Matt Quinn wrote this post about doctors charging Medicare for samples given to them by drug companies. Astra Zeneca has already settled with the Feds at a cost of $330m for promoting that behavior. As I’ve mentioned many time, I think Medicare’s structure makes it easy to defraud, so I don’t place all the blame on the docs. I actually think Matt’s a little over-critical of physicians (and by extension drug companies) here. But Matt used to work in the business of marketing oncology drugs to physicians and knows many of the tricks. So bear that in mind when you read his post below:
A federal judge is blaming a pharmaceutical company (Astra Zeneca) for a physician, Dr. Saad Antoun, billing for (injectible) samples of their drug which he was given for free: "The judge said Antoun appeared to be ‘the kind of doctor everybody wants to go to and that this was a mistake of bad judgment fostered upon you by the drug company.‘" The full story from the Report on Medicare Compliance is here.
My question: if this doctor is so helpless as to 1) not ask Astra directly about "misleading labeling" regarding billing for samples 2) not ask his peers/staff about the legality of billing for samples and 3) not do the (minimal) research needed to know that it violates federal law and 4) follow the directions of a drug rep in running his practice and treating his patients, how much faith should anyone have that this guy is competent in his profession? Would it be the drug company’s fault if he used Zolodex improperly and it harmed or killed a patient? Perhaps the label was "misleading" or the drug rep told him about an off-label use that he had heard about.
My take is that Dr. Antoun knew exactly what he was doing — or should have. Egregious pharmaceutical marketing only works because physicians allow it to work. If physicians rejected trips, graft in the form of "unrestricted educational grants" and honoraria, free meals, gas, and concert tickets and other "non-scientific" aspects of drug marketing, then the companies would stop spending money on this stuff. But many physicians don’t. External agencies only need to regulate a profession when members of that profession can’t conduct themselves ethically. I guess Judge Farnan can’t understand this and refuses to keep up the government’s (taxpayers’!) side of the deal.
Someone had better start taking the problem of memory loss and statin drugs seriously! In March 2004 I started taking Lipitor. Soon after, I began having trouble at my work. I was an administrative assistant to the VP of a stress-filled company. I attributed my forgetfulness to the stressful atmosphere. In March 2005, I lost my job because I had become an “under performer.” I still attributed my fogginess to the stress. After three months at home, I found another job doing accounting work for a small company. It is not a stressful atmosphere. I had been an accountant for many years and was glad to get back to this type of job. I have always been a detail-oriented individual. The first job they trained me on was invoicing customers. It is simple and anyone should be able to do it, even without an accounting background. My supervisor always checked over my work and invariably found errors, and my accuracy did not improve. Then my sister sent me a website talking about this problem. That was the first I had heard about it. I quit taking the Lipitor and within 10 days, my supervisor noted that there was a marked difference in my performance. I have been off Lipitor for four months and am doing fine at this job. However, I am angry about losing my other job and the accompanying salary. Don’t believe for a minute that Pfizer doesn’t know about this problem. When I told my pharmacist about my problems, she said that she had seen articles in journals about memory loss. I’ve never considered any kind of lawsuit before, but this cover-up cost me my retirement.