http://bmj.com/cgi/content/full/324/7348/1234/b
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Dr David Franklin, a former employee of the Warner- Lambert Pharmaceutical Company, has filed a lawsuit against the company, alleging that its sales representatives encouraged doctors to prescribe gabapentin (Neurontin) for unapproved uses.
Gabapentin was approved by the Food and Drug Administration in 1994 for the treatment of epilepsy, including elementary partial seizures and complex partial seizures with impaired consciousness.
Dr Franklin has accused Warner-Lambert's sales representatives of encouraging doctors to prescribe the drug for pain, bipolar disorder, and attention deficit disorder in children. Unsealed court documents show that some doctors, in exchange for money, allowed sales representatives into their examining rooms to meet patients, review medical charts, and recommend what drugs to prescribe.
Dr Marcia Angell, former editor of the New England Journal of Medicine, said having sales representatives tell doctors what to prescribe while examining patients was "inexcusable."
"Drug companies have no business being involved in education or clinical care," she said (New York Times, 15 May, p B2).
The documents also show that Warner-Lambert tracked whether doctors prescribed gabapentin and rewarded those who were considered high volume prescribers by paying them as speakers and consultants and also paying them to enter patients in clinical trials.
Dr Franklin estimated that Warner-Lambert's tracking programme involved 75 to
100 doctors in several northeastern states. Each doctor was paid $350
(£240; 
385) or more for each day that they let
sales representatives watch as they examined patients.
It is also alleged that Warner-Lambert tried to influence doctors who wrote articles about gabapentin for medical journals by paying them, sometimes secretly, and even hiring a marketing company to write first drafts.
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