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Lucia Paccione’s conscience earned her a much greater financial reward than her sales skills possibly could have, even in her best selling years. Paccione was a pharmaceutical sales representative for Cephalon of Chester County, Pennsylvania, and unlike many of her bosses, she wasn’t willing to check her ethics at the door every morning to help her company increase its already massive profits.After Paccione’s bosses instructed her and the other members of Cephalon’s sales force to market the company’s drugs for “off label” uses, Paccione filed a whistleblower complaint against the company. As a result, Cephalon has been found guilty of many offenses, and Paccione has received the largest share of a $46,469,978 settlement that she will divide with three other courageous whistleblowers.

The federal suit accused Cephalon of promoting three of its drugs, Actiq, Gabitril, and Provigil, for uses that the FDA had not approved.

In its agreement with the U.S. Justice Department, Cephalon agreed to pay $375 million to settle False Claims Act charges. False Claims Acts allow private citizens with knowledge of fraud to help the government recover ill-gotten gains.

The total settlement against Cephalon was $431 million, and the suit disclosed that the company had willfully engaged in myriad illegal activities, such as:

• Encouraging sales reps to make false statements about the efficacy of Gabatril, and providing dosing recommendations when none had been determined for depression.

• Leaving “huge doses of Gabatril” with psychiatrists when no approved use or dosage existed for psychiatric conditions.

• Assisting physicians in securing Medicaid reimbursement for Actiq when off-label use was ineligible for Medicaid payment.

Cephalon’s actions were not unusual.

Disregard for the law and for the health of their customers is business as usual for many pharmaceutical companies.

In 2008, a distressing number of the world’s largest drug manufacturers were found guilty of illegal actions, and the suits against them indicate that many unethical and illegal behaviors are integral parts of their business models. To earn their huge profits, drug companies consistently:

•Spend much more on marketing than on research

•Instruct sales representatives to promote their drugs for unauthorized uses

•Hide damaging studies

•Publish deliberately deceptive reports

•Deny any wrongdoing

As a result of their actions, these companies routinely pay staggering sums to settle the lawsuits that arise when their drugs harm and kill people.

Cephalon’s $431 million fine sounds like a painful loss, but in the drug industry it’s the equivalent of a speeding ticket. Compared to Eli Lilly‘s charge for illegal marketing of its schizophrenia drug Zyprexa, $431 million is a bargain. Lilly will take a $1.4 billion charge for urging doctors to prescribe Zyprexa to people who didn’t need it. And Pfizer has agreed to pay $894 million to settle personal injury claims that arose from Celebrex and Bextra, which are COX-2 inhibitors that caused heart attacks and strokes.

In 2008, penalties against big drug companies have come on a frighteningly regular basis. Johnson & Johnson and GlaxoSmithKline have joined Cephalon, Merck, and Lilly in paying large fines for unlawful practices.

The fines are huge, but Wall Street just shrugs them off because profits continue to roll in.

The bottom line is that the bottom line is all that matters for big drug companies. Their philosophy is that if breaking the law will earn them a dollar, and if lawsuits take 50ç of that dollar, then they are still 50ç ahead.

What that means to anyone who’s been harmed by a dangerous drug is that the manufacturer is expecting your lawsuit. If you, or anyone you know, has suffered because of a prescription drug, contact me to start the process of recovering damages for your injuries.

And if you know of wrongdoing by a drug company or any other kind of business, take the courageous step of being a whistleblower.

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Richard Alexander