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Since 2008, major pharmaceutical companies have paid $6.5 billion to settle accusations of paying kickbacks and engaging in marketing fraud. The doctors who accept these kickbacks, in return for widely prescribing a particular pharmaceutical (or advocating that it be prescribed for off-label uses) have been named as co-defendants in many of these lawsuits. In the lawsuits that settled in the past 3 years against pharmaceutical companies for this type of marketing fraud, 75 doctors were named as co-defendants. A recent investigation by ProPublica found that not one of these doctors has been disciplined for the instrumental role they played in these fraudulent practices.
The practice of acting as a paid spokesman is one we are all familiar with. Michael Jordan tells us that Hanes makes good underwear, but we all realize that he is being paid by Hanes to do so. For a doctor to use the respected position they enjoy in our society to influence how patients make decisions about their health is to be expected. However, for them do so based on which pharmaceutical company is paying them the biggest kickback, without disclosing those transactions to the patient, is verging on criminal.
We applaud the decisions that have forced drugmakers to pay for the fraudulent marketing schemes they have pursued. However, this fraudulent marketing only works when there are two sides involved: the pharmaceutical company and the doctor. As long as the doctors implicated in these frauds are not disciplined or held accountable, the pharmaceutical companies will continue paying doctors kickbacks to push their products for uses not approved by the FDA, or to patients who would be better served by other medicines. The Justice Department usually pursues these claims based on information provided by “whistleblowers” from the pharmaceutical companies. The drugmakers settle these cases for huge amounts of money, although the sums involved are negligible when compared to the revenues generated by the drugs they are marketing. The doctors, although they seem to be the “small fish” in a case like this, are equally culpable and should be held accountable whenever they are complicit in these fraudulent practices. Without such a precedent being set, the pharma companies will look at these settlements as an acceptable cost of doing business, and find another doctor willing to accept kickbacks. The only way to stop this cycle of fraud is to hold ALL of the guilty parties responsible.