The Pharma Bea ,tA Fine Mess

Two years ago, a Pfizer public relations executive was giving a speech before a business group about communications outreach, and he confessed to having a certain amount of confusion over the bad image that has plagued the pharmaceutical industry.

“We develop life-saving medicines that you take, that will prolong your life, that will cure certain diseases,” said Ray Kerins, an aggressive, but affable public relations veteran, who candidly attributed some of the problem to the industry’s unwillingness to engage the media. “How in the hell do we have such a bad reputation? It makes no sense.”

Unfortunately for the pharmaceutical companies, it does make a certain amount of sense, at least if one has read any of the recent stories about the behavior of some drugmakers. One company after another has been fined and berated by the federal government for engaging in marketing practices that have raised questions about the extent to which such violations are now considered by the industry to be a cost of doing business.

Take Pfizer. The world’s biggest drug maker just a few weeks ago agreed to pay a record-breaking $2.3 billion fine to settle civil and criminal charges brought by prosecutors over fraudulent promotional activities concerning more than a dozen prescription medicines, most notably Bextra (painkiller), but also Geodon (antipsychotic), Zyvox (antibiotic) and Lyrica (epilepsy).

The deal was the culmination of a long-running and sweeping investigation by dozens of federal and state agencies that found the drugmaker engaged in a variety of illegal tactics to boost prescriptions. In particular, Pfizer sales reps were told to inform doctors of drugs that could be prescribed for uses that were not approved by the FDA.

Even worse, many Pfizer activities occurred after the drug maker had already paid a $430 million fine five years earlier and signed a corporate integrity agreement for illegally marketing Neurontin, another epilepsy treatment. In fact, the latest agreement marks the fourth time since 2002 that Pfizer has reached a settlement over its egregious marketing practices. In effect, the drug maker has been an incurable recidivist.

But when it comes to violations, Pfizer is not alone. The list is long. Earlier this year, Eli Lilly paid $1.4 billion to settle civil and criminal charges of illegally marketing Zyprexa (antipsychotic), which was the previous record-setting agreement. Also in 2009, federal prosecutors announced a civil lawsuit against Forest Laboratories for alleged off-label promotion of its Lexapro and Celexa antidepressants, a scheme that the government claims involved paying kickbacks to doctors to encourage prescriptions for children.