In a lawsuit filed by the State of Alaska against Eli Lilly, lawyers recently discussed an email sent by Eli Lilly?s new CEO, John C. Lechleiter. The email, sent to other Eli Lilly executives in March of 2003 ? when Lechleiter served as Lilly?s executive vice president for pharmaceutical products ? appears to encourage employees to promote its drug Zyprexa for off-label use.

The Zyprexa lawsuit seeks reimbursement for medical costs of Medicaid patients who were diagnosed with diabetes while taking the drug, approved to treat schizophrenia and bipolar disorder in adults. Zyprexa causes severe weight gain and cholesterol problems, however, and has been linked to diabetes.

In the email, Lechleiter discusses Zyprexa use by children and teenagers, noting that employees were already promoting a second Eli Lilly drug, Stratera, to pediatricians and child specialists. He said employees could also discuss Zyprexa use for such patients.

?The fact we are now talking to child psychs and peds and others about Strattera means that we must seize the opportunity to expand our work with Zyprexa in this same child-adolescent population,? Leichleiter wrote.

Lechleiter also encouraged Eli Lilly to obtain data on the use of Zyprexa in the treatment of ?disruptive kids? in attempts to increase Zyprexa?s sales. Many psychiatrists, however, say Zyprexa is only appropriate for severely mentally ill patients because of its physical side effects, some of which are especially pronounced in younger patients.

The disclosure of Lechleiter?s email comes while Eli Lilly is under federal criminal investigation for its promotion of Zyprexa and for understating the drug?s risks to doctors.

While health care professionals are permitted to prescribe drugs off label, it is a violation of federal law for a company like Eli Lilly to encourage or promote off-label use.

Between 2000 and 2002, Eli Lilly documents reveal that the company aggressively tried to expand Zyprexa?s sales into markets for which it had not been federally approved, including elderly patients suffering from dementia.

Since 2003 Eli Lilly has repeatedly increased the price of Zyprexa after prescriptions for the drug fell sharply. However, Zyprexa remains Eli Lilly?s best-selling product, with sales of close to $5 billion in 2007.

Source: Alex Gerenson, ?Eli Lilly e-mail discussed unapproved use of drug,? New York Times, March 15, 2008 (http://www.nytimes.com/2008/03/15/business/15drug.html?_r=1&ex=1363233600&en=1211b48085219f50&ei=5088&partner=rssnyt&emc=rss&oref=slogin).