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Last month, at the request of Oregon first lady Aimee Kotek Wilson, the state’s top behavioral health official met with representatives of one of the world’s largest pharmaceutical companies.
The drug reps work for Janssen Pharmaceuticals, a division of Johnson & Johnson (2023 sales: $85 billion), which makes long-acting injectable drugs to treat schizophrenia. It’s a big, hotly competitive market. Janssen has gone to federal court repeatedly to protect patents on its Invega Sustenna and Invega Trinza brand injectables, which generated sales of nearly $2.9 billion in 2023.
WW previously reported that Kotek Wilson met with Janssen representatives Aug. 15, 2023. That information came from the first lady’s calendar, which the governor’s office released April 26, along with thousands of emails. But those emails did not shed any light on matters discussed at the meeting. Now, however, emails released by the Oregon Health Authority on May 15 in response to public records requests from WW and The Lund Report provide context for that meeting—and subsequent communications from drug company officials.
Following the Aug. 15 meeting, Leslie Fox, who works for Janssen’s Strategic Customer Group, followed up with Kotek Wilson. (Fox’s LinkedIn profile says her role is “impacting sales, enhancing market position and impacting health policy with providers, patient and disease advocacy groups.”)
“Sophia [Yu, another Janssen official] and I would like to thank you for meeting with us last Friday. We appreciate you sharing your passion for those with serious mental illness and how long-acting injectables are part of the solution,” Fox wrote. “You expressed an interest in having Sophia share this data with others within the State, including the Behavioral Health Advisor and the Behavioral Health Director who will both be starting in early September,” Fox wrote. “Please let us know when those opportunities would be best suited.” (Fox and Yu didn’t respond to a request for comment.)
Fox alluded to Juliana Wallace, Kotek’s newly hired behavioral health adviser, and Oregon Health Authority behavioral health director Ebony Clarke, who moved to the state agency from Multnomah County last year.
On Sept. 5, Kotek Wilson forwarded Fox’s email to Clarke, Wallace, and Kotek’s health care adviser, Kristina Narayan: “I wanted to share this email with you between the three of your positions, you should be able to access this information. It was very interesting. We can talk more about it.”
The conversation then went quiet.
Records show that Johnson & Johnson, Janssen’s parent company, made a $5,000 contribution on Nov. 6 to Kotek’s political action committee. That amount is twice Johnson & Johnson’s previous largest contribution to an Oregon politician, $2,500 to Gov. Kate Brown in 2017.
Kotek campaign spokesman Thomas Wheatley says the contribution was routine. “The contribution from Johnson & Johnson was part of a fall 2023 fundraising event,” Wheatley says. ”Between September 2023 and December 2023, the governor’s political committee had six separate events that together raised roughly $295,000. Overall, the governor’s political committee raised a total of just over $470,000 in this same time period.” Wheatley said he didn’t know anything about the meeting Kotek Wilson held.
On Feb. 5, 2024, Fox emailed Kotek Wilson again. “I wanted to check in and follow up on our discussion from last summer,” she wrote. “I know that we were waiting for the new behavioral health director and team at OHA to start their roles in early fall. Look forward to a continued discussion.”
Kotek Wilson forwarded the message to Clarke and Wallace, this time with a notable change: She copied her wife, the governor, on the email.
“Leslie Fox is a contact from Robin Henderson who I spoke with in August of 2023, she has some interesting data to share. She reached back out to me today,” Kotek Wilson wrote. “Perhaps we could set up a zoom call for an introduction and a brief overview and then you can decide what or if you want to further explore.”
In addition to Kotek Wilson adding her wife to the email thread, the source of the original contact—Robin Henderson—is noteworthy. As WW reported earlier, Henderson, the CEO of behavioral Health at Providence Health & Services Oregon, appears regularly on Kotek Wilson’s calendar. Kotek Wilson told WW earlier that Henderson helped prepare her for speaking engagements, but it’s also the case that Providence has significant policy and financial issues before the state and access to the governor’s office for a company like Providence could be an asset.
Wallace and Clarke responded immediately and with enthusiasm to Kotek Wilson, both copying the governor on the email. “Thank you for reaching out. I am very curious about this data set. A zoom call sounds like a good first step,” Clarke wrote.
A Salem pharmaceutical lobbyist, speaking on condition of anonymity, says the exchange was unusual.
It is simply not common that drug company officials would get a meeting with somebody so close to the governor, the lobbyist says, and also with the behavioral health director of OHA. “That just doesn’t happen,” the lobbyist adds.
The reason: Oregon long ago established a rigorous process for the state to select the drugs paid for by the Oregon Health Plan. Drug companies are keen to do business with the state because the more than 1 million Oregonians covered by OHP consume a lot of medications. Generally speaking, the state prefers generic medications because they are cheaper. Johnson & Johnson has repeatedly gone to court to protect the patents on its injectable schizophrenic medications, which preserves its ability to charge higher prices.
On April 3, according to the emails, Clarke met with Fox (the first lady bowed out at the last minute). After the meeting, Fox followed up with an email to Clarke, copying the first lady.
After thanking her for the meeting, Fox referred to studies that showed the benefits of giving patients long-term injectables, i.e., the product her company sells, sooner in their treatment. “I am also attaching the work that the Mental Health Clinical Advisory Group did to provide guidance for clients with schizophrenia,” Fox wrote. “This is the work where they look to move LAIs [long-term injectables] to an earlier use for those diagnosed with schizophrenia.”
At a May 1 press conference Kotek held to discuss the departures of three out of four top advisers in her office (they left, records show, because they thought the first lady’s involvement in policy and staff issues created an untenable situation), the governor downplayed her wife’s role. “You can see from her calendar, she has not been meeting with staff since the first of the year.”
Related: Aimee Kotek Wilson is Her Wife’s Closest Adviser and Highest Priority
But the OHA emails released yesterday show that, in addition to her communication about the pharmaceutical representatives, Kotek Wilson was included in a workgroup organized by the National Alliance of Mental Illness Oregon to try to restructure the state’s civil commitment policy. Emails show the first lady was part of a group of policy experts scheduled to meet six times beginning in January.
Kotek responded to questions about the first lady’s interactions with the drug company representatives and the NAMI meeting with statements:
“In preparation for the September 2023 roundtable focused on the intersection of serious mental illness (SMI) and homelessness, the Governor’s Office was connected with [Johnson & Johnson] to get a better understanding of the consumer data they might be able to share in order to understand the breadth of the SMI population in Oregon.”
“J&J, like other pharmaceutical companies, is uniquely able to provide consumer data related to the use of certain drugs, such as long-acting injectables, among the SMI population broadly. No specific J&J product was discussed, but rather the potential sharing of data related to this vulnerable population. In the months following, J&J followed up by email and First Lady appropriately handed off the discussion to the Oregon Health Authority.”
An OHA spokesman, Timothy Heider, says the meeting was simply an opportunity to share information. “Oregon continues to face an acute shortage in care that will take several years to close. State health officials want to explore every opportunity to improve treatment access and treatment outcomes,” Heider said. “OHA’s Behavioral Health Director Ebony Clarke and members of her staff met with Johnson & Johnson representatives to learn about their diagnostic tool and injectable treatment medication. No follow up meetings have been scheduled.”
Kotek added that the first lady’s participation in the civil commitment workgroup ended long ago.
“Since the beginning of the year, the First Lady has not been involved in nor has she attended the NAMI Civil Commitment work group virtual meetings,” Kotek said. “She was copied on some emails but has not engaged or participated in conversations.”