Three Cheers for the prestigious New England Journal of Medicine! They are one of the first mainstream publications to blow the whistle on greedy pharmaceutical executives who drive up sales by pushing doctors to prescribe dangerous drugs for off-label (non-approved) use. The corruption of these white collar drug pushers is so out of control that the journal authors stated, “drastic action is essential to preserve the integrity of medical science and practice and to justify public trust.” ¹

This very revealing statement underscores a sad fact that has been apparent to many of us for some time — the whole medical profession is on the brink of a meltdown thanks to the greed and unethical marketing practices of Big Pharma.

The motivating factor in this latest drug company scandal involves the Parke-Davis/Pfizer drug Neurontin, which was introduced in 1993 to a relatively narrow market —individuals affected with a specific seizure condition called partial complex seizures. Two years after its introduction, Neurontin’s 1995 sales were a respectable $98 million. By 2004 however, that number jumped to an astounding $3 billion.² As you might guess, this tremendous spike in sales was not related to an increase in people suffering from seizures.

Instead, it was due to an overly aggressive Parke-Davis marketing campaign in which doctors were continuously pushed and often misled to prescribe Neurontin for off-label uses like pain management for migraines, epilepsy control, and even bipolar disorder. While manipulative marketing practices may not be illegal, pushing pharmaceutical drugs for non-approved use is. And this is where the medical profession’s hands are dirty too.

Parke-Davis recruited physicians and paid them handsomely to act as salesmen/spokespersons, consultants, researchers, and educators — all to promote and dramatically increase sales for the off-label use of Neurontin. Their researchers even developed clinical trials which enabled neurologists to use the drug on their patients for various disorders at twice the approved FDA dosing limit of 1800 mg per day.

One would have to surmise that the physicians on the Parke-Davis payroll were either ignorant of the law or found it more lucrative to simply ignore — either way, it’s nothing to be proud of.

The story of Neurontin, as shocking as it is, is far from unusual. Pushing drugs for non-approved use is common practice in the pharmaceutical world. And it might have been successfully swept under the rug if it were not for one lone voice of honesty. David Franklin, a Parke-Davis pharmaceutical rep was strong-armed by a company executive to promote Neurontin for off-label use, who told him in part, “…I don’t want to see a single patient coming off Neurontin before they’ve been up to at least 4800 mg/day. I don’t want to hear that safety crap either, have you tried Neurontin, every one of you should take one just to see there is nothing, it’s a great drug.”³

Soon after, Mr. Franklin left Parke-Davis and filed a suit against them (and their parent company Pfizer) claiming that the off-label marketing of Neurontin amounted to “false claims” intended to elicit money from the federal government. To avoid criminal charges and civil liabilities, the company agreed in 2004 to pay fines of $430 million, a small fraction of its illegal $3 billion windfall. A class action suit filed by parties who purchased the illegally marketed Neurontin (and possibly suffered severe side effects) has not yet been settled.

It would be naïve to think that the Neurontin case was the turning point in cleaning up the unethical business practices of the pharmaceutical industry, especially when our own government oversight is so often corrupt and incompetent. But it might be a start. The fact that one of the country’s leading medical journals has now acknowledged the role their profession plays in greed-driven pharmaceutical marketing should be a wake-up call to every doctor who is writing out prescriptions while investing heavily in Big Pharma or working for them on the side.

What this means for the rest of us is pretty simple — stay as healthy as you can for as long as you can. And don’t look to Big Pharma to have a panacea for all that ails you, especially if a natural approach will solve your problem. As Dr. Mark Wiley said in an excellent THB article:

Everyone needs to get a physical every year, including blood and urine tests. If a problem is found, they should seek alternative, non-toxic, non-invasive methods to balance the body. After a period of time, they should have more tests run to see if the problem is better or worse. If better, continue with alternative medicine. If worse, and in the red zone of health, then turn to mainstream medicine for help. Not the other way around!

Following this simple common sense advice could be our most effective strategy for breaking the stranglehold that Big Pharma has on our lives and our health.

References

1. Landefeld CS, Steinman MA. The Neurontin Legacy — Marketing through Misinformation and Manipulation. NEJM, 8 January 2009; 360: 103-6.
2. http://www.pyrabang.com/view.php?ref=retsey&post_id=10201&visitor=true
3. http://www.essentialdrugs.org/edrug/archive/200901/msg00023.php

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