NORMAN (Legal Newsline) – A corporate spokeswoman for Johnson & Johnson and its drug subsidiary Janssen Pharmaceuticals on Thursday faced questioning by lawyers for the State of Oklahoma who attempted to link the company’s quest for profits to an opioid epidemic in the state.
“You would agree there is a crisis in Oklahoma?” asked attorney for the state Brad Beckworth.
“I would agree there is a drug crisis,” responded Kimberly Deem-Eshleman, southeast regional business director for Janssen Pharmaceuticals.
Deem-Eshleman and Beckworth
“An opioid crisis?” Beckworth pressed.
“It is my understanding this is a drug and opioid crisis,” Deem-Eshleman said.
Plaintiff attorneys for the state referred to the current climate as “opia-phobia.”
The bench trial in the Cleveland County District Court is being streamed live courtesy of Courtroom View Network.
The suit launched by Oklahoma Attorney General Mike Hunter alleges that J&J and Janssen carried out a fraudulent advertising campaign to over-supply opiates in Oklahoma for profits. J&J's opioid brands are Duragesic, which dispenses opioids by the use of a timed-release patch, and a pill called Nucynta.
The Oklahoma case is the nation’s first attempt to punish drug companies for their pain-killing medications and is being closely watched by other jurisdictions. Further litigation could be expected if the state prevails.
Two other co-defendant pharmaceutical companies, Purdue Pharma of Connecticut and Teva Pharmaceutical based in Israel, earlier settled with Oklahoma, $270 million from Purdue and $85 million from Teva. That left J&J (and Janssen) as sole defendants in the case.
Beckworth questioned Deem-Eshleman about sales representatives selling the drugs to doctors.
“You use sales reps all around the country?” he asked.
“Yes,” Deem-Eshleman said.
“They were not required to be doctors?”
‘Did they train on the internet?”
Deem-Eshleman explained that training took several months including at-home study to start and visiting corporate offices in New Jersey for further instruction, followed by going into the field to train with a mentor.
“Did you ever have a talk about addiction or talk to law enforcement?” Beckworth asked.
“I don’t know,” Deem-Eshleman responded.
“Does addiction lead to bad things?”
Beckworth asked if doctors to be sold the products had been referred to by J&J personnel as “targets.”
“That is a term used when marketing any product,” Deem-Eshleman answered. “It’s the audience.”
“You have to spend money to make money right?”
“You make it sound dirty,” Deem-Eshleman said. “It (targets) is not a dirty term.”
“Drugs can kill,” Beckworth said.
“If used inappropriately,” Deem-Eshleman agreed.
“Is it a true statement, if over-supply, people can die?” Beckworth asked.
“Objection!” defense attorneys called.
“Sustained,” ruled Judge Thad Balkman.
“The intent was to sell more of the drugs,” Beckworth said.
“The intent was to educate doctors about the benefits and risks,” Deem-Eshleman said.
Beckworth asked if it amounted to influence.
“If you call that influence, I would call it education,” Deem-Eshleman said.
Deem-Eshleman said with new drugs coming out all the time doctors cannot keep up with the latest information without the help of sales reps.
She agreed the company paid doctors to serve as promotional speakers at events and were sometimes provided dinners as part of their compensation.
She also agreed sales results were checked by monitoring the number of doctor prescriptions written and filled which determined sales rep pay, but disagreed there were sales quotas.
“We have call plans, there was no quota in place,” Deem-Eshleman said.
Beckworth exhibited a J&J "code of conduct" that stated “Our first responsibility is to doctors, nurses and patients. Our final responsibility is to our stockholders.”
“Is truth part of the code?” Beckworth asked.
“I would expect yes,” Deem-Eshleman said.
“How much money is spent to abate the crisis in Oklahoma?”
“I don’t know,” Deem-Eshleman said.
“You don’t know if a single dollar was spent?”
Defense attorneys objected saying the question was unfair. The objection was sustained.
“You have to market (drugs) in a truthful and not misleading way,” Beckworth said.
“Our sales reps should be truthful and not mislead,” Deem-Eshleman agreed.
Beckworth exhibited an opinion paper from the early 2000s that stated drugs like OxyContin (produced by Purdue Pharma) were being over marketed to doctors and primary care providers (PCPs) who lacked necessary skills in pain management and opioid prescribing.
Asked to state a percentage of the risk of addiction from using such drugs, Deem-Eshleman said the individual risk was unknown.
Beckworth exhibited a chart that showed a dramatic rise in the opioid market between 1995 and 1999 reaching $1.1 billion in revenue.
Testimony introduced a day earlier indicated that Tasmanian Alkaloids, a poppy processing subsidiary of Johnson & Johnson from 1982 to 2016, produced about 40 percent of the world’s legal opiate crop. The firm based in Tasmania developed a new strain of poppy that officials called Norman, the crop used to create a substance called thebaine that was used in the production of OxyContin and other opioids.
Beckworth showed an inter-company memo from Janssen in 2002 that said, “The vast majority of people who are given these medicines (opioids) by doctors will not become addicted."
“You’re not talking about your drugs you’re talking about opioids, not a brand, just opioids,” Beckworth said.
“It (document) is talking about opioids, yes,” Deem-Eshleman said. “That was what was believed in the market at that time.”
“You were the opiate market,” Beckworth said. “You created the Norman poppy.”
Defense attorneys objected to the statement. The objection was sustained.