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groups of patients who are young and healthy; however, these often differ substantially on one or more critical factors selecting appropriate medications for the frail elderly.

medications relevant to Thus, the

information derived from studies on taken from trials of younger adults evidence supporting the safe and unstudied patient population.

the benefits and the risks of drugs did not contribute quality clinical effective use of Risperdal for an

  • In April 2003, Janssen sent out a "Dear Healthcare Provider" letter indicating that Risperdal (1) enhanced the risk of cerebrovascular events such as strokes and (2) was neither safe nor effective when prescribed for dementia-related psychosis.

158.

During

Lisitza's

tenure

at

Omnicare,

the

Omnicare

computer-based

pharmacy

system was designed in such a way that it was unable to flag patients with a medical history

indicating that Risperdal was not a preferred medication. This was one of the reasons that the

Risperdal switch was not implemented at Jacobs. However, the switch was implemented at other

Omnicare facilities.

159.

While

the

confidential

information

and

documentation

that

would

reveal

additional names, dates, times, and places relating to the negotiation and implementation of the

illegal Market Share Agreement is solely within the possession of Janssen and Omnicare,

Lisitza's superiors conceded the existence, implementation, and financial impact of the Risperdal

Market Share Agreement to Lisitza and instructed him about what he was required to do to

accomplish the financial objective of the Risperdal Market Share Agreement.

160.

While

the

Risperdal

rollout

was

unsuccessful

at

Jacobs,

Lisitza was

aware

of

thousands of prescriptions switched at other Omnicare facilities pursuant to the Risperdal Market

Share Agreement.

161.

Janssen

worked

with

other

entities

who

dispensed

pharmaceuticals,

including

dispensing pharmacies, pharmacy benefit managers, and hospitals, to illegally gain market share

for Risperdal in the atypical antipsychotic market through illegal kickbacks-for-switches

44

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