Allen Jones did…

Posted on Sunday 16 September 2012


Whistle-blower honored in Texas, fired in Pa.
Dealings between public employees and drug firms were similar in both states. Reaction was very different.
Philadelphia Inquirer [Philly.com]
By David Sell
September 16, 2012

In Texas, Allen Jones determined that state employees were getting kickbacks from pharmaceutical companies, and his efforts resulted in his being named Whistle-blower of the Year and awarded about $20 million of the state’s $158 million settlement. In Pennsylvania, where Jones was a commonwealth-paid investigator, he and his information were dismissed – twice, almost a decade apart. Jones had discovered malfeasance that was similar in both states, with the drug companies wanting state officials to help push higher-priced antipsychotic drugs to foster children, among other wards of the state, through taxpayer-funded Medicaid programs. In Texas, the attorney general turned the information into a $158 million payment from Johnson & Johnson’s Janssen subsidiary, which makes the antipsychotic drug Risperdal. The company offered to settle Jan. 19 after six days of trial testimony…
I guess it was Senator Grassley’s Investigation of corruption in academic psychiatry involving the Department I was affiliated with that woke me up to the extent to which the pharmaceutical industry had invaded my specialty of psychiatry. I started writing about it, and the more I looked, the worse it looked. When I happened on the TMAP/CMAP story and first read Allen Jones narrative, it took me a while to take it in. A public mental health system invaded by a major drug company? Aided by the State’s primo Department of Psychiatry? Spread to a third of our States by the Director of Texas Mental Health? The Pennsylvania Office of the Inspector General firing the investigator who happened on the scheme? It read like the fantasy of a summer beach novel author, not a story that actually happened.
 
When it finally came to trial, we went to Austin to see it happen. I think it took that to make it real for me. After six days of testimony, J&J shut down the trial and settled, but not before making it more real than I could’ve ever imagined. The Director of Texas Mental Health was indeed an evangelist for the drug company. Jannsen’s drug reps did hawk the off-label prescription of their drug, Risperdal to Child Psychiatrists treating Medicaid kids, Foster children. Each witness was more damning than the last. Jannsen’s behavior was indefensible and I found myself wondering why they ever let the case go into a courtroom.
 
The next part of this article is a story I knew less well. It’s about how the State of Pennsylvania, Allen Jones’ home, dropped the ball and didn’t use Jones’ information in prosecuting Janssen.
Though J&J did not acknowledge any wrongdoing, the settlement was a significant moment in the firm’s continuing multiyear, multi-court, national legal fight over Risperdal. Similar circumstances but a wholly different story in Pennsylvania. In 2002, as he investigated the Department of Welfare, Jones was rebuffed by supervisors in the Office of Inspector General, one of whom allegedly told him to "quit swimming against the current in the pharmaceutical case," and that pharmaceutical companies "write checks to both sides of the aisle." Steven J. Fiorello, a pharmacist who oversaw drug policies at state hospitals, was convicted in Dauphin County Court of Common Pleas on conflict-of-interest charges, but the state never used his information in its later efforts to stop the practice. Jones was fired in 2004. Despite the personal and financial hardship he endured until getting millions from the Texas case, Jones tried to help Pennsylvania again. In April 2011, he wrote to the new state leadership, including Gov. Corbett, then-Acting Attorney General William Ryan, and Inspector General Kenya Mann Faulkner, offering similar information that might expose current fraud. Jones had also shared more-recent information with Iowa Sen. Charles Grassley, who has held several hearings about overprescribing of antipsychotics through Medicaid. The OIG eventually sent two men to see Jones. Then he got a letter from OIG general counsel Wesley Rish – the same Wesley Rish who was among the OIG leaders who ignored his information in 2002, fired him in 2004, and were defendants in the first of two lawsuits. "You have not presented any issues which rise to the level of fraud, waste, abuse or misconduct within the OIG’s jurisdiction," Rish wrote in a letter dated June 10, 2011. Sitting in his central Pennsylvania cabin – off the beaten track, off the electrical grid – Jones shook his head when he read from the letter, a copy of which he gave to The Inquirer. "They’re saying nothing rises to the level of fraud after Texas?" Jones said. "The same facts we used in Texas are available in Pennsylvania. The same pattern of deceit. The same lies regarding kids. The same off-label marketing. The same corruption of public employees. The same everything. I helped Texas get $158 million, but Pennsylvania says, ‘This isn’t a concern of ours’?"…
The article goes on to document that absent Jones’ testimony and information, the Pennsylvania suit died on the vine. Meanwhile:
Besides Texas, Louisiana ($258 million), South Carolina ($327 million), and Arkansas ($1.2 billion) filed individual state suits and won big, at least so far, though J&J is appealing…
The "why?" of Pennsylvania’s actions is as opaque to me as it was to Allen Jones – a mystery…

In the course of following the Texas Trial as it developed, I’m pleased to say that there was something else this story made real for me – Allen Jones himself. I’ve gotten to know him over these months, and he is exactly what this article says he is. He had returned to work for the PA OIG, and his first case turned out to be something pretty rotten. He refused to be waved off by his superiors and was determined to get to the bottom of what he had found – so he got fired for doing his assigned job. Allen is a bright, intense, principled guy. He’s not the kind of person you can shut up by firing him. That’s just throwing gasoline on the fire. So he became an expert on the topic, and set out on a decade-long hegira that lead to that Texas courtroom.

He knew the patients targeted by J&J’s TMAP scheme from his previous work in public mental health and the courts, people with chronic mental illness, substance abuse problems, and disintegrated families living on the edge of society. I think knowing who he was fighting for fueled his quest. J&J was preying on people who had limited or no real choices. So he stuck to his solitary task until finally joined in his whistle blower suit by the State of Texas.
Whistle-blowers get 15 to 35 percent of a settlement, depending on how many there are and their contributions to a case. The Texas attorney general decided Jones’ share. Jones said getting the money was a "relief," and that "the rest of my life could be better for me and for my family than the last decade had been." But there were painful times. "I had passed through 10 years of living very close to the bone," Jones said. "My firing for ‘willful misconduct’ destroyed any chance I had to continue in my career [as an investigator]. The first years were dark ones. I lost the home I had built when I was 26 years old, lost my good credit and a whole lot more. I moved to my cabin in the mountains with no electricity or running water." He is married for the second time. College educations for grandchildren and stepchildren are set. He now also has a place in a "sleepy fishing village" in Florida. As idyllic as that sounds, he cautions would-be whistle-blowers to be ready for "dark" days, get sound advice, and not assume there will be a payoff. Indeed, do it for a cause beyond cash. "They are now drugging fewer foster kids in the state of Texas in 2012 than they were in 2006," Jones said. "Those are the things I think about and smile over in the quiet of my house."
As a person, Allen is an action figure, pursuing the everyday projects of life with the same high energy he brought to his whistle blower suit – figuring all the angles until he sees the path to get where he’s headed. He’s capable of being a very happy guy, standing on the front of a fishing boat as an example, even when the fish weren’t biting. I’ll bet it’s the same in his mountain cabin. But most of all, he’s a kind person, and I suspect it was the felt kindredship with the people in the public systems he’d worked with that kept him going during those "dark" years. The pharmaceutical executives, their reps, the involved State officials, their lawyers – none had a personal connection to the people their systems were supposed to serve. Allen Jones did…
  1.  
    September 16, 2012 | 12:37 PM
     

    Risperdal reproached!

    The ‘atypical’ antipsychotics-Risperdal,Zyprexa,Seroquel… are essentially reformulated 50 year old Thorazine at 10-20 x’s the price.Zyprexa was hailed as, ‘the most successful drug in the history of neuroscience’.
    How can that be legitimate as the conditions the drugs are approved for are only 1% of the population?
    Zyprexa especially was ‘pushed’ off-label and made Eli Lilly $67 billion to date.
    –Daniel Haszard

  2.  
    September 16, 2012 | 4:00 PM
     

    Mickey,

    At the end of the day, it’s not really about drugmakers or whistleblowers or anything/anybody else…

    It’s about psychiatry and psychiatrists.
    The buck stops with the prescribers.

    Pat Bracken, M.D., Ph.D. talks about the loss of “legitimacy” in psychiatry in the first video on this link –

    http://postpsychiatry.com/?page_id=35

    I think what you’re doing in many ways is great… exposing the corrupt drugmakers, etc.
    It’s exciting to read, to follow… but it’s not the *real* story, is it, doc?

    And it’s certainly not the *whole* story, or the one that needs to be told, by those active in your profession… who aren’t yet retired, and who aren’t afraid to come forward.

    The sad truth is that they are nowhere to be found.
    50,000 psychiatrists in the U.S.
    Yet, hardly a peep…

    Where are they?!\
    *That’s* the story!

    Duane

  3.  
    Melody
    September 17, 2012 | 8:03 AM
     

    Duane–

    It’s not just psychiatric doctors . . . it’s ALL doctors. They are THE line between patients and drugs. Years ago, when synthetic insulin was introduced, doctors could have advocated for the retention of natural insulins, but most took the easy way out, converted their patients to the latest-greatest from BigPharma. Because no one was counting the bodies, it is impossible to know how many diabetics died because of this . . . but looking to doctors to demand ethical behavior from the drug manufacturers is just TOO DIFFICULT or too time consuming or too un-profitable. I’ve been an avid follower of 1boringoldman . . . and keep waiting that his counterpart in other fields of medicine will step forward. But so far, it ain’t happenin’.

  4.  
    September 17, 2012 | 9:47 AM
     

    Thank you Allen Jones, and thank you for the lower rate of antipsychotics prescribed to kids in Texas…

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