The trial of TAP officials accused of defrauding Medicare over the sale of the cancer drug Lupron starts today in Boston. Matt Quinn isn’t sure that the blame is falling entirely where it should:

Although “two health plans, 26 group practices, and 25 individual doctors from Massachusetts to California were offered or took bribes, including cash, free drugs, Red Sox and Yankees tickets, and trips to swanky resorts, according to a list of “kickback transactions” filed in US District Court in Boston…None of the medical professionals face charges in this trial.”

It appears that federal prosecutors are using tactics from that other drug war in their efforts to root out corruption and fraud in Big Pharma: get the minor criminals to “turn” in order to land the “big fish”. But there is a fundamental difference between the two scenarios. Big Pharma sinks to these lows BECAUSE medical “professionals” demand it of them (for example…):

“In documents supporting those charges, prosecutors asserted that Lahey Clinic officials agreed to continue prescribing Lupron only if TAP offset the clinic’s cost by about $100,000 by paying for a Christmas party, golf tournaments, and seminars and for providing free drug samples.”

“At Yale-New Haven Hospital, the documents say, the urology department in 1999 asked for and received $10,000 from TAP to fund a seminar after threatening to switch patients from TAP’s prostate cancer drug Lupron, to a less expensive competitor.”

“A urology practice affiliated with the former New England Deaconess Hospital in Boston also played TAP against its competitor and from 1995 to 1998 received 111 free doses of Lupron, worth at least $400 each, according to the indictment and kickback records. The doctors prescribed the samples to patients and billed Medicare for the full cost of the drug, turning the samples into a cash kickback…”

Oh, and street drug dealers don’t agree to the Hypocratic Oath…

Of course, this kind of kickback / fraud is largely a moot point if the government/payers quit paying for injectable drugs…