British drugmaker GlaxoSmithKline distributed misleading medical journal articles, held conferences at lavish resorts and paid kickbacks to physicians — all to illegally promote the use of its prescription drugs, federal prosecutors said in announcing $3 billion in penalties against the drugmaker this week, the largest ever.

The New Hampshire treasury is expected to receive a little more than $2 million in the settlement, representing New Hampshire's share of losses to Medicaid, the joint federal-state health care program for the poor, said Senior Assistant New Hampshire Attorney General Jeffrey Cahill.

The settlement also calls for Glaxo to plead guilty to misdemeanor criminal charges later this week in Boston. A $1 billion criminal fine is part of the settlement.

“Let me be clear: we will not tolerate health care fraud. And, in every instance where we uncover it, we will use all available tools to hold those responsible to account,” said Deputy U.S. Attorney General James M. Cole at a Washington press conference on Monday.

The company issued a statement on its website Monday. Chief-executive Sir Andrew Witty said: “I want to express our regret and reiterate that we have learnt from the mistakes that were made.”

The settlement involves some of the company's signature drugs — depression drugs Paxil and Wellbutrin, the nausea drug Zofran and the diabetes drug Avandia.

In cases involving Paxil, Wellbutrin, Zofran and other drugs, Glaxo promoted them for off-label uses, which means to treat sicknesses not approved by the FDA.

The company did so by preparing, publishing and distributing a misleading medical journal article in one case, federal prosecutors said. In another instance, it promoted off-label uses during meetings at lavish resorts.

Glaxo pushed Paxil as an anti-depressent for children and adolescents, and Wellbutrin for weight-loss and proper sexual functioning.

Prosecutors said Glaxo also withheld data about adverse heart effects associated with Avandia.

According to the website healthpricer.com, sixty 100-milligram tablets of Wellbutrin go for $215; twelve 8-milligram doses of Zofran sell for $144.

Cahill said he was not in position to comment on any possible prosecution of physicians receiving kickbacks. Physicians are legally allowed to prescribe medication for off-label uses, but drug companies cannot encourage them to do so, Cahill said.

Cahill said the settlement only involves fraud claims against government health care programs. He said any private insurers would have to bring their own claims.

The settlement does not prevent Medicaid patients from suing Glaxo over any adverse health effects from the drugs.

Cahill said the violations took place between 1998 and 2003. He said there is no direct evidence that inappropriate activity took place in the Granite State. Diagnosis codes were used to determine the extent of off-label uses, and formulas determined losses to Medicaid programs.

The total New Hampshire settlement of $3.98 million must be split with the federal government.

He said New Hampshire, other states and the federal government are involved in numerous investigations into the illegal marketing of prescription drugs.

mhayward@unionleader.com