Midwest Health Journalism Program fellow Jim Doyle, a reporter at the St. Louis Post-Dispatch, tells the story of Forest Pharmaceuticals (a subsidiary of Forest Laboratories), which has been accused by federal regulators of sketchy marketing practices, primarily involving its antidepressants Celexa and Lexapro and unapproved pediatric use. The company has pleaded guilty to federal criminal charges and agreed to pay $300 million in criminal and civil penalties, Doyle reports.
Responding to questions on Ms. Coleman’s behalf Monday, Kelly E. Cunningham, a spokeswoman for the university, said the president satisfied the policy by disclosing her outside work. Ms. Coleman has never had to recuse herself from any discussion or action at the university because medical purchasing and investment decisions are so remote from her, Ms. Cunningham said.
“The same is true at J&J,” she added. “There has never been a discussion or decision at the board level that involved something related to the UM. But, of course, if there were, she would recuse herself.”
It’s not uncommon for university presidents to sit on corporate boards, Wilson found, but it appears that pharmaceutical companies are a special case given the major role universities play in medical research and health care delivery.
Thomas Donaldson, a corporate governance expert and professor of business ethics at the Wharton School of the University of Pennsylvania, reviewed the case on Monday for The Times. He said many university presidents serve on corporate boards, but biomedical company boards pose special issues because of the possible ties to university research and medical schools.
“Because of the role of research and also the entrepreneurial interest that lies behind a lot of modern advances in medicine, this is a very difficult issue,” Professor Donaldson said in a telephone interview. “We’ve been aware for decades really that this potential for conflict of interest exists, but we haven’t as a moral community or even inside universities gotten our arms around it yet.”
The group’s state chapters – except for Alabama, Arizona, Connecticut and Hawaii – reported their own donations to Grassley, he wrote in a letter to NAMI’s executive director and president of the board of directors. According to the letter, the California chapter received $632,000 in contributions between January 2005 and October 2009, the most of any state. Ohio NAMI received $623,000 and New York NAMI $448,000. The top ten states received a total of $3.84 million.
Again, Heisel focuses on the deposition of Wyeth ghostwriter Karen Mittleman and related documents and memorandums. He lists the names of some key ghostwriters to look out for, then details a number of specific cases when production and marketing concerns clearly outweighed science, at least as far as the pharmaceutical manufacturers were concerned.
Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.
Pfizer and Lilly lead a parade of U.S. companies that have paid $7 billion in penalties after promoting drugs for uses not approved by the FDA. This unlawful behavior may not end until prosecutors force a drugmaker into bankruptcy.
Even as prosecutors extract promises from the companies’ lawyers to never market off-label uses again, the pharmaceutical giants are doing just that because the revenue is so much greater than the penalties.
Harvard professor Jerry Avorn says “Marketing departments of many drug companies don’t respect any boundaries of professionalism or the law.”
Evans breaks down the numbers to show why drugmakers see off-label prescribing as so essential. He also talks to a former “medical liaison” with Warner-Lambert who grew concerned about his own role in pushing potentially harmful uses of drugs and filed a lawsuit against the company.
He writes that “prosecutors and judges have been unwilling to use the ultimate sanction – a felony conviction that would render a company’s drugs ineligible for reimbursement by state health programs and federal Medicare.” That, as one prosecuter says, is “potentially a death sentence for a drug company.”
Pierce’s piece can be divided into three sections, each illuminating and alarming in its own way: How this crew of insiders pushed the envelope to force through Part D in 2003 (Hint: A legendary abuse of the legislative process helped), how they’ve returned and who’s paying them (see a nifty chart of those connections here), and what they’re up to this time around (more of the same, only this time they’re wealthier).
Alongside Pierce’s story, she and ProPublica have launched “Eye on the Health Care Reform,” a feature in which Pierce will keep up with the reform effort’s legislative journey.