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In 2002, the drug industry through its trade group, the Pharmaceutical Research and Manufacturers of America (PhRMA), adopted a voluntary code barring companies from providing entertainment to doctors, including tickets to concerts and athletic events. The code also prohibited the companies from allowing the physicians to bring their spouses or staff to marketing events or from giving non-medical related gifts.

Not the villains

Both Dr. Kassirer and Mr. Thacker said the sports figures were not the villains in this scenario.

“Whether it’s sneakers, beer or pharmaceuticals, there’s nothing wrong with athletes trying to make a buck off their fame,” said Mr. Thacker.

Steve Spurrier, head football coach at the University of South Carolina, was paid $35,000 for a 2007 appearance in Columbia, S.C., hometown of the university. Mr. Spurrier, a former Heisman Trophy winner and 10-year NFL veteran, coached the University of Florida to a national championship in 1996. He also was the head coach for the Washington Redskins in 2002 and 2003.

He and Mr. Manning were among only two speakers to be paid $35,000.

According to an official who helped arrange the meetings, the athletes would speak after a physician gave a talk about the Novartis drugs. The physician speakers would be paid $2,000 to $2,500 per event.

Most of the sports figures did not respond to requests for a comment.

“You talk about your life and sports,” said Mr. Huff of his speech for Novartis at the Greenbrier Resort in his native West Virginia in December 2008 for $16,500. “It beats working for the mines, like all my relatives did.”

Mr. Huff, an All-American college player and NFL Hall of Fame linebacker, is the color commentator for the Washington Redskins radio network. In an interview, he said he would have posed for photos at the event since as a former athlete “I know to start to smile as soon as I see a camera.”

A spokesman for Mr. Spurrier said he was asked by Novartis to speak about football and coaching, and he wasn’t sure but thought he was paid around $20,000.

Pleaded guilty

The $36.5 million settlement with the Justice Department was part of a larger agreement between Novartis and Justice, in which the company agreed to pay $422 million to settle criminal charges and civil claims that it illegally marketed one of its top-selling drugs for unapproved uses along with kickback claims.

Novartis pleaded guilty to a misdemeanor charge of illegally marketing its anti-epilepsy drug, Trileptal, from 2000 to 2004 to psychiatrists and pain specialists for the treatment of bipolar disease and neuropathic pain, even though the FDA had not approved it for those uses. The company paid a combined criminal fine and forfeiture of $185 million.

It also agreed to pay $237.5 million to settle civil claims from its off-label marketing of Trileptal and paying kickbacks to promote it and the other five drugs.