[e-drug] Drugs companies are defrauding healthcare systems?

["Klara Tisocki" <ktisocki@yahoo.ie>]

E-DRUG: Drugs companies are defrauding healthcare systems?
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I wonder how Big Pharma will try explain away all
this? 

Klara Tisocki

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http://bmj.bmjjournals.com/cgi/content/full/329/7472/940-e
BMJ  2004;329:940 (23 October), Drugs companies are
defrauding healthcare systems, conference hears

London Lynn Eaton 

Pharmaceutical companies are among those deliberately
defrauding healthcare systems throughout Europe, a
conference in London heard this week. 

More than 150 delegates from 20 of the 25 European
Union states attended the two day event looking at
fraud and corruption across the European healthcare
system. Although delegates considered everything from
health tourism (where individuals from one country go
to another to receive free or cheap health care) to
how to identify fraud, a recurring concern was the
blatant fraud by some drug companies. 

"In any country, pharmaceutical fraud is a big
problem," said Marieke Koken-Vossestein, head of the
department of claim control at the Zorgverzekeraars
Nederland (a Dutch department that develops antifraud
policies across all health insurance schemes in the
Netherlands). 

The fraud can range from doctors claiming for work
they have not done through to drug companies who bribe
doctors by paying them for switching patients to a new
drug. 

Professor Peter Schonhofer of the Institute of
Pharmacology, Bremen, said the fraud included not
being able to view data from clinical trials submitted
to the German regulatory body, the Federal Institute
of Drugs and Medicinal Products. 

"If they have information they don't tell us it," he
told the BMJ. "We don't have access to relevant data."

That could mean therapeutic decisions were
inappropriate - but because the relevant data were
covered by a commercial confidentiality clause, those
outside the institute could never know how appropriate
the treatment was. 

He also cited what is euphemistically called a "drug
use study," whereby a doctor is paid anything from
Euro 200 to 500 for transferring a patient
from one drug to another and then filling in a form to
say what they have done. 

"We know that the pharmaceutical industry in Germany
has spent 1bn a year for such drug use studies. And
it is not just in Germany. In Italy, GSK
[GlaxoSmithKline] spent 28m over a 12 year period
just for doctors to provide a signature." 

State investigations of bribery by drug companies are
becoming increasingly common, with two cases in the
last year alone (BMJ 2004;328:1333). 

In the United Kingdom tighter antifraud measures have
led to ongoing legal action against the manufacturers
of warfarin and penicillin. 

Jim Gee, chief executive of the Department of Health's
NHS Counter Fraud and Security Management Service,
said they had evidence to suggest the existence of a
price fixing cartel. Six pharmaceutical companies are
allegedly involved in fixing the price of warfarin,
costing the NHS #28m; seven are allegedly involved in
keeping the price of penicillin high, costing the NHS
#30m. 

The Serious Fraud Office has yet to decide whether
criminal action should be pursued on these cases, and
the civil cases have yet to be heard. 

The NHS Counter Fraud Service is also pursuing a
further #100m for alleged price fixing of a generic
version (ranitidine) of Zantac when the patent for
that drug expired. 

"Clearly these companies operate in the other
countries too," Mr Gee said, suggesting that other
European countries might also have been similarly
defrauded. 

Mr Gee said the NHS had done a great deal to try to
tackle fraud and that although other countries had
health insurance based systems, from what those
delegates had told him, the level of fraud was as bad,
if not worse.