The pharmaceutical trade group PhRMA has guidelines in their code that suggest no gifts should be provided for the personal benefit of the healthcare provider.
Pharmaceutical companies can legally market their products to doctors, but it’s essential for healthcare providers and pharmaceutical employees to know when and how marketing becomes bribery.
Attorney James D. Young has extensive experience working with whistleblowers, and has seen first-hand the challenges that healthcare professionals can face when speaking out against fraud.
In this interview, James offers his insights into Big Pharma’s payments to doctors and how healthcare workers can stay alert to potential pharmaceutical misconduct.
Pharmaceutical companies can legally offer meals, speaker fees and certain other payments to doctors. Under what circumstances might these payments constitute fraud?
“When these benefits are provided in order to induce prescribing, they might be deemed kickbacks. The AMA has guidance which suggests no gifts should be accepted if there are strings attached.
Also, the pharmaceutical trade group PhRMA has guidelines in their code that suggest no gifts should be provided for the personal benefit of the healthcare provider.”
What types of red flags could alert healthcare providers to pharmaceutical fraud?
“Obviously, cash payments could be a sign of fraud.
Deception in the form of false clinical study results or false regulatory approvals is another sure sign of fraud.”
What kinds of evidence would someone need to report pharmaceutical fraud in their workplace?
“More evidence is always better. Historically Drug Reps would leave behind written materials for offices to mull over. Over time they transitioned to displaying the information via an iPad or computer to eliminate the evidence trail.
Receipts and proof of payments are good, and photos, even from social media, can be quite useful in connecting misdeeds or corruption.
Anything connecting the fraud to the submission of claims for government insured patients is crucial. At the end of the day, there is no clear definition of what is required, which is why we prefer to work with whistleblowers early on in order to develop with them the specifics of the case and the evidentiary needs.”
In your experience working with healthcare whistleblowers, what are the particular challenges of speaking out against pharmaceutical companies?
“Blackballing is not a myth. It can be quite difficult to find employment within the pharma world once your name is connected to a qui tam or whistleblower case.
Retaliation is also quite [common] in reaction to questioning whether your company may be violating any laws or rules.”
When pharmaceutical companies are sued by the government for alleged fraud, are they required to reform in any way?
“Almost every successful resolution of a health fraud case against a drug company involves serious changes to their behavior in the form of Corporate Integrity Agreements or CIAs.
Sometimes these agreements can fundamentally alter the ways the company markets its products, but often the agreements are mere window dressing which come well after the fraud has occurred.”
Learn more about pharmaceutical fraud here, or contact us to report fraud safely and confidentially.
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