Tuesday, April 27, 2010

Encouraging Physicians to write off label...an Insiders perspective

Today it was announced that Astra Zeneca will be forced to pay a fine of $520 million dollars for inappropriate marketing practices (read encouraging pharma reps to influence the docs to write off label)

Here's how it works...you have a drug company that spends gazillions of dollars to get their drug through testing and approval to be indicated to treat a certain ailment. Seroquel (Astra Zenecas) Anti-Pyschotic had a narrow indication: schizophrenia. By law the drug company cannot encourage a physician to write this drug for anything other then schizophrenia...But here is what is interesting...The Doctor is God, he can write any drug for anything he wants to...if he wants to try Seroquel out on a 6 year old boy who has ADHD, or write it to treat alzheimers in old people, that is within his purview.

One of the drugs that I sold was called Alinia...and it was indicated to treat crypto and giardia (2 nasty stomach bugs) there was another indication that they tried to but never got and that was for "C Diff" another bug you don't want to get. Anyways, it got around that the docs were writing Alinia "off label" for C Diff and of course the company was happy, and the reps were happy because the more a doctor writes a drug that we sell, the more money we make. So again, by law I was absolutely forbidden to encourage a doctor to write my drug for C Diff because it is not indicated for that. One manager at Cardinal told us "When a doctor asks you about writing for C Diff, we must tell them that it is not indicated for C Diff and leave it at that" But another manager said, "We might include that while this is not the indication, many doctors have had success writing it for C Diff" So off the record in a very 'don't ask don't tell' kind of way it was officially prohibited, but unofficially it was winked at.

So that ladies and gentlemen is the weird, wacky, world of pharmaceutical sales.

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Brett said...

Gar, If I'm reading you right, the pharmaceutical industry is a bit schizophrenic on how doctors may or may not be encouraged. Perhaps rather than fining Astra Zeneca, they should have required them to give a lifetime supply of Seroquel to the industry and everything would have been settled. Hmmm?

More than just a hat rack my friend.