The drug was also referred to internally as "snake oil." Both are indicators that dubbing your product with a cute internal nickname can be a bad idea.
The same diagram shows various pain-related conditions, such as diabetic peripheral neuropathy (DPN), even though the FDA did not approve Neurontin to be used for those conditions. It's illegal for drug companies to promote pills for unapproved uses. At the bottom of the slide, a cauldron labelled "MAC" -- which probably stands for the name of the marketing unit, "Medical Action Communications" -- emits comical flames:
(Click to enlarge.) The Kaiser Foundation Hospitals and Kaiser Foundation Health Plan used the slide in a lawsuit which claimed they were misled into believing the drug was appropriate for migraines and bipolar disorder. The Oakland, Calif.-based HMO alleged it was forced to pay $90 million more than it should have for the drug. The jury awarded Kaiser $142 million in damages; that verdict followed a $430 million settlement with the Department of Justice for promoting the drug for unapproved uses.
An email in the same case showed a Pfizer executive describing Neurontin as "snake oil." According to another slide presented in the case, David Franklin, a former sales rep for Neurontin testified:
... we ended up referring to this as snake oil, because of all these diverse indications.Pfizer previously said about the case:
We are disappointed with the verdict and will pursue post-trial motions and an appeal ... The verdict and the judge's rulings are not consistent with the facts and the law.
Kaiser itself continues to recommend Neurontin for the same uses they sought recovery for in this case. Kaiser's own physicians and several of their expert witnesses prescribed Neurontin for their patients based on their sound medical judgment.Related: