Pfizer To Pay Record Penalty Over Promotions

Pharmaceutical giant Pfizer reached a settlement Wednesday with the federal government that is not only the largest health care fraud settlement in history, but also includes the biggest criminal fine as well.

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NOAH ADAMS, host:

Pharmaceutical industry giant Pfizer, Incorporated has agreed to pay a huge fine to the federal government to settle charges that it illegally marketed several of its top-selling drugs, including the pain medication Bextra.

Associate Attorney General Tom Perrelli called the settlement historic in a news conference this morning.

Mr. TOM PERRELLI (U.S. Associate Attorney General): In a combination civil and criminal settlement, Pfizer has agreed to pay $2.3 billion, the largest health care fraud settlement in the history of the Department of Justice.

ADAMS: I'm joined now by NPR's digital health editor Scott Hensley, who's been following the story. Welcome, Scott. That's a big amount of money, even for a big drug company.

SCOTT HENSLEY: It really is. They weren't exaggerating when they called it a historic settlement.

ADAMS: Now, tell us how we got to this place with Pfizer.

HENSLEY: Yeah. Bextra is a painkiller that the company took off the market, actually, four years ago over safety concerns. But before the drug was removed, the company was selling it heavily for all kinds of pain relief, beyond the arthritis relief that it had been originally approved for.

Now, it's one thing for a physician to decide for an individual patient, I'd like to use this drug in this way, but for the company to try and induce doctors to use the drug for unapproved uses was the problem.

ADAMS: The real, actual use for Bextra is what?

HENSLEY: Osteoarthritis, primary dysmenorrhea, which is menstrual periods and rheumatoid arthritis, the pain associated with those conditions. What Pfizer was trying to do was make it into a high-powered, all-purpose painkiller that would be used for all kinds of conditions. And one of the ones that FDA was really concerned about was the use of the drug after surgery because some studies had shown a potentially higher risk for cardiovascular problems after surgery.

ADAMS: And the government - what happened, the government gets suspicious, starts investigating?

HENSLEY: Yeah. In this case a whistleblower came forward and alerted the government back in 2003, I believe, to some of the practices that the government ended up pursuing. And in the end, there were a half-dozen whistleblowers who aided the government in investigating the case.

ADAMS: And if you're a top-level management for another big drug company, you're looking at this story today and saying what?

HENSLEY: We'd better be more careful. Pfizer agreed to unprecedented oversight as a result of this settlement, but it should be pointed out it's the fourth settlement that the company has entered into with the government in this decade alone for health care fraud charges. So, that's one reason why the fines are so big and why the restrictions are so severe.

ADAMS: And the Obama administration sends out the secretary, Health and Human Services Secretary, Kathleen Sebelius, to make this announcement. It means a lot to the Obama administration in terms of health care reform, as you're suggesting?

HENSLEY: Absolutely. The symbolic importance of sending out Sebelius can't be underestimated. They brought out everybody who had just about any connection to the case for the news conference today and kept hammering on this as an example of the administration's commitment to saving money by routing out fraud wherever they could find it.

ADAMS: Scott Hensley, our digital health editor. You can read more about this story and others on the NPR health blog at npr.org. Thanks, Scott.

HENSLEY: Thank you.

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