Healthy Skepticism Library item: 19258

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

Silverman E
When Reps Are Told To Sell ‘Gobs Of Dope’
Pharmalot 2011 Jan 5
http://www.pharmalot.com/2011/01/when-reps-are-told-to-sell-gobs-of-dope/

Full text:

The behind-the-scenes activities in which off-label marketing is alleged are rarely pretty, but every so often, a lawsuit reveals accusations of behavior that can give one pause. Take the case involving CV Therapeutics, which was bought two years ago by Gilead Sciences. A whistleblower lawsuit filed by former sales rep Ricardo Forges reveals that a director of training told him to sell “gobs of dope” and to “get those pills in people’s mouths any way you can.” Crude, but to the point, yes?
The circumstances in which this brazen message was conveyed, according to the lawsuit, were somewhat odd. That’s because the sales training focused mostly on Ranexa, even though the chronic angina med was not yet approved by the FDA and Forges was hired to market Aceon, a blood pressure pill. However, CV managers harped on the potential for Ranexa to become a hugely important revenue generator.
In fact, more than one CV manager insisted that Ranexa was “not your plain old angina drug,” and Forges claimed in his lawsuit that, once Ranexa was approved, his supervisor specifically instructed him to promote the med to treat diabetes, arrhythmia, diastolic dysfunction, ischemia and left ventricular dysfunction. Reps were told to “expand beyond angina and into the ischemic cascade – help (doctors) see angina equivalents.”
It didn’t end there. In June 2007, a district manager told Forges and another rep during a meeting that he expected them to do “whatever it takes” and to convince docs to write Ranexa scrips. And he continued by saying: “I do not care what you do to sell the drug. I don’t see anything and I don’t hear anything. Just get it done. Just get the scripts.” This same manager distributed material with handwritten notes that highlighted points to promote Ranexa off-label, according to the suit.
However, this district manager also taught reps how to game the reimbursement system and provided partially completed authorization forms. Unnamed patients were already marked down as suffering from “chronic stable angina” and prescribed other meds. In other words, the CV team knew the off-label promotion was wrong and thought a work-around system would cover their tracks.
Since August 2009, the marketing had been investigated by the Office of the Inspector General of the US Department of Health and Human Services. However, the feds last month decided not to intervene, or join, the lawsuit, which Forges simultaneously dismissed voluntarily, although he retained the right to refile the case in the future. Nonetheless, the behavior of the CV team is now memorialized and may prompt others to stop and think before they refer to meds as dope. You never know who is taking notes.
Hat tip to Bnet