‘Call notes’ between Oklahoma doctors, Johnson & Johnson sales reps presented in opioid trial

NORMAN, Okla. - The state of Oklahoma claims pharmaceutical sales representatives used unreliable data when presenting new medicine and products to Oklahoma doctors.

On the fourth day of trial against the nation's largest drugmaker Johnson & Johnson, the state of Oklahoma questioned the company's designated corporate representative Kimberly Deem-Eshleman for the third day in a row.

The lawsuit championed by Oklahoma Attorney General Mike Hunter claims Johnson & Johnson fueled the state's opioid crisis through deceptive marketing. Most of Deem-Eshleman's testimony has been focused on the company's marketing practices, primarily the use of sales representatives.

'Call notes' presented by the state Friday were comments written by a company sales representative after speaking with an Oklahoma doctor about a particular new drug or product.

The notes date back to the early 2000s.

"We’re educating them on Duragesic," Deem-Eshleman testified on one note.

Brad Beckworth, an attorney representing the state, said the act of 'educating' doctors should come from medical schools and questioned why sales representatives were assuming the role.

"You were educating them on taking something everyone knew should be prescribed with extreme conservatism," Beckworth said.

One call note in particular said a doctor was hesitant when presented a new product and concerned it would have a high risk of addiction and abuse. According to the note, the sales representative who spoke the doctor said a study was presented to counter that.

Earlier this week, the state said that study - along with others - have been criticized by agencies like the FDA, claiming they were unreliable. This point was brought up multiple times Friday.

"The study itself, all of the studies… the Simpson, Allan, the Miligan... all of those studies were valid studies. They were studies that were considered good science. They were reviewed and in peer reviewed journals," Deem-Eshleman said in response. "It wasn’t that the studies were bad studies or they weren’t informational studies... that they didn’t have good science. The FDA indicated they just did not want us to use them in promotional activity and that letter came 2004. We didn’t agree that they were bad studies and bad science. We talked to the FDA about that."

Johnson & Johnson stopped this call note process in 2009. Deem-Eshleman testified their system was changed to "streamline it" by using a 'drop down' option as opposing to writing texts.

They claim it made the process easier, but the state questioned their motive.

"Your sales reps came into the state over 125,000 times. You’re telling me they have the time to go and talk to doctors about these addictive drugs and you didn’t think they should take the time to write down what was being said?" questioned Beckworth. "Perhaps they were calling on doctors with such frequency and intensity that the only thing that mattered was pushing more of your drugs."

Deem-Eshleman said she did not agree with that statement.

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