Settlement amount: $520 million
As with some of the other marketing investigations, the case against U.K.-based AstraZeneca ($AZN) began with a whistleblower lawsuit. Once Justice Department investigators started digging into the company, they found it pursued a host of tried-and-true ploys to get doctors to write off-label prescriptions for its psychotropic drug, like paying them fees for articles and studies ghostwritten by others.
Seroquel had been approved for treatment of a number of psychiatric uses, such as schizophrenia, but investigators found that AstraZeneca was trying to get physicians to write prescriptions for a long list of uses for which the drug was not approved. That included everything from Alzheimer's disease and attention deficit hyperactivity disorder to sleeplessness and post-traumatic stress disorder. It is still often prescribed off-label for PTSD, something the Armed Forces is now studying.
The DOJ says AstraZeneca targeted "doctors who do not typically treat schizophrenia or bipolar disorder, such as physicians who treat the elderly, primary care physicians, pediatric and adolescent physicians."
To get untangled from legal complications, it signed a 5-year Corporate Integrity Agreement that, among other things, required it post any financial relationships it has with doctors. The result has been that AstraZeneca has the best disclosure system in the industry with a searchable database that gives all the dope on cash payments, royalties and even payments made through third-party organizations.