AstraZeneca pays $520m fine for off label marketingBMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c2380 (Published 29 April 2010) Cite this as: BMJ 2010;340:c2380
All rapid responses
The news article in the BMJ on quetiapine (1) and the 520 million
dollar fine had a terrible sense of deja vu. A similar previous news
article on olanzapine involved an even bigger fine of 1.4 billion (2).
Olanzapine and quetiapine are both anti- psychotics. They both hit a
variety of receptors,including serotonin, dopamine and histamine ones.
Olanzapine is a thienobenzodiazepine, while quetiapine is a
dibenzodiazepine derivative (3). Both drugs are related to clozapine. They
are both second generation atypicals. They both were praised at the onset
as revolutionary, but they were shoved onto the scene after slanted trial
designs that did not impress the FDA (4). They both have been associated
with off- label marketing by pushy drug reps, and they both incurred
punishing financial penalties as a result.
Olanzapine and quetiapine are like twisted twins possessing the
dubious ambience so often associated with all anti- psychotics, from
chlorpromazine onwards. Why is it that anti- psychotics incite the worst
predatory commercial instincts in drug companies? The drugs are themselves
able to incite a form of greed that is itself not quite sane- rather like
a frenzied gold rush. Perhaps they are in the end fool's gold that
benefits nobody, the patients least of all.
(1) AstraZeneca pays $520 fine for off-label marketing. Janice
Hopkins Tanne. BMJ 2010;340:c604.
(2) Eli Lilley pays record fines of $1.4 bn for promoting off- label
use of olanzapine for common disorders. Zosia Kmietowicz. BMJ
(3) Drugs in Pysciatry. Basant K. Puri. OUP 2006. pgs. 82-89.
(4) Mad In America. Robert Whitaker. Perseus. 2002. Chapter 11. Not
Competing interests: No competing interests