Healthy Skepticism Library item: 15239
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Publication type: news
Kowalczyk L.
US cites Boston psychiatrist in case vs drug firm
The Boston Globe 2009 Mar 6
http://www.boston.com/news/local/massachusetts/articles/2009/03/06/us_cites_boston_psychiatrist_in_case_vs_drug_firm/
Full text:
Complaint alleges kickbacks to MDs
Federal prosecutors say that a Massachusetts General Hospital psychiatrist became a “star spokesman” in helping a pharmaceutical company promote its drugs for treating depressed children, even though the medications were not approved for pediatric use by the US Food and Drug Administration.
In a complaint unsealed last week in US District Court in Boston, prosecutors allege that New York-based Forest Laboratories Inc. illegally marketed the drugs Celexa and Lexapro for use in children by paying kickbacks, including lavish meals and cash payments disguised as grants and consulting fees, to induce doctors to prescribe the drugs. They also say the company misled doctors and the public by failing to disclose the results of a negative study.
In the 34-page complaint, prosecutors said that from 1999 to 2006, Dr. Jeffrey Bostic, director of school psychiatry at the hospital, gave more than 350 Forest-sponsored talks and presentations in 28 states, many of which addressed pediatric use of Celexa and Lexapro.
“Forest also paid Dr. Bostic to meet other physicians in their offices in order to ease their concerns about prescribing” the drugs, the complaint said. Doctors are allowed to prescribe children drugs not approved by the FDA for pediatric use, a practice called “off label” use.
The government said that Bostic became “Forest’s star spokesman in the promotion of Celexa and Lexapro for pediatric use” and that the company paid him more than $750,000 between 2000 and 2006 for his presentations. The complaint quotes an unnamed Forest sales representative as saying, “Dr. Bostic is the man when it comes to child psych.”
Bostic declined to be interviewed, but the hospital gave the Globe a statement describing him as a “highly regarded practitioner and educator in the field of psychiatry.” The hospital said Bostic cooperated with the government, providing investigators with information about his speaking engagements.
“The United States complaint is brought against Forest Laboratories, not Dr. Bostic,” the statement said. “The complaint consists of characterizations and allegations by the United States, not established facts. In those speaking engagements, Dr. Bostic talked to fellow physicians about the treatment of patients with various mental health conditions, not about one or two specific drugs.”
On his Mass. General website on school psychiatry, Bostic outlines several treatments for depression in children and teenagers, including counseling and cognitive behavior therapy, as well as antidepressants. He mentions Lexapro and Celexa along with several other medications, and says, “There is no best medicine to treat depression.”
Dr. Michael Jellinek, president of Newton-Wellesley Hospital and chief of child psychiatry at Mass. General, said he has known Bostic for years. “He has absolute integrity,” Jellinek said. “I have seen no bias in terms of any choice of treatment or particular medication.”
The allegations against Forest are part of a legal and political backlash against potential conflicts of interest in medicine, particularly in psychiatry. US Senator Charles E. Grassley, Republican of Iowa, has accused another Mass. General child psychiatrist, Dr. Joseph Biederman, of failing to tell Harvard Medical School until last March about most of the more than $1.5 million that the pharmaceutical industry paid him in consulting and speaking fees between 2000 and 2007. Biederman has said in statements and letters to the Globe that he has been conscientious about requirements that he disclose payments to his employers and that drug company money has not biased his research.
Harvard would not comment on whether Bostic disclosed his speaking fees, saying faculty disclosure forms are confidential.
In a statement, Forest said it “is committed to adhering to the highest ethical and legal standards, and off-label promotion and improper payments to medical providers have consistently been against Forest policy.”
Liz Kowalczyk can be reached at kowalczyk@globe.com.
