U.S. officials probing payments by drug and device makers to doctors overseas

The New York Times reports that federal officials are investigating whether a dozen drug and device makers "made illegal payments to doctors and health officials in foreign countries." Although pharmaceutical companies routinely contract with doctors in the United States to be consultants, experts say the situation is more complex overseas because "in much of the rest of the world, doctors are government employees. And even consulting arrangements that would be considered routine in the United States might violate the Foreign Corrupt Practices Act, particularly if the payments are outsize or the arrangements are not disclosed to the governments. Of even greater concern to prosecutors in the United States are unusually large payments made to foreign doctors who oversee the growing number of clinical trials that drug and device makers conduct abroad, according to Kirk Ogrosky, a former top federal prosecutor who now represents drug and device makers at a Washington law firm. More than 80 percent of the drugs approved for sale in 2008 involved trials in foreign countries, and 78 percent of all people who participated in clinical trials were enrolled at foreign sites, according to a recent investigation by Daniel R. Levinson, the inspector general of the Department of Health and Human Services. Medical ethicists have long worried that many of these trials are conducted in countries that federal auditors rarely visit and where research controls may be scant" (Harris and Singer, 8/13).

In a separate story, The New York Times also explores "the expanding role of the nation's pharmacists in ways that may benefit their customers and also represent a new source of revenue for the profession. Some health plans are even paying pharmacists to monitor patients taking regular medications for chronic illnesses like diabetes or heart disease. ... At independent drugstores and some national chains like Walgreens and the Medicine Shoppe and even supermarkets like Kroger, pharmacists work with doctors and nurses to care for people with long-term illnesses. They are being enlisted by some health insurers and large employers to address one of the fundamental problems in health care: as many as half of the nation's patients do not take their medications as prescribed, costing nearly $300 billion a year in emergency room visits, hospital stays and other medical expenditures, by some estimates" (Abelson and Singer, 8/13).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.