Pfizer on the Line for Warner-Lambert's Past Problems

A former Warner-Lambert employee has blown the whistle on the company's "shadowing program," alleging that some physicians accepted money in exchange for allowing pharma sales representatives to meet with patients, review charts, and recommend prescriptions. According to the lawsuit, Warner-Lambert-since acquired by Pfizer-tried to boost sales of its epilepsy drug Neurontin (gabapentin) by tracking prescriptions and rewarding high-prescribing physicians with gifts such as cash, trips to resorts, and lucrative speaking and consulting jobs-as well as paying them to enter patients in clinical trials. The program allegedly paid 75-100 US doctors at least $350 per day to let sales reps watch patient examinations.

Warner-Lambert is also accused of encouraging doctors to prescribe Neurontin for more than a dozen off-label conditions. Reportedly, in 2000 nearly 80 percent of Neurontin prescriptions were for unapproved uses. It is legal for doctors to prescribe drugs for unapproved uses, but it is illegal for a pharma company to promote such uses. Although some doctors say the medicine is effective against pain as well as bipolar and attention deficit disorders, the New York Times reported that independent researchers found Neurontin does not work for some of those off-label uses and may actually make patients worse. Moreover, the lawsuit argues that Medicaid paid tens of millions of dollars in reimbursement for off-label Neurontin prescriptions that were ineligible for coverage.

Pfizer's response is that the alleged incidents took place long before the company merged with Warner-Lambert and that its policy strictly forbids sales reps from encouraging off-label uses of any of its products.

The lawsuit also details Warner-Lambert's practice of hiring marketers to write articles about the unapproved uses of the $2-billion-a-year medication, then finding doctors to sign their names as authors. According to one invoice, a marketing company was paid $12,000 for each article and $1,000 for each doctor willing to serve as author. The practice of using marketing companies as "ghost writers" is not illegal, though it is viewed as unethical by medical journal editors.