Invokana Lawsuits Consolidated into New Jersey MDL

A federal judicial panel has centralized more than 50 Invokana lawsuits in New Jersey federal court.

The lawsuits claim that Invokana can cause ketoacidosis and other injuries.

The lawsuits claim that diabetes medications Invokana and Invokamet cause ketoacidosis, kidney damage, and other injuries.

More cases are expected in the multidistrict litigation (MDL) over Johnson & Johnson’s blockbuster drug, which was recently revealed as a top-spending brand on doctor payments.

Hold J&J Accountable

Judges Grant Centralization, Citing Commonality

Plaintiffs alleging harm from Invokana and Invokamet in September requested that the U.S. Judicial Panel on Multidistrict Litigation (JPML) consolidate 55 individual lawsuits in Jew Jersey federal court, citing enhanced efficiency.

On December 7 the JMPL agreed and issued an order transferring lawsuits from California, Georgia, Illinois, Kentucky, Louisiana, and Minnesota to the District of New Jersey under Judge Brian R. Martinotti.

“We find that the Invokana/Invokamet actions involve common questions of fact, and that centralization of these cases will serve the convenience of the parties and witnesses and promote the just and efficient conduct of this litigation,” the Panel wrote. “The actions share factual questions arising from allegations that taking Invokana or Invokamet may result in patients suffering various injuries, including diabetic ketoacidosis and kidney damage.”

Plaintiffs claimed in their consolidation request that J&J knew about kidney damage and ketoacidosis caused by Invokana/Invokamet, but did not warn patients while continuing to promote the drug. Plaintiffs also allege that Invokana and Invokamet are defectively designed and were not adequately tested.

Multidistrict litigation centralizes similar cases for pretrial proceedings, making it easier for lawyers to coordinate their activities. Individual cases are tried in the jurisdictions where they were originally filed.

Several MDL cases, known as bellwether cases, are typically singled out and tried first.

The Panel says it is aware of 44 additional related federal lawsuits.

New—but Not Necessarily Improved—Diabetes Drug

Invokana (canagliflozin) was approved in 2013 to treat Type 2 diabetes. It belongs to a new class of diabetic drugs known as sodium-glucose co-transporter 2 (SGLT2) inhibitors. Invokana works differently than older diabetes drugs, and poses new risks.

Invokana works differently than older diabetes drugs, and poses new risks.

Diabetic patients do not produce enough insulin, causing dangerous blood sugar spikes that damage the body over time.

Older diabetes drugs increase insulin levels, but SGLT2 inhibitors are different. They reduce the amount of blood sugar the kidneys reabsorb into the body by expelling some sugar through urination.

This mechanism of action is associated with an increased risk of acute kidney damage. The FDA strengthened existing kidney damage warnings for Invokana and other SGLT2 inhibitors in June 2016, but some say this was too little, too late.

Invokana is also linked to potentially-fatal excessive blood acids (ketoacidosis), increased bone fracture risk, cardiovascular side effects, and amputations.

J&J Spent Millions on Invokana Doctor Payments

In 2015, Invokana’s second full year on the market, sales surged 123% to $1.3 billion.

That same year, public records show, J&J spent $20.9 million promoting Invokana to physicians. Only two brands—Xarelto and Humira—were associated with higher doctor spending. Other top-spending brands for 2015 were Viekira, Eliquis, and Androgel.

These figures come from ProPublica’s Dollars for Docs, which is based on disclosures required under the Physicians Payments Sunshine Act, part of the 2010 Affordable Care Act.

Included in the payments data is money for speaking, consulting, meals, travel, gifts, and royalties. Although doctors who receive drug company money are not formally obligated to prescribe certain products, research shows that doctors receiving payments tend to prescribe more brand-name drugs than those not receiving payments.

Invokana spending reflects increased SGLT2 competition in a growing diabetes treatment market.

Contact us to report an Invokana complication and learn your legal rights.

How to Find Out If Your Doctor Is on the Payroll of Big Pharma

Nestled within the 20,000+ pages of the Affordable Care Act (aka “Obamacare”) is something known as the Physician Payments Sunshine Act.

The Sunshine Act mandates that manufacturers of drugs and medical devices disclose payments to physicians of more than $10. It also requires that drug and device maker payment data be posted on a publicly accessible website administered by the Centers for Medicare and Medicaid Services (CMS). These provisions are intended to help patients make better-informed healthcare decisions and to discourage financial ties that could increase health care costs.

As the New England Journal of Medicine (NEJM) explains, patients who find out that their doctor is involved with industry might trust the doctor less and be less inclined to accept treatment recommendations or care from them. “Given the evidence that greater physician financial involvement with manufacturers is associated with higher utilization of expensive, brand-name products, such dynamics could reduce costs,” writes NEJM.

With U.S. healthcare costs skyrocketing, and with high brand name drug costs a major culprit, the cost-lowering aspect of transparency is certainly important. But beyond that, patients simply have a right to know whether their doctor is taking medical industry money. What they do with that information is up to them. Without adequate knowledge, however, transparency is impossible.

Here’s how to find out if your doctor is taking money from Big Pharma:

  1. Visit OpenPaymentsData.CMS.gov
  2. Enter the first and last name of your doctor
  3. Click “Search”
  4. Find and click your physician’s name in the records results
  5. If multiple results appear, click “refine your search criteria,” add more information, and repeat the search

Alternately, patients can visit ProPublica’s “Dollars for Docs” website and search by doctor, drug, or device.

ProPublica, using data obtained through the CMS Open Payments tool, recently published an analysis that shows the more money doctors receive from the medical industry, the more they prescribe brand name medications.

While this may not seem like an earth-shattering finding, the evidence for it up until now has been piecemeal. Prior to the Sunshine Act, there was no centralized mechanism for tracking physician payments from drug and device companies.

According to ProPublica, from August 2013 to December 2014 alone, pharmaceutical and medical device companies made $3.49 billion in payments to more than 680,000 doctors.

Doctors tend to deny that financial influences have any bearing on what they recommend to patients. ProPublica says their analysis doesn’t prove industry payments sway physicians to prescribe certain drugs or a particular company’s drugs, but that overall, payments benefit drug companies’ bottom line.

In a health care system that should be serving the people, and not the powerful, this is reason enough to discourage financial ties between the medical industry and doctors.

“There is a very good reason why drug companies spend billions of dollars on their sales and promotional efforts: the strategy works,” says James D. Young, an attorney for Morgan & Morgan who is nationally recognized for his work in pharmaceutical litigation.

Young adds, “The next time your doctor writes a prescription for a brand drug, ask her why she chose that drug over generics or competitors.”