Beginning in 1992, Mark Duxbury and Dean McClellan are high-flying salesmen for Johnson and Johnson, Ortho branch – happily promoting the drug Procrit, (or Epogen -- erythropoietin), for anemia. The drug stimulates the bone marrow to produce more red blood cells. Developed by fledging company Amgen, it was licensed to Ortho for specific uses. Their careers take off, and they earn bonuses and stature, peaking in 1993. Soon, however, Duxbury realizes that he is being encouraged to promote the drug for off-label uses and in higher doses that will enhance sales and profits through kickbacks. He soon realizes that the drug is not safe when used in these situations. People are dying because their unnaturally thickened blood results in strokes and heart attacks.

He raises objections with his employer. For voicing concerns he is ostracized and then fired in 1998. Along with the stresses of his work, the financial difficulties and emotional turmoil, Duxbury’s home life is in tatters; his marriage falls apart and he worries about his daughter Sojourner (Sojie). He develops multiple health problems, including sleep apnea and dependency on drugs and alcohol.

Enlisting the help of the famous lawyer Jan Schlictmann (A Civil Action
), whistleblower Duxbury launches a qui tam lawsuit in 2002 against his former employer. This is a civil action under the False Claims Act, which can offer cost recovery should the charges prove warranted. The lengthy process is still going. The last ruling issued in August 2009 allowed the case to proceed. But Duxbury soon after died of a heart attack in October 2009 at age 49.


Contacted by Duxbury in 2004, the investigative journalist Kathleen Sharp initially hesitated to take up the project. After the FDA issued increasingly alarming warnings about the dangers of Procrit in 2006-7, she began to take his concerns more seriously.

Relying on interviews and documents from courts and private papers, Sharp reconstructs the events in a narrative that resembles a novel, with direct quotes and even the inner thoughts of the players. Reference notes bolster the claims made in her narrative.

The importance of this book is to raise awareness about the behavior of pharmaceutical companies in duping their own salesmen, the health care profession, the public, and the government in order to profit -  even at the cost of human life. The thorny legal aspects of the industry result in multiple lawsuits that contribute to the ever higher costs of drugs.


Penguin issued the same book in 2012 under the title Blood Medicine.

This interview with the author explains more about her methods in writing the book.





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