|
|
Attorneys general in 47 states, including Massachusetts, are investigating whether pharmaceutical giant Pfizer illegally marketed an epilepsy drug to physicians, leading to an explosion in prescriptions for unapproved medical conditions.
David Waterbury, assistant attorney general in Washington state, said in a court filing in US District Court in Boston this week that he is leading the fraud investigation for the states and the District of Columbia, including whether the company made illegal payments to Medicaid providers. In the filing, he indicated that he requested extensive data from state Medicaid programs over the past eight months, including the prescribing practices of individual doctors for dates before and after their exposure to specific marketing practices.
In a civil lawsuit filed in 1996, a former company sales representative turned whistleblower subpoenaed similar information from 30 state Medicaid programs, including Massachusetts. The US attorney’s office in Boston is conducting a criminal investigation, while the state Medicaid programs also have launched civil and criminal reviews. In Massachusetts, Medicaid spending on the epilepsy drug, Neurontin, grew from $1.1 million in 1996 to $14.1 million in 2000, the height of the marketing campaign. Last year, the program spent $21 million on the drug, which is approved only for epilepsy in certain cases and neuropathic pain, said Dr. Annette Hanson, medical director for the Massachusetts Medicaid program. Hanson is reviewing the growing number of prescriptions for mood disorders, bipolar illness, and sleep problems - all uses that have not been approved by the US Food and Drug Administration. The program is considering requiring doctors to obtain permission before prescribing the drug. “I’m concerned about its usage in areas where there’s no evidence of effectiveness,” she said.
Two years ago, about three-quarters of Neurontin prescriptions nationally were written for off-label uses, pushing sales to $1.75 billion last year. Hundreds of pages of internal company memos, voice-mail messages, and records on individual physicians are part of the civil lawsuit brought by Dr. David Franklin against Pfizer Inc. and Parke-Davis, which merged two years ago and is now referred to as Pfizer. These files, unsealed in the spring, detail the company’s marketing strategy, including ghost-writing journal articles for doctors and rewarding the largest potential prescribers with seaside trips. Waterbury’s affidavit was attached to a court filing by Franklin’s attorney, Thomas Greene of Boston, asking the judge for more time to gather evidence.
Many drug companies have used such strategies for years to increase sales of their drugs. But federal and state prosecutors, angry over the soaring costs of prescription drugs to state Medicaid programs, are increasingly investigating and bringing charges against companies that market drugs illegally. Pfizer spokesman Andy McCormick declined to comment on the investigation yesterday, but company officials have said in the past that the allegations were made against Parke-Davis six years ago, before the company merged with Pfizer. McCormick said the company disclosed in federal financial filings in April that the US attorney in Boston and “several state attorneys general” are investigating the matter and may seek fines and damages.
Liz Kowalczyk can be reached at kowalczyk@globe.com. This story ran on page D2 of the Boston Globe on 10/18/2002.© Copyright 2002 Globe Newspaper Company.
|
