WHEN IS A CONSULTANCY A KICKBACK?

Department of Justice Picks Up the Knife

Today's NYT has an interesting article about the DOJ's current move toward increased civil and criminal prosecution against physicians--mostly surgeons--who ask for kickbacks from device companies for using their products.

But what is a kickback? And how does one distinguish between what companies and docs might call consultancy arrangements and the DOJ calls criminal behavior? Is it a question of proving purely self-aggrandizing intent--having, in essence, recordings of docs making sweet deals for themselves? And at what point does this become criminal behavior rather than a violation of professional ethics?

Curious minds really do want to know.

http://www.nytimes.com/2009/03/04/health/policy/04doctors.html?emc=tnt&tntemail0=y

FRAUDULENT SLIP

Forest Accused of Fraud re: Celexa and Lexapro

My goodness, we haven't seen the Justice Department this active in pharma cases in a very long time. But after the recent major DOJ actions against Lilly/Zyprexa and Pfizer/Bextra, it looks like Forest's promotion of Celexa/Lexapro (mirror images of the same molecule) is the next target. This according to the New York times, as described here:

http://www.nytimes.com/2009/02/26/business/26drug.html?ref=business

As described in the article, the charges will remind most of us of Paxil--suppressing negative studies on the antidepressant, and particularly regarding its effect on kids. Suicidality appears to be, yet again, part of what remained unreported. And all this in the context of unapproved promotion and, it appears, some whistleblowers within the company.

From the perspective of this observer, it does appear that the Justice Department is reviving itself. This is not to say it has all happened in the last few weeks. Cases like this take years to develop. But perhaps there is a new commitment to actually friggin do something.

Pardon my Scottish.