea; it just seems like the logical question to ask.
That said, even if Riseprdal has net benefits, that’s no excuse for burying the data. If it causes problems but is still good on balance, that’s fine, but then make the case: admit the problems and explain why the positives still win. Assuming the facts of the story as conveyed by Kristof (based on reporting by Steven Brill) are correct, the ethical violations seem clear and they seem large, and it seems ridiculous for this guy to be getting a 25 million dollar job—or, should I say, for our tax dollars to go to a company that’s paying this guy and, indirectly, encouraging future data-hiding. Moral hazard and all that. This is even worse than the American Statistical Association giving its Founders Award to a multiple plagiarist, or Columbia University Teachers College and the New York City Department of Education hiring a liar, cheat, and thief as principal of a new school.
But, all this aside, I’d be interested in seeing an analysis of the total costs and benefits here.
P.P.S. Johnson & Johnson is popular! At least, it used to be. In a Pew survey from a few years ago, 95% of respondents expressed a favorable view of that company (among those willing to give a rating).