Lollipops & Lawsuits

The charges, however, don't end there. California Democrat Henry Waxman, chair of the House Oversight and Government Reform Committee, is looking into marketing at Cephalon and other companies. Cephalon is also under scrutiny by several state attorneys general. Connecticut A.G.Richard Blumenthal says he's found evidence that Cephalon paid doctors to promote off-label use and targeted even those who admitted they did not "have the potential to treat cancer pain."

Blumenthal launched his query after learning of a fatal Actiq overdose at a party. The "perc-o-pop" can be deadly and addictive if it's not prescribed in a controlled environment. Susan Kathryn Smith, 24, is clean today, but she describes Actiq's euphoria as "like going back to the womb." Her father, an anesthesiologist, found her passed out in his office after she stole his samples. Still, Portenoy and others note that the drug is not nearly as rife on the street as painkillers such as OxyContin and Vicodin. "If you're talking about denying it to people with chronic pain who really need it, out of concern that a very small proportion of people will abuse it," says Portenoy, "that's a terrible public-health decision."

Cephalon stopped promoting Actiq last September, when its patent expired, though it could still be subject to fines and other sanctions if it is found to have violated the law. In the meantime, the company has shifted its focus to Fentora, a new painkilling tablet that, like Actiq, is approved only for cancer pain. Later this year, though, the company plans to petition the FDA for broader Fentora approval. That's one way to avoid off-label marketing—make a bigger label.

© 2007