What’s It Take? RICO?

George Lundberg, MD, a physician and medical journalist, has a fresh approach to deal with outrageous practices by the pharmaceutical companies, RICO. In an opinion piece in Med Page Today he points out that a $3 billion dollar fine Glaxo Smith Kline (GSK) has agreed to pay is probably a fraction of the profit generated by the no-nos that triggered the fine.

In published reports GSK is said to have poured huge bucks into goodies for doctors, delivered by those well-dressed attractive professionals who whisk into your doc’s office with their sample case in tow, while you wait for hours to see the doc. They have tons of neat stuff, vacations meetings in exotic locations, dinners, speaking engagements with fat fees, prime seats at entertainment events, and on, and on. Of course most of this is out of bounds according to their industry code, but GSK reportedly ignored the rules as some of the pharma giants do.

GSK is said to have used the access thus gained to promote drugs for uses outside FDA approved boundaries. Once a drug is on the market doctors aren’t limited to its approved uses; they can prescribe it for anything they choose. Pharmas take advantage of this loophole to increase sales of their drugs. GSK is said to have pushed this opening to the limits, including in one case urging docs to prescribe a drug not approved for children, teens and young adults because in clinical trials the drug had triggered a small number of this demographic to become suicidal. Adults became suicidal in small numbers on this drug as well. However, suicidal kids and teens are not at all the same thing; they are already too prone to dark thoughts.

Are fines or industry codes going to reduce the level of bribery some pharmas practice? A practice that’s illegal everywhere except New Zealand and the USA. Pharmas pour billions into marketing in America; more than three-quarters of it into an effort to influence the drugs doctors prescribe. To be fair, many docs do not allow the pharma hustlers into their office. But too many welcome them and happily accept their bribes goodies even though they will swear these pharma bribes goodies have no effect on the scripts they write,,,,,, yea, right.

It is obvious that fines do not work; the pharmas look at them as a “cost of doing business.” What is it going to take to put a stop to these outrageous practices? Dr. Lundberg suggests that we recognize this scourge for what it is, racketeering, and go after those responsible –top pharma executives, maybe some docs– under the RICO Act. If these egregious activities threatened to trigger some serious jail time for the “Dons” of the pharmaceutical world, we’re pretty sure they would clean up their act. And we would all be much the better for it.

In fact, if the ethically challenged leaders in several sectors of our economy were to face RICO charges for their shenanigans, we would all be much the better for it.  For openers think LIBOR and rigging bond auctions.