Speaker Program Kickbacks: When Physicians Break the Law by Speaking for Pharmaceutical Manufacturers

Every single day across the country, physicians receive large speakers’ honoraria checks from pharmaceutical and medical device companies. These funds compensate the physicians for speaking at “educational programs,” intended to educate other healthcare providers about the latest and greatest science underlying particular drugs and devices. However, when these speaking engagements are nothing more than sham events intended to bribe prescribers, the federal Anti-Kickback Statute and the False Claims Act are violated, potentially triggering liability for both the speaker and the manufacturer.

The line between bona fide and sham speaker programs is not always clear. Some factors to consider are:

  • Do the programs truly have educational value to the attendees?
  • Are company-approved PowerPoint slides presented at the events?
  • Are the events are held at venues that are conducive to an education program (e.g., in sports bars, on fishing trips, at restaurants without private meeting areas)?
  • Does the manufacturer conduct internal ROI analyses of payments to speaker program leaders?
  • Do ROI analyses show a significant increase in their prescription writing for the manufacturers’ drugs after they begin receiving honoraria payments in connection with the drugs?
  • Are the speakers are nominated by sales reps, who pick doctors from among those they call on?
  • Are speakers selected and approved based upon any type of objective, bona fide criteria?
  • Do sales reps have a budget for speaker programs, which they are pressured to spend?
  • Does the manufacturer place no limit on the number of programs a doctor can attend or how often a doctor can attend the same program?
  • Is there a system to prevent a sales rep from repeatedly selecting the same doctors on his call list as attendees or speakers, on exactly the same topics?
  • Are there system controls to prevent a sales rep from arranging for the same doctors to take turns speaking and attending each other’s programs repeatedly?
  • Are sales reps able to sidestep per-attendee spending limits placed on events held at restaurants?
  • Do the sales reps spend lavishly on food and alcohol for attendees and speakers?
  • There is no prohibition against holding programs at restaurants that are high-end for the particular community in which they are located.
  • Are processes in place to ensure that sales reps are reporting truthfully on who attends speaker programs?
  • Does the manufacturer require signatures on attendance sheets at speaker events?
  • Do doctors repeatedly speak to the same attendees on exactly the same topics?
  • Does the manufacturer threaten to remove physician-speakers from the speaker’s bureau if they decrease their prescription volumes?
  • Are high-prescribing physician-speakers are permitted to speak at events even when they lack basic communication skills and knowledge of the drugs?