'Atypicals'still sell big in nursing homes

Here's something we've been wondering: How much does a black-box warning affect drug sales? According to a story in the St. Petersburg Times today, not much, at least not for the atypical antipsychotics.

In February, doctors were warned that dementia patients using this group of drugs--which includes Eli Lilly's Zyprexa, AstraZeneca's Seroquel, and Johnson & Johnson's Risperdal--are more likely to die. By some estimates, "atypicals" kill about 15,000 nursing home residents a year. But one in four of those residents still take the drugs, and sales to the elderly continue to rise.

Why? Nursing homes are often strapped for time and staff, and dementia patients can be disruptive and difficult. Their families often are at their wit's end. Dying sooner may seem preferable, if the patient's quality of life in the meantime is measurably better. Weaning patients off the drugs, as one Florida nursing home did, takes lots of time, effort, and determination.

And then there's the marketing push. Pharma reps can't sell the drugs as dementia remedies, because that's an off-label use. But according to nursing home doctors, sales reps dance awfully close to the line. According to court documents, Eli Lilly had a special "long-term care" sales force, and even invented a hypothetical elderly patient deemed ideal for Zyprexa.

- read much more in the St. Petersburg Times article

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