speaking of about time…

Posted on Wednesday 27 July 2011

Drug firms paid ‘independent’ experts
Practice led to AG-whistleblower lawsuit
KXAN – Austin Texas
by Nanci Wilson
26 Jul 2011

Doctors working in state hospitals and community mental health centers began switching patients to the atypical antipsychotics because they were deemed the best treatment by an expert panel convened by the Texas Department of Mental Health and Mental Retardation. But a detailed examination of public records documents on file in a whistleblower lawsuit that has been joined by the Texas Attorney General’s Office allege that the experts hired to evaluate the drugs and make recommendations for their usage were also accepting hundreds of thousands of dollars in payments from the companies developing and marketing the medications.

It started in the middle 1990s when MHMR contracted with University of Texas and some of its professors to evaluate the medications and develop a set of treatment guidelines. The program was named the Texas Medication Algorithm Project, or TMAP. The result was step-by-step guidelines for treating major depression, bipolar disorder, schizophrenia, attention-deficit hyperactivity disorder.

TMAP was supposed to be based on the latest science, evaluated by an independent group of experts in the field. But a 2004 lawsuit filed by whistleblower Allen Jones and the Texas Attorney General’s Medicaid Fraud Division against Janssen Pharmaceuticals, a division of Johnson & Johnson, suggests that the project was actually a vehicle for boosting sales of expensive new drugs that government funded studies found were not more effective, but cost far more than conventional medications. According to records compiled from company documents, Janssen was making substantial payments over several years to the decision makers, many of whom were University of Texas professors.

While the professors were under contract with the state of Texas to provide their expert opinions on medications, records show many were also being paid by the companies whose drugs were being evaluated. The suit alleges that Janssen improperly influenced the development of TMAP and compromised the objectivity of the decision makers by paying consulting fees, funding research and providing extravagant meals and lavish travel.

Such relationships were not always disclosed in TMAP manuals distributed to state hospitals and community mental health centers. The depth of the financial relationship between the drug companies and the Texas Department of Mental Health weren’t always disclosed, either…
Finally, an article in the press that lays out the extent of the corruption in the Texas Medication Algorithm Project [TMAP] and presages the suit scheduled to go to trial in November against Janssen [J&J] filed by Allen Jones and joined by the State of Texas. It was a blatant pharmaceutical company driven scheme to force Texas State Health System physicians to use drugs under patent rather than generic drugs which were equally effective and a good ten-fold cheaper. Hopefully, all of the discovery documents will be made public. It wasn’t just the huge amount of money bilkoed from Texas and the dozen plus other states who adopted the plan, the Atypical Antipsychotics were toxic to many of the patients who were taking them. Properly exposed, this suit should make the whole PHARMA stealth marketing scenario available for the world to see. Keep those articles coming…

    July 27, 2011 | 4:40 PM

    Interesting comment from Emory psychiatrist Charles Raison on CNN’s HealthChat blog about effect of anti-depressants a propos your research. This was written for the lay public interested in health.


    He quotes studies that show the relative relapse rate of subjects in controlled studies of antidepressants. Those who were on the antidepressant were MORE likely to relapse after stopping the meds than those on the placebo.

    This academic, research psychiatrist has changed his long-held views on the efficacy of antidepressants and make him more cautious in their long-term use.

    July 27, 2011 | 5:18 PM

    Excellent article; thanks for posting it. As made clear in the article, it wasn’t only the pharmaceutical companies paying off the TMAP decision makers.

    I’ve copied below a section that gives a sense of the dollars involved between one company & one decision maker:

    “The Centers for Medicare/Medicaid refused to pay the estimated $25,000 bill for VNS treatment for depression. Most insurance companies wouldn’t pay, either.

    But that didn’t deter the TMAP team from including the VNS on the revised guideline for treating depression. Such decisions were made behind closed doors and records revealing which members approved the inclusion are not available.

    Rush’s relationship with Cyberonics was not fully disclosed to the University of Texas in his annual Statement of Financial Interest filing. His filing dated Aug. 7, 2006, lists his role as a member Cyberonics Speakers Bureau with an annual income equal or less than $10,000.

    But in records submitted to the office of U.S. Sen. Charles Grassley, R-Iowa, by Cyberonics, Rush was paid $100,000 in 2006 by the maker of the VNS. Cyberonics also reported paying Rush more than $75,000 in 2003 and 2004, and $62,000 in 2005.”

    I just hope that all of the payments get disclosed through the lawsuit.

    July 27, 2011 | 6:22 PM

    “I just hope that all of the payments get disclosed through the lawsuit.”
    Check the documents posted with Nanci’s article. They are listed just below the video.

    July 28, 2011 | 2:11 PM

    TMAP is a testimonial to the climate during those years. PHARMA reigned supreme and they thought they could do anything they wanted to do. The academic psychiatrists that helped them need to be prosecuted as well. It’s not possible that they didn’t know what they were doing…

    July 28, 2011 | 7:52 PM

    The academic psychiatrists will plead insanity, and claim they were not responsible for their actions as they did not know right from wrong.

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