Healthy Skepticism Library item: 299

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Publication type: news

Lavioe D.
Drug Company Employees Face Mass Trial
Associated Press Writer 2004 Apr 12

Full text:

For years, they’ve been the standard freebies that drug companies have offered in an attempt to get doctors to prescribe their medications: expensive dinners, golf outings, trips to ski resorts and drug samples.

But federal prosecutors claim the gift-giving has gone too far.

This week, 11 current and former sales executives from TAP Pharmaceutical Products — a leading drug company — go on trial, accused of conspiring to pay kickbacks to doctors, hospitals and other customers.

The charges focus on efforts to get doctors to prescribe Lupron, the company’s prostate cancer drug, as well as Prevacid, its heartburn drug.

Jury selection is scheduled to begin Tuesday, and the case is being closely watched by the drug industry and the medical profession.

Critics say the gift-giving drives up the already high cost of prescription drugs and erodes public confidence in doctors.

“Despite the fact that most doctors will deny that they are influenced, in fact, they are,” said Dr. Robert Goodman, an internist from New York who started a movement five years ago to eliminate pharmaceutical company influence. His Web site, nofreelunch.org, urges doctors to reject all freebies, even something as inexpensive as a pen.

Doctors approached by the 11 TAP employees were offered gifts including trips to swanky golf and ski resorts, and “educational grants” used to pay for cocktail parties, office Christmas parties and travel, according to prosecutors.

Defense lawyers say the sales executives were simply doing their jobs.

“As far as I can tell, this is the first time there has ever been a prosecution under the health care statute in which salespeople are being charged with a crime (for things) which they thought were completely within their job descriptions,” said Royal Martin, a Chicago attorney who represents Carey Smith, a former TAP executive.

It’s not the only case taking drug companies to task. Lawsuits filed in New York, California and Texas accuse other companies of bribing doctors and pharmacists to favor their products, costing consumers and government health plans millions of dollars.

In 2001, TAP agreed to pay $875 million to settle charges that it inflated prices and bribed doctors to prescribe Lupron, admitting it violated the Prescription Drug Marketing Act.

More than a dozen TAP employees and several doctors were also indicted.

Four doctors have pleaded guilty, while a fifth will be tried separately from the 11 TAP employees.

Federal prosecutors would not comment on the case before trial.

Catherine Stueland, a spokeswoman for TAP, based in Lake Forest, Ill., said the company has strengthened ethics standards for employees since the 2001 settlement.

“TAP is committed to the highest ethical standards in its marketing and business activities,” Stueland said.

In response to both criminal prosecutions and lawsuits, the drug industry’s lobbying group, the Pharmaceutical Research and Manufacturers of America, adopted new guidelines in April 2002.

The group’s new code allows drug representatives to offer meals to healthcare professionals, but only if they are “modest” and do not include spouses or other guests.

The code says items worth $100 or less, if they are “primarily for the benefit of patients,” can be offered to healthcare professionals. “For example, an anatomical model for use in an examination room primarily involves a patient benefit, whereas a VCR or CD player does not,” the code states.

But critics say both the drug industry guidelines and the American Medical Association’s guidelines on gifts are too vague and include no real penalties for not following them.

“We’ve all heard about older patients who have to choose between food and drugs, or they’re only taking half their drugs so they can pay for food,” Goodman said. “Meanwhile, doctors are being wined and dined by drug companies.