Behind the "Miracle" Drug Story: Q&A With Writer Ben Wallace-Wells

What surprised you reporting this story?
What was striking about it was how regular this was for them, how normal. This is one of the biggest scandals in recent pharmaceutical history. Eli has already paid 2.6 billion dollars in fines and to settle lawsuits — just an enormous amount of money. And yet, it's a 3 or 4 billion dollar a year drug. What's most disturbing about this whole story is that as bad as all this press has been and though Eli have settled investigations by federal prosecutors and claims by people who have been hurt by using this drug for huge amounts of money, they still came out way ahead.

It becomes just part of their cost of doing business.
Yeah. One of the doctors I talked to who is an expert in this case said to me, "We've seen this with a number of drugs." There's a 10-year patent protection companies get when they introduce a drug. Usually, around year two or three, there'll be a lot of reports of problems with a particular drug. Obviously, this doesn't happen with every drug, but it's a consistent pattern with those drugs where something's gone wrong. For four or five years the company will fight tooth-and-nail with any scientists who say that they've cooked the books. They'll be very antagonistic to reporters who ask questions and then, around year 10 you start seeing a lot more accommodations. They start going to researchers and saying, "Well, maybe you guys were right all along." They'll start settling suits, and they'll start saying to reporters, "Yeah, maybe we did something wrong." So, right now, Eli Lilly is right on the cusp of that and they're beginning to settle suits. The difference in part is that if you're on year three of a patent, you're still hoping to goose most of your profits out of it. By year eight, there's not that much left, so you're much more open to acknowledging difficulties with the drug. There's this arc that repeats itself again and again.

Do the doctors and psychiatrists who prescribe these bear some responsibility?
I think they do. One of the things that you realize when you make your way through a story like this is that there are hundreds of studies that are out there that say completely contradictory things about a particular drug. Many studies have been sponsored by the industry and many others have been conducted by independent researchers. For a particular physician, particularly a physician who is not in the practice of dealing with schizophrenia drugs, to make his way all through that material, with all of these very strongly stated but completely conflicting claims is a really difficult task. So, at some level, it's a lot to expect of particular physicians to be able to sort all this out. But the way that a lot of physicians seem to deal with it is to just sort of trust the drug companies a little more than is warranted. What seem so ridiculous to us is what pharmaceutical/drug reps do, and we deal with this a little bit in the story, like leaving muffins with doctors or leaving pens with the name of their drug really work. I think that you'd prefer a medical profession that was less susceptible to such cheap pay-offs. You wish that the sales pitches were a little less successful and that's kind of a depressing part of it and that the doctors were a little more skeptical and a little more circumspect.

Related Stories:

• Bitter Pill
• How America Lost the War on Drugs