Image of male nurse pushing senior woman in a wheelchair in nursing facility

Pfizer Inc., the largest drug maker in the world, will pay a record $2.3 billion in criminal and civil fines over illegal promotions of four prescription drugs.

The government said the company promoted the drugs for off-label purposes. Off-label refers to using drugs for medical conditions other than those approved by the Food and Drug Administration. Drug manufacturers are prohibited from marketing drugs for uses that have not been approved by the FDA. Those four drugs are the pain killer Bextra, the nerve pain and epilepsy treatment Lyrica, the schizophrenia medicine Geodon and the antibiotic Zyvox. The civil settlement also covers nine other medicines. To promote the drugs, Pfizer entertained doctors at consultant meetings at resort locations, paying their expenses and giving perks, authorities said. 

Under terms of the settlement, Pfizer must pay $1 billion to compensate Medicaid, Medicare, and other federal health care programs. A portion of the $1 billion in civil penalties will be distributed to 49 states and the District of Columbia, according to agreements with each state’s Medicaid program.