Given the nature of the industry, there is often a lot of collaboration and contact between physicians and Big Pharma; sometimes these conflicts of interest can be quite costly. In the past physicians haven’t gotten in as much trouble as the big companies bribing doctors or providing kickbacks. Going forward physicians may face more severe consequences.
According to a Modern Healthcare report, insiders in health care’s enforcement and legal defense communities expect individual physicians will begin to face more scrutiny. Like just about everything in the health industry, the government’s desire to get health care costs under control is fueling the change.
A recent report in PLOS Medicine revealed that only a small number of physicians actually disclose their conflicts of interest in subsequent journal publications after they had been involved with off-label marketing of pharmaceutical products. Since the companies can’t promote off-label uses of their drugs, they often rely on physicians to do the work for them and pay physicians handsomely for the service.
According to the PLOS article, off-label uses are so important to pharmaceutical companies because some have made more money off a drug for its off-label uses than for its approved uses.
Unfortunately, for the companies, they are more lucrative targets and typically easier to get evidence against, Modern Healthcare reported. In the article, Roderick Thomas, chairman of the white-collar and government investigations practice for Wiley Rein in Washington, D.C., was quoted as saying:
“Even though there have been a lot of high-profile prosecutions and other civil and criminal agreements with companies, the physicians or providers absolutely should not be lulled into believing that they are not targets. It is critically important that physicians have a strong compliance program.”
Companies, though, look to settle cases faster. In early July, GlaxoSmithKline paid a record $3 billion in fines for illegally promoting two drugs for uses they were not approved and for failing to report safety data on another. The company had actually expected the fines to be worse and had set aside even more than $3 billion.
As a part of the government’s attempt to crack down on this area of the industry, the U.S. Department of Health and Human Services made it a requirement in 2008 that payments to doctors be disclosed on the sites of large drug companies. In 2013 all drug companies and devicemakers will need to disclose and publish online those payments, according to a requirement in the Affordable Care Act.
This isn’t the only area where the government is looking to prevent waste in health spending. In October, hospitals with excess readmissions will see their Medicare reimbursements reduced by as much as 1% this year and more in subsequent years.