State to get $916M in lawsuit against makers of Plavix blood thinner

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The state has been awarded more than $900 million in a lawsuit against a pair of pharmaceutical companies that sold drugs they knew to be ineffective in certain ethnic groups.

Between 1998 and 2010, more than 834,000 prescriptions were written in Hawaii for the drug Plavix, a blood thinner used to reduce the risk of heart disease and stroke, Gov. Josh Green explained Tuesday.

However, for a significant proportion of residents, the drug did not work.

Green said the drug was found to be less effective among ethnic groups such as Hawaiians, Pacific Islanders and Asian Americans, because those groups are less likely to have a certain enzyme required to activate the drug. But the drug did not include any warning about this until 2010, when the U.S. Food and Drug Administration required a “black box” warning on the packaging.

Because there was inadequate warning the medication could be less effective among those groups — which make up a large part of the state’s population — the state Department of the Attorney General in 2014 filed a lawsuit in First Circuit Court against the pharmaceutical Bristol-Myers Squibb Company and three U.S.-based subsidiaries of the French pharmaceutical company Sanofi-Aventis.

That lawsuit initially received a court judgement of $834 million after the 2014 filing, but the companies filed for an appeal to the Hawaii Supreme Court. That appeal, which went to trial last October, ended with a split verdict: While the higher court affirmed the pharmaceutical companies committed unfair acts as defined by the Federal Trade Commission, it reversed the lower court’s decision about whether they committed deceptive acts, and required a second trial, following arguments by the defendants that they had not been allowed to adequately present their case.

That second trial once again ended with a judgement in favor of the state, this time to the tune of $916 million — divided 50/50 between Bristol-Myers Squibb and Sanofi-Aventis.

“This is something extraordinarily big,” Green said, calling the judgement “the largest award in (Hawaii’s) history.”

“It’s not about the money, it is about being committed to the health and safety of our communities,” Green said. “We already have health disparities for our local people. Native Hawaiians, for instance, live 10 years shorter lives because they often don’t get health care. But this adds insult to injury, because they were also very likely getting a prescription for a medication that might not work for them.”

Green said the court found that Bristol-Myers Squibb and Sanofi-Aventis “deliberately turned a blind eye to save profits,” and that such deceptive practices have no place in Hawaii.

Attorney General Anne Lopez said the case sends a strong message to every business that comes to Hawaii that unfair and deceptive practices will be prosecuted.

Special Deputy Attorney General Rick Fried, who was hired as local counsel on the case, said his team confirmed that Bristol-Myers Squibb and Sanofi-Aventis knew in 1997 that Plavix was less effective among Asians, Hawaiians and Pacific Islanders, because of correspondence buried among more than 12 million documents produced during discovery.

“It isn’t like this is dealing with a hangnail,” Fried said. “If you’re getting a drug that isn’t effective or is only partially effective, it’s going to end with a lot of people dying.

“There’s no way to determine how many died in Hawaii because they were given a drug that wasn’t effective for them.”

Reading from the court verdict, Fried said the court found that the correspondence found within the documents was far more convincing — and damning — than any witnesses produced by Bristol-Myers Squibb and Sanofi-Aventis.

While Green said Bristol-Myers Squibb and Sanofi-Aventis are welcomed to appeal the case again, he said the money awarded will go to the state general fund. But, he added, he hopes the money could be used to improve the state’s health care system.

“We’ll develop a plan to put substantial amounts of resources into, for example, stroke prevention and cardiovascular treatment, augmenting public health initiatives that have been underfunded too long,” Green said. “We have great needs, as everyone knows, in health care.”

Email Michael Brestovansky at mbrestovansky@hawaiitribune-herald.com.