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Glaxo's Speed Dial
During the trial, Tracey wanted to use an exhibit that he referred to as a "telephone book," full of influential doctors on Glaxo's speakers' bureau for Paxil and have Healy go through some of the names.
"What I would like to do is put it into the record and have him identify who these people are," Tracey explained to the judge in chambers, outside the hearing of the jury.
"Many of them are influential psychiatrists who have published on Paxil," he said. "I want him to go through seven or eight names so later when the jury hears literature by these authors they will be able to put it into context."
What I am going to do "is show the jury how all-encompassing their strategy for identifying and cultivating psychiatrists were in the country," Tracey said.
"That's part of Doctor Healy's opinion," he said, "how they identified these hundreds of doctors across the country to change the culture that existed."
While Healy was testifying, Tracey introduced the 171 page list and had Healy identify some of the doctors.
Healy testified that Lori Altshuler is "a figure who is very well known in the field of women's mental health and would have written some key articles on the idea that it may be appropriate to use antidepressant drugs for women who are pregnant."
He identified Vivian Burt as "a person who is a fairly big name in the women's mental health field and, again, a person who is an advocate for using antidepressants in women of childbearing years, and in particular, has talked regularly about the use of Paxil for women of childbearing years."
He said Lee Cohen had been on the Paxil advisory board. "Dr. Cohen wrote an article that has since become quite famous," he told the jury. "It became famous not because of the contents of the article, but because Dr. Cohen and co-authors, most of whom are on this list, failed to disclose the links to GSK or the other companies in the field that they had."
Some of Cohen's co-authors on this study titled, "Relapse of Major Depression During Pregnancy in Women Who Maintain or Discontinue Antidepressant Treatment," included Lori Atshuler, Vivian Burt, Jeffrey Newport, Zachary Stowe, and Aadele Viguera.
On July 11, 2006, with the headline, "Financial Ties to Industry Cloud Major Depression Study," the Wall Street Journal reported that, "the study and resulting television and newspaper reports of the research failed to note that most of the 13 authors are paid as consultants or lecturers by the makers of antidepressants," and "the authors failed to disclose more than 60 different financial relationships with drug companies."
Most of the authors, the Journal said, were psychiatrists at Harvard's Massachusetts General Hospital, Emory University, and the University of California Los Angeles.
The Journal noted that Cohen was a longtime consultant to three antidepressant makers, a paid speaker for seven, and had research funded by four drug companies. Adele Viguera, associate director of the Mass General perinatal psychiatry program and professor at Harvard, failed to disclose a paid speaking relationship with Glaxo.
Lori Altshuler, director of the Mood Disorders Research Program at University of California Los Angeles, failed to disclose that she was a speaker or consultant for at least five antidepressant makers. "Two of her colleagues -- Vivien Burt and Victoria Hendrick -- were also authors who didn't report financial relationships they have with antidepressant makers," the Journal reported.
In an expert witness report for the Novak Paxil birth defect case, Dr Dee Mangin points out that: "The Cohen study was not a controlled study, used a highly selected population likely to have a high relapse rate and not representative of a primary care patient population."
