What does it mean when a company has to sign three separate integrity agreements over the course of 7 years?

As reported in today’s Wall Street Journal,

“Pfizer agreed to pay another $1 billion to resolve whistleblower complaints that it illegally promoted Bextra, Geodon, the antibiotic Zyvox and the epilepsy drug Lyrica. The fine also resolves allegations that Pfizer treated doctors to meals, paid them for speaking engagements and subsidized their travel to induce them to prescribe off-label uses for those four drugs and nine others.

The settlement is the third in which Pfizer signed a “corporate integrity” agreement pledging to clean up its drug-marketing practices. It signed the agreements in 2002 over Lipitor and in 2004 over epilepsy drug Neurontin. Under the latest agreement, Pfizer will have to create a mechanism for doctors to report questionable conduct by Pfizer sales representatives.”

I think it means that there are deeply embedded values, assumptions, incentives and practices that lead predictably to breaches of integrity. Leading the way out of this will require more than pledges. It will take a thoroughgoing, multi-pronged transformation strategy that touches all the people systems in this enterprise. Pfizer is not the only drug company facing these problems, which should also tell us something about the culture of the industry and the health care system.

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