Pfizer Rep Claims Zoloft Touted for Failed Cheerleaders; Viagra for Women

Former Pfizer sales rep Blair Collins' whistleblower lawsuit contains a detailed guide to how some of Pfizer's reps allegedly promoted their drugs. Among the tactics they allegedly used were recommending the antidepressant Zoloft for girls who failed to make the cheerleading squad; and staging talks in which doctors recommended prescribing Viagra for women who had difficulty reaching orgasm.

Pfizer denies the allegations:

Pfizer denies all federal, state and qui tam allegations, with two exceptions. We acknowledge certain improper actions related to the past promotion of Bextra and Zyvox. Beyond those two exceptions we deny all federal and state and qui tam claims.

Blair begins his suit -- which was settled by Pfizer as part of the $2.3 billion Bextra deal with the Department of Justice -- by describing the budgets that Pfizer's reps and marketing staff had at their disposal on an annual basis. The suit gives these numbers.

Sales representatives had $28,000-$35,000 per year for meals, travel, expenses, etc.
Reps had an additional $8,500-$10,000 per year for speaker honoraria and preceptorship fees.
IHR's and specialty reps: $45,000-$450,000 for developing residents and fellows to speak, plus
$12,000-$15,000 for honoraria to staff and other specialists.
DMs: $80,000
RMs: $100,000
RMRs: $50-60,000
PharmD Pharmacy consultants: $40,000- $50,000
Disease Management Team: "Limitless" (hundreds of millions of dollars per year)

Pfizer expected a $10 return on every $1 it spent on its marketing, Collins alleges, and targeted doctors would see two or three different Pfizer reps every day.

In terms of off-label promotion, Collins claims he heard his colleagues describe to him how they persuaded doctors to look for child patients who might be depressed -- such as girls who didn't make the cheerleading team and boys who failed to get onto the school football team. Zoloft was not approved for depression in kids:

(Click on images to enlarge.) Similarly, Viagra is not approved for use in women. But Pfizer arranged for Dr. Chuck Rolle, head of Ob/Gyn studies at the University of Arizona Medical Center, to give talks, the suit claims. Inevitably, in the late 1990s, Rolle was asked by the doctors who attended the talks what the effect of Viagra was in women. Collins alleges he replied that Viagra was good for orgasm in women:

Rolle's sister was Jo-Anne Rolle-Harper, the Southwest Regional Manager of Pfizer's Lab Division, and later vp of the Steere Sales Division, Collins claims. Dr. Rolle did not immediately return a call for comment.

More generally, Collins claims he spent much of his time wining and dining doctors at various flashy events, such as Nascar races (at which docs got to meet the drivers), theater shows, strip clubs, casino nights, the Scott & White golf invitational, meals at the Four Seasons in Dallas, skiing at Breckenridge and Vail, and horse racing at Lone Star Park.

One trip allegedly involved a box at the Texas Rangers baseball stadium. Docs were given dinner and heard a talk -- and then everyone watched the game. It cost $8,000:

A more expensive version of the same trip involved a box at the Dallas Cowboys, Collins claims.

Sometimes reps were given "unapproved" studies that described off-label uses of the drugs they were promoting, Collins claims. Although reps were told not to use them, and the studies were labelled "do not detail," Collins claims "reps would use a paper cutter supplied by their DM to cut off the bottom of the glossy handout where it said 'do not detail' and then put copies in their detail binders":

When Collins began to complain about some of Pfizer's alleged activity, his boss sent an email asking his colleagues to "destroy" any unapproved materials:

Collins was eventually let go by Pfizer in 2003 after he complained to HR about the off-label promotion he allegedly witnessed. Collins claims Pfizer told him he had lost his "integrity." When he asked HR for a copy of his personnel file, which until then had contained nothing but glowing performance reviews, Pfizer HR said they had "lost" the file, Collins claims.

Of the settlement as a whole, Pfizer general counsel Amy W. Schulman said in a statement:

We regret certain actions taken in the past, but are proud of the action we've taken to strengthen our internal controls and pioneer new procedures so that we not only comply with state and federal laws, but also meet the high standards that patients, physicians and the public expect from a leading worldwide company dedicated to healing and better health.

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