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The Whistleblower, by Peter Rost, M.D., reminds me a lot of those Chinese finger traps you might have played with as kid. You stick a finger in each end of a bamboo woven tube and the harder you struggle to free yourself, the more difficult it is to escape. As adults, we know the secret to escape the confines of the Chinese finger trap is not to struggle. Employees too often approach the illegal operations of a corporation in the same matter; rather than risk a challenge they offer no resistance and allow the illegal practice to continue.

When Rost brought an illegal practice to his employer’s attention he thought he was doing a good thing. Little did he suspect that his efforts to help his employer avoid running afoul of Federal law was placing his career in something akin to a Chinese finger trap.

The problem began when as vice president of marketing for Pharmacia he was responsible for both U.S. and global marketing of a human growth hormone named Genotropin. What he first suspected, then later established, was that Pharmacia’s sales reps were in the practice of encouraging physicians to write ‘off-label’ prescriptions for Genotropin to be used for life-longevity. In the U.S., as well as in most of the world, it is a Federal offense for a pharmaceutical company to encourage physicians to write prescriptions for purposes other than the use for which they are approved. In the U.S. it is the Federal Drug Administration (FDA) which approves a drugs use.

What Rost uncovered were incentive programs to encourage the sales of Genotopin for life-longevity purposes. In addition, he also discovered that some countries used practices that made the sales of the drug appear higher than they should have been—also a Federal violation. The result was that the annual sales of Genotopin fraudulently exceeded $600 million annually.

When Pfizer purchased Pharmacia they had no idea that the sales for Genotopin were inflated and the actual sales were less than what the accounting books showed. Rost knew that Pfizer overpaid for Pharmacia. He knew that the illegal practices that he had uncovered were partly to blame for the inflated sales figures. Rost wanted Pfizer to know what he knew so they would be able to correct the situation and head off any Federal action that could be brought against them.

The harder he tried to convey to Pfizer the illegal practices that he had uncovered the tighter the metaphorical Chinese finger trap tightened around his career. Clearly, it appeared that Pfizer was not eager to act immediately on what Rost was telling them. They especially did not want their investors to hear anything that sounded like fraud or possible Federal violations.

You would think that Pfizer might appreciate knowing about fraud and Federal violations. Instead, what resulted is that Pfizer distanced themselves as far from Rost as possible. They could not fire him though. When there is an allegation that results in an investigation the company is required to retain the whistle blower. That did not keep Pfizer from doing everything possible to keep tabs Rost’s activities. His phone calls were screened, his phone was tapped, and his emails watched.

What you do not discover until the end of the book is that Rost risked a $600,000 a year job to bring the illegal practices to light. At first he was more interested in protecting his employer from Federal action, but when Pfizer took an offensive position forcing Rost to go outside the company for protection, he had no choice but to retain a lawyer and to make his allegations public.

Probably the most disturbing chapter in the book is chapter 19, How Corrupt Is the Drug Industry? The chapter deals with the exorbitant fines paid by the pharmaceuticals in just the past few years. For example, Pfizer was fined $430 million for encouraging off-label prescriptions of Neurontin. Considering Pfizer has sales that exceeded $2 billion dollars for Neurontin the fine makes little sense from a strict profit-and-loss position. The list of pharmaceutical companies that have paid exorbitant fines is too extensive to even begin to list here, but a quick Internet search results in a massive list of drug companies.

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