This was in the news a couple of weeks ago, but I held on to it so I could remind people of it again, the “too big to nail” syndrome”:
Imagine being charged with a crime, but an imaginary friend takes the rap for you.
That is essentially what happened when Pfizer, the world’s largest pharmaceutical company, was caught illegally marketing Bextra, a painkiller that was taken off the market in 2005 because of safety concerns.
When the criminal case was announced last fall, federal officials touted their prosecution as a model for tough, effective enforcement. “It sends a clear message” to the pharmaceutical industry, said Kevin Perkins, assistant director of the FBI’s Criminal Investigative Division.
But beyond the fanfare, a CNN Special Investigation found another story, one that officials downplayed when they declared victory.(Drew Griffin and Andy Segal, CNN)
Same old story. The corporatists are driving the bus, even when it has Democrat license plates. Bextra is a COX-2 inhibitor. In theory better and safer than generics like aspirin and ibuprofen that inhibit both COX-1 and COX-2, the greater specificity came at a 20 fold higher price, and, as it turned out, serious side effects — increased risk from heart attacks and strokes. The FDA refused to approve the drug in 2001 for acute post surgical pain, which required a higher dose, instead approving it only for joint and menstrual pain.
Off-label promotion for uses requiring higher doses is illegal. No problem for Pfizer. The promoted it — aggressively — to doctors who performed surgical procedures, according to a memo from a district manager CNN managed to obtain, “anyone that use[d] a scalpel for a living.” Not just pushed it for an unapproved use. Pushed it for double the approved dose and claiming the FDA has said it was safe.
Pfizer also deployed an army of doctor shills to promote the drug in “medical education” seminars and lectures, using them as public relations mouthpieces. There is enough shame here to go around and a lot of it has to fall on my fellow doctors who whored for Pfizer. The result was that by 2005, when Bextra was withdrawn from the market for safety reasons, half the profit from the drug came from off label uses. And they were caught at it.
That’s when Pfizer played the “too big to nail” card. The company had committed a major health care fraud and if convicted, would be forbidden to bill the government for drugs prescribed to Medicaid and Medicare recipients. That’s a big market. Big Pharma makes a bundle off of these federal and federal-state programs and Pfizer might have gone under if cut off. So instead of charging Pfizer with the crime, they charged a phantom subsidiary, Pharmacia & Upjohn Corporation, created two years earlier for the same reason: to immunize Pfizer. According to CNN, this is little more than a shell company erected for the purpose of taking the rap.
It’s true that Pfizer paid a big fine ($1.2 billion) and had to settle numerous civil suits. By CNN’s estimate, however, it amounted to only 3 months profit. Big Pharma is unbelievably profitable. Like Wall Street, it appears it can do whatever it wants and not be held accountable. They are “too big to nail.”
So they let the big guys go.
Who then nail the rest of us with unsafe drugs. I guess our coffins aren’t too big to nail.