So much for ‘patient care’

Although great strides have been made in efforts to make basic medicine affordable to the majority of Filipinos, the fight is far from over. Even at the risk of incurring the ire of our good friends from Pfizer who have taken time to explain Pfizer’s side of things, we will continue to write about the cheaper medicines issue.

We’d like to assure our friends from Pfizer that we are not in the business of bashing business giants like their company. However, current local and international issues hounding Pfizer compel us to ask the questions that Pfizer has so far failed to answer despite the lengthy conversations we’ve had with its representatives.

And now, Pfizer finds itself in another major controversy of global proportion.

Last week, various local and international media reported that Pfizer had offered to pay $2.3 billion to patients in the United States who have complained about Pfizer’s painkiller Bextra. According to the US Department of Justice, this is the biggest payout in history by a drug firm in connection with criminal charges filed against it.

The settlement offer means Pfizer will plead guilty to crimes in connection with the illegal promotion and marketing of Bextra, a pain medicine that has been pulled off the shelf over concerns regarding its safety, and 12 other products manufactured and marketed by Pfizer.

The US Justice Department said Pfizer’s marketing team promoted Bextra for acute pain, surgical pain and other uses that were not approved by the US Food and Drug Administration. The US Justice Department also said Pfizer’s sales force also promoted the drugs for its unapproved uses and dosages directly to doctors. This marketing malpractice is called “off-label” sales.

Pfizer got into this legal mess because six of its own sales representatives went to authorities to blow the lid on the marketing tactics for Bextra. The exposé by these Pfizer sales people sparked the probe by US authorities who apparently were not intimidated by the financial and political clout of Pfizer in their country.

We do not know if this $2.3-billion settlement offer following its plea of guilty for marketing malpractice involving Bextra has anything to do with an earlier $894-million settlement with some 7,000 patients who complained that they suffered elevated risks of heart attacks and stroke in connection with their use of Bextra and another Pfizer product called Celebrex.

But what is clear is that Pfizer has giant problems in connection both with the quality and the marketing of some of its products in the United States.

We also recall that a Pfizer chairman-chief executive, one Hank McKinnel, was forced to resign after a stunning revelation that its experiment on the drug “Torcetrapib” was found to have raised death risks by 60 percent. Pfizer went on record in 2006 as announcing an end to its experiment on this drug after an independent body discovered that there were 82 deaths among patients who took this Pfizer drug in a clinical trial.

We are not inventing these stories. All these facts have been told many times over by international media. They may not directly concern us since the historic settlement following a plea of guilty to a criminal offense and the 82 deaths in a clinical trial involving a Pfizer drug did not take place here in the Philippines.

But we are constrained to look at these developments in the wake of claims by Pfizer’s local operatives that this firm is “committed to patient care.”

We recall that in its letter to the editor in various newspapers including Standard Today, Pfizer accused columnists, including us, who questioned certain features of its discount gimmick called “Sulit Card” of “misleading” readers. In those letters, Pfizer’s local head made profuse claims that the drug giant is committed to “patient care.”

But in the light of the recent debacles suffered by Pfizer in the US, we feel compelled to ask whether that claim is true only for the Philippines and is not a global Pfizer commitment.

How can a firm supposedly committed to “patient care” put at risk the life and well-being of the 7,000 or so patients who bought Bextra? Or the thousand others who claimed they suffered the adverse effects of Celebrex? Or the other Pfizer products Gedeon, Zyvox and Lyrica?

How about the 82 patients who died in the aftermath of the clinical testing of Pfizer’s much-ballyhooed Torcetrapib?

If there is a commitment to patient care, how can its sales force in conscience market Bextra for uses that have not been approved by the US FDA? Doesn’t such practice put the health and life of patients in jeopardy? Do these deaths, marketing malpractices, and legal suits over adverse drug effects make Pfizer’s claim of a commitment to “patient care” one big myth? Is it just another marketing gimmick?

Can Pfizer’s local public relations powerhouse tell us now—without batting an eyelash—that the local Pfizer outpost does not and will never do what the US mother company does?

We are almost sure that these questions (we repeat—these are questions and not accusations) will trigger a fresh outrage from the Pfizer camp. But we are used to excoriating responses to our column pieces. The outrage of affected parties, however, has not dampened our enthusiasm for truth. That much we can assure our readers.

But unless and until the local Pfizer outpost is able to dissociate itself from the giant mess its mother company is in, it cannot stop us from warning fellow Filipinos to be wary over claims of commitment to “patient care.”

We also join the clamor within the medical profession for the Department of Health to come up with clear guidelines on the so-called “discount cards.” We understand where this clamor is coming from: the anxiety is there over suspicions that our doctors may have been unwittingly used in these promotional gimmicks.

Once and for all, we dare pharmaceutical firms to leave the medical community alone and not to use our doctors’ offices as their marketing outlets.

Perhaps, there is one other lesson that the Pfizer debacles involving Bextra, Celebrex, Torcetrapib and so on should teach everyone. The lesson is this: “patient care” cannot be appropriated by pharmaceutical companies.

Let’s face it. Pfizer is one big business interest. The Bextra debacle shows it has the capacity and the will to defy even the US FDA to advance its business agenda. Pfizer itself admitted that in court for which reason it is now ready to pay $2.3 billion.

Maybe, it is about time Pfizer leaves “patient care” to doctors. And leave doctors alone to care for their patients. Pfizer’s local cavalry should understand this view. Given what has happened to the patients who took Bextra and Celebrex—and worse, Torcetrapib—one might ask, who need such “care”? –Alvin Capino, Manila Standard Today