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What Integrity Means to Pfizer

by MARTHA ROSENBERG

The satire was biting:

“Thanks for making time to see me today,” posted a rep on cafepharma about a fictitious sales meeting with a psychiatrist. “Now, I know that you used Neurontin in the past for every condition under the sun. Pfizer knows very well that you guys were and still continue to be the largest writers of off-label Lyrica and so, in the spirit of Bextra [withdrawn in 2004] will you please write Lyrica as much as possible? Remember Dr, this is Pfizer. The company that never met an off-label sale that it wouldn’t cover-up.”

Don’t forget, writes the next poster on the pharma site, the psychiatrist answers, “Great! and I also heard that it is about to be approved on state Medicaid and I can write it for anything. Is this true?” to which the rep assents in defiance of, “that nice little 2004 CIA agreement.”

Pfizer’s nice little 2004 “CIA” or Corporate Integrity Agreement in which a company promises to sin no more to which the poster refers was for fraudulent marketing of seizure drug Neurontin. It was preceded by a CIA for fraud related to Pfizer’s cholesterol drug, Lipitor, in 2002.

And this month it’s followed by a CIA for mis-marketing pain drug Bextra, antipsychotic Geodon, seizure drug Lyrica and antibiotic Zyvox.

Pfizer’s $2.3 billion health care fraud settlement with the government announced this month by the US Department of Justice adds some firsts to the world’s biggest pharmaceutical company.

It is the largest health care fraud settlement in the history of the Department of Justice “to resolve criminal and civil liability arising from the illegal promotion of certain pharmaceutical products,”–and the largest criminal fine ever imposed in the United States. It covers Pfizer’s kickbacks to health care providers and false claims submitted to government health care programs, also known as our tax dollars, in violation of the Food, Drug and Cosmetic Act. Forty-three states will share in the “give backs.”

But it is not exhaustive.

In July, Pfizer signed a $75 million agreement with Nigerian authorities to settle criminal and civil charges over the deaths and injuries of children given its unapproved antibiotic Trovan in 1996 now restricted for US use except in extreme cases by FDA.

Pfizer has been funding the “grassroots” organization National Alliance for the Mentally Ill (NAMI) according to Pfizer rep Mark R. Westlock, a whistleblower whose testimony was included in the Bextra settlement and whose case against Pfizer is posted on Bnet.

And Scott S. Reuben, MD, former chief of acute pain at Baystate Medical Center, Springfield, MA and paid Pfizer speaker was found to have faked Bextra and Lyrica pain studies on which medical practice was based in a long medical con exposed this year–not just making up data but making up patients. PS The studies were retracted from medical journals.

Pfizer’s illegal Neurontin marketing featured the “usual suspects” of off-label marketing, kickback schemes, Medicaid fraud and falsified science.

But apparently New York City-based Pfizer didn’t learn its lesson. Part of the $2.3 billion settlement announced this month includes payments to states for illegally promoting its antipsychotic Geodon for unapproved uses like treating children and dementia in the elderly.

In fact FDA is considering approval of Geodon for “the acute treatment of manic or mixed episodes associated with bipolar disorder, with or without psychotic features, in children and adolescents ages 10 to 17” even as the settlement ink dries in what seems a little… retroactive. Seated on the FDA advisory panel in June as a citizen providing sunshine was a member of the Pfizer financed NAMI.

Pfizer representatives were fixtures at Western State Hospital, a mental hospital near Lakewood, WA, according to the News Tribune, where 118 prescriptions were written for Geodon on a single day, December 6, 2006.

Asked by reporter M. Alexander Otto in 2007 why reps made almost 200 visits in four years, Pfizer company spokesman Bryant Haskins said, “That’s where our customers are.”

See: “That’s where the money is.” (William”Willie” Sutton, bank robber.)

Martha Rosenberg is an investigative health reporter. She is the author of  Born With A Junk Food Deficiency: How Flaks, Quacks and Hacks Pimp The Public Health (Prometheus).

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