Pfizer's West Side Story: How "the Sharks" Sold Bextra Off-Label

Last Updated Sep 3, 2009 11:15 AM EDT

Pfizer had a sales team in Florida that called themselves "the Sharks" as they promoted Bextra off-label, according to documents filed in the one of the cases that led to yesterday's $2.3 billion settlement.

South Florida district sales manager Matthew Lustig addressed his team as "the Sharks," according to emails filed in the case (hosted on law firm Phillips & Cohen's web site). Here's one (click to enlarge):

It was not the only Pfizer sales team with a cute nickname. BNET previously noted the existence of "the Highlanders," a team that sold Bextra in Brooklyn, N.Y. A representative said:

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.
Lustig also rewarded sales reps who persuaded doctors to use Bextra off-label in surgical protocols with "Ace Points," that were worth money. In one email he praised sales rep Roger Catlett:
"Great job Roger! 5000 Ace Points [about $50.00] on the way."
John Kopchinski was the sales rep who won $52 million in his cut of the settlement, as a whistleblower who brought the off-label sales to the government's attention. He was one of the Sharks.

In Kopchinksi's district, doctors were given article reprints by sales reps addressing off-label uses, the suit alleges. The articles' first page indicated what Bextra was, and was not, approved for. But Pfizer had a way around that, according to the complaint:

Pfizer sales representatives were instructed, when leaving these reprints with doctors, to fold this first page over, so that it became the last page, not the first page, of the reprint as it was presented to the physicians.
Pfizer also paid doctors to do pretty much everything, the complaint alleges. Here's menu of what was on offer:

$250 to $1,500 for travel and meal expenses for conferences in luxury hotels. On these trips, golf was available. One email to the Sharks from Lustig said:

We have a number of people going to this meeting. If any of them want to golf let me know, I will be there.
$500 for a doctor to do a clinical paper review with a rep -- where the rep already was familiar with the material being "reviewed."

$1,000 for a "preceptorship," in which a rep would shadow a doctor for a day.

$250-$1000 to attend journal clubs, where a handful of doctors would discuss an article.

$250-$1,000 to make a presentation to a journal club.