(AP file)

Big pharmaceutical companies are making big bucks off aggressive (and illegal) marketing efforts, and unsuspecting Americans are paying the price.

   A Bloomberg report finds that American doctors write about 10 million prescriptions a year for unapproved uses of drugs.

   Seven drug companies have paid $7 billion in fines for illegal marketing schemes that have put millions of patients at risk for harmful side effects, including "chest infections, heart attacks, suicidal impulses or death."

   In September, a division of Pfizer pled guilty to charges that it had encouraged its sales staff to push the painkiller Bextra, intended for menstrual and arthritic pain, as a remedy for all kinds of acute pain. The company was fined a record $1.19 billion.

   Earlier this year, Lilly had to pay more than $1 billion for peddling a drug approved for schizophrenia as a dementia cure --despite the fact that in company-sponsored trials, the drug killed twice as many dementia patients as a placebo did.

   One problem appears to be the comparative weakness of the prohibition against drug companies promoting off-label marketing, enacted after the 1961 Thalidomide disaster. Despite the hefty fines, drug companies still have a lot more to gain than to lose from pushing their drugs well beyond the boundaries of their FDA-approved uses. The fines Pfizer paid for illegal marketing from 2001-08 amount to just 14 percent of the company's revenues from those sales.

Like they say, health care is a problem best solved by the free market, right?