The Pharmacia & Upjohn subsidiaries of Pfizer agreed to a combined settlement of $34.7 million with the United States on April 2, 2007. The agreements to plead guilty involved the promotion of Pfizer’s Genotropin growth-hormone product. Genotropin is FDA-approved for the treatment of hormone-related growth problems. Pharmacia solicited bids from pharmacy benefit managers (PBMs) to administer the distribution of Genotropin. Pharmacia paid the winning PBM over $12 million above the other bids. The government alleged that this payment was a kickback to induce the PBM to promote Genotropin, through formulary manipulation and marketing. In spite of the kickback, Pharmacia’s own calculations established that it would still make money on the drug given the PBM’s efforts. In addition to the kickback, Pharmacia admitted to the improper promotion of Genotropin for uses not approved by the Food and Drug Administration, including for anti-aging, cosmetic use, and improved athletic performance. In addition to the fine, the Pharmacia subsidiaries are permanently excluded from federal health care programs. The activities occurred prior to Pfizer’s acquisition of Pharmacia.