12 ms·

Johnson and Johnson, America’s Most Admired Lawbreaker

164 points by fahimulhaq 11y ago

brento 11y ago
This looks interesting and I'll bookmark it for later. Does anyone happen to have a TL;DL version for those who don't currently have time to read the whole thing right now?
- sp332 11y ago
  (This is the first of a series of articles about J&J's regulatory shenanigans.) The Food and Drug Administration had prohibited Johnson & Johnson salespeople from trying to promote Risperdal to doctors to treat children because of its feared side effects, including hormonal disorders. The company was also not allowed to promote it to treat the elderly except for the most serious psychotic disorders; it was thought to cause strokes, diabetes and other ailments in that population. But [...] Johnson & Johnson was reaping more than half of its Risperdal sales from prescriptions written for children to alleviate all kinds of behavior disorders, and for the elderly, who were given the drug for simple symptoms of dementia or restlessness. Johnson & Johnson emails, sales training manuals and business plans produced as evidence in the case revealed that the company organized special sales units illegally targeting doctors who treated the elderly and children. State mental institutions treating children, whose drugs would be paid for by Medicaid, were targeted, too. When it came time to explain their conduct at trials and to federal investigators, Johnson & Johnson executives and salespeople have unwaveringly, even indignantly, defended themselves. One salesman, who otherwise fit the salt-of-the-earth mold that R.W. Johnson had envisioned for his company’s employees, gave thousands of Risperdal samples in child-sized doses to Austin Pledger’s doctor in Birmingham, Alabama. Yet he insisted under oath in February he didn’t recall stepping around kiddie furniture and toys as he walked into an office with a sign that said “pediatric neurologist,” and that he had no way of knowing that the doctor wasn’t treating adults.
  - mfoy_ 11y ago
    (TL;DR of the TL;DR) J&J pushed their dangerous pills aggressively, illegally, and unapologetically. They targeted children and seniors.
werber 11y ago
I'm really happy to see quality long-form journalism. Was Highline it's own thing at one point or was it homegrown at the Huffpo?
- thehoff 11y ago
  Reading around looks like it was homegrown, headed up by two people from the New Republic. From their about page: "It's a new digital home for an old journalistic tradition. Think of it as a magazine that only runs cover stories—big, ambitious pieces intended to change the way you see the world or influence the course of policy. Investigations will take months, essays will be finely considered, the subjects we choose to write about will feel urgent and essential."
danso 11y ago
> “All the big pharmas have lawsuits,” the analyst concluded, sipping an espresso. “It’s just not a big deal.” A list of the $13B in fines paid by pharma companies just in 2009 to 2014: http://projects.propublica.org/graphics/bigpharma http://projects.propublica.org/graphics/bigpharma
- werber 11y ago
  It looks like the majority are mental health drugs, that's really scary.
  - imperio59 11y ago
    That's because these drugs are the mad scientist experiments of a bunch of psychiatrists who are crazier than the patients they pretend to be "helping". If you also look at how many mass shooters were on these drugs which were prescribed off label and caused their violence, you start to realize the real cost on society of these so called "cures".
    - deleted 11y ago
      [deleted]
    - sbov 11y ago
      In particular, SSRIs have been linked to increased violence in men aged 15-24 (but not other demographics), yet we continue to prescribe them to people in that demographic.
  - deleted 11y ago
    [deleted]
- thehoff 11y ago
  Following through the links to Dollars for Docs: https://projects.propublica.org/d4d-archive/companies/johnson-johnson https://projects.propublica.org/d4d-archive/companies/johnso... How is this legal? I'm ignorant of the details but for instance, if you click on California and look at Speaking, top of the list doc got $86,550!
thehoff 11y ago
Great read so far, read Chapter 1 not realizing there were 15! I love these long form reads where it seems like the author actually did an investigation and is taking care to report. On topic (again only got through chapter 1) I hope that J&J, or better yet those actual PEOPLE, that were involved get punished. And not the that's the cost of doing business punished. I doubt it but one can hope.
scratchandsniff 11y ago
Can this be the new standard for HuffPo journalism? Or do I have to tolerate a dozen listcles and politically charged drivel before?
jonstokes 11y ago
The tragedy here goes far beyond the direct damage to the patents who were prescribed this vile stuff off-label. There's also the collateral damage to the medical establishment that supports this -- can anyone argue that the anti-vaxxers don't have a point when they're on about exactly this sort of profit-driven evil from Big Pharma? I myself am an anti-anti-vaxxer (a pro-vaxxer?) who actually supports state-mandated vaccinations, but this puts me in the very uncomfortable position of having to defend one corner of an industry that does the kinds of things described here and a government that has failed at the most basic oversight. So the next time you read about a measles outbreak at a theme park or you see a scientifically illiterate ghoul like Jenny McCarthy peddling her child-killing nonsense on TV, spare a thought for Johnson & Johnson, because they're feeding the anti-vaxxer paranoia and kneecapping legitimate public health efforts.
- LordKano 11y ago
  The anti-vaxxers would have a point even if J&J wasn't involved in shady activity. I am not an anti-vaxxer. I was vaccinated. I had my children vaccinated. I just hold the position that the power of the state shouldn't be used to compel people to inject substances into their bodies, even if we think we have a good reason for doing it. I'm not looking to delve too deeply into the politics of it but there are good reasons to oppose mandatory vaccinations.
  - aggie 11y ago
    Vaccination is not an onerous requirement and there is very good reason to believe it is beneficial to public health when widely administered. If you want to reject it on principle alone, you'll have to address why your liberty in principle is more important than my health concern in practice.
    - sp332 11y ago
      It could still be a civil suit - if someone actually got sick because you weren't vaccinated, they could sue you for damages. Also, once you give the government the authority to require people to be injected, they will probably start expanding it in various directions. That's really not a power I want to give to them.
cs702 11y ago
"Tragic" is the only word that does justice to the events described by this article. The most interesting aspect of the story for me is how the company's culture has changed for the worst over time. Johnson & Johnson was started and for many decades was run by sincerely idealistic do-no-evil entrepreneurs, who wanted to focus on "patients first and profits last"... but now this business is run by executives who seem to be doing the exact opposite while claiming to abide by the same values. This is a huge challenge for successful founders: how does one ensure that a company's culture and values don't degrade long after the original team is gone? The author, Steven Brill, a successful entrepreneur and writer[1], wrote another powerful long-form article about the insanity of healthcare bills in the US a couple of years ago: http://time.com/198/bitter-pill-why-medical-bills-are-killing-us/ http://time.com/198/bitter-pill-why-medical-bills-are-killin... Highly recommended if this is of interest to you. -- [1] https://en.wikipedia.org/wiki/Steven_Brill_(journalist) https://en.wikipedia.org/wiki/Steven_Brill_(journalist)
- deelowe 11y ago
  In a typical corporation, psycopaths are the cream that rises to the top. I've seen it happen time and time again.
  - EyeballKid 11y ago
    Or, as Jarvis Cocker put it: "Shit floats" :-)
    - deelowe 11y ago
      To me that implies more that people who are bad at their job get promoted. Ive met plenty of vps, politicians, etc.. and the majority will not hesitate to challenge your very livelihood if they feel it gets them a leg up on the world. Hell, most will make passive aggressive comments with a smile.
- cheepin 11y ago
  "This is a huge challenge for successful founders: how does one ensure that a company's culture and values don't degrade long after the original team is gone?" More than just a founder problem. This has been a defining problem for empires throughout history: how to make sure the next guy doesn't mess it up.
agentgt 11y ago
My mother was a pharmaceutical sales rep for many years where she did rather well despite her age most likely because she was previously a RN. I say age because the pharma companies blatantly hire "sexy and young" to sell to doctors. Now I'm sure there are other companies that age and appearance discriminate but the pharma companies are especially egregious in that they really don't care if the sales person is qualified or not. And this is important because the doctors rarely have time to do research on the samples that they were given. So its sort of a good thing to give the doctor as much info as possible but this rarely happens as pharma sales person Barbie and Ken could care less. Pharma sales have strict compliance but guess who enforces those compliances? The pharma companies. Not the FDA. So guess what they use the compliance issues for... to get rid of older employees or to screw over other companies (ie tattle telling). Its completely fucked up.
- drzaiusapelord 11y ago
  >doctors rarely have time to do research on the samples that they were given. Maybe back in the old days, but now with instant journal access, instant press access, etc its really not an excuse. Self-compliance and regualtion isn't all that terrible especially when the alternative is underfunded and politically controlled organizations like the FDA. We like to believe in this myth that they're above the fray when it comes to commercial and political interests, but that's just not true. The FDA has no shortage of whistleblowers. This attitude of "OMG IF ITS NOT 100% SOCIALIZED ITS SHIT" is extremely questionable. I don't know why its taken up uncritically on internet forums. One of the nice things of US society is that we have a more sophisticated idea of public/private partnerships which leads to interesting outcomes. This builds a lot of flexibility, creates investor confidence, and is just better business. For example, why are all these miracle drugs from the US and not from, say, Greece? Its clear there are many, many advantages to the US system. Silicon valley wouldn't have existed in a high regulatory environment, yet here you are on a forum dedicated to technology startups largely centered in that area and derived from that culture.
  - Retra 11y ago
    Why do you attribute the US's success in this area to its economic system and not it's massive population, fertile & expansive territory, socio-political isolation, and worldwide military presence?
calibum 11y ago
Until we start sending people to jail, such abuses will continue.
- petra 11y ago
  True. And we should also target doctors that give shitty treatment as a result of such shenanigans.
datashovel 11y ago
“Oh, they’ve already reserved for that stuff,”... Is it just me or does this kind of attitude make you say "F* YOU Wall Street".
6stringmerc 11y ago
Huh, and I already disliked the (loose) association with the Robert Wood Johnson Foundation which aims for prohibition to return in the United States.
pricechild 11y ago
Reading through I found several diagrams in the articles were potentially misleading. Images are scaled based on height rather than area, making 2x increases look like 4x. Thankfully the numbers are quoted which lets me form what I think is a better opinion.
fisherjeff 11y ago
This article makes it hard to stomach drug manufacturers' claims that drug prices are so high due to regulatory burden. J&J spent a lot of time and a ton of money to bring a new drug to market, sure, but the only apparent improvement over the previous generation is their own revenue. It's hard to believe this is an isolated incident.
everyone 11y ago
I recommend this documentary film about the 1% made by an heir to the Johnson & Johnson fortune. https://www.youtube.com/watch?v=HmlX3fLQrEc https://www.youtube.com/watch?v=HmlX3fLQrEc
tracker1 11y ago
I wonder if a shareholder could drive a lawsuit based on the violation of corporate charter?
Theodores 11y ago
Same company, different drug, same story: http://www.amazon.com/Blood-Medicine-Blowing-Deadliest-Prescription/dp/0452298504 http://www.amazon.com/Blood-Medicine-Blowing-Deadliest-Presc... This book is totally gripping and it also sheds light on the EPO scandal of the cycling world. I do not recommend books lightly but this book is a must read and also a literary 'secret' that is going to be made into a film. Add it to your Christmas list. I read it a while ago with my Dad reading it too. It was the best thing we read that year - happy times, a book club of our own. Needless to say I have sent this article on to him for his enjoyment.
codyb 11y ago
It's hard to know what to think in regards to big pharma. One conclusion I've come to in recent years is that the EPA should have the funds to actually do the testing themselves (as opposed to receiving results from the automotive manufacturers for example), and so should the FDA. This idea that companies won't submit doctored results to these standards we provide as a nation is laughably false, clearly. Another thing is that somebody needs to go to jail. And it should be from the top of the chain to the bottom. If you're a sales rep dealing with pamphlets which you've explicitly been told can't be left out in case of regulators, your options should be "whistle blow" or be held accountable along with the rest of that chain. In a country with over two million people in jail you'd think we could nail one of these bastards. It's just so gross. Then there's all the issues with the US Taxpayer directly funding vast amounts of the research that goes into these pharmaceuticals and not receiving anything in return (except for exorbitant unregulated health care costs). The taxpayers need to benefit from the corporate profits which come from taxpayer funded research. I'm not exactly sure what to think about all the advertisements for drugs on our tvs and to our doctors. Most of me thinks it's disgusting. I'm not one to think there should be a profit motive in healthcare as it can lead to awful stories like this (I'm done with chapter one, I figure I can do one a day). Unfortunately these are, at the moment, opinions, and I can in no way fully flesh them out, offer concrete evidence as to why it should be any other way, or really truly expand on the issues. That'd be a post of it's own and a few weeks research I think. Something needs to change though.

164 points by fahimulhaq 11y ago

This looks interesting and I'll bookmark it for later. Does anyone happen to have a TL;DL version for those who don't currently have time to read the whole thing right now?

sp332 11y ago
(This is the first of a series of articles about J&J's regulatory shenanigans.) The Food and Drug Administration had prohibited Johnson & Johnson salespeople from trying to promote Risperdal to doctors to treat children because of its feared side effects, including hormonal disorders. The company was also not allowed to promote it to treat the elderly except for the most serious psychotic disorders; it was thought to cause strokes, diabetes and other ailments in that population. But [...] Johnson & Johnson was reaping more than half of its Risperdal sales from prescriptions written for children to alleviate all kinds of behavior disorders, and for the elderly, who were given the drug for simple symptoms of dementia or restlessness. Johnson & Johnson emails, sales training manuals and business plans produced as evidence in the case revealed that the company organized special sales units illegally targeting doctors who treated the elderly and children. State mental institutions treating children, whose drugs would be paid for by Medicaid, were targeted, too. When it came time to explain their conduct at trials and to federal investigators, Johnson & Johnson executives and salespeople have unwaveringly, even indignantly, defended themselves. One salesman, who otherwise fit the salt-of-the-earth mold that R.W. Johnson had envisioned for his company’s employees, gave thousands of Risperdal samples in child-sized doses to Austin Pledger’s doctor in Birmingham, Alabama. Yet he insisted under oath in February he didn’t recall stepping around kiddie furniture and toys as he walked into an office with a sign that said “pediatric neurologist,” and that he had no way of knowing that the doctor wasn’t treating adults.
- mfoy_ 11y ago
  (TL;DR of the TL;DR) J&J pushed their dangerous pills aggressively, illegally, and unapologetically. They targeted children and seniors.

werber 11y ago

I'm really happy to see quality long-form journalism. Was Highline it's own thing at one point or was it homegrown at the Huffpo?

thehoff 11y ago
Reading around looks like it was homegrown, headed up by two people from the New Republic. From their about page: "It's a new digital home for an old journalistic tradition. Think of it as a magazine that only runs cover stories—big, ambitious pieces intended to change the way you see the world or influence the course of policy. Investigations will take months, essays will be finely considered, the subjects we choose to write about will feel urgent and essential."

danso 11y ago

> “All the big pharmas have lawsuits,” the analyst concluded, sipping an espresso. “It’s just not a big deal.” A list of the $13B in fines paid by pharma companies just in 2009 to 2014: http://projects.propublica.org/graphics/bigpharma http://projects.propublica.org/graphics/bigpharma

werber 11y ago
It looks like the majority are mental health drugs, that's really scary.
- imperio59 11y ago
  That's because these drugs are the mad scientist experiments of a bunch of psychiatrists who are crazier than the patients they pretend to be "helping". If you also look at how many mass shooters were on these drugs which were prescribed off label and caused their violence, you start to realize the real cost on society of these so called "cures".
  - deleted 11y ago
    [deleted]
  - sbov 11y ago
    In particular, SSRIs have been linked to increased violence in men aged 15-24 (but not other demographics), yet we continue to prescribe them to people in that demographic.
- deleted 11y ago
  [deleted]
thehoff 11y ago
Following through the links to Dollars for Docs: https://projects.propublica.org/d4d-archive/companies/johnson-johnson https://projects.propublica.org/d4d-archive/companies/johnso... How is this legal? I'm ignorant of the details but for instance, if you click on California and look at Speaking, top of the list doc got $86,550!

thehoff 11y ago

Great read so far, read Chapter 1 not realizing there were 15! I love these long form reads where it seems like the author actually did an investigation and is taking care to report. On topic (again only got through chapter 1) I hope that J&J, or better yet those actual PEOPLE, that were involved get punished. And not the that's the cost of doing business punished. I doubt it but one can hope.

scratchandsniff 11y ago

Can this be the new standard for HuffPo journalism? Or do I have to tolerate a dozen listcles and politically charged drivel before?

jonstokes 11y ago

The tragedy here goes far beyond the direct damage to the patents who were prescribed this vile stuff off-label. There's also the collateral damage to the medical establishment that supports this -- can anyone argue that the anti-vaxxers don't have a point when they're on about exactly this sort of profit-driven evil from Big Pharma? I myself am an anti-anti-vaxxer (a pro-vaxxer?) who actually supports state-mandated vaccinations, but this puts me in the very uncomfortable position of having to defend one corner of an industry that does the kinds of things described here and a government that has failed at the most basic oversight. So the next time you read about a measles outbreak at a theme park or you see a scientifically illiterate ghoul like Jenny McCarthy peddling her child-killing nonsense on TV, spare a thought for Johnson & Johnson, because they're feeding the anti-vaxxer paranoia and kneecapping legitimate public health efforts.

LordKano 11y ago
The anti-vaxxers would have a point even if J&J wasn't involved in shady activity. I am not an anti-vaxxer. I was vaccinated. I had my children vaccinated. I just hold the position that the power of the state shouldn't be used to compel people to inject substances into their bodies, even if we think we have a good reason for doing it. I'm not looking to delve too deeply into the politics of it but there are good reasons to oppose mandatory vaccinations.
- aggie 11y ago
  Vaccination is not an onerous requirement and there is very good reason to believe it is beneficial to public health when widely administered. If you want to reject it on principle alone, you'll have to address why your liberty in principle is more important than my health concern in practice.
  - sp332 11y ago
    It could still be a civil suit - if someone actually got sick because you weren't vaccinated, they could sue you for damages. Also, once you give the government the authority to require people to be injected, they will probably start expanding it in various directions. That's really not a power I want to give to them.

cs702 11y ago

"Tragic" is the only word that does justice to the events described by this article. The most interesting aspect of the story for me is how the company's culture has changed for the worst over time. Johnson & Johnson was started and for many decades was run by sincerely idealistic do-no-evil entrepreneurs, who wanted to focus on "patients first and profits last"... but now this business is run by executives who seem to be doing the exact opposite while claiming to abide by the same values. This is a huge challenge for successful founders: how does one ensure that a company's culture and values don't degrade long after the original team is gone? The author, Steven Brill, a successful entrepreneur and writer[1], wrote another powerful long-form article about the insanity of healthcare bills in the US a couple of years ago: http://time.com/198/bitter-pill-why-medical-bills-are-killing-us/ http://time.com/198/bitter-pill-why-medical-bills-are-killin... Highly recommended if this is of interest to you. -- [1] https://en.wikipedia.org/wiki/Steven_Brill_(journalist) https://en.wikipedia.org/wiki/Steven_Brill_(journalist)

deelowe 11y ago
In a typical corporation, psycopaths are the cream that rises to the top. I've seen it happen time and time again.
- EyeballKid 11y ago
  Or, as Jarvis Cocker put it: "Shit floats" :-)
  - deelowe 11y ago
    To me that implies more that people who are bad at their job get promoted. Ive met plenty of vps, politicians, etc.. and the majority will not hesitate to challenge your very livelihood if they feel it gets them a leg up on the world. Hell, most will make passive aggressive comments with a smile.
cheepin 11y ago
"This is a huge challenge for successful founders: how does one ensure that a company's culture and values don't degrade long after the original team is gone?" More than just a founder problem. This has been a defining problem for empires throughout history: how to make sure the next guy doesn't mess it up.

agentgt 11y ago

My mother was a pharmaceutical sales rep for many years where she did rather well despite her age most likely because she was previously a RN. I say age because the pharma companies blatantly hire "sexy and young" to sell to doctors. Now I'm sure there are other companies that age and appearance discriminate but the pharma companies are especially egregious in that they really don't care if the sales person is qualified or not. And this is important because the doctors rarely have time to do research on the samples that they were given. So its sort of a good thing to give the doctor as much info as possible but this rarely happens as pharma sales person Barbie and Ken could care less. Pharma sales have strict compliance but guess who enforces those compliances? The pharma companies. Not the FDA. So guess what they use the compliance issues for... to get rid of older employees or to screw over other companies (ie tattle telling). Its completely fucked up.

drzaiusapelord 11y ago
>doctors rarely have time to do research on the samples that they were given. Maybe back in the old days, but now with instant journal access, instant press access, etc its really not an excuse. Self-compliance and regualtion isn't all that terrible especially when the alternative is underfunded and politically controlled organizations like the FDA. We like to believe in this myth that they're above the fray when it comes to commercial and political interests, but that's just not true. The FDA has no shortage of whistleblowers. This attitude of "OMG IF ITS NOT 100% SOCIALIZED ITS SHIT" is extremely questionable. I don't know why its taken up uncritically on internet forums. One of the nice things of US society is that we have a more sophisticated idea of public/private partnerships which leads to interesting outcomes. This builds a lot of flexibility, creates investor confidence, and is just better business. For example, why are all these miracle drugs from the US and not from, say, Greece? Its clear there are many, many advantages to the US system. Silicon valley wouldn't have existed in a high regulatory environment, yet here you are on a forum dedicated to technology startups largely centered in that area and derived from that culture.
- Retra 11y ago
  Why do you attribute the US's success in this area to its economic system and not it's massive population, fertile & expansive territory, socio-political isolation, and worldwide military presence?

calibum 11y ago

Until we start sending people to jail, such abuses will continue.

petra 11y ago
True. And we should also target doctors that give shitty treatment as a result of such shenanigans.

datashovel 11y ago

“Oh, they’ve already reserved for that stuff,”... Is it just me or does this kind of attitude make you say "F* YOU Wall Street".

6stringmerc 11y ago

Huh, and I already disliked the (loose) association with the Robert Wood Johnson Foundation which aims for prohibition to return in the United States.

pricechild 11y ago

Reading through I found several diagrams in the articles were potentially misleading. Images are scaled based on height rather than area, making 2x increases look like 4x. Thankfully the numbers are quoted which lets me form what I think is a better opinion.

fisherjeff 11y ago

This article makes it hard to stomach drug manufacturers' claims that drug prices are so high due to regulatory burden. J&J spent a lot of time and a ton of money to bring a new drug to market, sure, but the only apparent improvement over the previous generation is their own revenue. It's hard to believe this is an isolated incident.

everyone 11y ago

I recommend this documentary film about the 1% made by an heir to the Johnson & Johnson fortune. https://www.youtube.com/watch?v=HmlX3fLQrEc https://www.youtube.com/watch?v=HmlX3fLQrEc

tracker1 11y ago

I wonder if a shareholder could drive a lawsuit based on the violation of corporate charter?

Theodores 11y ago

Same company, different drug, same story: http://www.amazon.com/Blood-Medicine-Blowing-Deadliest-Prescription/dp/0452298504 http://www.amazon.com/Blood-Medicine-Blowing-Deadliest-Presc... This book is totally gripping and it also sheds light on the EPO scandal of the cycling world. I do not recommend books lightly but this book is a must read and also a literary 'secret' that is going to be made into a film. Add it to your Christmas list. I read it a while ago with my Dad reading it too. It was the best thing we read that year - happy times, a book club of our own. Needless to say I have sent this article on to him for his enjoyment.

codyb 11y ago

It's hard to know what to think in regards to big pharma. One conclusion I've come to in recent years is that the EPA should have the funds to actually do the testing themselves (as opposed to receiving results from the automotive manufacturers for example), and so should the FDA. This idea that companies won't submit doctored results to these standards we provide as a nation is laughably false, clearly. Another thing is that somebody needs to go to jail. And it should be from the top of the chain to the bottom. If you're a sales rep dealing with pamphlets which you've explicitly been told can't be left out in case of regulators, your options should be "whistle blow" or be held accountable along with the rest of that chain. In a country with over two million people in jail you'd think we could nail one of these bastards. It's just so gross. Then there's all the issues with the US Taxpayer directly funding vast amounts of the research that goes into these pharmaceuticals and not receiving anything in return (except for exorbitant unregulated health care costs). The taxpayers need to benefit from the corporate profits which come from taxpayer funded research. I'm not exactly sure what to think about all the advertisements for drugs on our tvs and to our doctors. Most of me thinks it's disgusting. I'm not one to think there should be a profit motive in healthcare as it can lead to awful stories like this (I'm done with chapter one, I figure I can do one a day). Unfortunately these are, at the moment, opinions, and I can in no way fully flesh them out, offer concrete evidence as to why it should be any other way, or really truly expand on the issues. That'd be a post of it's own and a few weeks research I think. Something needs to change though.