Amgen Rep Fired For Balking At Off-Label Sales
20 CommentsBy Ed Silverman // November 28th, 2007 // 9:36 am
A former Amgen sales rep is suing the biotech for $10 million before an arbitrator, claiming she was fired in retaliation for not complying with an aggressive and unethical marketing strategy for its Enbrel rheumatoid arthritis med, The Record reports. Elena Ferrante, 49, alleges Amgen sales managers encouraged reps to promote off-label and encouraged docs to prescribe Enbrel to patients who may not have needed the drug, according to Ferrante’s lawyer, Lydia Cotz.
When Ferrante refused to cooperate, Cotz says her client was fired, ostensibly for other reasons including not attending client dinners and bringing a dog to a client’s office. Ferrante was a top seller who made about $400,000 a year in sales at the time she was fired, according to Cotz. Ferrante was fired from Amgen in August 2005, after nearly eight years. She’s also claiming age bias and a violation of disability rights, claiming the biotech never filed a Workers Compensation claim on her behalf after she injured her back lifting boxes on the job. Here is the complaint.
The trouble started in 2002 after Amgen acquired Immunex Corp., according to documents filed with JAMS, a private arbirtration service. The documents claim Amgen sales managers promoted manipulated data to docs that ignored studies showing a worsening of congestive heart failure among patients who were prescribed Enbrel; that sales managers promoted scrips for mild cases of psoriasis by reinterpreting them as more severe; and that reps were asked to look inside patient files for insurance data they asked doctors to use to write to insurers to pay for Enbrel.
“The company does not comment on pending litigation or personnel matters,” Amgen spokesman Dave Polk tells the paper. “Our sales creed emphasizes that Amgen sales representatives follow compliance guidelines with absolute consistency.” But in papers filed in the arbitration hearing, Amgen denied each of the main points in the suit and also asked that Ferrante pay all costs and fees involved with the suit. Her suit “fails…to state a claim or claims upon which relief may be granted,” Amgen argues, adding that because Ferrante was an “at will” employee, with no contract, she could be terminated.
UPDATE: Cotz tells us that next week she will begin issuing subpoenas to doctors in hopes of learning more about their interactions with Enbrel reps and prescribing decisions.
Because of binding arbitration, Ferrante’s case must go before JAMS, instead of the courts, says Cotz.
Source: The Record
Nathan
Ed,
Can you give us a summary of the purpose / goals of your web site? The “about” button just talks about your background, not about what the goals and purpose of your website is. Here’s why I ask. Look at the titles of your articles from the last couple days:
“Amgen Rep Fired For Balking At Off-Label Salesâ€
“Boom! Arrested For Selling Revamped Viagraâ€
“Oxfam Rips Pharma A New Oneâ€
“Flu Meds Should Get Stronger Psychiatric Warningâ€
“Patent Challenge Taking The Glee Out Of Gleevec?â€
It seems that all your articles talk about are the trials, tribulations, and shortcomings of the pharma industry. Where are your articles about the breakthroughs? Where are your articles about the SUCCESSFUL clinical trial results that are constantly being reported? Where are your articles about the studies showing that vaccine use among infants is lowering infection rates among the elderly by a “herd effect”? Where are your articles about the 4 million people who have received free or nearly free prescription medication through the PPA program (www.pparx.org)?
Your articles (and particularly the titles you choose for them) constantly leave the industry on the defensive.
Our industry, like all other industries, has its share of greedy and slimy people who will do anything to make a buck. But it’s an industry that is doing a tremendous service for society — and I think that your choice of news topics does not clearly present the fact that we in the drug industry are doing something worthwhile and beneficial.
Ed Silverman
Hi Nathan,
With all due respect, I think a broader view is warranted. The site is a mix of news, views and commentary - lots of links, some original reporting and plenty of comments - about pharma for folks who are interested in pharma and its issues. These people may work in pharma or have a professional interest in pharma (docs, academics, lawyers, congressional aides, marketing and pr specialists, and on and on), or they simply have some other reason for wanting to know about the business and its products (consumers, for example).
That said, I’m a journalist, and look for stories that are interesting - and different stories are interesting to different people for different reasons. And there are, in fact, a wide variety of stories/posts on this site. I would invite you to do some due diligence before cherry picking or deciding that a few recent items are representative of the wider array, especially given that this site began its life back in January.
Take a look at the first week of November when the following topics were covered - the FDA Risk Communication panel members; Torcetrapib findings; Wyeth’s Essner complains about the FDA; Gardasil can help women up to age 45; a setback for Momenta pharma; Drug stores sue the federal government; Acid reflux meds overprescribed for infants; Fen phen settlment trust scammed by family; Amgen battles CMS; FDA’s Woodcock and approval rates - and then there was a day with lots of posts about the Vioxx settlement. Spend some time going back through the months and I believe you will find posts about a variety of topics that are of import to people with differing views.
There are posts stemming from Wall Street analyst reports, academic reports, legislation, medical studies, FDA reports, litigation and papers issued by all manner of consulting firm. There are Question and Answer interviews (did you read the one with the former FDA Medwatch director? Or the one with the former AstraZeneca exec, who offered some insights into the PPA programs?). The news and items come from all directions.
I’m not attacking the industry. I’m not defending the industry. This is an industry undergoing enormous change and challenge. As I’ve said for years, I believe making improvements is a worthy goal. But there is tension involved in making profits. There is tension involved in creating the right environment to make new meds. There is tension involved in paying for medicine. I follow the tension.
Thanks for stopping by,
ed at Pharmalot
Dan
I’m not a journalist, nor am I an advocate of any particular pharmaceutical blog, yet it appears that the articles that appear on pharmalot as well as other pharma blogs bring to our attention those issues that are possibly bypassed by large media in general, in large part, so it seems.
me
I remember on multiple occasions that in company all staffs at the Thousand Oaks civics art plaza and IS all staffs in b27 them talking and bagging about off label sales. I left in 05, so I don’t know if it changed. But they were pushjing this in front of thousands of people, so it wont stay hidden, I’m sure.
Atlex
Ed,
We’ve been down this road before…I understand that reporting, by nature, tends to expose the negative rather than highlight the positive. That’s understandable. I don;t think you intentionally focus on the negative…it’s just part of the job. My concern is not necessarily what you report, but how it is positioned. For instance in this case, someone reading the headline would assume that it has been proven that Amgen fired someone due to his/her refusal to promote off label, as opposed to an accusation by a very disgruntled former employee. Of course, it is too early to know one way or the other.
Atlex
Ed Silverman
Hi Atlex,
Yes, headline writing is an imperfect art (certainly, not a science). And I can always stand to improve. Sometimes, the right words don’t fit in the space. Other times, I simply choose the wrong words. In retrospect, I suppose a question mark after the headline for the Amgen sales rep post might have worked along the lines you’re suggesting. And that’s a fair observation.
In any event, I continue to try to get it right. Please continue to let me know when I don’t. And as always, thanks for stopping by.
ed at Pharmalot
Jack
Sales reps make $400,000? Why I’d I go to the medical/science side?
Nathan
Ed,
Here’s a few more examples of poorly worded titles that lead to false impressions:
“Wyeth’s Essner Takes Parting Shot At FDA” — this implies that Essner was in continual conflict with the FDA and it masks a serious problem that he was raising.
“Novartis Employee Blows Whistle And Gets Fired”. No explanation needed. You can write a title like that if she wins the lawsuit. Until then, come up with something more neutral.
“Glaxo To Peddle Mevacor Over The Counter” — Since when did “peddle” become an appropriate way to talk about sales of a lifesaving medication? Would anyone possibly read anything positive into the title of this article?
“Pfizer Dodges Chantix Liability By Nixing Test” — Are you saying that Pfizer would be liable for the homicide in question if they did the test and it came back positve? That’s what your title implies.
I realize that as a journalist you have to question and doubt things. However, be sure that you question and doubt BOTH sides.
Jane
Nathan, Looks like your employer has you working in the wrong department. You should see about writing black box warnings and stop wasting your obvious talents on websites rewriting titles of other peoples posts!
Ed Silverman
Hi Nathan,
First, as I indicated earlier, I’m not perfect. I make mistakes, but I am happy to correct them. As to your interpretations, I have to disagree with the examples you cite.
For instance, I don’t see how the Essner headline implies ‘continual conflict.’ He’s about to leave his ceo post and has a bone to pick with the FDA. That’s all. (Wyeth has had its share of difficulties with the FDA this past year, though, as you may recall).
With the Novartis rep, the headline is actually accurate - she raised an issue and was fired. Whether she was fired wrongfully is what will be determined in the litigation.
With Glaxo, peddle is another word for selling, at least where I come from in Brooklyn. I’m not aware that peddling has a negative connotation. Is a street peddler a bad thing to be if one can’t afford a storefront?
And as for the Chantix story, Pfizer minimized its exposure to both liability and adverse publicity by not doing the test. I think you’re turning it inside out.
It’s my job to question people. Please don’t presume that I save certain questions or skepticism for only group, or only for those who represent one point of view, or only for those who hold only one set of interests.
And now it’s time to get back to work.
Regards
ed at Pharmalot
Donna
Dear Nathan,
Did you take Ed’s advice and archive some of the past topic’s I think not…back to the real world when the shit hit’s the fan it’s alway’s hard for some to swallow, all of of us on here know the good that medicine does, we have all been cured of something because of medicine, we all know someone who is still alive because of medicine no one is denying that, your missing the point and taking side’s yourself, we are entitled to know the bad as well, and I think Ed is fair on both side”s……..
Nathan
Ed and Donna,
Fair enough.
I still disagree with the titles of the articles in many cases — and I still think that this site devotes too much emphasis on the minutia of misdeeds among anyone associated with the pharma industry. I guess I just got fed up with yet another story about unethical practices of sales reps. I’d like to see positive stories about the advancement of medicine and the positive impact that pharmaceuticals are having on our world. You are correct — if I look closely (very closely) I can find them here from time to time. I just wish I didn’t have to hunt so hard for them.
JMM
Nathan,
with all due respect- advertising, public relations and a host of tertiary other organizations are multi-billion, million dollar industries due to pharma patting itself on the back. i think you miss the far larger picture when all you do is industry cheerleading–because there is some work to be done in every industry and unfortunatley due to the nature of products which mean life or death for many pharma has a stronger burden to bear in that area than say Microsoft. Instead of taking Ed to task for pointing out the issues perhaps the question should be why are they such issues to begin with- $400,000 a year for a sales rep when the average physician call lasts 13 minutes? Obviously that adds a great deal to the “cost of medicine” and perhaps more responsible stewardship of the public trust and actual operating costs would get pharma out of a great deal of trouble?
Ed Silverman
Hi Nathan,
I don’t think you have to hunt. There are always interesting items out there, and I try to find as many as I can. Yes, some are about misdeeds, and there have been several of late. But there were other types of items as well.
As an example - I wrote a few posts recently about problems with IMS data. Is that an industry misdeed? I don’t think so. But that’s of interest to a segment of the universe, and there was that tension I mentioned earlier, and so I followed it.
You haven’t mentioned the Provenge controversy. The issue there is FDA policy and procedures, at least as some see it, and the dilemma over experimental meds. I’ve written many posts about that topic, which I don’t believe would be confused with misdeeds or a negative outlook about the potential for medicines. Type Provenge in the search box. You won’t have to look very hard at all.
I posted recently about the depature of the Pfizer vice chairman and attempted to explain some of the reasoning behind that decision. For better or worse, that was a widely read item (especially since there was a Biogen angle involved). Misdeeds? Nope. Just inside baseball at a big company. I enjoy that as much as any kind of post. I think others do, as well.
Last week, I ran a post about a consulting firm report that offered an outlook on pharma careers, which was another widely read post. And almost every week - either Wed or Thurs morning - I post an item about people who have moved from one job to another. Why? Because people like to know what’s going on in their own company or at rivals or they’re interested in a name they recognize. Misdeeds? No.
Perhaps what you’re detecting is that I tend to focus on the business side of life - Wall Street views, legislation, litigation, patents, employee matters - because I’ve been a business journalist, primarily. I am trying to encompass more health or science items, at least when I recognize them and when I believe they are pertinent to the site. This may explain the reason you see some material more than others. But I am not adverse to running such things. In fact, I have frequently run items based on medical studies. And the ‘Pharmalot, Pharmalittle’ section often has links to wire stories about health issues and study results (granted, these are not full posts, but I include them because I know they may be of interest).
Like it or not, you work in an industry - and I follow an industry - that has been rife with controversy. I agree that the good and important work shouldn’t be obscured. By the same token, I believe the misdeeds, as you put it, are worth noting, at least those that speak to the issues that can stand some improvement. Then, perhaps, it would be possible to learn from mistakes - and everyone can focus more on the good that the industry does.
But those are my two cents, adjusted for trade and budget deficits. I look forward to your thoughts.
Cheers,
ed at Pharmalot
Donna
Nathan,
Let’s see Motrin worked better on my children’s fever’s then tylenol, counted on it every time they did’nt feel well, Zocor thankgod keep’s my dad’s cholesterol in check, with his hypertension and all, coumidin keep’s my mom well after having valve replacement..she also take’s Phenobarbital because of seizure’s,from mini stroke’s leading up to the biggie..i have a cousin who’s a heart transplant recipient and live’s on drug’s ?? well to live…and i could go on with it all just in my little world, but there’s the flip side,i have a dear friend who became very depressed after the passing of his mom, went to his doctor was given samples of wellbutrin to try, mind you no literiture accomanied this med, felt ok for about 7 week’s and one morning while driving to work went to the nearest hospital and checked himself in…why..he said his skin felt like it was crawling…and something was’nt right..he was in the hospital for two day’s on no med’s and a DR. see’s him and say’s he should’nt be on Wellbutrin told him about suicide side effect’s and how bad it was then put’s him on Cymbalta, now i’m not a DR. but first thing i thought was that he was’nt weaned off the first drug and does it matter, guess not 2 week’s later he’s in the hospital feeling almost the same way he did the first time and they double his med’s and that was 10 day’s ago all i know is that he’s now just easily aggitated and overwelmed tryinging to run his business, struggling is how his wife put’s it…and she walk’s on eggshell’s around him not to rock the boat, then there’s my nephew while seperated from his wife was prescribed an antidepressant and i don’t know what it was i do know he stopped taking it maybe that was what caused him to hang himself in the bathroom doorway, maybe cause he was’nt weaned off or maybe he could’nt stand being on it. that we’ll never know…I’m not a Pharma Basher I know both side’s and i think everyone should………
Donna
I’d also like to know from all you Pharma Puppie’s out there that are so defensive with what’s being said, has this not touched your life in any way? maybe because your aware of the danger’s you can warn the one’s you love, most of us can’t we find out the hard way…
BP MD
Nathan-
Who are you? head of PR for a Big Big Pharma company? The industry has quite a large amount of corruption in the commercial area, from the head honchos on down. Physicians and scientists in pharma try to keep things on the right side, but many face dire consequences for doing so. If you question anything, you are disloyal and dislodged. The Big Pharma companies have made their bed and now must lie in it. The only industry more reviled by the population at large is Big Oil. has Big Pharma done good things/ Absolutely! Do they do a lot of bad things? Definitely! Ed and many others simply want to offer a broad view as to what’s going on. If you want all sugar, then read the companies’ press releases. If you want lots of important issues, then check Pharmalot. Don’t be defensive as it’s probably not you. It’s more the people that run the commercial show. They just can’t help themselves and their getting some of their due.
BP MD
PS: Been there, done that. I loved it because of the medicine and science, but also hated it because my oath, my ethics and my principles were repeatedly attacked by extremely disgusting marketing and sales tactics that are repeated over and over and over again by some very bad apples in the industry.
Nathan
Ed,
I want to apologize for questioning your journalistic integrity. I was going to send you a private email, but I criticized you in public and I’ll apologize in public as well.
I disagree with some of the content you choose to present and I disagree with the way some of them are presented (titles in particular). However, you are correct. I didn’t really do my “due diligence” before speaking. When it comes to interviews, you ask balanced question from both sides of the table. I can only assume that you do the same when you are writing.
Overall, your site is very informative. Donna, you are correct — it certainly has given me the ability to see things from “the other side of the table” from time to time.
CV MD, I don’t know what pharma company you came from, but I sure hope I don’t buy drugs from them. I’m a early stage scientist (pre-clinical trial) at a major pharma company. I can tell you that in my “neck of the woods”, there is nothing but honesty and good intentions. However, I will readily admit that I have no control and limited knowledge of what happens to my inventions when they reach the clinical stage of development.
Susan
Hi Nathan,
Please let us all know the URL of YOUR pharma blog, as we are eager to hear “the other side” of the story.
Best wishes,
Susan
BP MD
Hi Nathan-
As I indicated, I loved the medicine and the science and I agree with you about R & D (pre-clinical and clinical). What I hated were the commercial guys twisting the truth AND frequently breaking the law! Off-label promotion has practically become the standard in Big Pharma. This is particularly agregious when there are safety implications for patients. I’ve seen it happen. They even hide it from the medical and regulatory teams and go behind their backs with secret marketing and sales tactics that they develop and sell to senior management.