How to Motivate Off-Label Promotion? Gives Reps Trays of $50 Bills

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Three years ago, a former Cephalon manager filed a whisteblower lawsuit over alleged illegal marketing of two drugs – the Treanda treatment for chronic lymphocytic leukemia and the Fentora painkiller – prompting the US Attorney in New York to open an investigation into the drugmaker, which is now owned by Teva Pharmaceutical. Now, though, further details are emerging about the extent to which Cephalon executives allegedly conspired to use questionable studies and off-label marketing tactics to boost sales of Treanda, in particular. The allegations, which were made by a former Cephalon employee listed as 'John Doe,’ cite familiar-sounding shenanigans, but an executive strategy session sheds new light on the effort. Here is the background: Cephalon sought to promote Treanda for an unapproved use - in this case, front-line treatment for indolent, or slowly progressing, non-Hodgkin's lymphoma, according to the lawsuit. The medication was only approved for CLL and second or third-line iNHL. But in 2008, Cephalon executives were nervous that marketing exclusivity tied to orphan drug status would expire in 2015.

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