The Worst Drug Company Marketing Techniques (PHOTOS, POLL)

The Huffington Post recently learned that pharmaceutical industry insiders are expecting the health care reform legislation agreed to between the White House and Senate Democrats to result in a surge of new profits for drug companies -- more than $137 billion, according to one estimate.

But, are these profits deserved? Over the past several years, the Justice Department has clashed with a number of pharmaceutical companies over what it says were a host of illegal schemes to boost profits. As a result, huge drug companies have paid out billions in fines and settlements.

These charges include paying kickbacks to health care providers, illegal pricing and off-label marketing (which is a euphemism for pushing drugs on patients who don't need them). Bloomberg reported this week that the practice of off-label marketing -- where drug companies promote a drug for uses other than those approved by the FDA -- is widespread:

"Marketing departments of many drug companies don't respect any boundaries of professionalism or the law," says Jerry Avorn, a professor at Harvard Medical School in Boston and author of "Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs" (Random House, 2004). "The Pfizer and Lilly cases involved the illegal promotion of drugs that have been shown to cause substantial harm and death to patients."

With the massive penalties and settlements that drug companies have paid out in the name of profits, we took a look at some of the biggest cases of the last several years. Check them out below, and vote for the worst offender.

Pfizer -- $2.3 billion

Earlier this year, Pfizer, the world's largest pharmaceutical company, pleaded guilty to a fraud charge and, along with its subsidiary, agreed to pay a record $2.3 billion fine. The penalty stemmed from allegations that the company advocated the use of certain drugs for treatments beyond what had been approved by the FDA. In the case of Bextra -- which has since been withdrawn from the market due to concerns about the drug's safety -- Pfizer executives reportedly encouraged the company's salespeople to recommend the painkiller for the alleviation of pain unrelated to arthritis or menstrual discomfort, the only conditions it had been approved to treat. This wasn't Pfizer's first violation for off-label marketing: in 2004, it was hit with a $430 million penalty after it was charged with recommending its epilepsy drug Neurontin for other uses.

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[msI]

What would be interesting to know is how do the penalties relate to the actual profits they made off their schemes and where do all these billion dollars of fines go? If the profits outweigh the penalties, they will just keep doing what they're doing, cause it doesn't hurt THEM if they get fined. And as for the fines paid, are they going back to the public in any way or shape or form?

[pomegrante]

just ask real patients about the reactions to the legal poison big pharm puts out:

www.askapatient.com

[jalowe1957]

Does anyone remember when Eli Lilly took a red Prozac capsule, changed its color to purple, repositioned it as a drug for menstruati­on-induced behavioral disorder, and called its "new" drug Sarafem?

In one of my plays, I called Sarafem for what it was: a neuroleptic drag queen.

[DemocratCongress]

Can congress & Obama stop the backpedaling on wall street compensation?

good articles; http://financeopinionss.blogspot.com

where is the reform?

[goodnews7]

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[drjasonmd]

Enough is enough. Companies who engage in these practices should cease to exist. Maybe fund managers will think twice before investing in them if that were the case. Maybe the companies would think twice about engaging in these practices if their very existence were on the line.

And for the practitioners who fell for these sales tactics, you have betrayed your Hippocratic oaths out of laziness and deserve no quarter. Doctors who base their prescribing habits on the word of pharmaceutical reps and not on the published medical literature should cease to be allowed to practice. If you don't have time to read the literature, you don't have time to practice.

Sound harsh? I don't care. There's no excuse for this. When I prohibited pharmaceutical reps from my practice 10 years ago, my colleagues said I was crazy. Why should I rely on laypersons who are compensated for sales volumes to provide me with information. There are volumes of literature published, and plenty of services out there to help keep on top of it all. There are also treatment guidelines available for free everywhere. I didn't know it was unproven is not an excuse. Doctors are the ultimate gatekeepers in this, but they followed the path of least resistance in the pursuit of ... I'm not sure what they were pursuing, unless it was kickbacks.

Prescribing based on anything other than the evidence is unethical and any harm that results from it is malpractice. There is no excuse. None.

[Steve Gilmore]

First Thank you for practicing sensible medicine. I never understood this;

Why do Americans pay more for drugs than anyone else in the world when we pay dearly for R&D of the most expensive, most prescribed drugs?

http://www.citizen.org/publications/release.cfm?ID=7065

"According to the NIH, taxpayer-funded scientists conducted 55 percent of the research projects that led to the discovery and development of the top five selling drugs in 1995. "

"The drug industry’s top priority increasingly is advertising and marketing, more than R&D. Increases in drug industry advertising budgets have averaged almost 40 percent a year since the government relaxed rules on direct-to-consumer advertising in 1997. Moreover, the Fortune 500 drug companies dedicated 30 percent of their revenues to marketing and administration in the year 2000, and just 12 percent to R&D."

This makes no sense, I want an informed doctor to tell me what I need, not to watch a TV commercial and go tell the doctor, I think I want to try this or that.

It's asinine, remember, oxycodone, the most addictive drug on the planet, was advertise as harmless.

[krissymax]

Dr. Jason is absolutely right. But, watch out for some peer-reviewed articles that are written by drug company employees and/or that tout clinical studies paid for by BigPharma. I have read many that distort and or outright hide the negative side effects. I wish every doctor was as careful as you! That should be mandatory CME.

[drjasonmd]

I'm even more skeptical of studies funded by pharma manufacturers. They have a very spotty track record and they clearly have no shame. With time, most of the shenanigans come to light. Their strategy seems to be to just publish BS to increase sales and then just pay a fine years later after the billions are made.

Luckily, the universal healthcare systems that exist in Europe fund many very large clinical trials (and I can read most Western European languages). Those systems have a vested interest in saving money with better outcomes and cost-effectiveness. Since most have a single payer system, they won't pay for a brand-name medication unless it has been shown in several large studies to be more effective than the generics that already exist. They are an invaluable source for good information, but all scientific literature requires a healthy dose of skepticism.

Even so, a single study isn't enough to change my prescribing habits. It takes many trials and lots of peer-review before guidelines change; the same should apply to prescribing habits. I'll never 't understand why so many physicians jump around every time a study is published.

I'd be satisfied if simply following established treatment guidelines was mandatory CME. Unfortunately, too many physicians have a lot of old habits that are not supported by the literature. It's not very scientific. But then again, a lot of physicians still consider medicine to be an art, not a science. I refuse to accept that.

[mudshark12]

Let me pose a question: Of these seven, which do you think is the more greedy and dishonest? a) Big Pharma, b) Wall Street, c) Madison Ave [advertisers] d) The Banks, e) Big Oil, g) Big Coal or g) America's Government. I honestly can't figure this one out and would like to receive Huffpost's help in deciding this issue, can we have a poll?

[krissymax]

The Article forgot TAP Pharmaceutical Takeda Abbott and their wonder drug Lupron, which was fined more than 875 Million dollars. This case is about bribing doctors to prescribe Lupron a highly toxic cancer drug. Besides costing the tax payers billions in medicare fraud etc. Apparently the drug doesn't work like Abbott claims. See JAMA July 2008 and JAMA August 2009. These drugs couldn't be more scary in my opinion. To learn more about this drug check out this . . .

http://www.hugginslaw.com/id61.html

[nopilikia]

Knock off this pay a huge fine but admit no wrongdoing BS a start having these people serve some prison time. H-ll, the Mob/Drug dealers are getting into medicare fraud. Less risk, more money and hardly ever any jail time.

[iktomi]

Organics---Douglas Labs has excellent---Blow off GNC

[Philclock]

"We're from the government. We're here to guarantee you low prices for your drugs."

[nopilikia]

Trust us.

[drjasonmd]

Then they should probably write the right to negotiate prices in the next Medicare bill.

[marsha1951]

Everyone of the greedybastards that fork the middle class and poor are snakebas/tards. My wish is that someday, they will have to live in a homele$$/shelter and apply for foodstamp$. Where'sDexter when we need/him?

[lemonyashes]

Good idea. And "snake oil salesmen" might be more descriptive. :)

[Sievehead]

So goes the "World of Men", as David Mamet calls it in "Glengarry Glen Ross". Don't like it? Join a monastery, pal, 'cause this is how it works for the vast majority of mutant chimps who make up the world at large. The hard and cold fact is: People like drugs. People who make the drugs like money. People who push the drugs like money. People who invest in the people who make and push the drugs like money. America adores, worships and hungers after nothing more frantically than money. You do the math...

[futate01]

So morality has no place in human behavior. Fine. I'm going to come to your house and because I like it, and I'm a big strong guy, I'm going to enter your house, beat you to a blo-dy pulp and toss your broken c0rp5e in a ditch since after all we do live in a "world of men".

Forget teaching self control. Why, when I can just take what I want, right? You are brilliant aren't you? Do you always let fictional movie characters make all your decision for you? Grow a brain and think for yourself, even if for only a second, Mr. Simianhead.

[marsha1951]

The greedy do not have morals or ethics. The system is all about/uckfing the littleperson.

[bbaker2580]

from the fines and tax levies listed with the photos, and the last few being relatively small, it may be around $15 billion - the article says profits are estimated at $137 billion... so the fines are basicly chump-change, call it cost-of-do­ing-busine­ss and fuhgeddaboutit. $15 gets you $137 - who wouldn't take that deal?

[cycle3man]

It is not the Drug Companies that are responsible for

killing patients that are given meds tht are untested for 'OFF LABEL USE"

It is the people that work for the drug companies that are responsble for

pushing these drugs The CEO down the complete chainof command

to the salesperson pushing the 'know nothing doctors that are responsible.

I want to know why no body is brought up up charges, put on trial and if found

guilty, thrown in jail to do some hard time. No one ever seems to go to jail.

The companies pay up, never plead guilty and go on to repeat the same again.

The dead patient remains dead as a door knob and no one goes to jail.

All this bull shot would stop on a dime if jail time was the punishment!

[Jiovanna]

Agreed! Hard to fight the drug mafia--it could mean being deep-sixed!

[oonamanoona]

The fault is on the back of the doctor that prescribed the drug. The salespeople may be unethical but it is the doctor that gets the med to the patient. No one holds a gun to the Dr's head.

[cycle3man]

You gotta' be kidding. Doctor or not it is close to impossible to practice medicine

and try to understand what each drug does, it's side effects, trying to match it to your

patient and still make a living,

I have an idea, all the doctors chip in and develop their own evaluation facility

that would provide info about each drug independent of the drug companies.

Then the doctors would have a chance of properly prescribing.