Pfizer Lipitor mailing misleadingly implied only certain statins had cardiovascular outcomes evidence (AUTH/2179/10/08)

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Key facts

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Case number	AUTH/2179/10/08
Complainant	Pharmacist head of prescribing team
Company	Pfizer Limited
Product	Lipitor (atorvastatin)
Material	Single A4 mailing (ref LIP3086)
Main issue	Selective outcomes-trials table and framing gave a misleading impression of the evidence base for statins
Applicable Code year	2008
Breach	Yes
Clause(s)	7.2
Complaint received	20 October 2008
Case completed	10 December 2008
Appeal	No appeal
Sanctions	Undertaking received

Reviewed by Dr Anzal Qurbain (FFPM) — ABPI Final Signatory

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A pharmacist head of prescribing team complained about a Pfizer Lipitor (atorvastatin) mailing (ref LIP3086).
The single A4 sheet was headed: “Lipitor: an evidence-based choice for lowering cholesterol to improve cardiovascular outcomes”.
Front page: a bar chart compared LDL-C reduction from baseline across doses of pravastatin, simvastatin, rosuvastatin and atorvastatin.
The mailer asked: “Do you prescribe a treatment which has evidence of improved cardiovascular outcomes through cholesterol lowering?”
Overleaf: a table stated numbers of published cardiovascular outcomes trials: Lipitor (12), rosuvastatin (2), ezetimibe/simvastatin (1), ezetimibe (0).
The complainant alleged the table should also have listed simvastatin and pravastatin (which have substantial outcomes evidence) and therefore gave a false impression of the evidence base for statins.
Pfizer said the table was intended to focus on “alternative lipid lowering strategies” likely to be considered alongside Lipitor as second line, not to be an exhaustive list.
The Panel considered that, in context (including the front-page comparison with first-line statins), the table and question implied some treatments lacked outcomes evidence and therefore misled readers.

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