Door Open to Sue Pfizer in BC Says Researcher

If there are any plans for British Columbia to follow the lead from other jurisdictions and try to recover money from Pfizer Inc. for a drug the company's been found to have marketed fraudulently, Health Minister Kevin Falcon said he's unaware of them.

"That's a decision at the staff level," he said yesterday [March 31]. "I'm not aware of anything that staff is doing in terms of going after them for the dollars that were spent."

Last week Pfizer lost a $142.1-million U.S. court decision for illegally promoting the epilepsy drug Neurontin for unapproved uses.

Kaiser Foundation Health Plan Inc. and Kaiser Foundation Hospitals argued in a federal court in Boston that it "was misled into believing migraines and bipolar disorder were among the conditions that could be treated effectively with Neurontin," Business Week reported.

The story quoted Kaiser's lawyer, Tom Sobol: "The jury found Pfizer engaged in a racketeering conspiracy over a ten-year period... That bodes well for future cases.”

Pfizer, which lost a similar case in 2004, has said it will appeal the ruling. Spokespeople for the company did not respond to The Tyee by publication time.

BC should sue too: researcher

In B.C., Minister Falcon confirmed today [April 1] that the health ministry has not yet done anything about pursuing a case against Pfizer, but said it always reserves the right to pursue such a case in the future.

Health policy researcher Alan Cassels said that in B.C. the government is much too cozy with the pharmaceutical industry in general, and Pfizer in particular.

"Drug safety is not a political issue, it's a public health issue," he said. "If drug companies in B.C. are marketing their drugs illegally to B.C. physicians, deceiving patients, and wasting millions of taxpayer dollars in the process then we B.C. citizens expect them to be punished."

Thanks to earlier court cases Pfizer's "criminal behaviour" has been known for at least five years, but B.C. has done nothing about it, he said.

Instead it has involved representatives from Pfizer and other companies in recent years in the restructuring of the province's drug approval process. "This government rewards criminal recidivists, inviting criminally-prosecuted drug company members to 'advise' them on running B.C.'s public drug plan," he said.

B.C. should "get tough on crime" and at least "stop the profiteers from raping our drug plan in the name of public health," he said.

Scrapped watchdog issued warning

As it happens, the threatened Therapeutics Initiative (TI) at the University of British Columbia, which got sidelined from the province's drug approval process after the Pharmaceutical Task Force's report, wrote about Neurontin, sold in Canada as gabapentin, in its most recent bulletin.

In B.C., consumption of the drug is still rising, and $30 million was spent on the drug in the province in 2009, they write. About $19 million of that came from public funds.

The TI had written about the drug in 2000, but at that time concluded there was little evidence available. Ironically, studies that have come out through Pfizer's court cases have given them more to work with and allowed another look at the drug.

"Misleading promotion pushed gabapentin to blockbuster status," the new bulletin said. "Scientific evidence suggests gabapentin has a minor role in pain control."

The New Democratic Party's health critic, Adrian Dix, said gabapentin is another example where the TI protected patients and likely saved the provincial government money.

In this case the TI's 2000 advice may also have been good for the company, he said. "It may be, given the conduct of Pfizer, that the Therapeutics Initiative's correct analysis of the value of their drug, saved them from some liability."

The bigger question, he said, is the amount of influence drug companies have on provincial policy.

"The industry has always done this, they spend more on marketing than they do on research," said Dix, noting that pharmaceuticals are the fastest growing part of the health care budget. "The government's undermining programs and initiatives that would protect the public and save money while focussing its cuts on hospitals."

It makes no sense for the government to ignore the TI's work and advice, he said. "We need some people on our side and the patients' side to protect patients and the Therapeutics Initiative is part of that."

The Therapeutics Initiative provided advice to the province on drug decisions, but it never made the final decisions, he said. "For them to deliberately choose ignorance in the making of health policy is not a good sign for the future."