1 Boring Old Man

Who is Alex Gorsky? He is a West Point Graduate who finished his Army Service as a Ranger in 1988 and went to work for Janssen. He began as a drug rep, rising up the ladder to President of the Janssen subsidiary of Johnson & Johnson in 15 years. He left for several years to lead Novartis, North America, and then returned to J&J and as of April 2012 is CEO for all of Johnson & Johnson with a base salary of around $6.8 M/year [oh yeah, he works with Boy Scouts]:

During the years from 1995 to 2003, all of those positions had to do with Janssen’s Risperdal, the first of the blockbuster atypical antipsychotics. Many of the allegations against J&J have had to do with corrupt marketing practices during his tenure, and his lawyers have fought long and hard to keep him off the stand. This May Deposition is in a Pennsylvania Civil suit and his only testimony that I know of that’s publicly available. He was deposed for the Texas Trial but it wasn’t used in the trial last January. He was obviously well prepared for this deposition:

^{Q. Mr. Gorsky, before we look at this document, did you meet with your counsel before the deposition to prepare?
A. Yes, I did.
…
Q. In total, Mr. Gorsky, how many hours do you think you met with Mr. Murphy, Mr. Powers and/or Ms. Warren?
A. Ten hours, plus or minus.}

• Omnicare: Omnicare is an eldercare chain. The two allegations were that the FDA had warned J&J not to advertise efficacy for Risperdal in the elderly for lack of evidence. Janssen neither told Omnicare nor their own sales staff of the warning. The second charge was that J&J paid rebates [kickbacks] to Omnicare to use more Risperdal [Omnicare has already admitted guilt and settled for $100 M]. Gorsky denies wrongdoing [page 6+].
• Joseph Biederman: I’ve covered the Biederman story ad nauseum [see bipolar kids: not someone to jerk around…, bipolar kids: harvard for sale…, bipolar kids: harvard acts…]. J&J gave Joseph Biederman $500,000 to start a Research Center which was heavily oriented towards using Risperdal. In return, Biederman signed on to a J&J written study, did CME presentations, etc. In this deposition, the lawyers produced documents showing J&J’s plans to use Biederman to support off-label prescription of Risperdal to children. Gorsky claimed that J&J’s only motives were altruistic [Biederman has been censured by Harvard and apologized] [pages 14-35].
• Prolactin: Risperdal elevates Prolactin levels producing breast enlargement and sexual side effects in some. J&J essentially ignored this fact. Gorsky acts as if he’s unaware of the problem [though this particular suit is about this problem]. These were Gorsky’s most evasive moments in the Deposition [pages 35-40].
• Off Label Promotion to Children: I quoted the transcript in the last post [hear here…]. The documents quote Gorsky about growing the pediatric market at a time when there were no pediatric indications. The question about how they could do that without off-label promotion was never answered [because it had no answer]. This was the most damning section of the Deposition, particularly with the TMAP testimony showing the Janssen reps pushing Risperdal for children to Doctors treating Medicaid and Foster children [the TMAP trial…, see Tone Jones testimony][pages 40-51].
• Miscellaneous: Chortling together over a diabetic death in a competitor’s clinical trial, seeding the audience so a question would allow a CME speaker to talk about "off-label" uses, only showing positive findings on a poster, blah, blah blah…

The documents speak for themselves – loudly. And in many ways, the Deposition itself is exemplary of the crime. The misleading graph or table in the ghost-written paper is like Gorsky’s answers – sins of omission or distortion rather than out-right lies. Janssen’s dealings with Omnicare were shady – benefiting Omnicare and Janssen, but not the old people being cared for. Joseph Biederman sold his expertise and did pay with deliverables – ultimately delivering hard to control kids to the antipsychotic market. Janssen did ignore the Prolactin problem to the detriment of many patients. The off-label promotion of Risperdal for use in kids was rampant, and was on purpose. There really were any number of miscellaneous misdeeds along the way. The claims of altruism and adherence to their credo really were window-dressing to cover a now obvious truth.

Alex Gorsky is a looker, a Ranger, a West Point graduate, has a Wharton MBA, makes at least $6.8 M/year, and his whole career has been involved with selling an Atypical Antipsychotic to people, the majority of whom would’ve been better off not taking it. Johnson & Johnson Stockholders will keep their ill-gotten gains from earlier and take a small future hit from the penalties levied by the courts. Gorsky’s salary and benefits will grow if he can continue to deliver on Wall Street. If not, he’ll float down on a golden parachute and be replaced by a clone.