We represent qui tam whistleblowers under the federal False Claims Act. The false claims act is an enormously effective and powerful law and provides for powerful remedies on behalf of the federal government, against contractors, companies, healthcare providers, that choose to defraud the government.
There was a new division created. The whole point of it was to go out and educate the speakers. They wanted to make sure that everyone knew what they were talking about if they were going to get up in front of a group of physicians. It was a very open job description. I don’t think they even knew what they were going to do with us to start with, so they were open to suggestions, and we were valued voices within the organization; experienced reps, who knew their studies, knew the data, and had good relationships with the thought leaders.
It wasn’t the job that I had planned on doing. It wasn’t about educating the physicians and going through slide decks and bringing them new studies. It became, I was the manager of all of these speaker events and there were specific quotas and budgets that had to be met, and had to be spent. “Here is $100,000 that you need to use for speaker programs.” I was the one who oversaw who got checks, who was getting paid and who wasn’t.
Typically, these individuals have been working in these companies, sometimes their entire careers; and through one mechanism or another become aware of fraud. Perhaps management changes, perhaps they’re sent to a different division. In my experience these are very principled people. They will not put up with fraud.
There was a meeting that we had in Las Vegas. I remember the Director of Sales standing on the stage and saying, “our goal is to have the most medical events of any other pharmaceutical company.”
Who cares if you have the most events but none of them are quality, and you have the same three guys showing up every Wednesday night for the dinner club? What impact are we making on the patients? We are all about the patients. Patients first. We are doing this because we care about the patients – but really it was about the money instead.
Too often, some pharmaceutical manufacturers have cornered segments of their market by strategically seeking out and paying kickbacks to the highest-prescribing specialists in the country. The most common kickback payouts have involved sham speaker programs.
Manufacturers that have devised bogus speaker programs have filled their speakers’ bureau with “thought leaders” based on the physicians’ prescription potential, rather than their true credentials. Oftentimes, the speaker recruitment efforts have focused on those providers who are prescribing competitor products. For especially prolific prescribers, senior managers have flown across the country to wine and dine the physicians and to pitch the monetary benefits of joining the speaker program.
In the most egregious sham speaker programs, the recruited physicians have been paid thousands of dollars to attend training sessions held at luxurious resorts and venues. Typically, while these training have lasted half a day, the attendees have been flown in for an all-expense-paid extended weekend getaway.
Once the physicians have survived this “training” weekend, they are then inserted into a full calendar of paid speaking gigs, including roundtable discussions, advisory boards, and even patient outreach programs. Oftentimes, in sham speaker programs, the speakers’ honoraria have varied based on the speakers’ prescription volume, and the speakers have been paid for events even when no attendees show up.
These manufacturers have also closely monitored the prescription levels of their speakers. If the speakers’ prescription levels dip below previous numbers, sales reps have been directed to discuss the downward trend with the offending provider. Physicians who prescribed the most would typically receive the most speaking opportunities. Those who did not use as much product would not be used, even though they had the same (or greater) training and qualifications to speak.