The heart-failure drug Natrecor seemed sure to become a blockbuster after Scios put it on the market in 2001.
Besides its use in hospitalized patients, many clinics began giving it to walk-in patients in weekly sessions dubbed "tuneups.''
Some people -- including prominent heart specialist Dr. Eric Topol -- say Scios encouraged this with a hotline and brochure explaining how to bill Medicare for the sessions.
There was only one problem: Some medical experts contend Natrecor was never approved for such tuneups. Some also say it may not be as safe as initially thought.
Scios says studies show the drug is safe. And it has launched a campaign to clarify to doctors that the drug is not recommended for repeated use in patients in a clinic setting.
Nevertheless, the drug's sales have sagged and the company is under investigation by the U.S. attorney in San Francisco for allegedly engaging in "off-label'' marketing, promoting drugs for uses not approved by the government.
Since this case came to light, critics in two major medical journals have cited Natrecor as an example of how easy it is for drug companies to peddle their medicines for unapproved purposes.
Although doctors are allowed to prescribe drugs for off-label treatments, companies are forbidden from promoting their drugs for such uses.
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