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Healthy Skepticism Library item: 12225

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: news

Armstrong D.
Pfizer Is Sued Over Lipitor Marketing
The Wall Street Journal 2007 Dec 20B5
http://online.wsj.com/article/SB119811136568740957-email.html


Full text:

A former Pfizer Inc. official in a lawsuit accused the company of illegally boosting sales of its top-selling drug Lipitor through an elaborate campaign of misleading educational programs for doctors.
Jesse Polansky, claims that the educational campaign was a key part of a marketing strategy that “led thousands of physicians to prescribe Lipitor for millions of patients who did not need medication” and could be harmed by overly aggressive treatment.
The lawsuit was filed in U.S. District Court for the Eastern District of New York in February 2004. It was immediately sealed to allow federal prosecutors time to decide if they wanted to intervene in the case. In August, the government said it wouldn’t intervene, lifting the seal. Pfizer was served a copy of the suit yesterday, according to Dr.
Polansky’s lawyer, Steve Berman of Hagens Berman Sobol Shapiro.
The failure of the government to intervene may signal that prosecutors are skeptical about the merits of the case. The government hasn’t intervened in other cases which led to huge fines against drug companies. One example is another case involving Pfizer, this one for the off-label marketing of Neurontin.
Pfizer said, “We believe this case has no merit. Furthermore, after reviewing the allegations in this complaint, the government declined to intervene in this action… . Pfizer does not condone the off-label promotion of our products. We believe that our sales and marketing practices are solely based on our prescription information as approved by the U.S.
Food and Drug Administration.”
Dr. Polansky was Pfizer’s director of outcomes management strategies from 2001 to 2003, and his responsibilities included reviewing some of the marketing materials for Lipitor and other Pifzer products. He says he was fired by Pfizer after complaining about marketing he considered to be improper. Dr. Polansky now works as the senior medical officer for Medicare in a unit that investigates fraud and abuse at the big government health insurer.
The suit seeks compensation for Dr. Polansky as a whistleblower under laws that could give him a share of money recovered for any overpayments made by federal health-insurance programs.
Lipitor, a type of cholesterol treatment known as a statin, is the world’s biggest-selling drug , with sales of $13.6 billion last year, according to IMS Health.
The allegations against Pfizer echo concern elsewhere that continuing medical-education programs for doctors are often sales pitches for “off-label” uses of drugs. A congressional committee this past summer said it was concerned there was little oversight of these programs — where doctors are often wined and dined — or enforcement when companies use them as marketing tools.
Pharmaceutical companies are prohibited from marketing drugs for indications other than what the FDA approves them for, although doctors aren’t prohibited from prescribing them for unapproved uses. Independent educational programs can discuss off-label uses that aren’t FDA approved. But Dr. Polansky’s lawsuit charges that the Pfizer-funded programs weren’t independent.
The Lipitor educational programs were run by companies paid by Pfizer through “unrestricted educational grants,” the lawsuit says. It alleges that the educational programs were integrated into the marketing plan for the drug, citing an internal Pfizer marketing plan for Lipitor with a page titled “Medical Education Platform Supports the New Positioning.”
Among other things, Dr. Polansky says Pfizer wanted to extend Lipitor use beyond the indications found on the drug’s label by targeting people at moderate risk of developing heart disease or having a heart attack. He said the educational programs for doctors deliberately misrepresented the drug’s label to encourage Lipitor therapy for people in the moderate-risk category who didn’t need the drug.
In his suit, Dr. Polansky also said the Pfizer programs included deliberate misinformation promoting the idea that kidney-disease patients may need to be treated with statins. While kidney disease is recognized by some doctors as a risk for heart disease, it isn’t part of the federal guidelines that factor into Lipitor’s approved use.

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909