Whistleblowers are a rare breed. What drives them? Beloved by Hollywood, are they heroes, saints, publicity seekers, or are they simply obsessed? The drug industry has seen a number of high profile whistleblowers come forth recently. At best, theyve saved lives, but even when they havent changed the status quo, theyve managed to open up discussion about ways to improve an extremely secretive industry.
But why do whistleblowers do what they do? The costs to career and personal life are extremely high, and the fiercely competitive drug industry, unforgiving. Consider some recent cases: in 1998, Canadian researcher Dr. Nancy Olivieri disclosed issues with a drug being developed by Apotex. She was removed from her post, but later reinstated and praised for her service to the public. Six years ago, FDAs Robert Misbin complained about the dangers of the Type-2 diabetes drug, Rezulin. He wound up resigning from the Agency, after he received his first negative performance review. The writing was on the wall, he said at the time. In 2004, Dr. David Graham, Senior Drug Safety researcher at FDA, blew the whistle on problems with the testing and approval of Mercks drug, Vioxx, as did Dr. Eric Topol of the Cleveland Clinic. We read in the press of Dr. Topols being demoted since then.
But pharmas whistleblowers arent all researchers. Last May, Mark Livingstons case against Wyeth Pharmaceuticals was heard in Greensboro, N.C. court. Livingstons lawyers invoked Sarbanes-Oxley, traditionally used for accounting fraud, to allege violations of good manufacturing practices at the Prevnar vaccine plant in N.C. Merck had a completely different story to tell, and Livingston lost his case, but plans to appeal. At the heart of his case, he says, was a question asked by someone who worked in the facilitys quality assurance department: Are we about saving lives or about making money?
What makes whistleblowers persist in their missions? Generally, by the time their allegations become public, theres no turning back. The die is cast.
So what would it take for a pharmaceutical marketing executive to blow the whistle three times, on three separate employers? Today we interview Peter Rost, an M.D. who has spent the last 20 years working in pharmaceutical marketing.
His story began six years ago when he headed up marketing for Wyeths Nordic division. Dr. Rost had noticed a pattern of tax evasion and expense account padding involving some company executives working outside of the U.S.
Rost blew the whistle, but soon found himself transferred across the ocean to what the New York Times described as a windowless office in Philadelphia and greatly diminished job responsibilities.
He resigned and sued the company, moving the following year to Pharmacia, where he was hired as vice president of marketing for a product line focused on Genotropin, synthetic human growth hormone, a controversial drug and the lynchpin to boomer-targeted anti-aging fountain of youth therapies.
Pharmacias sales team was promoting the drug for unapproved uses, or practicing off-label marketing. Salesmen were also offering direct bribes to doctors and distributors and all-expenses-paid junkets.
The next year, an investigation was launched, and Pharmacias marketing director was dismissed. Yet, Rost alleges, the practices continued, as if they had been ingrained in the sales culture.
Two years later, Pharmacia was bought by Pfizer, and Rost continued to bring up these issues by that time, he was reported as alleging, 25 to 30% of childrens prescriptions and over half the adult prescriptions for Genotropin were being used for off-label purposes. His lawyer informed the company that Rost would be filing a qui tam action suit; at Pfizers request, the Department of Justice launched an independent investigation.
Then, starting in 2004, Rost started to speak out about high drug prices, advocating re-importation of drugs, testifying before Congress and appearing on the television news show, 60 Minutes.
Over time he found himself increasingly isolated at the company. Ultimately, his email and cell phone were cut off, and he says he was spied on by hired detectives and harassed by lawyers.
Last year, Pfizer fired Rost, who has responded with a wrongful termination lawsuit.
He has also gone on to become a blogger, first on the Huffington Post. Some of his posts were bitter diatribes against Pfizer and its then CEO Hank McKinnell; some were on topics completely unrelated to pharma. He may have earned a reputation, among some, as a lightweight by blogging about his student days as a model, or a married friends love affair. But he is a marketing specialist after all he had studied blogging as if it were a science, blending topics surest to increase readership and using IT to analyze his audience, sometimes to a frightening degree, even disclosing some information on visitors. He ultimately discovered a troll on his blog, actually a member of the sites IT staff. He now blogs privately and has published a controversial book entitled, The Whistleblower: Confessions of a Healthcare Hitman.
A great deal has been written about Dr. Rost, both positive and negative. While praised by some, he has also been accused of being relentlessly self-promotional, and a serial or professional whistleblower.
His book has received quite a bit of publicity, but we wanted to get a better understanding of what drives this complex figure, and to ask him a few tough questions. Is he an altruist, an egoist, or a bit of both? PharmaManufacturing.com contributor Ed Silverman interviewed Dr. Rost at his home in New Jersey earlier this month. And so we present Peter Rost, in his own words.
E.S.: Why are you suing Pfizer for wrongful termination? You were terminated last year. What led to that?