Boehringer Ingelheim Overview
Boehringer Ingelheim is a Germany-based drug manufacturer which is privately owned by the Boehringer, Liebrecht and von Baumbach families in Ingelheim an Rhein, Germany. Boehringer has affiliates in 145 international areas, including the U.S. and is one of the 20 largest pharmaceutical manufacturers in the world. The company had 2021 revenue of nearly $20 billion with products in Animal Health and Prescription Medicine and has an estimated 48,000 employees around the world.
Boehringer describes their mission as “Value through Innovation” and has produced several unique medications including Flomax for enlarged prostate, Viramune for HIV, Spiriva for pulmonary disorders, Tradjenta for diabetes and Pradaxa for blood clot prevention.
Though Boehringer has maintained a reputation of advanced research and philanthropy, it has been warned by the U.S. Food and Drug Administration (FDA) on more than one occasion for poor quality control and safety violations at some production facilities. Some Boehringer products have caused serious side effects resulting in permanent injury or death. The company was also accused of failure to adequately warn patients and the medical community about potential risks and is facing thousands of lawsuits over the medications Pradaxa and Tradjenta.
History of Boehringer Ingelheim
Boehringer Ingelheim was founded in 1885 by Albert Boehringer in Nieder-Ingelheim, Germany as a tartar factory, manufacturing pharmaceutical acid salts and textile dyes. In 1893, Boehringer developed a process by which bacteria could be used to produce lactic acid to be used in the food, dye, and leather industries, which led to dramatic growth of the company.
Through the first and second World Wars, the company suspended the production of organic acids but continued Research and Development, and introduced new pharmaceutical products in pulmonary, gastrointestinal, and cardiovascular medicine. During World War II, the Ingelheim factory was forced to close but for only a few months until production was resumed with Allied permission.
During the 1950’s through the 1980’s the company continues international expansion, acquisition and mergers. The Animal Health division was established with the acquisition of Pfizer’s veterinary products and a number of new-category medications or humans were produced in the company’s main therapeutic areas (cardiac, pulmonary and GI) including Atrovent and Alupent for pulmonary disorders, Catapresan, Persantine, and Mexitil for cardiac disorders, and Buscospan for GI disorder. In 1977, the company’s first medication to treat thrombosis and embolisms (blood clots), Asasantin was launched and in 1987, the first thrombolytic for acute heart attacks was launched, Actilyse.
In 1991, the family owned company shifted management to the Board of Managing Directors and restructured R&D activities and in 1994, the formation of separate companies for each division was announced. Since that time, the company has acquired a number of companies, formed or ended co-marketing relationships and has divested its generics division, Roxane pharmaceuticals. Boehringer conducted an asset-swap with French company, Sanofi Aventis and traded their consumer health division for Sanofi’s Merial animal health company which resulted in BI being a global leader in animal health.
In 2018, Boehringer increased its focus in biopharmaceutics with partnerships and acquisitions to access new medications in oncology, immunology, and vaccines.
Boehringer Ingelheim Products
Boehringer’s history includes legacy medications such as:
Newer medications have included Aptivis for the treatment of HIV, Aggrenox for the treatment of strokes, Micardis for the treatment of hypertension, Metalyse for the treatment of heart attack, Spiriva for the treatment of COPD, Pradaxa for blood clot prevention and Tradjenta/Jentaduo for the treatment of Type 2 Diabetes. Pradaxa and Tradjenta were both released in 2011 and both have resulted in thousands of lawsuits for drug injuries alleged to be caused by the medications.
Boehringer Manufacturing Issues
Despite a mostly good reputation, the company has a spotty history involving drug manufacturing, clinical testing, and safety issues.
In 2011, a division of Boehringer, Ben Venue Laboratories, located in Bedford, Ohio was voluntarily closed after the FDA found irregularities within the plant. Issues included mold, rusty tools, and a barrel of “unknown liquid” which was later confirmed to be urine. The company spent $300 million to upgrade the factory but closed the facility at the end of 2013 after it was unable to return to full-scale manufacturing.
In 2012, the company paid $64,475 to settle U.S. Environmental Protection Agency (EPA) violations regarding mishandled mercury waste and was required to spend hundreds of thousands to develop a qualified hazardous waste facility. After a serious of missteps in manufacturing, the management of Boehringer Ingelheim was restructured.
- 2008 – 2009 – Foreign material discovered in pharmaceutical ingredients and failure to adequately investigate the contamination
- 2009-2012 – Contaminated batches identified in 2009 were used to produce medications until 2012
- 2013 – Failure of Spiriva inhaler lots to meet dose uniformity product specifications which were released for shipment
- 2013 – Inconsistent reports filed with FDA in response to warning letters
In March of 2014, Boehringer Ingelheim and Eli Lilly announced that a new diabetes drug that was intended for co-promotion would not be approved by the FDA due to previous cGMP violations at the Boehringer plant in Ingelheim that had not been corrected. A warning letter had been issued by the FDA in May of 2013 regarding a reinspection conducted 6 months after the original violation in 2012. Empagliflozin was not approved until August of 2014.
Unethical East German Research Studies
In 2013, a report in the German weekly magazine, Der Speigel, indicated that at least 50,000 patients including premature infants had been involved in over 600 clinical trials at hospitals in East Germany beginning in 1983, before the reunification. The article indicated that for each trial, “Western” pharmaceutical companies had paid up to 800,000 Deutsche Marks (about $2.1 million) to be split between the hospitals and the East German government.
Allegations of improper research included Boehringer Ingelheim along with other international companies such as Sanofi of France, Ciba Geigy (now part of Novartis), Schering AG (now part of Roche), and Bayer. Experts indicated that the trials conducted with government cooperation in East Germany could not have been conducted in West Germany or other Western nations due to safety concerns.
Patients used in these trials were reportedly not given or unable to provide for informed consent required by global standards such as International Committee on Harmonisation (ICH) and as adopted by the FDA. The government of unified Germany has been unable to confirm or deny these allegations and companies involved have provided no comment or denied violation of standards.
Boehringer Product Issues
Boehringer Ingelheim has faced thousands of lawsuits for two notable products:
- Anticoagulant Pradaxa
- Antidiabetic Tradjenta
Many of the lawsuits have yet to be settled and may remain in court systems.
Pradaxa (dabigatran), was approved in 2010 as a new type of anticoagulant to prevent clot formation in heart arrhythmia. It is a type of drug known as a factor Xa inhibitor that, unlike the older medication Coumadin, does not require routine blood testing. It was developed as an improvement over Coumadin but unlike the older medication, does not have an antidote.
Pradaxa is one of Boehringer’s bestselling products and produced over $1.5 billion in 2013 revenue for the company but many patients have reported serious side effects. Pradaxa may cause uncontrolled bleeding leading to hemorrhage and death in some cases which cannot be reversed.
Thousands of lawsuits regarding injury and death caused by Pradaxa have been filed against Boehringer Ingelheim. Patients have claimed that the company failed to adequately warn patients and the medical community about the bleeding risks and lack of antidote.
Boehringer Ingelheim was forced to pay $931,000 by a U.S. District Court Judge for withholding or failing to preserve “countless” files regarding Pradaxa drug development, marketing plans or employee phone message. The missing documents related to the requests of the records sought by litigants who had sued the company over injuries caused by Pradaxa in December of 2013, prior to the first Pradaxa lawsuit court dates.
The company claimed that they had made 32 million pages of information available, but they had been bombarded with “overly burdensome” requests by patient lawyers. The company also claimed that many of the documents were not relevant.
Boehringer has settled 4,000 federal lawsuits for $650 million but many lawsuits may remain, and more may be expected against Pradaxa and similar medications such as Bristol Myers Squibb’s Eliquis.
Tradjenta or Trajenta (linagliptin) is an anti-diabetic medication used for the treatment of Type 2 Diabetes. It is manufactured in partnership with Eli Lilly & Company and is in the same medication class as Byetta, which has caused numerous problems.
Tradjenta is a member of the “incretin” group of anti-diabetics such as Byetta and Bydureon but Tradjenta is taken as a pill and not an injection. Byetta and Bydureon have been implicated in a number of lawsuits due to serious side effects such as hypoglycemia, pancreatitis and pancreatic cancer.
Tradjenta may cause similar serious adverse events as Byetta and Bydureon, including pancreatitis and pancreatic cancer, along with lesser-known side effects of rhabdomyolysis and autoimmune disorder. Boehringer Ingelheim, along with co-marketer Eli Lilly, may be facing thousands of Tradjenta drug injury lawsuits similar to those filed for Byetta and Bydureon.
The active ingredient in Tradjenta, linagliptin is also part of a combination product, Jentadueto which also contains metformin. Due to its composition, Jentadueto may also be included in future Tradjenta lawsuits.
Notwithstanding claims relating to this product, the drug/medical device remains approved by the U.S. FDA.