Drug company targets US state health officials

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http://bmj.bmjjournals.com/cgi/content/full/328/7435/306

 

BMJ 2004;328:306 (7 February), doi:10.1136/bmj.328.7435.306

 

Drug company targets US state health officials

Washington Ray Moynihan

 

 

 

A major pharmaceutical company has sought to influence state government

officials with trips, perks, lavish meals, and other payments, says an

investigator from the Pennsylvania Office of Inspector General.

Investigator Allen Jones told the BMJ earlier this week that he had discovered

that the drug company Janssen was sponsoring educational events for state

employees, funding individuals’ travel arrangements, and paying honorariums of

up to $2000 (£1100; €1610) each to key officials who held influence over the

drugs prescribed in state-run prisons and mental hospitals.

Yet as his investigations widened, Mr Jones was dropped from the case and told

by a manager that " drug companies write cheques to politicians " on both sides of

politics. Mr Jones subsequently started legal action, accusing his employer of

trying to bury important evidence of wrongdoing. Although no formal report has

been released, many of his findings were reported in the New York Times last

Sunday (p BU1).

Janssen is the subsidiary of healthcare giant Johnson & Johnson that markets

risperidone, the atypical antipsychotic medication widely used in the treatment

of schizophrenia.

Along with other drug companies that make new antipsychotics, in the late 1990s

Janssen funded the development of state based guidelines for the treatment of

schizophrenia, heavily favouring the newer more expensive medications over older

cheaper ones. The guidelines, initiated first in the Texas prison and

psychiatric systems, are currently being adopted in other states, including

Pennsylvania.

A spokesman for Janssen, Doug Arbesfeld, confirmed to the BMJ that the company

had made payments to state officials and helped to sponsor the guidelines, but

he flatly rejected claims that the company was seeking influence. " We provided

funding to the Texas Department of Mental Health so their officials and

physicians could share their experience with the guidelines in other

states—professional to professional. " Referring to the scientific debate about

the relative merits of the newer versus older drugs, Mr Arbesfeld said some

guideline groups were more aggressive in their support for the new medications,

and some more conservative, but the Texas guideline was somewhere in the middle.

In 2002 the journal Psychiatric Services published an article comparing four

different schizophrenia guidelines, concluding that the Texas medication

algorithm project was the easiest to use, but far less scientifically rigorous

than two of the others (Psychiatric Services 2000;53:888-90).

A spokesperson for the Office of Inspector General could offer the BMJ no

comment on allegations of improper influence or on why Mr Jones was dropped from

the case. However, Stephanie Suran, from the Pennsylvania Department of Public

Welfare, although defending the guidelines as being good for patient care, said

the allegations of improper influence were now before the state Ethics

Commission.

Federal health authorities are also understood to be investigating, and Janssen

last week received a subpoena for documents relating to risperidone.

 

 

 

 

 

 

 

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