And so the next chapter in the sad saga continues this morning as Peter Rost, Pfizer exec-cum-whistleblower, writes on his blog that he received proof of off-label marketing from one or more AstraZeneca employees, whose nom de drug is ‘Gang of Seven.’

By providing such information, the employee(s) wish to offer proof that earlier claims, which Rost, Pharmalot and others have posted, are in fact legitimate. This type of venue allows an employee to circumvent or supplement an internal investigation fraught with retaliation. And Rost is a convenient medium, because he understands, having done that sort of thing himself. Meanwhile, you may recall last week the drugmaker acknowledged internal complaints and claimed an investigation is under way.

The material they supplied includes a slide presentation developed by the same AstraZeneca district sales manager who edited the Mid-Atlantic Oncology newsletter in which former regional sales manager Mike Zubillaga called a doctor’s office a “big bucket of money.” That got him fired 10 days ago and jumpstarted the controversy.

This slide presentation was supposedly forwarded to an AstraZeneca Mid-Atlantic Regional trainer and compares Arimidex with Novartis’ Femara (letrozole), both of which are breast-cancer treatments. One issue: the comparison was made between two drugs that weren’t tested in a head-to-head trial. And company policy forbids employees from making comparisons with competitive products unless instructed to do so:

“Employees may not initiate any discussion involving comparisons with competitive products unless specifically instructed to do so. In such cases, approved materials and training will be provided to the employee. As with all product discussions, all such product comparisons may be made only in the context of an objective, balanced presentation. The benefits of one product and the shortcomings of another may not be singled out.”

The district manager who developed this presentation appears to have understood that showing the presentation to docs would be a no-no. This is what she wrote:

“Hey guys. Below you’ll find the updated BIG 1-98 presentation put together by [name redacted] and myself for your background use. Please make sure that you study this information thoroughly. Hopefully it will make understanding the benefits of Arimidex over letrozole a little easier for all of us. We really worked on simplifying all of the data for your use. Please remember that this is for background use only and should not be used in front of or with customers. Knowledge is Power!”” Rost asks a good questions: If the material can’t be shown to a doc, why should a rep “study this information thoroughly”?

Highlights of the slide show include No. 12: Comparing Cardiac events from NEJM (using AstraZeneca’s Armidex) vs. cardiac events from JCO (using letrozole) is like watching miracles happen! ….Grade 3-5 cardiac events (the serious ones) are significantly worse for letrozole!” In other words, the manager is expressing glee that more people are harmed by a rival med. There’s also a template indicating AstraZeneca sales reps were requested to sell Armidex against Femara.

You can read Peter Rost’s blog here.[tags]Arimidex, AstraZeneca, Femara, Mike Zubillaga[/tags]