May 14 2013

ProPublica: Pay to Prescribe? Two Dozen Doctors Named in Novartis Kickback Case

Newswire | Published 14 May 2013, 10:50 am | Comments Off on ProPublica: Pay to Prescribe? Two Dozen Doctors Named in Novartis Kickback Case -

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On Jan. 23, 2008, the pharmaceutical company Novartis threw a party at a restaurant on Long Island. The party, which cost $1,250, was ostensibly for doctors to learn about cardiovascular drugs made by the company, with Novartis sales representatives present as well.

But no doctors ever came, according to a whistleblower lawsuit against Novartis that was unsealed last week. Instead, nine sales reps ran up the tab, and the company wrote an honorarium check to Dr. Robert Nissan, a Long Island family practitioner who wasn’t present, the lawsuit alleges.

The party, the lawsuit maintains, was one of “countless” events held by Novartis over a decade that were designed to direct kickbacks — cash, meals and favors to relatives — to doctors who prescribed the company’s drugs.

Last week, the Department of Justice joined the whistleblower lawsuit, which was originally filed in 2011 by Oswald Bilotta, a former Novartis sales representative on Long Island. “Novartis corrupted the prescription drug dispensing process with multi-million dollar ‘incentive programs’ that targeted doctors who, in exchange for illegal kickbacks, steered patients toward its drugs,” Preet Bharara, the U.S. attorney for the Southern District of New York, said in a statement.

Novartis has disputed the government’s allegations of wrongdoing; Nissan did not return several requests for comment.

Whether such payments by drug companies to physicians are kickbacks or a legitimate marketing and educational practice is a recurring controversy — as ProPublica has extensively reported. Our Dollars for Docs database tracks $2 billion in payments to doctors from 15 drug companies, including Novartis. All but one have settled government lawsuits alleging improper marketing practices.

A number of the doctors named in the Novartis case have received substantial sums since 2009, Dollars for Docs shows, including one physician who was paid more than $150,000 combined from six different drug companies.

Historically, the doctors cited in cases alleging improper marketing have not faced consequences. A ProPublica investigation in 2011 found that none of more than 75 doctors named in lawsuits since 2008 had been sanctioned, despite charges of fraud or conduct that put patients at risk.

Generally, payments like those in Dollars for Docs made for speaking, consulting, travel, meals and other promotional purposes are legal.

Novartis has only publicly reported payments since 2010, when the company pleaded guilty to a misdemeanor and paid $422.5 million to settle charges it had illegally promoted Trileptal, an anti-seizure drug, and had paid kickbacks for prescribing its drugs. Aside from the misdemeanor plea, Novartis denied wrongdoing.

The latest lawsuit is one of two filed last week by the Justice Department against Novartis in U.S. District Court in Manhattan. The company is also accused of paying kickbacks to pharmacies to promote Myfortic, a drug that suppresses the immune system. Novartis — which is bound by a corporate integrity agreement from its 2010 settlement — has disputed the allegations in both cases.

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