Prosecutors To Crackdown on Doctors On the Take - NYT

[Guest guest]

ALLIANCE FOR HUMAN RESEARCH PROTECTION Promoting Openness, Full Disclosure, and Accountability http://www.ahrp.org and http://ahrp.blogspot.com FYIIt appears that the medical profession is finally due for a rude awakening:by selling their professional integrity to drug and device manufacturers,doctors have lost their special status in society. Like theirbenefactors--drug manufacturers--who violate the law, doctors will beprosecuted in court by the federal government.The chief counsel to the Inspector General of the Department of Health andHuman Services, has concluded that:  "Somehow physicians think they're different from the rest of us. Butmoney works on them just like everybody else." "The strategy of looking at the companies alone was not completelysuccessful in terms of our objective to deter health care fraud."   "So it's fair to say that the government is looking at evidence ofcriminal wrongdoing even by doctors."The move against doctors, The New York Times reports, is part of a diversecampaign to curb industry marketing tactics that enrich doctors but increasehealth care costs and sometimes endanger patients. Taken together, the newmeasures are likely to transform the relationship between medicine andindustry.So, doctors who have sold their integrity for cash from industry will beprosecuted in short order. First in line: the IG will be filing civil and criminal charges against anumber of surgeons who demanded profitable consulting agreements from devicemakers in exchange for using their products."What we need to do is make examples of a couple of doctors so that theircolleagues see that this isn't worth it. We want to send the message to thephysician community - particularly surgeons - that you can't do this."Doctors will be facing jail time, fines and loss of their medicallicenses--and be excluded from Medicare and Medicaid programs--therebyseverely limiting their potential pools of patients.Contact: Vera Hassner Sharavveracare212-595-8974http://www.nytimes.com/2009/03/04/health/policy/04doctors.html?scp=2 & sq=gardiner%20harris & st=cseTHE NEW YORK TIMESMarch 4, 2009Prosecutors Plan Crackdown on Doctors Who Accept KickbacksBy GARDINER HARRISWASHINGTON - Federal health officials and prosecutors, frustrated that theyhave been unable to stop illegal kickbacks to doctors from drug and devicecompanies, are investigating doctors who take money for using theseproducts.For years, prosecutors rarely pursued doctors because they believed thatjuries would sympathize with respected clinicians. But within a few months,officials plan to file civil and criminal charges against a number ofsurgeons who they say demanded profitable consulting agreements from devicemakers in exchange for using their products."What we need to do is make examples of a couple of doctors so that theircolleagues see that this isn't worth it," said Lewis Morris, chief counselto the inspector general of the Department of Health and Human Services. "Wewant to send the message to the physician community - particularly surgeons- that you can't do this."The move against doctors is part of a diverse campaign to curb industrymarketing tactics that enrich doctors but increase health care costs andsometimes endanger patients. Taken together, the new measures are likely totransform the relationship between medicine and industry.Over the past year, for instance, prosecutors have greatly increased finesthat are collected as part of plea agreements with drug and device companiescharged with illegal marketing tactics. In January, Eli Lilly announced itwould pay a record fine of $1.4 billion to settle federal criminal chargesthat it illegally marketed Zyprexa, an antipsychotic medicine. Two weekslater, Pfizer announced that it had set aside $2.3 billion to pay anexpected fine over charges that it illegally marketed Bextra, a painkillerthat has been withdrawn from the market.Michael J. Sullivan, the United States attorney for Massachusetts, said thatprosecutors - after winning record fines from a record number of companies -realized that they needed to expand the scope of their targets."The strategy of looking at the companies alone was not completelysuccessful in terms of our objective to deter health care fraud," Mr.Sullivan said. "So it's fair to say that the government is looking atevidence of criminal wrongdoing even by doctors."Besides jail time and fines, doctors convicted in the cases could lose theirlicenses for a time and be excluded from the federal Medicare and Medicaidprograms, severely limiting their potential pool of patients.Dr. Charles D. Rosen, an orthopedic surgeon and president of the Associationfor Medical Ethics, predicted that the pending cases would tarnish theentire profession. "The abuse of the public trust by the few will hurt themany," Dr. Rosen said.Also, as part of plea bargains, federal health officials are forcing agrowing number of drug and device makers to post publicly all payments madeto doctors who serve as consultants or speakers. Manufacturers haverepeatedly used consulting payments in illegal schemes to persuade doctorsto prescribe drugs or devices in inappropriate and unapproved ways,according to federal charges.Prosecutors are hoping that public disclosures of the details of theseagreements will make criminal conduct more difficult to conduct and easierto spot, and that they will discourage doctors from taking money and giftsfrom manufacturers at all."The rules of the game have changed," said Dr. David Rothman, president ofthe Institute on Medicine as a Profession at Columbia University. "You'vegot to presume that anything you take from a drug or device company is goingto be on a Web site. Your colleagues will know; your patients will know.That's going to stop a lot of doctors from pocketing their gifts and funds."Since a substantial share of doctors accept money from drug or devicemakers, the public postings could have considerable effects.In Minnesota, the state's unique payment disclosure and gift limit law hasled a growing number of academic and private medical centers to imposesevere restrictions on industry marketing practices. Park Nicollet HealthServices, one of the largest health systems in the state, banned allindustry gifts and nearly all free drug samples and has made public alldoctor consulting payments.The Department of Health and Human Services inspector general's power torequire payment disclosures extends only to companies charged withwrongdoing. A bill sponsored by Senator Charles E. Grassley, Republican ofIowa, and Senator Herb Kohl, Democrat of Wisconsin, would mandate that alldrug and device makers disclose such payments.Companies that have announced their intentions to disclose payments todoctors even before the legislation is passed have won plaudits fromethicists and industry critics. "Being more transparent by opening up ourbusiness to the public is an important step to building trust andconfidence," John C. Lechleiter, the chief executive of Eli Lilly, said in aspeech to the Economic Club of Indiana in September.On Feb. 9, the chief executive of Pfizer, Jeffrey B. Kindler, said thedisclosures were part of the company's commitment to increased transparencyand would "earn the trust of patients and the public."Neither executive mentioned that prosecutors would soon require them to makesuch disclosures anyway. In addition to Eli Lilly and Pfizer, companies thathave agreed to disclose payments to doctors include Merck, Cephalon,GlaxoSmithKline and Medtronic. Some executives contend that the disclosureswill increase public support for the payments. "Through greater transparencyabout the nature of these relationships, we will help people betterunderstand how important they are to developing life-saving and enhancingproducts for patients who need them," Bill Hawkins, chairman and chiefexecutive of Medtronic, said Tuesday.But doctors who have seen details of their consulting deals made public saythey have been tarred.Dr. Richard Grimm, a Minnesota researcher, twice served ongovernment-sponsored hypertension panels that create guidelines about whento prescribe blood pressure pills. But when state records revealed that hehad earned more than $798,000 from drug companies from 1997 to 2005,invitations to serve on such panels dried up, he said.  "There's thisautomatic assumption that if you make money from a drug company, you must becorrupt," Dr. Grimm said.Prosecutors are hoping the new measures will finally stop drug and devicecompanies from repeatedly breaking the law.Eli Lilly, for instance, pleaded guilty to illegal marketing charges in 1985related to its arthritis drug Oraflex, in 2006 related to its osteoporosisdrug Evista, and in January related to Zyprexa. In 2004, Pfizer paid a $430million fine and pleaded guilty to criminal charges that it illegallymarketed the epilepsy drug Neurontin, and it now faces similar charges overits marketing of Bextra.A common problem in illegal drug and device marketing cases is doctors'willingness to delude themselves into thinking that cash, lucrative tripsand other kickbacks do not affect them, said Mr. Morris, the chief counsel."Somehow physicians think they're different from the rest of us," Mr. Morrissaid. "But money works on them just like everybody else."Mr. Sullivan, the United States attorney, said officials hoped to send astrong message to doctors. "I have been shocked at what appears to bewillful blindness by folks in the physician community to the criminalconduct that corrupts the patient-physician relationship," he saidDuff Wilson contributed reporting.FAIR USE NOTICE: This may contain copyrighted (C ) material the use of whichhas not always been specifically authorized by the copyright owner. Suchmaterial is made available for educational purposes, to advanceunderstanding of human rights, democracy, scientific, moral, ethical, andsocial justice issues, etc. It is believed that this constitutes a 'fairuse' of any such copyrighted material as provided for in Title 17 U.S.C.section 107 of the US Copyright Law. This material is distributed withoutprofit.  =====In accordance with Title 17 U.S.C. Section 107, this material is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes.

[Guest guest]

ALLIANCE FOR HUMAN RESEARCH PROTECTION Promoting Openness, Full Disclosure, and Accountability http://www.ahrp.org and http://ahrp.blogspot.com FYIIt appears that the medical profession is finally due for a rude awakening:by selling their professional integrity to drug and device manufacturers,doctors have lost their special status in society. Like theirbenefactors--drug manufacturers--who violate the law, doctors will beprosecuted in court by the federal government.The chief counsel to the Inspector General of the Department of Health andHuman Services, has concluded that: "Somehow physicians think they're different from the rest of us. Butmoney works on them just like everybody else.""The strategy of looking at the companies alone was not completelysuccessful in terms of our objective to deter health care fraud." "So it's fair to say that the government is looking at evidence ofcriminal wrongdoing even by doctors."The move against doctors, The New York Times reports, is part of a diversecampaign to curb industry marketing tactics that enrich doctors but increasehealth care costs and sometimes endanger patients. Taken together, the newmeasures are likely to transform the relationship between medicine andindustry.So, doctors who have sold their integrity for cash from industry will beprosecuted in short order. First in line: the IG will be filing civil and criminal charges against anumber of surgeons who demanded profitable consulting agreements from devicemakers in exchange for using their products."What we need to do is make examples of a couple of doctors so that theircolleagues see that this isn't worth it. We want to send the message to thephysician community - particularly surgeons - that you can't do this."Doctors will be facing jail time, fines and loss of their medicallicenses--and be excluded from Medicare and Medicaid programs--therebyseverely limiting their potential pools of patients.Contact: Vera Hassner Sharavveracare212-595-8974http://www.nytimes.com/2009/03/04/health/policy/04doctors.html?scp=2 & sq=gardiner%20harris & st=cseTHE NEW YORK TIMESMarch 4, 2009Prosecutors Plan Crackdown on Doctors Who Accept KickbacksBy GARDINER HARRISWASHINGTON - Federal health officials and prosecutors, frustrated that theyhave been unable to stop illegal kickbacks to doctors from drug and devicecompanies, are investigating doctors who take money for using theseproducts.For years, prosecutors rarely pursued doctors because they believed thatjuries would sympathize with respected clinicians. But within a few months,officials plan to file civil and criminal charges against a number ofsurgeons who they say demanded profitable consulting agreements from devicemakers in exchange for using their products."What we need to do is make examples of a couple of doctors so that theircolleagues see that this isn't worth it," said Lewis Morris, chief counselto the inspector general of the Department of Health and Human Services. "Wewant to send the message to the physician community - particularly surgeons- that you can't do this."The move against doctors is part of a diverse campaign to curb industrymarketing tactics that enrich doctors but increase health care costs andsometimes endanger patients. Taken together, the new measures are likely totransform the relationship between medicine and industry.Over the past year, for instance, prosecutors have greatly increased finesthat are collected as part of plea agreements with drug and device companiescharged with illegal marketing tactics. In January, Eli Lilly announced itwould pay a record fine of $1.4 billion to settle federal criminal chargesthat it illegally marketed Zyprexa, an antipsychotic medicine. Two weekslater, Pfizer announced that it had set aside $2.3 billion to pay anexpected fine over charges that it illegally marketed Bextra, a painkillerthat has been withdrawn from the market.Michael J. Sullivan, the United States attorney for Massachusetts, said thatprosecutors - after winning record fines from a record number of companies -realized that they needed to expand the scope of their targets."The strategy of looking at the companies alone was not completelysuccessful in terms of our objective to deter health care fraud," Mr.Sullivan said. "So it's fair to say that the government is looking atevidence of criminal wrongdoing even by doctors."Besides jail time and fines, doctors convicted in the cases could lose theirlicenses for a time and be excluded from the federal Medicare and Medicaidprograms, severely limiting their potential pool of patients.Dr. Charles D. Rosen, an orthopedic surgeon and president of the Associationfor Medical Ethics, predicted that the pending cases would tarnish theentire profession. "The abuse of the public trust by the few will hurt themany," Dr. Rosen said.Also, as part of plea bargains, federal health officials are forcing agrowing number of drug and device makers to post publicly all payments madeto doctors who serve as consultants or speakers. Manufacturers haverepeatedly used consulting payments in illegal schemes to persuade doctorsto prescribe drugs or devices in inappropriate and unapproved ways,according to federal charges.Prosecutors are hoping that public disclosures of the details of theseagreements will make criminal conduct more difficult to conduct and easierto spot, and that they will discourage doctors from taking money and giftsfrom manufacturers at all."The rules of the game have changed," said Dr. David Rothman, president ofthe Institute on Medicine as a Profession at Columbia University. "You'vegot to presume that anything you take from a drug or device company is goingto be on a Web site. Your colleagues will know; your patients will know.That's going to stop a lot of doctors from pocketing their gifts and funds."Since a substantial share of doctors accept money from drug or devicemakers, the public postings could have considerable effects.In Minnesota, the state's unique payment disclosure and gift limit law hasled a growing number of academic and private medical centers to imposesevere restrictions on industry marketing practices. Park Nicollet HealthServices, one of the largest health systems in the state, banned allindustry gifts and nearly all free drug samples and has made public alldoctor consulting payments.The Department of Health and Human Services inspector general's power torequire payment disclosures extends only to companies charged withwrongdoing. A bill sponsored by Senator Charles E. Grassley, Republican ofIowa, and Senator Herb Kohl, Democrat of Wisconsin, would mandate that alldrug and device makers disclose such payments.Companies that have announced their intentions to disclose payments todoctors even before the legislation is passed have won plaudits fromethicists and industry critics. "Being more transparent by opening up ourbusiness to the public is an important step to building trust andconfidence," John C. Lechleiter, the chief executive of Eli Lilly, said in aspeech to the Economic Club of Indiana in September.On Feb. 9, the chief executive of Pfizer, Jeffrey B. Kindler, said thedisclosures were part of the company's commitment to increased transparencyand would "earn the trust of patients and the public."Neither executive mentioned that prosecutors would soon require them to makesuch disclosures anyway. In addition to Eli Lilly and Pfizer, companies thathave agreed to disclose payments to doctors include Merck, Cephalon,GlaxoSmithKline and Medtronic. Some executives contend that the disclosureswill increase public support for the payments. "Through greater transparencyabout the nature of these relationships, we will help people betterunderstand how important they are to developing life-saving and enhancingproducts for patients who need them," Bill Hawkins, chairman and chiefexecutive of Medtronic, said Tuesday.But doctors who have seen details of their consulting deals made public saythey have been tarred.Dr. Richard Grimm, a Minnesota researcher, twice served ongovernment-sponsored hypertension panels that create guidelines about whento prescribe blood pressure pills. But when state records revealed that hehad earned more than $798,000 from drug companies from 1997 to 2005,invitations to serve on such panels dried up, he said. "There's thisautomatic assumption that if you make money from a drug company, you must becorrupt," Dr. Grimm said.Prosecutors are hoping the new measures will finally stop drug and devicecompanies from repeatedly breaking the law.Eli Lilly, for instance, pleaded guilty to illegal marketing charges in 1985related to its arthritis drug Oraflex, in 2006 related to its osteoporosisdrug Evista, and in January related to Zyprexa. In 2004, Pfizer paid a $430million fine and pleaded guilty to criminal charges that it illegallymarketed the epilepsy drug Neurontin, and it now faces similar charges overits marketing of Bextra.A common problem in illegal drug and device marketing cases is doctors'willingness to delude themselves into thinking that cash, lucrative tripsand other kickbacks do not affect them, said Mr. Morris, the chief counsel."Somehow physicians think they're different from the rest of us," Mr. Morrissaid. "But money works on them just like everybody else."Mr. Sullivan, the United States attorney, said officials hoped to send astrong message to doctors. "I have been shocked at what appears to bewillful blindness by folks in the physician community to the criminalconduct that corrupts the patient-physician relationship," he saidDuff Wilson contributed reporting.FAIR USE NOTICE: This may contain copyrighted (C ) material the use of whichhas not always been specifically authorized by the copyright owner. Suchmaterial is made available for educational purposes, to advanceunderstanding of human rights, democracy, scientific, moral, ethical, andsocial justice issues, etc. It is believed that this constitutes a 'fairuse' of any such copyrighted material as provided for in Title 17 U.S.C.section 107 of the US Copyright Law. 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