Thursday, September 03, 2009

And What About Pharma for Pets?

Yesterday was a very busy day at the U.S. Department of Justice, with the announcement of the largest health care fraud settlement in U.S. history, the largest criminal fine imposed in U.S. history, and the largest False Claims Act case in history.

And yes, it was all about one company -- Pfizer.

John Kopchinski, one of the six primary whistleblowers in the case, is a former Gulf War veteran and Pfizer sales representative. He told Reuters:

"In the Army I was expected to protect people at all costs. At Pfizer I was expected to increase profits at all costs, even when sales meant endangering lives."

Why do I mention this?

Simple: Pfizer also makes pet medications, and a company that will rip off people and endanger human lives is not likely to tap the brakes when it comes to pets, is it?

Pfizer was nailed yesterday for off-label marketing and paying kickbacks to doctors, clinics and hospitals for Bextra (an anti-inflammatory drug), Geodon (an anti-psychotic drug), Lipitor (a cholesterol drug), Norvasc (an anti-hypertensive drug), Viagra (erectile dysfunction), Zytthromax (an antibiotic), Zyrtec (an antihistamine), Zyvox (an antibiotic), Lyrica (an anti-epileptic drug), Relpax (an anti-migraine drug), Celebrex (an anti-inflammatory drug), and Depo-provera (a birth control drug).

As one commentator noted, "What you see here is a company which essentially has a culture of corruption."

Pfizer's single biggest fraud (for which they paid $1.8 billion, of which $1.3 billion was a criminal fine) was for off-label marketing of the Cox-2 anti-inflammatory drug Bextra.

The veterinary analog to Bextra is another Cox-2 anti-inflammatory called Carprofen, which is not FDA approved for use in humans.

Pfizer markets Carprofen under the brand name Rimadyl, and charges a pretty penny for it even though no Cox-2 drug has ever been proven to be better than Aspirin or Ibuprofen for alleviating pain.

I have written about this before in a post entitled Rimadyl: Relief From a Swollen Wallet. As I note:

[A]lmost all Rimadyl sales by veterinarians for short-term use are a rip-off; you could be using buffered children's Aspirin or a low-dosage of Ibuprofen for a lot less money.

At the core of the scam you have drug company that has created a "me too" version of Ibuprofen that they sell through veterinarians. Veterinarians sell the drug at a big profit (more than 100 percent markup) and also create client dependency as folks have to come back in those cases where a recurring condition (like limber tail) might arise. The drug company makes a lot money, the veterinarian makes a lot of money, and you, the customer, are out of money

If you are interested in saving money and ditching Rimadyl (and the veterinary dependency that comes with it), be sure to read my post on aspirin and Ibuprofen use and dosage in dogs.

Dosage is critical with all drugs. As I note, "ANY medicine is a poison if it is not given in the proper dosage." And, just to put a point on it, Rimadyl might be the right drug for your dog in certain long-term-use cases. Again, see the link.


Rocambole said...

Bextra put a serious dent in my relationship with my doctor -- I'm glad Pfizer is being fined for their "activities."

When Bextra came out, EVERY woman I know was pressured by her doctor to take it for her period (sorry Patrick, but maybe your wife and daughter were pressured also). I, like most of my friends, tried to politely turn my doctor down -- I was happy with Aleve which I could take when I needed and took care of the pain quite nicely, etc. Why change what was working?

For the only time in my life, my doctor did not back down -- she looked extremely uncomfortable, but she kept pushing me to take this drug in spite of my objections. I finally had to "get nasty" and walk out of the office to get her to stop pushing the drug on me!

For the next year, I'd get calls from my female friends when they had just been to the doctor -- and they were all just as upset as I had been, becuase their doctor wouldn't take "No" for an answer about Bextra and they had to either walk out or very, very firmly end the conversation. "My doctor has never been like this!" was the refrain I heard all year.

I don't think my relationship, which was very good, with my doctor has ever recovered from this incident. She was pushing something on me that I truely didn't need and to this day, it bothers me greatly. Yeah, it's been years, but she proved that she -- and many other primary care doctors and ob-gyns in Southeastern PA, were willing to toss what was best for the patient for some type of kickback. So, I triple-weigh everything she says to me -- which really puts a crimp in our formerly very good relationship and probably delays good care because I'm not the most trusting person to begin with and trust really is important between a doctor and patient.

As a migraine sufferer, I have had good results with Relpax.

Pepper got limber tail again last month and we followed Patrick's advice for dosage -- 2 days of Advil (can't spell the generic) for her weight and her tail came right back! Thanks so much for the article, Patrick! :-D


Viatecio said...

I didn't realize how deep the vet is with my family until I mentioned the whole carprofen/ibuorpfen thing. The respone I got was "BUT Rimadyl is formulated differently so dogs can better absorb it and Dr Vet said that ibuprofen was poisonous to dogs." Basically everything but the "So there, Viatecio!" at the end.

I cannot WAIT until I have my own dog. It took just one experience for me to be jaded by our vet that I am so distrusting of that profession now. I'm looking forward to being the vet tech (maybe DVM if I put in the time and effort?) who might actually know something about medicine AND behavior. That and I'll be able to make my own decisions about my dogs instead of having to fight for some input on the family dog.

Dorene, rest assured that not all doctors are like that. The one I work for prescribes only what he feels is appropriate, and no patient has ever given us negative feedback like that. It's sad that docs are so owned by insurance and pharmaceutical companies that our health care is reduced to...well, what you experienced. Great to hear that your dog is doing great, too. Has your vet berated you for using the ibuprofen at all?

Rocambole said...

I haven't told my vet about the ibuprofen -- I was so frustrated with Pepper's yearly bout with Limber Tail that I ended up talking with the researchers at Auburn University and we came up with a treatment plan that was pretty much was Patrick suggested.

So, when Pepper got limber tail last month (it's a design flaw with that Shiba Inu tail on the Border Collie body -- when she gets too excited -- usually when she had treed a cat -- she gets Limber Tail [ie, a sprained tail]), I checked the bookmark on Patrick's article, weighed Pepper and gave her the recommended dose for her weight for two days (no more than 3 was the recommendation if the tail wasn't coming back up). This way, I was able to treat about 3 hours after the incident, and since she completely resonded to treatment, I didn't go see the vet. I'll let him know when she goes back in next, so he can note it on her chart, but with university researchers behind me, I should be okay.