Florida Issues Subpoenas In Prozac Case

The Florida Attorney General’s office yesterday issued subpoenas to drug manufacturer Eli Lilly & Co. and others in its investigation of whether free samples of the antidepressant Prozac sent to consumers violated state law.

In addition to the drug manufacturer, the attorney general’s office subpoenaed Walgreens, the pharmacy that supplied the drugs for the sample, as well as Holy Cross Hospital in Fort Lauderdale, FL, and three doctors and a physician’s assistant in its medical group who are accused of writing prescriptions for the drugs used in the sample.

The investigation was sparked by a lawsuit filed last week by a South Florida woman, identified in court papers only as S.K., who charged Eli Lilly, Walgreens and the doctors of sending her an unsolicited sample of Prozac Weekly, a once-a-week version of the drug, by mail.

According to the attorney general’s office, a consumer received a sample in a Walgreens envelope in at least one case, and investigators are trying to determine how many others there were. Accompanying the sample was a letter signed by the three doctors offering “a more convenient way” to take Prozac.

“If you wish to try Prozac Weekly, stop your daily antidepressant one day before starting Prozac Weekly, then take only Prozac Weekly once a week thereafter,” the letter read. “Congratulations on being one step to full recovery.”

At issue is whether the drug manufacturer acted together with doctors and the pharmacy to market a drug, and failed to disclose that the sample was advertising material and not medical advice. The Florida Attorney General is trying to determine whether the campaign was a violation of the state’s Deceptive and Unfair Trade Practices law.

“Don’t pretend to be somebody’s friend if you’re just trying to sell me something,” said John Newton, senior assistant attorney general with the Florida Attorney General’s office’s civil rights and economic crimes divisions.

A deeper question is how widespread the practice of sending unsolicited drug samples by mail has become. For example, Newton said that the Florida Attorney General’s office has another open investigation into whether the pharmacy chain Eckerd has been involved in similar practices.

Newton added that Eckerd Corp. is cooperating in the case — and that his office does not believe Eckerd is the only pharmacy to participate in such practices.

Stephen Sheller, the Philadelphia attorney representing S.K. in the lawsuit, said his phone has been ringing off the hook from consumers voicing complaints similar to his client’s since news of the lawsuit broke. The issue goes beyond Eli Lilly and calls into question the aggressive practices drug detailers use to market medicines, Sheller said.

Eli Lilly has issued an apology for its role in the incident and said it understood consumer concerns. The drug manufacturer has not issued a statement in response to the Florida subpoenas.

“It is inappropriate and inconsistent with corporate policy for Lilly sales personnel to support programs in which medicine is mailed to patients without the patient's request,” the company said in a statement. “We are investigating this matter vigorously and are taking appropriate action.”

Walgreens said in a statement that it only filled legitimate prescriptions issued by doctors and did not provide any patient information to the doctors or to Eli Lilly. The company’s involvement was limited to the one store that issued the drugs, and its involvement in the program has ended, Walgreens said.

A spokeswoman at Holy Cross Hospital said it was the hospital's policy not to comment on litigation.

Sheller said he is not satisfied with the Eli Lilly and Walgreens explanations. He noted that, despite issuing an apology, Eli Lilly had not sent a letter of warning to consumers who had received the drugs, and he wondered why Walgreens would fill a prescription – which he said it received by fax – and then send it out by mail without question.

“If a detail rep decided that he had the right to do this, you wonder what the heck is going on in this field,” Sheller said.

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