I have noticed that this drug is being extensively prescribed for all kinds of mood and pain disorders. This is a systemically disruptive drug with insidious side-effects, yet it is often forced upon pain patients as a trial before more medications that are usually more effective are used.
The U.S. Supreme Court this week let stand a jury verdict that ordered Pfizer to pay $142 million to Kaiser Foundation Health for the illegal marketing of Neurontin, an anti-seizure drug that is widely prescribed off-label to treat fibromyalgia and migraines.
The cases stem from a 2004 settlement with the U.S. Department of Justice, in which Pfizer agreed to pay $430 million dollars in fines to resolve misdemeanor criminal and civil charges for the marketing of Neurontin, which is also known by its generic name, gabapentin.
After the settlement, Kaiser and other insurers sued Pfizer to recover the cost of Neurontin prescriptions they paid for, but were prescribed for conditions the drug did not effectively treat.
Neurontin was approved by the Food and Drug Administration in 1993 to treat epileptic seizures and in 2002 to treat some types of neuropathic pain.
But the drug companies also promoted the drug for other uses through publications, medical seminars and in private communications with doctors.
more and more physicians prescribed it off-label to treat a wide variety of conditions, including bipolar disorder, depression, diabetic neuropathy, migraines and fibromyalgia
According to some estimates, over 90% of Neurontin sales are for off-label uses.
Neurontin’s popularity seemed to mystify some of Pfizer’s own executives. In a 1999 email under the subject heading “social phobia,” Christopher Wohlberg, who was then Pfizer’s executive medical director, wrote this:
“Gabapentin (Neurontin) is the ‘snake oil’ of the twentieth century. It has been reported to be successful in just about everything that they have studied.”
Another Pfizer executive wrote in a memo that there was “negligible evidence” supporting Neurontin’s use to treat bipolar disorder or depression.“
“There is pretty good consensus among experts in the area that gabapentin is not a good anti-manic treatment,” wrote Atul Pande, then vice-president of Pfizer’s neuroscience division.
Both the memo and the email surfaced years after they were written, after discovery motions were filed by lawyers suing the company.
Also, as another article points out:
Pfizer is now officially a racketeering influenced corrupt organization.
Yet although the description of the RICO statute that 1BoringOldMan quoted notes the law can be used to go after the leaders of organized crime, no individual at Pfizer who authorized, directed, or implemented the relevant misbehavior, which was in this case the promotion of Neurontin for off-label uses, for which its benefits were at best unproven, at worse nonexistent, even if its harms are well-documented.
…true health care reform will not occur until the leaders of large health care organizations are made accountable for their actions, and are prevented from becoming amazingly rich while their organizations repeatedly commit unethical or illegal acts that harm patients’ and the public’s health.