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Archives | (July 2002)
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THE RISING TIDE OF PRESCRIPTION DRUG COSTS:
A CORPORATE CON JOB (cont.)
------------------------------------------------------------------ Page 6 of 6 Sometimes, however, there is much more than a free meal involved. Just-released court documents from a lawsuit allege that sales representatives of Warner-Lambert participated in a program that paid physicians to allow them to review patient charts and make recommendations concerning what medications the patients should receive. The purpose of the program was to develop so-called “off label” uses for a drug called Neurotin. Neurotin had been developed and was approved as a treatment for epilepsy. Warner-Lambert wanted to increase the market for its product. According to the court documents, Warner-Lambert sales reps convinced doctors to use Neurotin for everything from pain to bipolar disorders to attention deficit disorder in children. The only trouble was that Neurotin was ineffective as a treatment for many of these conditions and in some cases could actually make them worse. Doctors were paid $350 for each day they allowed the Warner-Lambert rep into their examination room. They were also hired as consultants, paid to give speeches or to write journal articles (in some cases just to put their names on articles that were prepared by ghost writers) and paid to recruit patients for clinical trials. Even if the drug wasn’t effective for many of the disorders the physicians were prescribing it to treat, the sales program proved very effective. In 2000 78% of all prescriptions written for Neurotin were “off-label.” More important, because of the widespread off-label use sales of the drug were increasing 50% per year. Dr. Jonathan Spom of NIH told the New York Times “ Neurotin is being used like water for disorders where there is not much evidence that it is effective.” “Big Pharma’s” defenders would likely argue that what happened with Neurotin was an aberration, not likely to be repeated. Unfortunately this is not the case. For example Takeda Chemical Industries and Abbott Laboratories joint venture, TAP Pharmaceutical Productions recently had to pay $875 million to settle civil and criminal charges stemming from a scheme that defrauded Medicare and Medicaid of millions of dollars. The way the scam worked was that TAP sales personnel would give doctors free samples of its drug, Leuprorelin (known as Lupron in the U.S.). The TAP personnel would then help the doctors get reimbursements for the drug’s retail cost – even though they had paid nothing for it. Since each dose costs hundreds of dollars, it proved highly lucrative for the physicians involved. Of course, once a patient was started on Lupron with the free sample, they would generally continue to take the drug generating thousands of dollars in sales annually for each patient. Free drugs were not the only inducement TAPS employees offered. They also provided “educational grants,” free trips, free medical equipment and a host of other gifts. Although in this case, as with Neurotin, the corruption was eventually discovered, the real question is in how many instances has it gone undetected? A FATALLY FLAWED SYSTEMIn the end, the rapid rise in pharmaceutical costs is in actuality a symptom of a more fundamental problem: the unprecedented control “Big Pharma” and “Big Medicine” exert over healthcare in the United States. Their ability to manipulate every aspect of healthcare from research institutions to regulatory bodies to even the individual doctor’s office is evidence that the system itself is inherently flawed. If allowed to continue unchecked, what little remaining freedom we have regarding our health care choices will soon be lost. The time has come for each of us to stand up and be counted before it is too late. |
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