When former pharmaceutical rep Mark Duxbury first called Kathleen Sharp in 2004 he gave her the hard sell. “He was real affable and charming like any good American salesman,” Sharp says, mainly because he was desperate to close this deal.

The reason? He was hawking himself. Duxbury was at the center of a massive big-pharma scandal—he had helped doctors make millions off Medicare by encouraging them to inject their patients with larger-than-approved doses of the red blood cell booster Procrit. And that drug might be killing patients.

He wanted Sharp to tell his story, and in the process expose all the questionable practices plaguing the medical industry. The result, Blood Feud, has the potential to change how America perceives health care and those who are supposedly trying to heal us. 

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Why was this story not really pieced together before now? This seems too big for the media to have ignored it for so long.

These types of stories—and there so many of them are out there—we don’t know how to cover them. So many of our newspapers and magazines are cutting back and can’t do these kind of in-depth stories. They can’t put all the pieces together like this.

This book was a way I could do that…My goal was to bring something that impacts us all down to a gut level. I wanted my brothers to read this, guys who are longshoremen, or my sisters with three kids, because these are things that average people need to know.

It’s unbelievable what these companies—Johnson & Johnson and its subsidiary Ortho—could get away with.

FDA said last summer that these drugs [Procrit, Epogen, epotein alfa] are so dangerous that most people shouldn’t use them. The thing that always shocked me about this story was that there was never a scientific test that proved these drugs were safe at any level—at any dosage. Those tests were never done. How it could sell billions and not have those tests is shocking.

Did you end up losing faith in our medical system while writing this?

It’s hard not to read this book without feeling that. I think so much of our medical and health care system has been monetized by for-profit systems. Doctors made a lot of money off Procrit. It had to be injected in the doctor’s office.

So patients had to come to them, which meant the doctors could bill Medicare directly—even if salespeople like Duxbury had given them free samples. They could make a lot of money off this through Medicare. There were a lot of doctors, universities and hospitals that were culpable in this. It’s hard to find anyone who looked good in this.

It really takes someone with a unique moral compass then to do what Duxbury did—to step up and try to stop a multibillion dollar company.

I think it takes a very strong person. When I was researching the book I learned that there is a distinct profile for whistle-blowers. The pay a heavy price for coming forward. They can’t sleep at night. They lose their families. They lose their jobs. In some cases they lose their sanity. All of that happened to Mark. He paid for doing this, but he couldn’t live with himself if he didn’t.

There are times where it’s not just about saving people. He does have a reason to get back at J&J—the company fired him on potentially trumped-up charges of sexual harassment.

There is a vendetta here. But we humans don’t have one reason for doing things, and Mark had multiple reasons, but he really was concerned about people and what was happening to them.

When did you realize what Duxbury had been telling you had serious teeth?

By 2007 I realized that this was one heck of a story. The FDA started to question Johnson & Johnson. A committee in Congress started to investigate how Johnson & Johnson and Amgen [the company that discovered epotein alfa, the generic version of Procrit] were promoting these drugs, which one Congressman said might have even been illegal.

Everything that Mark has been telling me about the off-label uses was real, and they were actually killing people. But the drug makers were promoting those uses on TV. That was my ah-ha moment: Here was a person who could lead me through this complex story.

But you never got Johnson & Johnson on the record.

I asked J&J multiple times over the years for a sit-down interview and they wouldn’t. If they had, this would have been a very different book. But that also gave me insight into what it’s like to be Mark, what it’s like to deal with this monolithic entity. I got some insight into what it was like to be a whistle-blower.