Three American doctors have accused Sandoz Pharmaceuticals of premature promotion of the use of cyclosporine-A for psoriasis, which is outside the drug's established indication as an immunosuppressant for organ transplants.
The three doctors from Harvard and Dartmouth Medical Schools say that Sandoz distributed a report entitled "Consensus Report: Cyclosporine-A for Psoriasis". This was produced at a conference in Spain sponsored by the drug company whose participants included employees of and one dermatologist paid by Sandoz.
This was sent to selected American dermatologists, say the doctors, and Sandoz was so keen on getting them to read it that it offered $l00 for completing a "brief quiz" and engaged in follow up telephone calls to encourage the doctors to complete it.
Speaking for Sandoz, Dr David Winter wrote in to the Journal of the American Medical Association to say that the questionnaire was a "market research tool" designed to determine whether there was sufficient interest in cyclosporine to embark on the testing required to get drug approval. The time spent filling out the form seemed to warrant the $l00 fee, he said. "To consider any of these activities as promotional does seem to be a manipulation of information."
Echoing the AMA Drug Evaluations and the US Pharmacopeia Drug Index, which says there is not enough data to prove the drug's safety for psoriasis, Sandoz reports in the Physician's Desk Reference that the drug causes liver and kidney toxicity, that lymphomas have formed and that one in l000 patients undergoes anaphylactic shock. There's also substantial risk of hypertension, convulsions, and even heart attacks.