• Bloomberg, Monday, November 9, 2009 10:39 AM

David Evans' lede zeros in on Pfizer and the fact that, even while it was settling a fraudulent marketing case with the feds in 2004, it was engaging in similar activities -- specifically off-label marketing -- in another unit. In September, its Pharmacia & Upjohn unit paid the largest criminal fine in U.S. history after pleading guilty to instructing more than 100 salespeople to promote Bextra, a drug approved only for the relief of arthritis and menstrual discomfort, for treating acute pains of all kinds.

But the article paints a broader picture of widespread wrongdoing in the industry. Eli Lilly, Bristol-Myers Squibb and four other drug companies have paid a total of $7 billion in fines and penalties, with six of them admitting in court that they have marketed medicines for unapproved uses, Evans recounts. And critics charge that it's not a harmless game.

"Marketing departments of many drug companies don't respect any boundaries of professionalism or the law," says Jerry Avorn, a professor at Harvard Medical School. "The Pfizer and Lilly cases involved the illegal promotion of drugs that have been shown to cause substantial harm and death to patients."

But the fines are a pittance compared to the profits the companies can realize, and they regard the risk of getting caught as just another cost of doing business, says Lon Schneider, a professor at the University of Southern California's Keck School of Medicine in Los Angeles. "There's an unwritten business plan," he says. "They're drivers that knowingly speed. If stopped, they pay the fine, and then they do it again."

Read the whole story at Bloomberg »