Former drug-company rep alleges systemic fraud

[babylonsister]

Blowing the Whistle, Many Times

By MARY WILLIAMS WALSH
Published: November 18, 2007


WHEN Cynthia Fitzgerald started out in pharmaceutical sales 20 years ago, she received ample training on the right and wrong ways to sell medical products. Right was selling on the merits. Wrong was luring customers with perks and freebies. It was O.K. to buy doctors lunch or dinner, for example, but tempting them with lavish gifts was taboo.

“There were pretty stringent rules back then,” recalls Ms. Fitzgerald, now 50 and a grandmother living in Dallas. “It was really clinically driven.”

But she says those early lessons didn’t serve her so well when she went to work on the other side of the table in 1998, in health care purchasing. Going by the book, and expecting her colleagues and employer to do the same, cost her a job, most of her friendships and several years of her life, she says.

Eventually, Ms. Fitzgerald decided to file what could become one of the largest whistle-blower lawsuits on record. And her case, which names more than a dozen companies as defendants — some with well-known names like Johnson & Johnson, Becton Dickinson and Merck — offers a window onto a little-known world, where billions of dollars’ worth of medical products are sold each year to institutional buyers like hospitals.

The suit, filed in 2003 in federal court in Dallas, and unsealed this year, argues that improper sales practices, together with erroneous accounting, are invisibly draining millions of dollars out of vital public programs like Medicare through overcharges or unauthorized uses. While whistle-blower cases typically involve, at most, a handful of companies, Ms. Fitzgerald’s alleges systemic fraud across a whole network of companies and more than 7,000 health care institutions.

Her contentions are set against a complex backdrop: spiraling health care costs and debates about Medicare. State and federal authorities in Texas are investigating Ms. Fitzgerald’s allegations, and any decision by them to join her case may give the suit momentum in the courts. But her corporate adversaries dispute her accusations.

more...

http://www.nytimes.com/2007/11/18/business/18whistle.html

[Faux pas]

1. Blessed are the whistle-blowers. n/t

[TahitiNut]

6. Whistle-blowers lose friends, jobs, and employability. They're (we're) lepers in the job market.

It's almost like a combination of many of the hyper-reactive things we see on DU regarding Nader, Code Pink, Cindy Sheehan, and Cynthia McKinney. Co-workers distance themselves from a whistle-blower like it's a contagious disease - and then rationalize that aversion. All of a sudden, the whistle-blower is held to standards against which nobody else is held. They're "rocking the boat" and "too negative" and "making mountains out of molehills" and not "being a team player" and "not being realistic." Co-workers find themselves in the position of being able to curry favor with a boss ... just by feeding into the file that's invariably opened. After losing the job, the whistle-blower finds job openings where initial enthusiasm suddenly evaporates - without credible explanation. If the whistle-blower job-seeker pays an agency to do surreptitious reference-checking (pretending to be a potential employer), s/he'll be amazed to discover folks who seemed very supportive (remaining at the place of former employment) are back-stabbing. Human resources personnel strangely adopt a "by the book" closed-mouthedness and, if asked about the eligibility of the former employee for re-hire will happily say "no, they're not eligible for rehire." (This is one of the cracks in the legal system - it's not actionable, so far.)

It's one of the more important areas for the creation of far more extensive legal protections and safety-nets, imho. The realities of the job market are far different than generally assumed - and the legal 'protections' are anything but.

[Faux pas]

31. It's so disgusting (and disappointing) that the system is set up

to protect the wicked. I think the whistle-blowers of the world should be given medals and treated like heroes.

[Vincardog]

2. Good luck getting "authorities in Texas" to do anything other than kissing Corporate a$$.

[Selatius]

13. I doubt the situation is much better in any other state of the Union. Big PhRMA is immense in size

It operates in every region of the country, so their influence likely extends into most if not all state legislatures in this nation. They've got the resources to keep this lawsuit tied up in court proceedings for years.

[Vincardog]

15. The SCO Texas has a way of illegally ruling on the facts of the case in favor of Corporations. The

legislature of Texas is almost as corrupt. I can think of few other states where it is this blatant.

[HCE SuiGeneris]

3. Brave soul. I hope she stays safe. n/t

[knitter4democracy]

4. All right! I hope this blows all that crap wide open!

I hate all the drug rep crap Hubby brings home for the kids (he doesn't like keeping it in the office). I hope it means fewer drug rep visits he has to manage to avoid (he checks the schedule and then conveniently is rounding at the hospital during those times). I have sat in enough doctors' waiting rooms in this last year to have seen more than my fair share of reps--what gives? How many do they need? I hate all the ads in the journals, too. Really annoying.

[blondeatlast]

22. Ugh--I can relate. The other day I shared my longtime PCP's waiting room with

THREE drug reps. I could hardly contain my contempt, I really couldn't.

Is your husband familiar with this group? Alas, none of my doctors are too keen on this, but I keep hoping:

http://www.nofreelunch.org/

[knitter4democracy]

27. Yes, but he feels like the lunches are really for the staff, so . . .

He sometimes grabs food from them and dashes, but he figures the drug rep lunches for the office are really for the staff, and they wouldn't like to give that up. I don't blame them, really.

Hubby's favorite question for any drug rep is how it's different on the molecular level from its rival or how it works on the cellular level. He and one of the partners teamed up on one of the gals one day when she obviously didn't understand what she was selling and explained how everything in that class work, how hers was only a smidgen different and barely even that, and she actually thanked them, saying her company almost never really explained how any of the drugs worked or how they were different from their competitors. After that, Hubby does more to stay away from them--he figures if he knows more than they do about the drugs, then it's a waste of everyone's time for him to pretend to listen.

[blondeatlast]

29. Sounds as if he's got the goods on them. May as well take them for all their worth if

he isn't influenced by them and it appears he isn't. That's good to hear.

My sister is a pharmacist and she tells me all kinds of things about how Big Pharma works--not of course, the pharmacists don't prescribe so they are lucky to get a pen once in a while!

[knitter4democracy]

30. I'm surprised they mess with him--he always prescribes generic.

He rarely prescribes the new one over the older, more known one. So, he's a lost cause for them, but they keep trying. Heck, they send crap to the house, too. Flyers, books, pamphelets, all doubles of what they send to the office. Very annoying. I can't imagine how much money they waste on just postage.

[williesgirl]

5. Send this to KO so he can publicize it. rec'd

[Richard Steele]

7. K&R

[annabanana]

8. "corporate adversaries dispute her accusations"

I'll just bet they are. They probably shouldn't worry. Their lobbyists are the hardest working grifters in DC. Their bucks are in everybody's pockets.

[lovuian]

9. Making money off the Sick is the lowest form of beings

America is fed up
Universal Health

[varkam]

10. It's an interesting fact about whistle-blowers that....

...they are almost never liked when they're blowing on the whistle.

K&R. This is an important story.

[flashl]

11. K&R n/t

[Kurovski]

12. K&R.

'For her part, Ms. Fitzgerald bristles at the idea that her lawsuit is without merit or, in response to common critiques of whistle-blower cases, about easy money. “I thought they were really nice people,” she says. “I was so grateful and thankful to have a steady income again. I wouldn’t have rocked the boat for any small thing to save my life.”

So why did she rock the boat?

“It was wrong,” she says of the behavior she asserts she has witnessed. “And I knew it was wrong.”'

[MasonJar]

14. Oh, I'm sure that the state of Texas authorities and the federal authorities

are going to enter this suit. Oh, sure.

[BlueIris]

16. Pharmageddon, here we come!

[L0oniX]

17. Damn drug dealers

[Not Sure]

18. My wife blew the whistle on a large hospital

in Texas a few years ago. It nearly cost her a career in health information (she was able to find *one* job, so I have to say "nearly"). At the time she didn't want to do it, but after weeks of worry, her conscience couldn't take it anymore. Funny thing is, just the other day a little blip appeared on the news touching on this same hospital and the systemic fraud she alerted authorities to.

You want to see fraud and corruption, look no further than our current system. After what I've heard from my wife over the years, I can tell you anyone you hear about who sounds anything like Cynthia Fitzgerald is telling the truth. Everyone in the hospital business knows each other in a particular region and only if you're willing to move and start over (and in some cases, not even then because the consulting companies and even the hospital chains spread the word real quick) will you have a chance at continuing your career after blowing the whistle. I guarantee you nobody does it big like this in the hospital business over an affair or a personal grudge. It takes some commitment to stand up to these people who will lie you into oblivion to shut you up. Why? Because they're guilty as hell. "We'll look into it." "You have our support." "Thank you for your input." It doesn't take a private eye to find examples of rampant fraud in nearly any hospital, just someone with access to and familiarity with the data. I know my wife hates to see fraud anymore, because (and how's this for cynical?) she knows she is obligated to report it. Employers know she won't hesitate to do it either, so only those hospitals out of loop will hire her. It's pretty effed up knowing that's how it works. I guess the same is true in my line of work. I haven't been to a construction site in 15 years that didn't have less than a million dollars worth of fines coming to them for unreported EPA violations. But get the EPA to show up to a violator's site, heh, good luck!

The cure for this crap? Universal health care. F the insurance companies, just give me what they get north of the border. Whatever candidate champions it as close as possible to Canada's system, whether they are incompetent on every level but that one, whether they belong to the Democratic party, Libertarian, Communist or Republican parties, I don't care. Universal health care is my only issue at the end of the day.

Anyway, I know to some extent what Ms. Fitzgerald is up against, particularly in north Texas. This whole region is a money machine that chews up and spits out the Cynthia Fitzgeralds of the world. I'm sure we can expect a hit piece in the local rags to counter this story. Whatever the spin that gets put on it, I just hope everything is uncovered and the money gets taken out of the pockets of a few and put back where it belongs. It may not be a cure, but it would be one hell of a start.

[RevolutionStartsNow]

19. My dad spent his whole career as a pharma rep, and he says...

the whole system was a scam. I don't know why he never quit (it was all he was trained to do), but he was happy to retire early when he had a disability.

He values the friendships he made with doctors and pharmacists, but he knew he was peddling crap most of the time, and way overpriced crap at that.

[knitter4democracy]

28. I know a journal he'd love to get:

Placebo Journal! In an earlier issue a couple of years back, he had the Day in the Life of an Almost-Retired Drug Rep. Freakin' hilarious, so he made it into a poster. Hubby has several of the posters for his desk in the doctors' office area. :)

http://www.placebojournal.com

[lame54]

20. Thanks babylonsister

another great post. Just another reason for universal health care. Maybe then Pharma will get back to real research for drugs that actually cure or help serious disease. All they are doing now is making mega bucks producing all the "me too feel good drugs". These drugs do more damage with their side effects than good. Just watch any commercial for the various "feel good " or "male performance enhancement" and listen to the warnings (pretty scary shit). I have a son with a rare autoimmune disease and the medication used to control, (notice I said control not cure) was patented in the 50's. Why is there so little research being done to actually cure real diseases? Because we left it to the Corporate "free" market to decide. The time has come to take the "free" market out of our health care equation. It is costing us more than money, we are sacrificing our sick loved ones to them.
lame's wife

[redqueen]

21. Let's hope this goes somewhere.

These corporations have been given free reign too long. They're like big fat leeches that need to be removed.

[windoe]

23. Pharma/AMA/Insurance Company

alliances need to be broken. I worked in hospitals since the mid 70's and saw managements change during the Reagan administration. All of a sudden workers were being told the the 'bed count' was up or down, as an exuse not to give us the usual cost of living raise, and to reduce staff. More and more administrators were business majors, without any hospital experience, so they saw us workers as just numbers on a graph. They cut cost in machine maitenance, started hiring agency nurses and lab techs and part timers so they didn't have to pay benefits, fired all the vested experienced workers before their retirement came. This is how private hospitals are run now. All the money people are paying for their healthcare rises to the top to pay the salaries of these administrators, and they waste it making the hospitals look shiny. Doctors used to be administrators too, and controlled standards of care of the hospital. Now they often work under outside contract so they have little say in the way hospital departments are run.
Government and university hospitals have much more oversight and standardization of salaries, but they have suffered too.
It is sad to see all the millions of dollars made in healthcare get funneled away from the people who actually save lives. This is yet another facet of the healthcare crisis we are in and it would not take much to remedy it.

[BreweryYardRat]

24. My Pharmacology for Non-Med Students prof had similar stories from colleagues who were in sales.

I believe her.

[midlife_mo_Jo]

25. Thanks for posting, and bumped for later reading!

[flashl]

26. Should Ms. Fitzgerald suceed, let's hope its better than recent cases ...

Offer to settle Vioxx lawsuits comes with restrictions

Merck & Co.'s $4.85 billion offer last week to settle claims against it over the ill effects of Vioxx will do more than stabilize the future of the big pharmaceutical company, an Oklahoma City attorney said Tuesday.

If the settlement deal proceeds, it will benefit thousands of people whose health was harmed by taking the pain killer before it was yanked from the market in 2004, said William Federman, an attorney representing 129 clients in Oklahoma and elsewhere with personal injury claims over Vioxx.

Without the deal, he said, his clients and thousands of others across the nation faced years of court battles to recover damages after suffering ill effects when taking Vioxx.

Purdue execs plead guilty to OxyContin fraud

According to The New York Times, the parent company of Purdue Pharma has agreed to pay more than $600 million in fines to resolve claims that it fraudulently marketed OxyContin as a painkiller less prone to abuse with fewer side effects. In addition, three current and former executives of Purdue, including its president, have agreed to plead guilty to criminal charges of misbranding the drug. Federal officials told The New York Times that Purdue executives admitted that sales people were allowed to come up with their own fake scientific charts to back up false assertions that the drug was less prone to abuse than competitors on the market. Company President Michael Friedman has agreed to pay a $19 million fine, attorney Howard Udell will pay $8 million and former medical director Dr. Paul Goldenheim will pay $7.5 million.

In BOTH instances, the public got precious little for the drug-peddlers harm.