More information on drug research and approval

Minnesota disciplines a lower percentage of doctors than most states, however, it is also the only state that allows public access to its records.  Periodically and frequently this data base allows for the collection of some enlightening information.  This week, analysis of Minnesota's public records showed that many of the doctors who are recruited by drug companies to test or market their pharmaceuticals have documented convictions for fraud, reckless conduct, suspended licenses and other problems that would seem to make them ineligible to supervise drug studies.

In this recent study, at least 103 doctors who had been disciplined or sanctioned by the state medical board had received a total of $1.7 million dollars in compensation from drug makers.  The smallest payment was $1250.00; the largest was $479,000.00.  Of the 103, the New York Times reported that 39 were sanctioned for inappropriate prescribing practices, 21 for substance abuse, 12 for sub-standard care and 3 for mismanaging drug studies.  The FDA inspects fewer than one percent of drug trials, but when it approves a drug--usually through a committee dominated by drug manufacturer's representatives--the company becomes immune to suit in Michigan, even where there has been fraud or reckless non-disclosure.         

A prime example of the disciplined doctors was a psychiatrist who was convicted of "reckless, if not willful, desregard for the welfare of 46 patients," five of whom died under his care or immediately after release. His license was suspended and then restricted  for two years.  When he came back to practice, he resumed overseeing drug testing on his patients and was handsomely paid by pharmaceutical companies for doing so.  He claimed to have assisted in the study and approval of Paxil, Prozac, Risperdil, Seroquel, Aoloft and Zyprexa. 

A child psychiatrist who was convicted of fraud involving a Ciba-Geigy study continued to be hired by Eli Lilly for drug marketing until he decided, on his own, that given his reputation, he lacked credibility and was being hired only "to influence his own prescribing habits".  A former drug marketer told the authors of the investigation that manufacturers select phyisicians for marketing and speaking fees solely on the basis of the volume of prescriptions they are able to write.

Another Minneapolis psychiatrist who was criticized and forced to clinical re-training in 1994 told the authors that he was paid more than $350,000.00 over a seven year period (including $314,000 by Eli LIlley) because he is "respected by his peers".  Another, who pleaded guilty in 2003 to Medicaid fraud, collected $63,000.00 in 2004 and 2005.  He described the author's questioning as "ridiculous" and "insulting" and managed to justify prescribing Resperdil in the same way he justified buying his new Mercedes. (The maker of Resperdil paid him $30,000.00 over a two year period.) He concluded by telling the authors "I will pray for you daily."   I guess we should be praying for him, too.