So the book that Rost has been working on is out. (Here’s a very quick summary of his story I wrote back in March). It’s called The Whistleblower: Confessions of a Healthcare Hitman.

In contrast to John Mack’s review which calls it a little dull, I think it’s a very, very interesting tell-all and much more interesting than a fictionalized version would have been. It’s 200 pages and I devoured it in 2 hours. I am of course bitter that he stole my title, but we’ll let him off!

There are some problems with the book. First, Rost is a little late to the game on the series of corrupt practices that big Pharma has been involved in over the years. Marcia Angell did it better, and John Abramson gets better into the details. Rost’s chapter on that corruption (ch 19) is a big mess, because it presents several different types of malfeasance as being the same thing, whereas there are activities within big pharma that are way over the line, and others where the line may been approached but not crossed. In the latter case a pharma company may settle because it didn’t want to run the “death penalty risk” of not settling with an aggressive prosecutor and potentially being banned from government programs. The key point of that chapter gets a little lost—and that point is that breaking the law is a considered business risk for pharma and many other health care entities; more so when the “law” is unclear—which it often is.

However, the rewards are worth it and not just in pharma. After all St Barnabas paid a Medicare fine recently of $265m odd when it acknowledged overcharging some $630m! So crime does pay, and it pays in the health care world to fuzz up the notion of “crime”. (There is one great catch, which is that the front organization that nominated Rost for whiny whistleblower of the year was headed by a guy who’d done Federal time for Medicaid fraud). But I think the whole chapter could have been cut.

The other frustration with Rost’s book is that we don’t learn much about some key issues that are ongoing in the Genotropin suit and he hid the whole existence of the suit from the narrative, whereas I think it would have been better done to introduce it with everything else he was up to chronologically, as the rest of the book is organized. However, some of the lack of details is inevitable as that one has some while to play out…and at the moment it looks like Rost is facing an uphill battle. We do learn that there is or at least was an ongoing criminal investigation into the the Genotropin issue as well as Rost’s civil Qui Tam suit. That may have been public information but I didn’t know about it. But it’s a little like Wayne Rooney writing his autobiography aged 20!

Finally, Rost spends much time going on about how tough it is to be poor–but he was earning $500K a year until recently and must have some stashed away. He also doesn’t tell us how much he got out of Wyeth (and maybe he can’t under that settlement) even though he details in the book that apparently many Wyeth execs had to settle with their local tax authorities at great personal pain.

But in any event the book is mostly about what happened when Pfizer took over Pharmacia, and has some interesting revelations about how Pharmacia may have juiced its earnings to indue Pfizer to overpay. That, of course, wouldn’t exactly have been an unknown act (Enron? Worldcom?)—although Pfizer today is at pains to say that the SEC has already investigated this and found it baseless. Not that corporate America has any sway over the SEC, the DOJ or anything, unless your name is the same as the leader of the Senate’s, or the current President’s!

Other than those quibbles I genuinely found this a terrific page turner. For sure it’s written in a self-sympathetic manner. Well what did you expect? There’s no doubt that Rost enjoys pissing people off, and knows his way around some Internet tracking tools that few corporate suits understand. We also of course don’t hear Pharmacia/Pfizer’s side of the story—but it’s going to be very interesting if they try to explain that Rost was behind the Genotorpin scheme himself. Because their defense must be either that or he’s made the whole thing up. (And if they really are withholding a database of contracts from the DOJ, as Rost says, I assume that they’ll be found out one way or another).

But it’s a great read straight from the horse’s mouth of a guy fighting a massive corporation with the weapons he has at his disposal. And very entertaining too. I know that it will be read alot, especially in the pharma business! And it’s yet more embarrassment for a big corporation that had a knee-jerk reaction to a problem that it could have solved easily by a) coming clean and b) buying off the squeaky wheel.

It reminds a great deal of the Thatcher government that could have got rid of the whole Spycatcher scandal by paying the ex-spy his pension, and instead landed itself in deep doo-doo, while helping the ex-spy turned author Wright sell a ton more books!