Blue Cross Blue Shield's lawsuit against Pfizer (PFE) to recoup money it overpaid for Bextra and other drugs that were promoted for unapproved, "off-label" uses gives an idea of just how bad the "Bad Old Days" of drug marketing really were. Blue Cross claims Pfizer bought airfare to Caribbean resorts for 5,000 doctors who also received up to $2,000 "honoraria" each, plus golf games and massages just for listening to lectures about the now-withdrawn painkiller.
Blue Cross has also introduced a new tactic into the legal game of attempting to recover monies paid for illegally promoted pharmaceuticals: it names individual Pfizer executives as defendants, presumably in an attempt to "name and shame" them. Previously, plaintiffs in similar cases just sued the company they wanted money from.
The suit doesn't say the named executives specifically arranged the trips. Rather, it accuses them of preparing sales materials to convince doctors to use Bextra for surgical pain, an off-label use, among other acts. Pfizer says:
This is a case of an insurance company seeking its money back for medicines that physicians prescribed appropriately using their best medical judgments. Pfizer denies the allegations brought by the insurer in this case.Most of the allegations are not new -- they're based on the $2.3 billion settlement Pfizer reached with the feds in 2009. (Disclosure: They're also based on three stories I previously published on BNET: see related stories below.)
But Blue Cross does provide some numbers that indicate the massive scale of Pfizer's infamous Bextra business:
Pharmacia paid targeted physicians both airfare and two to three days' accommodations at lavish resorts in the Bahamas, Virgin Islands and across the United States. Pharmacia further entertained these physicians with golf, massages and other recreational activities. And Pharmacia paid them honoraria between $1,000 and $2,000 for attending. The number of attendees at this event often ranged from 50-100 health care professionals.
Pharmacia held almost 100 of these meetings. By simple arithmetic, Pharmacia thus promoted unapproved uses and dosages of Bextra to and provided entertainment for over 5,000 health care professionals.The executives named as defendants are Rick Burch, a former svp who planned and launched Lyrica; Jake Friedman, a former vp of sales responsible for promoting Lyrica and Geodon; Pfizer's executive director Mark Brown; and Matthew Lustig, a former South Florida district sales manager, who distributed documents to sales agents who promoted Bextra, Blue Cross says.
The most interesting name there is Lustig's: He's the least senior person on that list. At a company of Pfizer's size, he's pretty low on the totem pole, especially as it's quite well established that Pfizer's off-label push for Bextra was backed by management.
Blue Cross appears to be sending a message to all Pfizer employees, no matter how lowly: Don't push off-label drugs onto patients we cover, because we're taking names.
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