Eli Lilley – a criminal corporation that “…deeply regrets the past actions…”

I’ve followed the Zyprexa affair since the inception of this blog – it’s a scandalous example of all that’s wrong with big pharma today. Zyprexa is an unsafe drug that was illegally marketed in a very aggressive manner by Eli Lilley.

The only reason Lilley deeply regrets its past actions is because it got caught.

Nothing will change – the company will still market its dangerous drugs in illegal ways. There are ptofits to be made after all.

This from Philip Dawdy at Furious Seasons:

Eli Lilly Formally Pleads Guilty, Apologies To Investors, Ignores Victims

News is out that Eli Lilly today formally entered a guilty plea in court to criminal misdemeanor charges related to illegal off-label marketing of Zyprexa for dementia, a condition for which the diabetes-inducing atypical antipsychotic is not approved. The plea comes as part of a settlement Lilly reached earlier this month with federal prosecutors in Pennsylvania, wherein the Indianapolis-based drug maker also agreed to pay the feds and about 30 states $1.42 billion. So far, Lilly is on the hook for $2.7 billion in payouts over its nasty little mood pill and, as I noted earlier this week, the company could be forced to kick down another $4 billion to settle remaining states and class action lawsuits. Wouldn’t Col. Lilly be proud?

Hell, things got so messed up around Zyprexa that the company was outed by its own employees.

Two thoughts: the company is getting off cheap–Zyprexa has killed more than 3,400 people and injured many thousands more. Second, I can now refer to Lilly from here on out as a criminal corporation or use the adjective criminal in almost any way I want in referring to the company. So can you, and I encourage you to do so. Perhaps it’s time to get some T-shirts printed up. I wonder what size the CEO wears.

Meanwhile, Bloomberg reports that a Lilly executive yesterday apologized to investors in an analyst conference call (via BNET Pharma Blog):

“‘The company deeply regrets the past actions covered by the plea,’ said Phil Johnson, executive director of investor relations, in a call to investors.”

Two thoughts for Phil: you are apologizing to the wrong people. You should be apologizing to the many thousands of people your company’s drug has killed and maimed due to your company’s strategy of lying about how Zyprexa should be used in order to keep the company afloat when Prozac went off-patent in 2001. You should also apologize to the taxpayers everywhere who picked up much of the tab for your company’s rotten drug through Medicaid and Medicare. Anytime you criminals want to issue an apology to the public, you know where to find us. We’re the ones who aren’t on the analyst calls.

Two, you are a couple of letters short of a pretty decent first name.

Zyprexa – Lilly’s criminal drug marketing policies finally admitted

In March 2007, I wondered “how does a drug such as Zyprexa, that was approved for the treatment of adults with schizophrenia, and a few years later, was approved for short-term treatment of adults with manic episodes associated with bipolar disorder, become such a HUGE selling medicine?

“Despite its extremely limited original approved uses, Zyprexa has gone on to become the top selling antipsychotic worldwide with an estimated 20 million people having used the drug and Lilly’s best-selling product, with $4.2 billion in sales in 2005, which translates into 30% of its total revenues.”

Well, finally we know how they did it – they simply broke the law

This from Phil Dawdy at Furious Seasons:

News is out this morning (15 January) that, as expected, Eli Lilly has settled claims against it by the feds and numerous states for illegal off-label marketing of its antipsychotic Zyprexa. The company also pleaded guilty to a criminal misdemeanor charge of violating the Food, Drug and Cosmetic Act by promoting Zyprexa as a dementia treatment. The total settlement comes to $1.42 billion, bringing the company’s total Zyprexa settlements to date to about $2.7 billion. With more to come. Ten states have sued Lilly separately.

The settlement only covers off-label marketing of the drug for dementia. So what the hell happened to charges relating to the company’s lies about the safety of its drug in on-label uses such as schizophrenia and bipolar disorder? I think the feds and the states walked away from this too easily because the company, which I can now safely dub “criminal,” lied about the fact that its drug caused diabetes in all manner of patient populations. Surely, that’s worth something to the feds and the states.

Lilly has issued a statement:

“‘We deeply regret the past actions covered by the misdemeanor plea,’ said John C. Lechleiter, Ph.D., chairman, president and chief executive officer of Lilly. ‘At Lilly we take seriously our responsibilities to abide by all the laws governing our business practices, and we realize that we have a tremendous responsibility to the patients and healthcare professionals we serve. Every day and with every interaction we strive to operate in a responsible and compliant manner. Doing the right thing is non-negotiable at Lilly, and I remain personally committed to all of us at Lilly maintaining the highest standards of conduct.’”

Uh huh, just like with Prozac.

Two points come to mind about this story – first, although Lilley have paid out a huge amount – $3.12 billion in fines, they  still have made money with Zyprexa, such are the levels of sales their illegal marketing achieved.

Second – they broke the law which they admit – and in all probability the company has been directly responsible for the deaths of patients who took Zyprexa because of this illegal marketing.

And they’ve got away with it.

To find out more, just type Zyprexa into the search box on the left.

Lilly & Zyprexa – Glaxo & Seroxat?

I notice that Phil Dawdy at Furious Seasons has an update on the Zyprexa story. I’ve written about Zyprexa before but Phil is the Daddy on this one.

In March 2007, I wondered “how does a drug such as Zyprexa, that was approved for the treatment of adults with schizophrenia, and a few years later, was approved for short-term treatment of adults with manic episodes associated with bipolar disorder, become such a HUGE selling medicine?

“Despite its extremely limited original approved uses, Zyprexa has gone on to become the top selling antipsychotic worldwide with an estimated 20 million people having used the drug and Lilly’s best-selling product, with $4.2 billion in sales in 2005, which translates into 30% of its total revenues.”

This from Furious Seasons:

Late last week, US District Court Judge Jack Weinstein shot off his mouth in an opinion he filed in the midst of a merry-goround of opinions being filed as various Zyprexa cases under his purview are shaped up to march toward trial or settlement. Recently, Weinstein pressed Eli Lilly to settle all outstanding Zyprexa claims and various estimates put that figure at over $7 billion. Even at a payout of $7 billion, Lilly will be ahead on the deal. [Lilly has already settled about $1.3 billion in claims over its handling of Zyprexa].

Anyway, the judge let the FDA have it right in the kisser over Zyprexa, which, as most of you know, has been linked to thousands of cases of diabetes, hyperglycemia, massive weight gain, deaths and other problems:

“Compared to its peer agencies in other parts of the world, the FDA has arguably failed consumers and physicians by over relying on pharmaceutical companies to provide supporting research for new drug applications; by allowing them, through lax enforcement, to conduct off-label marketing; by acquiescing to industry pressure on drug labels; by not requiring doctors-the main line of defense against misusing prescriptions-to be adequately informed; and by leaving information dispersal and control largely to industry-influenced medical journals and non-governmental associations. The result of such claimed governmental failures arguably causes overuse and overpricing of pharmaceuticals, resulting in mass litigations such as this one for Zyprexa.”

Weinstein’s opinion is well-supported by the facts and he had more to say about the FDA in his opinion, which you can read  here (pdf file). As he notes elsewhere in the opinion, the drug regulators in other countries were not fooled by Lilly’s various smokescreens, but the FDA was.

He also went after Lilly:

“Lilly’s alleged lack of transparency, failure to warn, and deceptive or illegal marketing practices are but some of the factors that a juror could find led to this litigation….Lilly exaggerated the utility of the drug, both on and off-label, and de-emphasized its dangers, in order to support an excessive price. Evidence of defendant’s alleged failure to disclose its products’ side effects, its violation of obligations of transparency, and its deliberate encouragement of off-label use, permits-but just barely-a jury finding of liability under RICO.” [RICO is the federal Racketeer Influenced and Corrupt Organizations statute that was designed to prosecute various mafia families. That acronym coming out of the judge's pen should have Lilly running for its settlement checkbook].

What strikes me about the the Judge’s opinion in this matter is that it could so easily have been written about Glaxo and Seroxat:

“… lack of transparency, failure to warn, and deceptive or illegal marketing practices… exaggerated the utility of the drug, both on and off-label, and de-emphasized its dangers… violation of obligations of transparency… deliberate encouragement of off-label use…”

And in the same way that the FDA has “failed consumers”, so in the UK we see the MHRA has done the same.

Eli Lilly trying to dodge the Zyprexa bullet… “we pay up – you shut up”

Despite talking tough like all drug makers when faced with court action, it looks like Eli Lilly don’t really want to defend themselves in court.

Drug companies have so much money that they buy themselves out of trouble each and every time and then enforce confidentiality agreements to keep the details of the cases out of the public eye.

It’s very much a case of the drug companies taking the line “we pay up – you shut up”.

A few days ago we learned that Lilly had settled another 900 personal-injury claims against its antipscyhotic drug Zyprexa, including five set to go to court next month, thus avoiding what would have been the first trial in the U.S. The Indianapolis drug maker confirmed the settlement Wednesday but declined to reveal the amount. With the latest agreements, Lilly has settled more than 25,000 claims, leaving about 1,100 unsettled. Many of the plaintiffs have claimed Lilly underplayed the drug’s side effects, including weight gain and elevated blood sugar. Lilly has set aside $1.2 billion to pay claims.

Now Alex Berenson from The New York Times brings us this story:

Lilly in Settlement Talks With U.S.

Eli Lilly and federal prosecutors are discussing a settlement of a civil and criminal investigation into the company’s marketing of the antipsychotic drug Zyprexa that could result in Lilly’s paying more than $1 billion to federal and state governments see Drug Files Show Maker Promoted Unapproved Use (December 18, 2006).

If a deal is reached, the fine would be the largest ever paid by a drug company for breaking the federal laws that govern how drug makers can promote their medicines.

Several people involved in the investigation confirmed the settlement discussions. They insisted on anonymity because they have not been authorized to talk about the negotiations.

Zyprexa has serious side effects and is approved only to treat people with schizophrenia and severe bipolar disorder. But documents from Lilly show that between 2000 and 2003, Lilly encouraged doctors to prescribe Zyprexa to people with age-related dementia, as well as people with mild bipolar disorder who had previously been diagnosed only as depressed.

Although doctors can prescribe drugs for any use once they are on the market, it is illegal for drug makers to promote their medicines any uses not formally approved by the Food and Drug Administration.

Lilly may also plead guilty to a misdemeanor criminal charge as part of the agreement, the people involved with the investigation said. But the company would be allowed to keep selling Zyprexa to Medicare and Medicaid, the government programs that are the biggest customers for the drug. Zyprexa is Lilly’s most profitable product and among the world’s best-selling medicines, with 2007 sales of $4.8 billion, about half in the United States.

Lilly would neither confirm nor deny the settlement talks.

“We have been and are continuing to cooperate in state and federal investigations related to Zyprexa, including providing a broad range of documents and information,” Lilly said in a statement Wednesday afternoon. “As part of that cooperation we regularly have discussions with the government. However, we have no intention of sharing those discussions with the news media and it would be speculative and irresponsible for anyone to do so.”

Lilly also said that it had always followed state and federal laws when promoting Zyprexa.

The Lilly fine would be distributed among federal and state governments, which spend about $1.5 billion on Zyprexa each year through Medicare and Medicaid.

The fine would be in addition to $1.2 billion that Lilly has already paid to settle 30,000 lawsuits from people who claim that Zyprexa caused them to suffer diabetes or other diseases. Zyprexa can cause severe weight gain in many patients and has been linked to diabetes by the American Diabetes Association.

Prescriptions for Zyprexa have skidded since 2003 over concerns about those side effects. But the drug continues to be widely used, especially among severely mentally ill patients. Many psychiatrists say that it works better than other medicines at calming patients who are psychotic and hallucinating. About four million Zyprexa prescriptions were written in the United States last year.

Federal prosecutors in Philadelphia are leading the settlement talks for the government, in consultation with the Department of Justice headquarters in Washington. State attorneys general’s offices are also involved. Lawyers at Pepper Hamilton, a firm based in Philadelphia, and Sidley Austin, a firm based in Chicago, are negotiating for Lilly.

Nina Gussack, who is representing Lilly at Pepper Hamilton, said she could not comment on the case. Joseph Trautwein, an assistant United States attorney in the Eastern District of Pennsylvania, also declined to comment.

While a settlement has not been concluded and the negotiations could collapse, both sides want to reach an agreement, according to the people involved in the investigation. Besides the escalating pressure of the federal criminal inquiry, Lilly faces a civil trial scheduled for March in Anchorage, Alaska, in a lawsuit brought by the state of Alaska to recover money the state has spent on Zyprexa prescriptions. A loss in that lawsuit would damage Lilly’s bargaining position in the Philadelphia talks.

While expensive for Lilly, the settlement would end a four-year federal investigation and remove a cloud over Zyprexa. While Zyprexa prescriptions are falling, its overall dollar volume of sales is rising because Lilly has raised Zyprexa’s price about 40 percent since 2003.

Federal prosecutors have been investigating Lilly for its marketing of Zyprexa since 2004, and state attorneys general since 2005. The people involved in the investigations said the inquiries gained momentum after December 2006, when The New York Times published articles describing Lilly’s multiyear efforts to play down Zyprexa’s side effects and to promote the drug for conditions other than schizophrenia and severe bipolar disorder — a practice called off-label marketing.

Internal Lilly marketing documents and e-mail messages showed that Lilly wanted to convince doctors to prescribe Zyprexa for patients with age-related dementia or relatively mild bipolar disorder.

In one document, an unidentified Lilly marketing executive wrote that primary care doctors “do treat dementia” but leave schizophrenia and bipolar disorder to psychiatrists. As a result, “dementia should be first message” to primary-care doctors, according to the document, which appears to be part of a larger marketing presentation but is not marked more specifically. Later, the same document says that some primary care doctors “might prescribe outside of label.”

In late 2000, Lilly began a marketing campaign called Viva Zyprexa and told its sales representatives to suggest that doctors prescribe Zyprexa to older patients with symptoms of dementia.

The documents were under federal court seal when The Times published the articles, and Judge Jack B. Weinstein of Federal District Court in Brooklyn rebuked The Times for publishing them.

The settlement negotiations in Philadelphia began several months ago, according to the people involved in the investigation.

Last fall, the two sides were close to a deal in which Lilly would have paid less than $1 billion to settle the case, which at the time consisted only of a civil complaint.

Then Justice Department lawyers in Washington pressed for a grand jury investigation to examine whether Lilly should be charged criminally for its promotional activities, according to the people involved in the negotiations. A few days ago, facing the possibility of both civil and criminal charges, Lilly opened new discussions with the prosecutors in Philadelphia.

If you want to find out more about this entire story, I suggest you type Zyprexa into the search box on the left hand side of this page.

Zyprexa catch up

The Zyprexa controversy – it just won’t go away will it?

There’s lots of interesting stuff over at Clinical Psychology and Psychiatry: A Closer Look:

Zyprexa for Youth: What Marketing Plans?

The Zyprexa Whitewash

Lilly Updates Label: A Little Too Late

News catch-up

I’ve been very busy recently and as a consequence, I’m aware that my output has been slipping somewhat, so I think a news catch-up post might be in order.

Bob Fiddaman at Seroxat Suffers has been keeping his finger well and truly on the pulse with some great stories:

In Australia, Bob has managed to get GSK adverts for Aropax (Seroxat/Paxil) removed from the website of the Delphi Centre (their strapline: Expertise you can confidently rely on!) The problem is/was, under Australian law these ads should never have been there in the first place…

In another post, Bob looks at the way GSK tried to deal with criticism of Avandia: Sen. Charles Grassley said in a Senate floor speech Wednesday (Sept. 12) he has two internal e-mails from GlaxoSmithKline showing the company tried to silence a medical researcher who suggested Avandia may have health risks beyond those stated on the label.

“Based on this e-mail exchange, it seems to me that at least two drug company officials did attempt to silence a critic,” said Grassley, ranking Republican on the Finance Committee. “In fact, Dr. Buse stopped making any critical statements about Avandia shortly after this e-mail exchange,” which is dated June 25, 1999.

You can read the whole story here at Seroxat Sufferers.

Meanwhile over at Clinical Psychology and Psychiatry: A Closer Look, CL Psych has any number of great news items.

One that stands out for me is this one: Key Opinion Leader Contradicts Himself. This story concerns our old friend Dr Chuck Nemeroff and his somewhat bizarre and contradictory views on Serotonin and the good old chemical imbalance hypothesis… I think CL Pysch has the answer to the contadictions.

The other standout piece for me is about SSRI prescribing and suicide rates in the USA. You may have read some stories a couple of weeks ago claiming that declining SSRI prescription rates have lead to an increase in suicides… ah, well, perhaps not.

CL Pysch’s post includes a link to the New York Times article that has some great reporting on the story and very some telling quotes from respected researchers that may be slightly more independent than the authors of the original study that seemed to tow the big pharma line.

Lastly CL Pysch returns to the Zyprexa debate, with a post that shows exactly how one Lilly employee thought about different ways to suppress a study’s negative results. You simply must have a look at the email where the options were discussed. Naughty. Very naughty.

I’m sure these links will keep you busy for a while…

Go on… talk to me

Why not?

Why not just leave a comment and explain things to me – tell me how I’m wrong about you and your products, about you and the way you market them, about you and the way you harm people, about you and the data you kept hidden, about you and the regulators, about you and your lies.

Talk to me – I want to hear your side of the story – I really do.

Surely someone from my “visitors’ book” has something to say worth saying [except the Scientologists]:

Abbott Laboratories, North Chicago, Illinois

Abbott Laboratories, Gurnee, Illinois

Abbott Laboratories, Libertyville, Illinois

Accenture, United Kingdom

Adpepper.com

Allegiance Healthcare, Waukegan, Illinois

American Red Cross, National Headquarters, Washington

American Society of Clinical Oncology, Alexandria, Virginia

Amgen, Thousand Oaks, California

Anapharm, Quebec, Canada

Ashurst Morris Crisp, Edmonton, United Kingdom

Astra AB, Södertälje, Sweden

Astra Zeneca, Montchanin, Delaware

Avalanche Strategic Communications, Hackensack, New Jersey

Aventis Pasteur, Maidenhead, Windsor

Aventis Pharamceuticals, New Jersey

AXA Ireland

Bausch & Lomb, Rochester, New York

Bear Stearns Security Corporation, New York

Bayer Corporation, Pittsburgh, Pennsylvania

Biogen, West Roxbury, Massachusetts

Bircham Dyson Bell, London, London

BMG Avocats, Genève, Geneve

Boehringer Ingelheim Limited, Egham, Slough

Boehringer Ingelheim Pharmaceuticals, Danbury, Connecticut

Boehringer Ingelheim Pharmaceuticals, Redding, Connecticut

Boehringer Ingelheim Pharmaceuticals, Ridgefield, Connecticut

Boehringer Ingelheim Pharmaceuticals, Copenhagen

BKD LLP, Springfield, Missouri

Brigham Young University, Provo, Utah

Bristol Myers Squibb Pharmaceutical Research Institute, Monmouth Junction, New Jersey

Bristol Myers Squibb Pharmaceutical Research Institute, Plainsboro, New Jersey

Brown University, Providence, Rhode Island

Burson – Marsteller BVBA, Brussels

Burson Marsteller, New York

Burson Marsteller (SEA) Pte Ltd, Singapore

California State University, Northridge

Capital One Financial, Richmond, Virginia

Carnegie Mellon University, Pittsburgh, Pennsylvania

Charles University, Prague, Czech Republic

Church of Scientology International, Los Angeles, California

Cleveland Clinic Foundation, Cleveland, Ohio

CMP Media LLC, Great Neck, New York

Collective Intellect, Boulder, Colorado

Columbia-Presbyterian Medical Center, New York

Commission Europeenne, Wezembeek-Oppem, Brabant

Corbett Healthconnect, Chicago, Illinois

Cornerstone Partners, New York

Cypress Bioscience, San Diego, California

Debevoise & Plimpton,

DOIM, Laurel, Maryland

Edelman PR, Alexandria, Virginia

Edelman, London

Edelman PR, New York

Edelman PR, Seattle, Washington

E.I. du Pont de Nemours and Co., Wilmington, Delaware

Eli Lilly and Company, Europe

Eli Lilly and Company, Indianapolis, Indiana

Elron Technologies, Israel

Elsevier Science Limited, Bletchingdon, Oxfordshire

Emory University, Atlanta, Georgia

European Parliament, Brussels

Evergreen Medical Group, Kirkland, Washington

Experian Information Solutions, Roswell, Georgia

FDA, Parklawn Computer Center / DIMES HQ, Silver Spring, Maryland

Parklawn Computer Center / DIMES HQ, Rockville, Maryland

Finkelstein, Thompson & Loughran, Washington, District of Columbia

Fisher & Paykel Ltd., Northmead, New South Wales

Foote, Cone & Belding , New York

Forest Labs, New Hyde Park, New York

Genentech, Dixon, California

Genentech, San Francisco, California

General Motors Corporation, Bloomfield Hills, Michigan

Gerson Lehrman Group, Austin, Texas

Gilead Sciences, Boulder, Colorado

Glaxo., King Of Prussia, Pennsylvania

Glaxo, Raleigh, North Carolina

GlaxoSmithkline, Mississauga, Ontario

Glaxosmithkline S.p.A, Verona, Veneto

Group Health Cooperative, Seattle, Washington

Haymarket Media, Garfield, New Jersey

Health and Welfare Agency Data Center, Clarksburg, California

Hearst Corporation, New York

Hikma Pharmaceuticals, Amman, Jordan

Imperial College of Science, Technology and Medicine, London

Internal Revenue Service, Highland, Maryland

James, Houer, Newcome & Smiljanich, Birmingham, New Jersey

Jones, Day, Reavis & Pogue, Cleveland, Ohio

The Johns Hopkins Medical Institutions, Baltimore, Maryland

Josef Nopp KG, Leonding, Oberosterreich, Austria

Johnson & Johnson, Fort Wayne, Indiana

Johnson & Johnson, New Jersey

Johnson & Johnson, Europe

JP Morgan Chase & Co, Columbus, Ohio

JP Morgan Chase & Co, New York

Kaiser Permanente, El Cerrito, California

Kaiser Permanente Medical Care Program, Los Angeles, California

Kendle, Glasgow, Scotland

King & Spalding, Washington DC

Life Science Communications, Upper Holloway, Redbridge

LNS Communications, Brookline, Massachusetts

Loyola Marymount University, Los Angeles

Management Centre Europe, Brussels

Mayo Foundation, Rochester, Minnesota,

McCarter & English, Newark, New Jersey

Marcus Evans, Chicago, Illinois

McCann-Erickson GuangMing Lt, Hong Kong

McCann-Erickson, London

McCann-Erickson, New York

McCann-Erickson/Torre Lazur, Denville, New Jersey

MDE Investors, Washington, DC

Medical Broadcasting Company, Philadelphia, Pennsylvania

Meditech Media, London

Medstat Systems, Ann Arbor, Michigan

Merck and Co., Montgomeryville, Pennsylvania

Merck and Co., Skillman, New Jersey,

Meta Pharmaceutical Services LLC, Conshohocken, Pennsylvania

Microsoft Corp, United States

MORI, London

Morgen Walke Associates, Brooklyn, New York

Mount Sinai School of Medicine, New York

National Institutes of Health, Bethesda, Maryland

Neuronetics, Malvern, Philadelphia

Nelson Mullins Riley & Scarborough, Columbia, South Carolina

News Corporation, New York

Northwestern University, Evanston, Illinois

Novartis AG, Europe

Novo Nordisk Pharmaceutical, Princeton, New Jersey

Organon Pharmacy, Roseland, New Jersey

Otsuka America Pharmaceutical, Gaithersburg, Maryland

Performance Systems International, Toronto, Ontario

Pepper, Hamilton and Sheetz, Philadelphia, Pennsylvania

Pfizer, Australia

Pfizer, New York

Pfizer, Quaker Hill, Connecticut

Pfizer, United Kingdom

Phillips Lytle LLP, Buffalo, New York

Porter Novelli, New York

PricewaterhouseCoopers GTS UK, London

Publicis & Hal Riney, El Cerrito, California

Quintiles, Raleigh, North Carolina

Regulatory Affairs Professionals Society, Rockville, Maryland

Research Triangle Institute, Durham, North Carolina

R G C Jenkins & Co, London

R I S Christie, Toronto, Ontario

Rosen & Livingston, Brooklyn, New York

Ruder Finn, London

Sankyo Pharma, Parsippany, New Jersey

Sanofi Synthelab(s) PTE LTD, Singapore

Sanofi Techniques, Bourg-la-Reine

Schering-Plough Corporation, Plainfield, New Jersey

Scientific American, New York

Semyung University, Chungbuk, Kyongsang-bukto, Korea

Shire US, Wayne, Pennsylvania

Shock Hardy & Bacon, Overland Park, Kansas,

Smith Hanley, Indianapolis, Indiana

SmithKline Beecham, Ickenham, Slough, United Kingdom

SmithKline Beecham, North Weald, Havering, United Kingdom

St. John Medical Center, Tulsa, Oklahoma

St Josephs Health System, Anaheim, California

State of CA, Dept. of Consumer Affairs (DCA), Sacramento, California

Steptoe & Johnson, London

Steptoe & Johnson, Washington, District of Columbia

Syntex USA, Livingston, New Jersey

Syntex USA, Switzerland

Syracuse Research Corporation, Syracuse, New York

Takeda Pharmaceuticals A, Chicago, Illinois,

Takeda Pharmaceuticals North America, Lincolnshire, Illinois

Takeda UK Ltd, High Wycombe, Buckinghamshire

Texas A&M University, Corpus Christi, Texas

The Bill & Melinda Gates Foundation, Newington, Virginia

The McGinn Group, Fredericktown, Ohio

The Nielsen Company, New York

The Procter and Gamble Company, Cincinnati, Ohio

The United States Centers For Disease Control, Atlanta, Georgia

Trinity Mirror Group, London

TRW Space and Defense Sector, Torrance, California

Ulmer Berne, United States

University of California, Irvine, Irvine

University of Manchester, Manchester, England

University of Newcastle upon Tyne, United Kingdom

University of New Hampshire, Durham, New Hampshire

University of Portsmouth, Portsmouth, United Kingdom

University of Westminster, London

USA TODAY, McLean, Virginia

U.S. Dept. of Commerce – ITA, Cheltenham, Maryland

U.S. Dept. of Health and Human Services, Washington, District of Columbia

U.S. Department of State, Arlington, Virginia

U.S. Senate Sergeant at Arms, Arlington, Virginia

VJIL Consulting, Hyderabad, India

Waggener Edstrom, Portland, Oregon

Walgreens, Arlington Heights, Illinois

Warner-Lambert Company, Morris Plains, New Jersey

Wiley, Rein & Fielding, Washington, District of Columbia

WPP Group, New York

WPP Group U.S. Investments, Miami, Florida

Wyeth-Ayerst Research, Horsham, Pennsylvania

Wyeth-Ayerst Research, Waldwick, New Jersey

Young & Rubicam-Media Edge, San Francisco, California

What about you guys at Ogilvy and Mather Worldwide in New York? Who’s your client? What do they want to say?

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