Home Page >>
News Articles >> Psychotropic Drug Makers Bankroll Prescr..
Psychotropic Drug Makers Bankroll Prescribing Shrinks Part I
Washington, DC: On August 21, 2007,
the Associated Press reported that drug companies spend a lot of money
on the members of Minnesota advisory panels who help select the drugs
which are to be used by patients covered by Medicaid.
The news agency's review of financial disclosure records in Minnesota
found that a doctor and a pharmacist on the 8-member panel
simultaneously received large checks from drug companies for speaking
about their products.
According to the report, Minneapolis psychiatrist John Simon, appointed
to the panel in 2004, earned $354,700 from drug makers that included
Eli Lilly and AstraZeneca, from 2004 to 2006, in honoraria, speaker and
consulting fees, as well as other payments ranging from $500 to
records also showed that Robert Straka, a University of Minnesota
pharmacy professor, was paid $78,000 by drug companies while he served
on the panel from 2000 to 2006. He told the Associated Press that he
was paid for "educational talks" and that he routinely discloses his
ties with drug companies and did so as a panel member, both verbally
and in writing.
But according to information obtained with a public records request by
the AP, there is no indication that Mr Straka made any such disclosures
in meeting minutes dating back to February 2001, and other panel
members and staff interviewed by the AP could not remember Mr Straka
making any such disclosures either.
The Associated Press reported that roughly a third of the drugs on
Minnesota's preferred drug list were sold by companies which paid Mr
Simon or Mr Straka, but the news agency could not track any link
between the payments and their votes because the minutes from the
advisory panel meetings did not record how the 8 members voted.
The top-selling drugs prescribed to Minnesota Medicaid patients for the
years 2000 through 2006 included the atypical antipsychotic drugs
Zyprexa, marketed by Eli Lilly; Seroquel, sold by AstraZeneca;
Risperdal, marketed by Johnson & Johnson subsidiary Janssen;
Geodon, sold by Pfizer, and Abilify, from Bristol-Myers Squibb.
These drugs were originally FDA-approved for the limited use of
treating adults with schizophrenia or the manic phase of bipolar
disorder. However, the massive over-prescribing of this enormously
expensive class of drugs for unapproved uses has caused many states to
remove them from the Medicaid preferred drugs lists and requires
doctors to obtain prior authorization before prescribing them to
In fact, roughly 10 states are now suing several atypical makers for
Medicaid fraud to recoup the cost of purchasing the antipsychotics
prescribed off-label to Medicaid patients and also to recover the money
paid for medical care of the persons injured by the drugs.
The lawsuits allege that the drug makers illegally influenced doctors
to prescribe the drugs off-label to patients of all ages, for
conditions such as behavior and mood disorders, eating disorders,
anxiety, post traumatic stress disorder, insomnia, PMS, dementia, and
many other unapproved indications, and concealed the adverse effects
associated with the drugs.
The atypical makers are also facing tens of thousands of lawsuits filed
by patients, private insurance carriers and company shareholders for
According to Lilly's August 6, 2007, SEC filing, since August 2006,
Lilly has received civil investigative demands or subpoenas from a
number of states. "Most of these requests are now part of a multistate
investigative effort being coordinated by an executive committee of
attorneys general," the filing states.
"We are aware that approximately 30 states," Lilly wrote, "are
participating in this joint effort, and it is possible that additional
states will join the investigation."
The filing notes that the attorneys general are seeking a broad range
of Zyprexa documents, "including documents relating to sales, marketing
and promotional practices, and remuneration of health care providers."
Presumably, that would also include the "remuneration" of Minnesota
shrinks like Dr Simon. According to the August 27, 2007, Pioneer Press,
since 2002, Dr Simon has received more than $570,000 from six drug
makers, with most of the money coming from Eli Lilly, "whose
antipsychotic drug Zyprexa is the most costly each year for Minnesota's
fee-for-service health program for the poor and disabled," the article
In fact, Lilly's disclosure records for 2004 show payments to Dr Simon
totaling a whopping $91,854.95 in that one year, and he also received
another couple grand from Seroquel maker AstraZeneca.
Dr Simon told the Pioneer Press that companies pay him to speak about
their drugs at conferences and clinics or about the conditions that are
treated with the drugs. "Most of the psychiatrists who are really
good," he said, "have ties to industry."
Whether Dr Simon is a "really good" psychiatrist is certainly open to
debate. In 1997, the state medical board made him complete a clinical
training program and issued a report which said that Dr Simon,
"frequently makes abrupt and drastic changes in type and dosage of
medication which seem erratic, not well considered and poorly
integrated with nonmedication strategies."
The board also noted that Dr Simon prescribed addictive drugs to
addicts and failed to stop giving medicines to patients when they were
suffering severe drug side effects. He said in an interview with the
Times that the board's action was a learning experience and that drug
makers continued to hire him to speak because he was respected by his
For years, Dr Simon reportedly shared an office with another "really
good" psychiatrist by the name of Dr Faruk Abuzzahab. On June 3, 2007,
Gardiner Harris and Janet Roberts published a story in the New York
Times with the headline: "After Sanctions, Doctors Get Drug Company
Pay," and stated:
A decade ago, the Minnesota Board of Medical Practice accused Dr. Faruk
Abuzzahab of a "reckless, if not willful, disregard" for the welfare of
46 patients, 5 of whom died in his care or shortly afterward. The board
suspended his license for seven months and restricted it for two years
Over the past 20 years, this "really good" psychiatrist has repeatedly
prescribed narcotics and other controlled substances to addicts and
prescribed narcotics to pregnant women, one of whom delivered a baby
prematurely that died, the board found.
The Times reports that separately, in 1979 and 1984, the FDA concluded
that Dr Abuzzahab had violated the protocols of every study that the
agency audited and that he reported inaccurate data to drug makers.
The FDA said he routinely oversaw 4 to 8 trials at the same time, moved
patients from one study to another, gave experimental drugs to patients
at their first consultation and once hospitalized a patient for the
sole purpose of enrolling him in a study.
As recently as June 2006, the medical board criticized Dr Abuzzahab
once again for writing prescriptions for narcotics and this time to
patients he knew were using false names, according to the Times.
All that said, Dr Abuzzahab told the Times that he has helped study
many popular psychiatric drugs, including Lilly's Zyprexa and Prozac,
Janssen's Risperdal, AstraZeneca's Seroquel, Glaxo's Paxil and Pfizer's
A review of the Minnesota disclosure records for 2004 show that the
drug makers apparently thought it was beneficial to keep paying big
bucks to Dr Abuzzahab. Glaxo paid him $1,000, Pfizer gave him $750, and
Wyeth forked over $18,084, in that year alone.
In 2003, psychiatrist Dr Ronald Hardrict pleaded guilty to Medicaid
fraud. But a little charge like fraud apparently did not effect this
Minnesota psychiatrist's earning power either. The very next year,
disclosure records for 2004 show Risperdal maker Janssen paid him
$10,000; Seroquel maker AstraZeneca gave $1,250; Abbott Labs paid him
over $7500; Glaxo paid $1,500, and Wyeth forked over $8,846.
In reviewing the Minnesota disclosure records for 2004, the name Dr
Dean Knudson kept popping up. A September 2004 Newsletter from the Ada
Canyon Medical Education Consortium listed Dr Knudson as an associate
professor of psychiatry at the University of Minnesota Medical School.
He must be a "really good" psychiatrist, too, because in 2004 alone,
Lilly paid him close to $37,000; he earned nearly $2,750 from Pfizer;
Seroquel maker AstraZeneca paid him $6,700; Janssen forked over $3750;
Wyeth paid him $11,632, and he received $2,082 from Abbott. Lilly's
2003 forms also show another $8,740 paid to Dr Knudson.
The newsletter showed that Dr Knudson was paid to give educational
presentations on dementia. On October 18, 2005, the Associated Press
reported a study that showed atypicals used to treat elderly patients
with dementia raised their risk of death.
For the study, the researchers pooled the results of 15 studies on the
atypicals Zyprexa, Risperdal, Seroquel and Abilify and among more than
5,000 dementia patients, those taking any of the four drugs faced a 54%
increased risk of dying within 12 weeks of starting the drugs, compared
to patients taking placebos.
Another name that jumps out in the 2004 disclosure records is Dr David
Adson. According to the August 20, 2007, Pioneer Press, Dr Adson, of
the University of Minnesota, also has a state advisory role as the
clinical leader of a program funded by Lilly and provided free of
charge to Minnesota, which notifies doctors when their prescriptions
for psychiatric drugs are out of line with clinical standards.
Although the program is funded by Lilly, it is supposedly run by an
independent company called Comprehensive NeuroScience, Inc. All
totaled, 20 states have contracts with CNS to identify doctors "who are
prescribing psychiatric drugs outside of recommended guidelines for
safety and effectiveness," according to the Press.
Critics say the program is actually a scam set up with state policy
makers to make sure the expensive psychiatric drugs remain on the
Medicaid covered drug lists instead of being placed on the lists that
require prior authorization.
Ben Hansen, a member of the Michigan Department of Community Health
Recipient Rights Advisory Committee, has been investigating the
atypical makers' involvement in the Medicaid programs in Michigan and
other states and says that none of the states with CNS contracts
require prior authorization for the atypical drugs.
Mr Hansen published some of the results of his investigation in the
Spring 2007 Newsletter of the International Center for the Study of
Psychiatry and Psychology. By using the FOIA, Mr Hansen says he has
obtained nearly a thousand pages of documents which show that Medicaid
is being "milked like a huge cash cow."
According to Allen Jones, a former Medicaid fraud investigator, the
long list of corporate sponsors for CNS includes: AstraZeneca, Janssen,
Bristol-Myers, Pfizer, Lilly and Glaxo.
Back in 2002, Mr Jones found that Janssen was using CNS to funnel
payments to state officials who controlled the Medicaid preferred drug
lists in Pennsylvania to ensure that Risperdal would be on the list.
For his part, the leader of the Minnesota CNS program, Dr Adson, was
paid $5,200 by AstraZeneca, Glaxo shows $331,947 going to him, and
Pfizer gave him $1,000, in 2004 alone.
Also, in 2006, Dr Adson received $83,325 from AstraZeneca and roughly
$6,100 from Bristol-Myers, according to a compilation of disclosure
forms by the Pioneer Press and the watchdog group Public Citizen.
Legal Help If your child has been over prescribed drugs, please contact a lawyer involved in a possible [Lawsuit] who will review your case at no cost or obligation.
Search 10,000 recent
cases and settlements