Pfizer: Lipitor mailing ruled misleading due to selective presentation of 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	Mailing (single A4 sheet), ref LIP3086
Main issue	Selective table of cardiovascular outcomes trials implied only certain therapies had outcomes evidence, omitting simvastatin and pravastatin despite being shown on the front-page chart
Applicable Code year	2008
Breach clauses	Clause 7.2
Sanctions	Undertaking received
Complaint received	20 October 2008 (also reported as 23 October 2008 in the case report)
Case completed	10 December 2008
Appeal	No appeal

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 (single A4 sheet; ref LIP3086).
The mailer headline stated: “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, followed by the question: “Do you prescribe a treatment which has evidence of improved cardiovascular outcomes through cholesterol lowering?”.
Reverse page: a table stated numbers of published cardiovascular outcomes trials: 12 for Lipitor, 2 for rosuvastatin, 1 for ezetimibe/simvastatin and none for ezetimibe.
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 argued the table was intended to focus on therapies likely to be considered alongside Lipitor as second-line options, not to be an exhaustive list.

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