Would $2.3 Million Reach to the Moon and Back?

Every day I wake up to a plethora of headlines and editorials examining and opining on health care in this country. The other week there was a story about federal prosecutors levying a $2.3 billion fine on Pfizer Inc.(which makes Bextra, Lyrica, Lipitor and Viagra among many others) for several infractions, including promoting the off-label use of several drugs.

According to the Justice Department, that’s a big no-no.

Doctors can prescribe medication for off-label uses, but pharmaceutical companies may not market drugs for these off-label uses. Pfizer also got called out for providing physicians with perks like free golf and junkets to resorts.

I’m not sure how Pfizer is going to pay that fine, but I’m pretty sure they have enough money. Heck, the company just spent $68 million to acquire Wyeth, another huge pharmaceutical company. In any event, Pfizer is going to break the record when it pays up. The Justice Department says this is largest sum of money ever paid to the government for a fine and civil penalty.

All this got me to wondering: What does 2.3 billion look like in, say, stacks of $20 bills? If lined up end to end, would those $20 bills reach to the moon and back? Or would it take $5 bills to do that? Would they wrap around the earth a couple of times? How many mattresses could I stuff with $2.3 billion?

Certainly it’s enough to provide some health care for those in this country who don’t have it.

Fortunately, it looks like at least some of the penalty money will be used to do just that.

According to what I’ve read, about $331 million will go to states to help pay for Medicaid programs and some other things. (Only South Carolina declined this windfall.) Florida is going to use some of the money to reward people who report Medicaid fraud, and Illinois will use $11.3 million for its Medicaid program. New York will collect $66 million and California gets almost $35 million. Both states, according to wire reports, will use the money for Medicaid expenses.

Another chunk of money will go to five former Pfizer employees and a Pennsylvania physician who are going to split $102 million for blowing the whistle on the world’s largest drug manufacturer. One of the former employees didn’t mince words.

“The whole culture of Pfizer is driven by sales, and if you didn’t sell drugs illegally, you were not seen as a team player,” said John Kopchinski, who left the company in 2003 and will receive more than $50 million for his part in turning in the miscreants.

I confess: I’m conflicted about the contribution and role of pharmaceutical companies.

Many take big risks in developing drugs, and someone has to do that. Who else is going to slog through the immense barriers of time and money to bring forth new medicines that may or may not be effective? But are the high stakes tempting some companies to try to recoup and exceed their investments in other ways?

Maybe pharmaceutical research should be backed by the government and developed by universities who would be paid for the work, but whose goal was not to maximize profits at any cost.

In the meantime, perhaps if enough pharmaceutical companies continue down this path, and the government continues to get involved, we can finance health care for all the uninsured.

Disclaimer: The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of AMN Healthcare or its employees.