1 Boring Old Man

BLOGSCAN – US Supreme Court Turns Down Pfizer Appeal of RICO Conviction

Healthcare Renewal

by Roy Poses

December 13, 2013

Pfizer Inc, which boasts of being the world’s largest research based pharmaceutical company, also seems to be one of the world’s largest examples of health care corporations that have withstood an amazing number of settlements, fines, and at times convictions for misbehavior without major apologies, significant changes in leadership or corporate culture, or bankruptcy. [Look here for a list of the cases, and here for all we have written about Pfizer].

Pfizer, amazingly, has the malodorous distinction of having been convicted by a US jury as a RICO – a racketeering influenced corrupt organization in 2010 [look here]. Pfizer executives, of course, kept their office of counsel busy by appealing the conviction, all the way up to the US Supreme Court.

As discussed on the 1boringoldman blog, the court has now turned down the appeal and let the conviction, which had been affirmed by lower federal court, stand. So Pfizer is now officially a racketeering influenced corrupt organization.

Yet although the description of the RICO statute that 1boringoldman quoted notes the law can be used to go after the leaders of organized crime, no individual at Pfizer who authorized, directed, or implemented the relevant misbehavior, which was in this case the promotion of Neurontin for off-label uses, for which its benefits were at best unproven, at worse nonexistent, even if its harms are well-documented. Thus even this RICO conviction has not affected the impunity of top health care corporate leaders.

As we have said endlessly, true health care reform will not occur until the leaders of large health care organizations are made accountable for their actions, and are prevented from becoming amazingly rich while their organizations repeatedly commit unethical or illegal acts that harm patients’ and the public’s health.

And he points out the obvious. This is, indeed, a R.I.C.O. conviction, but there are still no direct convictions of the actual individuals involved. So far, all that means is that they are certified Racketeers, barring some kind of successful appeal. But I’m an optimist. This may not be the case that sends the offending executives to jail, but having the Supreme Court affirm that a R.I.C.O. case against a pharmaceutical company, particularly that pharmaceutical company, is possible is certainly a plus. So far, there have been increasingly impressive civil and criminal settlements, but not very many trials. And no flesh and bones in the docket.

Sooner or later, there’s bound to be a prosecutor who takes on actual people, and R.I.C.O. is tailor-made for that day – literally. The reason I’m optimistic? It’s because it is organized crime. Peter Gøtzsche isn’t just being melodramatic or metaphorical with Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare. He’s saying that the emperor is strutting down the street buck naked.

In my last post, I was talking about a moment of clarity that arose from a conversation with a friend forty years ago. Those moments come rarely in a life, but I had one much more recently that I’ve mentioned here before. I was sitting in the Allen Jones v. Janssen Trial in Austin Texas two years ago watching a videotaped deposition from Tone Jones, a former Janssen Sales Rep/District Manager [1][2]. It was hot and the testimonies had droned on for days. Jones lawyer was holding up a Janssen chain of command chart and meticulously asking about who knew of their off-label promotion of Risperdal for use in children, and about actively hiding adverse effects. And I came to myself and realized that he was directly pointing out that everyone on the chart was in the loop – all the way to the top of the chain, and Tone was confirming that, person by person. It wasn’t just some overly enthusiastic reps or some rogue marketeers, it was company policy. Since then, I’ve been increasingly aware that is true industry-wide. It’s the organized in organized crime.