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Healthy Skepticism Library item: 2484

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Charatan F.
Doctor sues company over unethical marketing.
BMJ 2002 May 25; 324:(7348):1234
http://bmj.com/cgi/content/full/324/7348/1234/b


Abstract:

Dr David Franklin, a former employee of the Warner- Lambert Pharmaceutical Company, has filed a lawsuit against the company, alleging that its sales representatives encouraged doctors to prescribe gabapentin (Neurontin) for unapproved uses. Gabapentin was approved by the Food and Drug Administration in 1994 for the treatment of epilepsy, including elementary partial seizures and complex partial seizures with impaired consciousness. Dr Franklin has accused Warner-Lambert’s sales representatives of encouraging doctors to prescribe the drug for pain, bipolar disorder, and attention deficit disorder in children. Unsealed court documents show that some doctors, in exchange for money, allowed sales representatives into their examining rooms to meet patients, review medical charts, and recommend what drugs to prescribe. Dr Marcia Angell, former editor of the New England Journal of Medicine, said having sales representatives tell doctors what to prescribe while examining patients was “inexcusable.” “Drug companies have no business being involved in education or clinical care,” she said (New York Times, 15 May, p B2). The documents also show that Warner-Lambert tracked whether doctors prescribed gabapentin and rewarded those who were considered high volume prescribers by paying them as speakers and consultants and also paying them to enter patients in clinical trials. Dr Franklin estimated that Warner-Lambert’s tracking programme involved 75 to 100 doctors in several northeastern states. Each doctor was paid $350 (£240; E385) or more for each day that they let sales representatives watch as they examined patients. It is also alleged that Warner-Lambert tried to influence doctors who wrote articles about gabapentin for medical journals by paying them, sometimes secretly, and even hiring a marketing company to write first drafts. (full text)

Keywords:
Acetic Acids/therapeutic use Advertising/legislation & jurisprudence* Amines* Anticonvulsants/therapeutic use Conflict of Interest* Cyclohexanecarboxylic Acids* Drug Industry/standards* Ethics, Professional* Humans United States gamma-Aminobutyric Acid* *news story United States relationship with pharmaceutical industry conflict-of-interest Neurontin ETHICAL ISSUES IN PROMOTION: LINKS BETWEEN HEALTH PROFESSIONALS AND INDUSTRY PROMOTION DISGUISED: GHOST-WRITING AND JOURNAL ARTICLES PROMOTIONAL TECHNIQUES: UNLABELED INDICATIONS SPONSORSHIP: RESEARCH

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909