neurontin for everything
How does a pharmaceutical company take an unproven, worthless and potentially dangerous drug like Neurontin and turn it into a billion dollar blockbuster? Through reports of deception, lies, and bribery, New York Times health writer and author Melody Peterson.
Peterson, in his book “Our Daily Meds,” reveals the trickery, pseudoscience, and greed behind the commercialization of many of today’s best-known drugs.
The history of one drug in particular, Neurontin, shows how deceitful, ruthless and callous some drug executives can be. The original clinical studies evaluating the efficacy of Neurontin for the treatment of epilepsy were less impressive.
The studies not only showed that the drug was ineffective and potentially dangerous, but in 5-10% of patients it increased the frequency and severity of epileptic seizures.
The FDA found the drug worthless and had serious concerns about its potential dangers. But they eventually caved to the pressure and allowed Neurontin to be marketed as a second-line drug. This meant that it was to be used only after other epilepsy drugs had first been tried and failed.
No troublesome drug executive was determined to turn Neurontin into a million-dollar blockbuster drug and a little thing like science wasn’t going to stop them. It didn’t matter that legitimate research had shown Neurontin to be ineffective in all 10 conditions for which it was promoted, including attention deficit disorder, fibromyalgia, chronic pain, diabetic neuropathy, fibromyalgia, mood disorders , migraines and bipolar disorder.
Concerned that scientific truth might interfere with their plans to establish Neurontin as a complete success, Pfizer tried to cover up these studies, including one showing that Neurontin was no better than placebo in reducing diabetic nerve pain: “I think we can Limiting the potential drawbacks of the study by delaying publication as long as possible…will be more important to how we write the study.”
Realizing that new studies would be costly and likely negative, they aggressively hatched a plan to ignore science, clinical trials, and morality, and began marketing Neurontin for a variety of chronic conditions. John Ford, a senior marketing executive, had this to say in a sales meeting: “Neurontin for pain, Neurontin for monotherapy, Neurontin for bipolar, Neurontin for everything.” Not to be outdone, Phil Magistro, a senior sales executive, left a voicemail for his sales force that read, “When we go out, we want to kick some ass. We want to sell Neurontin for pain relief. Is that okay? And monotherapy and whatever we can talk about. That’s what we want to do.”
And that’s exactly what the sales reps did; they drank the “purple Kool-Aid” and promoted snake oil for every ailment they could think of. And it worked; Eventually, 90% of Neurontin’s $2.7 billion in sales came from off-label use; 90% of the prescriptions were for unproven uses.
So how does a pharmaceutical company take an unproven and potentially dangerous drug and successfully market it to doctors? Easy, cheat and then buy them. The company paid marketing copywriters to write pseudoscientific and, of course, incredibly favorable articles about the wonders of Neurontin.
Medical Education Services, a ghostwriting marketing firm, was awarded $60,000 to create dozens of fabricated studies on Neurontin. The doctors were then paid $1,000 each to “approve” the article. An internal memo from this group is revealing: “Draft complete. We only need one author.” This particular piece was aimed at children with attention deficit disorder. Consider the side effects of Neurontin which include:
muscle bread
Skin rash and itching
puffy tassels
Throat pain and fever
aggressiveness
Difficult to focus
mental depression
Nightmares
Shaking chills
Increased chance of certain types of seizures
mood or mental changes
Nosebleeds or other unusual bleeding or bruising
difficulty breathing
Sores, ulcers, or white patches on the lips or in the mouth
Unusual tiredness or weakness
Wheezing, chest tightness, or shortness of breath
Sales representatives paid doctors to recommend this drug to 10-year-olds. Scary huh? Sales reps found that physicians were enthusiastic about attending meet, greet and treat dinners. Doctors were paid up to $300 to listen to Neurontin sales pitches while dining at 4-star restaurants. Doctors who gave these dinner talks were paid up to $100,000 a year.
And Neurontin sales executives were also happy to pay doctors $750 each to attend all-expenses-paid vacations, including one at the posh Chateau Élan resort, located just outside Atlanta. Doctors received hours of continuing education while being brainwashed into the wonders of Neurontin in the morning, leaving their afternoons free to lounge poolside, receive their daily spa treatment, play golf, dine on gourmet meals, and enjoy the evening entertainment, including free entertainment. tickets for the 1996 Summer Olympics.
Not satisfied with their increasing generosity, the marketing executives decided to simply pay the doctors $350 for each patient they placed on Neurontin. In 2004, the campaign of lies and deceit came to an end: Pfizer pleaded guilty to criminal fraud in promoting Neurontin and agreed to pay $430 million.
In October 2008, a new lawsuit, filed by the same lawyer, alleges that the company’s wrongdoing went far beyond what was originally charged. According to newly unsealed court documents, the company and its subsidiaries not only pressured Neurontin for off-label uses, the practice at the center of the first lawsuit, which Pfizer admitted as part of its settlement, but they did so knowing the drug was not cash. for several of those conditions. Pfizer, according to the documents, engaged in “absolute deception of the biomedical community and suppression of scientific truth”: it halted or halted the publication of negative study results; manipulating both trial designs and data to make the drug appear more effective than it was; and the use of questionable tactics to improve the image of the drug and increase its sales. The question is how many other drugs are on the market with few or no scientific studies to prove their effectiveness? Could Pfizer’s Lyrica, the spitting image of Neurontin (same drug in different packaging) be snake oil? Perhaps, since the studies for it and fibromyalgia are less than stellar, despite the real likelihood that the study was rigged to produce positive results.
Melody Peterson’s book “Our Daily Meds” is a must read for anyone who wants to make informed decisions about their most important asset, their health.
For an in-depth look at fibromyalgia, watch a 9-part video at http://www.treatingandbeating.com
Dr Rodger Murphree
205-879-2383