CPT Twit - Somewhere lies the truth, buried in the lies! The Harvey Weinstein Affair(s)...

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Health Care in America - Big Pharma Fraud, Cover Ups & Corruption

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The Hals Report

 
Fraud, Cover-Ups, and Corruption: Welcome to the Drug Industry

Erik Hals,  January 6, 2011

The Broken American Health Care System

There are no short cuts to the truth, and especially when it comes to the cutthroat world of big pharma and big bucks.  In this article we take a story that appeared in The Hals Report by Erik Hals.  It is another example of the extent big pharma is willing to go to secure business in the ruthless legal drug addiction market in America.

 

The United States health care industry is one of the largest in the world, with over 300 billion dollars spent on prescription drugs per year. (1) For many, these drugs have brought undeniable benefits, but in recent months the health care industry has fallen upon scandal after scandal.

Recently, two of the worlds largest pharmaceutical companies were fined billions of dollars after investigations into their secret working practices brought several fraudulent activities to light. Now, new revelations have emerged including pervasive fraud, corruption and huge kickbacks which were paid to doctors.

So, what do doctors receive kickbacks for and how do they work? We will begin with a man named David. A decade ago David was prescribed Risperdal for a psychiatric illness, a drug made by Johnson and Johnson. U.S. authorities never approved Risperdal for treating his disorder but the doctor prescribed it to him anyway, it had devastating consequences. He is now in a wheelchair with diabetes and Parkinson’s. In a current lawsuit against Johnson and Johnson, he blames Risperdal. (2)

The pharmaceutical companies didn’t trick the government though. U.S. regulators ruled Johnson and Johnson misled doctors about potential fatal risks associated with the drug, including diabetes. (3) There are more than 2,000 people bringing legal actions against Johnson and Johnson. The company claims the actions are without merit. (of course they do!) The U.S. government and several states are also suing the company in related cases.

Surprisingly, most of the leading pharmaceutical companies in the United States have been fined for fraud in the past. One of the most common types of fraud in the pharmaceutical world is known as off-label marketing. Off-label marketing is a technique in which pharmaceutical companies advise doctors to prescribe drugs for unapproved uses. This is known as fraud against the government because medicare ends up paying the expense for the drugs if they do not work.

Sharon Ornsby, a member of the FBI financial crimes unit, in an interview on Al Jazeera television said, “pharmaceutical fraud is one of our top three threats.”

The U.S. government is slowly beginning to show a fighting facade, but is that all it really is, a facade? In the last 2 years alone the U.S. government has fined six of Americas top ten pharmaceutical companies for fraud. Ongoing investigations continue against three of the four remaining companies. During this specific period in time the industry has paid out over five billion dollars in fines.

In September of 2009 Pfizer settled civil and criminal charges in the amount of 2.3 billion dollars with the federal government for illegally marketing four types of drugs. (4) The Pfizer corporation made over 180 billion dollars selling twelve twelve kinds of drugs and only paid 2.3 billion dollars in fines, talk about a phenomenal business plan!

Details of Pfizer’s behavior came to light when several insiders decided to become whistleblowers. Glen Demott was a top Pfizer representative selling the drug Bextra while earning 100,000 dollars per year. He claims he was trained to lie to physicians, “they were training us to say things to physicians that weren’t accurate. Bextra was not approved to be used for acute pain and we were out there trying to get standing orders for acute pain.” Eventually, Demott was forced out of his position with Pfizer. (5)

Demott is one of a growing number of whistleblowers exposing medical corruption across America. This is largely thanks to a U.S. law called Qui Tam. The law allows individuals with knowledge concerning fraud against the government to bring a legal case on its behalf and share in the proceeds.

Lewis Morris is chief lawyer for the U.S. health department and increasingly uses Qui Tam to expose drug industry corruption. Today there are over 1000 outstanding Qui Tam cases in the United States and they are slowly beginning to open up the secretive world of big pharma. For the first time, we can see millions of dollars in payments to doctors throughout the U.S.

Drug companies now publish physician payment figures online and in 2009 just a few companies paid doctors in the United States over 200 million dollars. (6) These giant sums of money pouring into the medical field will inevitably lead to corruption on every level of the pharmaceutical industry. (if it hasn’t already?)

We already know Risperdal can cause diabetes and Parkinson’s as we saw in Davids case, but now there is evidence the drug can cause serious complications in adolescent boys as well. (Gynecomastia: breast development.) (7) As we speak, federal investigators are still looking into claims concerning Johnson and Johnson. They believe the company illegally marketed Risperdal for use in children, including those with ADHD. But with so many drug scandals flooding the news, the countries regulators have begun to run low on resources.

Avandia used to be the worlds best selling diabetes drug for years. It earned its maker Glaxo Smith Kline billions of dollars, but now it is linked to over 100,000 heart attacks in the United States.

In July the U.S. food and drug administration held hearings related to the dangers of Avandia. (It’s license has already been suspended in Saudi Arabia) An investigation by the U.S. senate finance committee found the totality of evidence suggests Glaxo Smith Kline was aware of the possible cardiac risks associated with Avandia years before the evidence became public. (8) Glaxo Smith Kline also tried to prevent heart attack warnings from being printed on their products box.

Many of Americas leading pharmaceutical corporations appear distraught and amass in corruption. Will fines alone prevent this?

The U.S. government is continually reaching for stronger powers and controls over the industry. The department of health is even considering breaking up drug companies found guilty of corrupt and unethical practices. In the meantime, 1000′s of doctors continue to take cash payments from the drug industry and would argue they are doing nothing wrong. This deeply entrenched culture of corruption within the drug industry is a serious problem that will inevitably cripple our healthcare system beyond repair if something isn’t done about it . Say NO to big pharma.

Sources:
1. Reuters: prescription drug sales 300b$
2. Health Freedom Alliance
3. J&J Told to Pay $257.7 Million Over Risperdal Marketing Tactics
4. Pfizer pays a record $2.3 billion to settle criminal charges
5. Whistleblower Glen DeMott on False Claims Act Settlement Reached
6. PFIZER INC Officers & Directors
7. RISPERDAL
8. Avandia Maker Hid Risks for Years, Probe Finds

© The Hals Report 2012. All rights reserved.

http://www.thehalsreport.com/

Health Care in America - Obama and Big Pharma - Strange Bedfellows

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The Broken American Health Care System - CPT Reprint

When he ran for office Obama pledged to get control of health care costs and the first thing he did was have his then Chief of Staff Rahm Emanuel negotiate a multi billion dollar deal with big pharmaceutical companies to get their backing for his Obamacare health program.

Details of this deal have never been made public but he did get the support and money from big pharma to lobby and pass his health care program.  As profits continue to climb and costs continue to soar for prescription drugs in America let us look at how they have fared in selling their drugs under Obamacare.

Would you like to know what contributions you are making to drug companies in America? Here are the top 15 drug sales of prescription drugs for 2010 as reported by Bloomberg News.

As you will note, the drug is first, what it treats next, the annual sales in BILLIONS of dollars, and the percentage change over the previous year.  This does not include sales for livestock, fish and poultry use which can represent up to 70% of total antibody drug sales for big pharma, tens of billions more in revenues.

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Lipitor Topped Worldwide Drug Sales in 2010; Crestor Gains Most

1. Lipitor - High cholesterol - Pfizer - $10.7 - -6%

2. Plavix - Blood clot prevention - Bristol Myers - $9.43 - -4%

3. Remicade - Rheumatoid arthritis - J&J Merck & Co. - $7.99 - N/A

4. Advair - Asthma - GlaxoSmithKline - $7.94 - 2%

5. Enbrel - Rheumatoid arthritis - Amgen/Pfizer - $7.23 - N/A

6. Abilify- -Depression Bipolar Schizophrenia - Otsuka/Bristol-Myers - $6.78 - N/A

7. Humira - Rheumatoid arthritis - Abbott - $6.55 - 19%

8. Avastin - Cancer - Roche -  $6.22 - 8%

9. Rituxan - Lymphoma Leukemia - Roche/Biogen Idec - $6.11 - 9%

10. Diovan - High blood pressure - Novartis - $6.05 - 1%

11. Crestor - High cholesterol - AstraZeneca - $5.69 - 26%

12. Seroquel - Depression Bipolar Schizophrenia - AstraZeneca - $5.3 - 9%

13. Herceptin - Breast cancer - Roche - $5.22 - 7%

14. Zyprexa - Bipolar Schizophrenia - Eli Lilly - $5.03 - 2%

15. Singulair  - Asthma Allergies - Merck & Co. - $4.99 - 7%

*Estimated, Otsuka declined to provide 2010 sales. Some year-over-year sales comparisons are N/A because there isn’t comparable 2009 data.

To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net.

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Health Care in America - "Corruption at the Core of the Collapse

The Broken American Health Care System - CPT Reprint

What is the driving force behind the failure of the most expensive heath care system in the world to provide a better quality of life?  A lot of us have opinions.  So do the media, politicians and academia, but none seem to be addressing the reason behind every failure of an institution like medical care in society.

There comes a point when the institutions no longer serve the purpose they were created to address.  They evolve to a position where they believe the survival of the institution is more important than the mission of the institution.

When that happens, and inevitably it will when all good causes become their own bureaucracy, we have the seeds of corruption planted.

In America we spend about 9.9% of our disposable income on food.  Thirty years ago we spent 15% of our disposable income, meaning we spend over 5% less today on food than thirty years ago.

Now compare that to our experience with health care costs.

An article  was written June 28, 2009 by George Will titled: "Americans Will Regret Health Care Fix".  It described the cost of health care in America as follows.

The Hudson Institute's Betsy McCaughey, writing in The American Spectator, says that in 1960 the average American household spent 53 percent of its disposable income on food, housing, energy and health care. Today the portion of income consumed by those four has barely changed -- 55 percent. But the health care component has increased while the other three combined have decreased. This is partly because as societies become richer, they spend more on health care -- and symphonies, universities, museums, etc.

It is also because health care is increasingly competent. When the first baby boomers, whose aging is driving health care spending, were born in 1946, many American hospitals' principal expense was clean linen. This was long before MRIs, CAT scans and the rest of the diagnostic and therapeutic arsenal that modern medicine deploys.

In a survey released in April by NPR, the Kaiser Family Foundation and Harvard, only 6 percent of Americans said they were willing to spend more than $200 a month on health care, and the price must fall to $100 a month before a majority are willing to pay it. But according to Grace-Marie Turner of the Galen Institute, Americans already are paying an average of $400 a month.

Most Americans do not know this because the cost of their care is hidden. Only 9 percent buy health coverage individually, and $84 of every $100 spent on health care is spent by someone (an employer, insurance company or government) other than recipients of the care. Those who get insurance as untaxed compensation from employers have no occasion to compute or confront the size of that benefit. But it is part of the price their employers pay for their work.

During the past thirty years health care as a percentage of our gross domestic product has grown by more than ten times.  That does not include your taxes paid for the government expenditures on health care.  The cost now is over $2.6 trillion a year and rising, both in terms of treatment and insurance.

Make no mistake, health care, long a public service through churches, non-profit organizations, government owned facilities and other resources, has now become BIG BUSINESS.

Pharmaceutical corporations led the way into making health care a profit center, not a public service, and now virtually every aspect of our health care system is privately owned, profit centered, and financed by Wall Street.

Wall Street may be reasonably good at financing new businesses like the Internet companies and health care industry but once Wall Street takes control of the industry through controlling the financing, that company serves a new master, Wall Street profitability.

Before you get out your protest banners and decide to occupy hospitals, I mean it is fashionable to protest against anyone we think is ripping off the public, look in the mirror because you are the one embracing a system now under the control of the financial institutions.

My point is this.  Health care is more about serving Wall Street interests than the people's interest.  Of course this is America and we encourage capitalism and these health care capitalists are operating within the framework of the law.  I guess if you owned stock in enough health care companies you would be profiting from the gouging of the American public with excessive health care costs, but most of us don't own health care stocks.

Our health care industry has evolved to the point where moral and financial corruption permeate the entire system, even corrupting those in the industry who really want to help people.

The medical industry is dependent on funneling millions in campaign funds to politicians who have to vote on their funding, in bribing doctors to prescribe drugs, in bribing universities to compete on a cut throat basis for grants from private corporations for survival, and for encouraging doctors to own testing equipment which in turn has to be justified to keep.

Conflicts of interest and ethics issues dominate the health care landscape.  It has become so financially competitive that excessive and unnecessary treatment is the order of the day as a simple and nearly undetectable way to pad the revenue stream.

Why X ray a single tooth if you can X ray the whole mouth?  Why take one or two spinal X rays when you can take multiple X rays of the spine?  Why not set up follow up doctor appointments for reasons of billing for the office visits rather than transmitting test results?

If a drug company pays a doctor to prescribe their drugs, and the more drugs prescribed the more the doctor makes, don't you think more prescriptions will be written?

How can FDA employees fairly evaluate a New Drug Application (NDA) worth potentially billions of dollars in new revenue if the same employees can quit their jobs and go to work for the same drug companies for far more money?

The top five drugs in terms of sales revenue in America all make between $3 and $5 billion a year for the owners, the pharmaceutical company.  If new health research or treatment does not generate profits first and foremost, it is of little value to a profit driven health care system.

If congress or the president eliminated conflicts of interest in the industry, both in terms of the relationship between government workers and the industry and between the industry and practitioners, it would be a great start to cost reduction.

The same conflict of interest exists when doctors are convinced to own expensive equipment like CAT scan and MRI machines, blood laboratories, pharmaceutical offices and others.  If Medicare or a health insurance company allows excessive CAT scans and MRI analysis for the purpose of making sure people are diagnosed and the doctors own the machines, don't you think more screens will be prescribed?

There are a thousand and one ways to get caught in a conflict in an industry that is barely regulated.  Usually there are industry watchdogs like the Securities and Exchange Commission assigned to keep an eye on the system.  However, even they are subject to the same conflicts because the SEC failed to see the housing and banking crisis coming.  More than likely they just turned their back to it.

A comprehensive and fair conflict of interest law could be proposed by the president and approved by congress and a thorough ethics law could be adopted by the medical and health care industries and that would start to unscramble the layers of conflicts and ethics violations we face today.

Unfortunately, such leadership by our politicians and health industries is nonexistent and will be as long as the industry finances the political campaigns in Washington and through the nation.  So we also need campaign financial reform, meaningful reform, to fix that inherent problem.

Fix the conflict of interest, draw up enforceable ethics laws, and clean up the campaign finance mess and it will lead directly to reduced health care costs.  Once again, nothing has been proposed by politicians to correct this mess.

Isn't it about time to REALLY start fixing things?

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