March 27, 1991

Sandoz and the Monitoring of Patients Receiving Clozapine

Author Affiliations

Washington, Pa

Washington, Pa

JAMA. 1991;265(12):1528-1529. doi:10.1001/jama.1991.03460120042029

To the Editor.—  The Medical News and Perspectives article by Kleinerman1 explores the issues surrounding the clozapine (Clozaril) controversy. As with most social conflict, each protagonist voices a meritorious principle on which to base argument. The medical profession asserts its rights and responsibilities regarding clinical management. Public interest groups decry inordinate expense. Politicians are happily embroiling themselves in the controversy and offering their usual nonsolutions. The key to solving the dilemma lies in understanding its root cause, which has not been directly addressed. Sandoz' clozapine program director hints that the US Department of Veterans Affairs' proposal, which included monitoring its own patients, might have been acceptable had it indemnified Sandoz against liability.If product liability fears are the basis for Sandoz' position, it becomes apparent why the meritorious arguments of others have been rebuffed by Sandoz. While the Sandoz monitoring system does not provide absolute legal protection, it would