THE WHISTLE BLOWER Confessions of a Healthcare Hitman: FEATURED REVIEWS

THE WHISTLE BLOWER Confessions of a Healthcare Hitman

THE WHISTLEBLOWER is at once an unmasking of how corporations take care of malcontents and a gripping story of one man's fight to maintain his family and his sanity. Starting in 2003, the book details the illegal, even criminal business practices the author witnessed at his corporation, as well as his crusade to legalize the reimportation of drugs.


The Progressive Populist

Lone Wolf Takes on the Pharma Pack
By Jake Whitney

Early in Dr. Peter Rost's new book, The Whistleblower: Confessions of a Healthcare Hitman, Rost compares corporate culture to running with a wolf pack. "Everyone helps out and is friendly as long as it benefits the group," he writes, "but each wolf cares only about himself and will do anything to survive."

Rost is talking about the bad guys -- the greedy corporate executives and gutless, backstabbing coworkers who either take part in or turn a blind eye to corporate malfeasance. Rost, as the title indicates, is the good guy, and The Whistleblower recounts his career exposing corporate wrongdoing. But the question that lingers over his 200-page David vs. Goliath story is this: Is Rost, too, a wolf, attracted to whistleblowing by reasons more self-serving than altruistic?

Rost's career as a whistleblower began at the pharmaceutical giant Wyeth, where, as a top executive, he sued the company after blowing the whistle on tax fraud. His book skips this part (for legal reasons) and picks up a few years later, in the summer of 2002, when Rost was a successful vice president at Pharmacia -- a mid-sized, New Jersey-based drug firm. In July of that year, Pfizer, the biggest pharmaceutical company in the world, announced it would acquire Pharmacia, and Rost's book takes us through the acquisition up until his firing, on Dec. 1, 2005.

According to Rost, his termination from Pfizer was the final blow in a prolonged period of retaliation for his whistleblowing, which included shedding light on a string of illegal and/or unethical business practices: illegal marketing of Genotropin, a human growth hormone; wholesaler stuffing (to inflate sales numbers); and sexual liaisons among Pfizer management. But it was Rost's position on drug importation that made him famous.

While still a vice president at Pfizer, Rost infuriated his bosses by appearing before Congress and on 60 Minutes advocating the importation of drugs from Canada as a way to reduce pharmaceutical costs for Americans. This was a direct contradiction of the industry's (and the Bush administration's) line, which declared importation to be unsafe. But Rost, a native Swede, shot holes in the industry's argument by pointing out that drug importation had been taking place safely in Europe for 20 years.

All of this is recounted in fascinating detail in The Whistleblower, much of which reads more like a detective novel than a memoir. This is due in no small part to the fact that, as Rost's responsibilities at Pfizer were slowly removed, he was left with little to do but detective work. His account of what he discovered is alternately hilarious and terrifying.

In the book, Rost recounts how, following his appearance on 60 Minutes, Pfizer retaliates by disabling his corporate email, killing his cell phone and dropping his annual bonus. In response, Rost pens emails to Pfizer's general counsel and IT department demanding an explanation -- and he attaches an electronic tracer to the messages. The emails bounce around the company and then on to three "world-class law firms" and a huge communications company. Within a few days his emails are opened over 100 times, and Rost realizes he may be "outgunned" in his battle with Goliath.

Perhaps Rost's scariest discovery comes after pushing Pfizer management to address Pharmacia's illegal marketing of Genotropin. He uncovers a mysterious document stuck in his personnel file which turns out to be authored by a private investigator, hired by Pfizer, reporting on whether Rost ever purchased a weapon and whether he might be a danger to himself or others. It is around this time, Rost says, "I vowed I would expose the pharmaceutical industry and their methods."

Rost's critics say his whistleblowing has been more about seeking fame and fortune (the latter in the form of book deals and lawsuit settlements) than helping people. In fact, Rost does have an uncanny habit of making headlines by exposing deviousness wherever he goes -- most recently at, where he was "fired" after unmasking a frequent critic as the Post's very own technology manager.

But criticizing Rost's motives is off base, for two reasons. For one, every time Rost has spoken out, he's lost more than he's gained. By taking on Pfizer and publicly advocating importation, he insured he would never work in the industry again; at Wyeth, he lost what he said was the best job of his life. "I've never had more fun than when I was the managing director of the Nordic region," he said in a recent interview. "Nothing I've done since compares with that."

Second, Rost's book is about more than just himself. Much of the latter half, in fact, has nothing to do with Rost's battle with Pfizer, but is rather a litany of recent drug company corruption, and Rost argues convincingly that the FDA and America's major medical journals have been co-opted by the industry. When he moves on to examine the American economy at large, where he lays out some eye-opening statistics comparing skyrocketing CEO salaries with the static ones of American workers, we realize Rost has reached his destination.

Ultimately, The Whistleblower is an impassioned jeremiad against corporate greed, with Rost our inside man. The book's overriding theme is that the American political system is in danger of degenerating into a plutocracy (or "kleptocracy," as he dubs it) -- if it hasn't already. "The American democracy has been stolen by our new class of robber barons -- the CEOs of our largest corporations," he writes.

These assertions aren't new, but when spoken by a former vice president at the world's largest drug company, they take on added weight. Rost, after all, was reeling in almost a million dollars a year with Pfizer, and conceivably one day could've joined this ruling class. Instead, he chose to break away from the pack, and become a lone wolf. And we're all the better for it.

The British Medical Journal.

BMJ 2007;334:261 (3 February), doi:10.1136/bmj.39108.525810.59

Views & reviews

Telling the inside story?

Jeanne Lenzer, freelance medical investigative journalist, Cambridge, MA, USA

A sacked drug company executive claims to spill the beans on the industry in a new book

Peter Rost, erstwhile drug company executive, self proclaimed whistleblower, and now book author, first became a cause célèbre in August 2004 when he wrote an endorsement of The Truth about the Drug Companies, the book by former New England Journal of Medicine editor Marcia Angell. He posted a commentary on, saying, "I should start with a disclaimer. I'm a vice president within one of the largest drug companies in the world and I have spent close to 20 years marketing drugs. So I guess I'm not supposed to like this book. But the truth is I thought it was fantastic."

Rost's posting was picked up by the media and he became a much sought after guest on television and radio shows. He took up the cause of drug reimportation, a practice that would allow foreign drug companies to sell drugs in the United States. Reimportation, argued Rost, is widely practised in Europe and could drastically reduce drug prices in the US. His position was in sharp contrast with that of his employer, Pfizer, and to virtually all major US drug companies, which vehemently argued that reimportation would allow unsafe drugs to enter the US and would threaten the health and safety of its citizens.

But Rost began to run into trouble long before he became a public advocate of reimportation. In 2001, as the new head of the endocrine care division of Pharmacia, he learnt, according to his account, that the division's flagship drug, Genotropin, a synthetic form of human growth hormone, was being promoted for off-label uses. Off-label promotion of growth hormone is a felony under federal anti-doping laws. Pfizer, which bought out Pharmacia in April 2003, failed to put a stop to the off-label promotions, says Rost.

Rost alleges that it was his complaints about the marketing of Genotropin that led Pfizer executives to fire him. He was first informed in an email message on 3 February 2003 that he was to be sacked, but he managed to hold on to his job for two and a half years, until 30 November 2005, when he was finally let go. Rost filed a qui tam, or whistleblower, lawsuit against both Pharmacia and Pfizer in December 2005. In the suit and the book, Rost claims to describe some of the inventive marketing techniques used by the companies to promote sales of Genotropin to "anti-aging" clinics and for the treatment of short children who did not have growth hormone deficiency.

Rost, who paints himself as a regular guy in his book, is the quintessential marketer. Along with the publication of The Whistleblower, he has a Hollywood agent looking for potential movie deals; he has written a fictional thriller about the drug industry entitled, The Wolfpack; and he is scheduled to be interviewed for Sicko, Michael Moore's documentary movie, on the healthcare industry.

A niggling aspect of The Whistleblower is that Rost repeatedly wastes the reader's time defending his motives for his various actions as he sought to hang on to his job. Some of his actions appear simply indefensible. Rost, who earned over $600000 (£305 000; 460 000) annually (exclusive of benefits, annual bonus awards, and stock options) is hardly a man without warts. When Pfizer asked him to fire a number of his colleagues, Rost fired them—while bemoaning their fates in the book. He is at his worst, perhaps, when he spends an entire chapter on irrelevant speculation about the sexual activities of Pfizer's bosses. Rost makes no bones about why he wants to pursue possible sexual improprieties, even though he has no first hand knowledge of the events. "If they feared what I knew about them," he writes, "they would be less prone to take away the lifeline I had left—my salary."

Rost's book claims to chronicle problems in the way the drug industry manages to circumvent rules prohibiting off-label drug promotions. In addition, Rost's endorsement of reimportation is perhaps one of the most articulate defences made in the US. The Whistleblower may also reach some lay readers who were not moved to pick up any one of a number of more academic books on the drug industry. Finally, his overview of serious violations by nine top drug companies in his chapter" How corrupt is the drug industry?" should make one thing crystal clear: fines simply don't work. They are, as has often been said, simply the price of doing business.

"Working for a corporation," writes Rost, "is like running with a wolf pack. Everyone helps out and is friendly as long as it benefits the group, but each wolf cares only about himself and will do anything to survive. Compassion, loyalty, caring . . . these are all buzzwords invented to control the masses." Rost's take on the nature of industry might leave one wondering whether Rost isn't simply a very clever wolf himself.

The good news is that when the titans do battle—the fallout can be instructive.


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