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Fraud is bustin' out all over the world of healthcare

Pulling a Fast One

Healthcare fraud is going to cost us. One way or another– through higher taxes, higher medical bills, higher insurance premiums–we’re going to pay.

About $260 billion per year is lost to worldwide healthcare fraud and error, according to Reuters Health.

The Reuters article puts that into perspective by noting that $260 billion would control African malaria for a year, with enough left over to quadruple the budgets of UNICEF and the World Health Organization (WHO).

Which is pretty hilarious because WHO is currently under investigation for what you might call fraud.

Some government representatives in Europe seem to think that drug makers “influenced” WHO officials, who then scared the world half to death with a prediction that an imminent pandemic might wipe out millions of lives.

Yes, we’re talking about swine. And also swine flu, of course.

No one has actually used the word “fraud” yet, but European officials danced all around that word in a resolution that doesn’t spread much love for drug companies.

The resolution claims that drug makers purposely alarmed worldwide governments by manipulating official agencies.

“They have made them squander tight health care resources for inefficient vaccine strategies and needlessly exposed millions of healthy people to the risk of unknown side effects of insufficiently tested vaccines.”

Sounds like someone in Europe has been reading the e-Alert.

Doin’ a dime

Meanwhile, back here at home, fraud is bustin’ out all over.

We’ll start with a good guy–a whistleblower who was once a pharmacist for Omnicare, the largest U.S. provider of pharmacy services to assisted living facilities.

According to the U.S. Attorney in Boston, Johnson & Johnson executives secretly gave millions of dollars to Omnicare. The payback: Omnicare pharmacists allegedly recommended Risperdal–J&J’s schizophrenia drug–for Alzheimer’s patients.

And here’s a nice touch (and by “nice” I mean “unforgivable”): The Risperdal website warns that the drug is not approved for patients with dementia-related psychosis, due to increased risk of death.

Deplorable? Absolutely. But that’s the sort of corrupt behavior we expect from international drug giants. What’s TRULY remarkable is when you get a loner, a genuine loose cannon, who manages to extract boatloads of money from drug companies while publishing pure malarkey in prestigious medical journals.

Let me introduce Dr. Scott Reuben, a Massachusetts anesthesiologist. I’m afraid he can’t shake hands because he’s going to be in handcuffs and shackles for a while. Dr. Reuben recently agreed to plead guilty to healthcare fraud in exchange for a 10-year prison sentence, a fine of a quarter million dollars, and a forfeiture of $50,000 in personal assets.

Impressive!

Here’s what you have to do to earn that level of punishment: Use drug company research grants to publish more than 20 papers based on studies for which you simply make up some or all of the data.

That takes some moxie.

For about 12 years, Dr. Reuben pulled off this outrageous scam while publishing “research” showing favorable results for painkillers, including Bextra and Vioxx. Both of those drugs have since been taken off the market due to increased risk of heart attack and death.

And in a wildly creative moment, Dr. Reuben also provided “evidence” that the antidepressant Effexor was an effective painkiller.

According to an Associated Press report, Dr. Reuben has “expressed regret.” Right. I’m sure it’s the same regret felt at Johnson & Johnson headquarters and the executive suites of WHO–the regret of not getting away with it.

They regret. We pay.

To Your Good Health,

Jenny Thompson

Sources:
“Was Swine Flu a False Pandemic?” Ed Silverman, Pharmalot, 1/4/10, pharmalot.com
“Johnson & Johnson Charged with Kickback Scheme” Ed Silverman, Pharmalot, 1/15/10, pharmalot.com
“Mass. Doctor Accused of Fraud by Faking Research” Rodrique Ngowi, Associated Press, 1/14/10, ap.org

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