Drug Co. Accused Of Bribing Doctors To Prescribe Eye Drug

NYT has uncovered a program of hush-hush rebates they say Genentech gives to doctors to encourage them to prescribe the pricier eye medication Lucentis over cheaper alternatives.

Some doctors are calling it outright bribery and fear it will encourage more frequent injections, off-label uses, and discourage patients from using less costly medicine to treat the same issues.

Genetech said in a statement, “Rebate and discount programs are a common business practice across the industry, including in the field of ophthalmology” and that the programs “help reduce the cost of our medicines for hospitals, pharmacies and doctors.”

The doctors who become part of the program are not allowed to talk about the program’s existence. “The existence of this agreement is confidential,” says the contract they have to sign.

The first rule of eye club is that you don’t talk about eye club.

Genentech Offers Secret Rebates for Eye Drug [NYT]

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  1. SimplyStating says:

    We are shocked at this happening? But it is still funny how the company attempted and failed at shifting the blame.. lol

  2. kyramidx3 says:

    Within the past few months, I was prescribed Nasonex, and upon arriving at my local pharmacy, they told me the bill would be $120 or so. After regaining consciousness, I promptly called the physician who had prescribed me this Nasonex, and told him there was no way in hell I could pay this, PER MONTH, as I have no health insurance.

    He switched me to Flonase, and it is still about $30 per month. It is ridiculous, but I am prone to sinus infections and this stuff at least helps to fend off infections in my case.

    It is a shame that companies are so money hungry, and not just sincerely looking out for the public’s well-being. What a great thing that would be.

    • Nigerian prince looking for business partner says:

      I’ve been there too.

      I have an HSA with a high deductible plan ($5,000 deductible), which means I need to go through the price lists for anything that’s prescribed. She typically has a print out of the Wal-Mart, CVS, and Rite Aid price lists available.

      I really miss the days of $5 and $10 copays.

    • colorisnteverything says:

      I am on flonase, too, but that is because nothing else has worked and I have pretty severe allergies/asthma. I am also a poor grad student. There is a generic for flonase. Demand it. For me, a 3 months supply is like $10.00.

    • Bohemian says:

      There are generic versions of flonase that should be less than $30 at a decent pharmacy. Some doctors you have to demand they write for a generic or ask at the pharmacy counter if there is a generic of the drug or another one in that drug category that has a generic. Fluticasone is a generic of flonase.

      • catastrophegirl chooses not to fly says:

        some states the doctor has to write on the prescription that generic is ok, some states they don’t. where i am the state doesn’t require it and some pharmacies will automatically dispense generic unless the doctor writes “no generic” on it.
        gets really complicated

    • tiz says:

      try using a Neti Pot for your sinus infections. works wonders! same with allergies

      • Verucalise (Est.February2008) says:

        I don’t use a netti pot, I use a plain jane medicine syringe (about 2 TSP) and tilt my head back, push the solution in, and let it pour out. It’s great, and you can brew your own solution at home!

    • Phexerian says:

      30 dollars is about the price of fluticasone at a pharmacy. That is the generic of Flonase. Brand name Flonase would cost you much more.

    • Loias supports harsher punishments against corporations says:

      Always ask for generic version of the drugs you take. Ask WHILE WITH the doctor. As he is prescribing, ask him if there is a generic version available.

  3. SonarTech52 says:

    Genetech said in a statement, “Rebate and discount programs are a common business practice across the industry, including in the field of ophthalmology” and that the programs “help reduce the cost of our medicines for hospitals, pharmacies and doctors.”

    So if it’s helping to reduce the cost of medicine… why is the existance of the agreement secret??

    • OnePumpChump says:

      It reduces the amount of money that Genentech receives per-unit in the end, which counts as reducing costs if you’re being disingenuous or stupid.

    • jessjj347 says:

      Lots of agreements with physicians are confidential. I don’t know why you phrase it as being, “secret”. Who exactly should they be telling? The patient ? The FDA? I would think you mean that the physician should be telling the patient, but it seems to be more complicated than that…

  4. Coelacanth says:

    It’s basically a scam on the insurance companies and Medicare/Medicaid. If they reimburse drug costs based upon some “average” retail/wholesale cost plus a modest percentage, and then the opthalomologists are paid an extra rebate, doctors make a lot more, while the patients simply get the more expensive drug.

    ..and then the insurance companies renegotiate higher rates the next year!

    Everyone wins!

  5. Merujo says:

    You might want to correct the article – it’s not “cheaper alternatives” plural, it’s singular – Avastin – another Genentech drug. The off-label use of Avastin as an eye drug by a retinal specialist saved my vision. in 2006, I had a freak incident where a blood vessel started to grow like a weed behind my left retina. I was only 40 at the time, and there was nothing in my medical background to explain the situation. Basically, one day, all was fine, and I woke up the next morning unable to see/read/drive with both eyes. Went to the eye doc, was shipped to the retina guy that same day and had immediate laser surgery to try to retard the growth of the blood vessel, but that failed.

    My options were to go blind in my left eye (in a matter of days) or allow the doc to use Avastin on me in a series of injections to the eyeball. Lucentis, since I was not elderly or on a Medicaid/Medicare type program, would have cost me $2,000 an injection. The Avastin was $60 an injection. I had to sign a pile of documents stating that I understood this was an experimental protocol, that the use of Avastin (used normally as a cancer drug to try to retard metastatic growth) for my eye was not FDA-approved, and that, as with all experimental protocols, it came with plenty of potential risk.

    I cannot begin to express my gratitude to my retinal specialist for having the gumption to use this drug. Had Lucentis been my only option, I would have simply had to go blind in that eye and lost so much we take for granted.

    God bless the retinal rebels. And Jesus, wouldn’t it be nice for people with scary eye conditions who don’t have the benefit of Medicare/Medicaid or piles of money – and don’t have a “renegade ophthalmologist” – to know there are less costly – and astoundingly successful – options to going blind???

    • Coelacanth says:

      I’m glad things worked out for you… nothing scarier than a retinal emergency. At least they were able to identify the problem and ship you off to a specialist so quickly.

      ERs seem poorly equipped to handle that type of emergency, generally speaking.

    • Mauvaise says:

      Holy crap!! I’m glad your vision was saved, however, if it were me, I would be blind right now. I can’t even wear contact lenses – there is no way in hell I could stomach (1) injection IN THE EYE (!!!!) let alone a series of them.

  6. H3ion says:

    Aren’t there laws against paying off medical professionals to get them to use a particular medicine or device?

  7. Trapspam Honeypot says:

    Merujo,

    I one-hundred percent agree with with. I have had 13 Avastin injections over two plus years across both eyes for retinal bleeds. At $2,000 a pop for Lucentis my insurance, even under a federal program for lifetime coverage as a military retiree, would not have been possible. Yes, I pay an annual premium for my for my coverage so no flames from those that think this is free to vets. My retinal specialist has told me that two years ago I would have been blind in both eyes. I am a photographer and blogger and a founder of a rare cancer support group. Having my vision stabilized by a fab element of Avastin at a much reduced cost has been critical to affordable care. Three years ago Genentech did all it could including withdrawing the expensive product off the US market to prevent the extraction of the fab element needed to produce the more affordable product. Which as it was the first humanized recombinant genetic fab extracted element to work with saving vision with retinal damage. Congress intervened and prevented Genetech from stopping this affordable market approach. Knowing all this my retinal specialist and an expert at this procedure in the south would never accept any offer from Genetech or their sales reps.

  8. energynotsaved says:

    I was married to a pain doc. Drug money rules.

    When I see a doc, I say, “I don’t have RX insurance. Here is the Walmart list. Will you prescribe off of it?” Most will. If not, I change docs.

    However, I tried several on sheet drugs for one condition. I ended up with an expensive one. It was worth it.

    • terrillja says:

      Hopefully you never need some of the more advanced monoclonal antibody based drugs then. Because they are a PITA to make, a PITA to research and as such are some of the most expensive drugs out there. I’m all for lowering drug costs, but you have to realize how many iterations of test drugs are out there and how much work goes into getting biologics to market. This isn’t mix a+b and get c, package, good to go. Biological fermentations take a lot of time and space to manufacture (once you find a process to make them, which itself takes a lot of testing), it isn’t like making asprin in organic chemistry where you can have your refined product in less than an hour.

      Not to say that Genentech didn’t do some shady business here, but before everyone jumps on the “The drug cost is too high!” bandwagon, realize that every drug has a different process that can add hugely to the final cost in terms of r&d and manufacturing.

      • RvLeshrac says:

        Yeah, not like there’s ever been a study showing that R&D makes up one of the smallest portions of pharmaceutical spending.

        Oh, wait.

        http://www.sciencedaily.com/releases/2008/01/080105140107.htm

        • terrillja says:

          Oh wait, that is the industry as a whole, and is from data back in 2004 when companies used to spend their promo money on private jets, extravagant dinners, things that laws have been created to cut down on. Take out the money spent on Viagra and Enzyte and you probably halved the amount spent. In addition, a lot of R&D these days is actually acquisition of smaller companies or licensing costs. So if you don’t count the multimillion dollar takeovers of smaller companies for their IP as R&D, your numbers will be artificially low. The same goes for licensing fees. Companies have taken to buying up ideas from smaller companies and then taking that and developing the drugs rather than starting from step 1. So yes, they may spend less on in house R&D, but more on acquiring those who already have done the first steps. Then trials cost a couple hundred million. So simplifying it to $ for Ads> $ for R&D doesn’t even come close to telling the whole story.

      • Nigerian prince looking for business partner says:

        “Hopefully you never need some of the more advanced monoclonal antibody based drugs then. “

        Thank God for cheap Canadian drugs.

      • Coelacanth says:

        Well, hopefully as biologics become more widely used, there will advances in manufacturing technology to scale them in a cost-effective fashion.

        Too bad Genzyme keeps having problems with tainted products…

  9. dg says:

    In other news, “Water’s Wet!”

  10. sopmodm14 says:

    big pharma making money off our health ?

    spend the money and goto a trainer at a gym

  11. sonneillon says:

    Almost every industry has this type of thing going on it it. Rebates are one wording, spliffs are another.

  12. ldub says:

    Hey, it’s just the free market at work, folks. Nothing to see here…. move along…..

    • ResearchGuy says:

      Free market? IDK if there’s anything “free” in the Rx drug industry – certainly not the medications themselves. You cannot freely choose/purchase an Rx drug (legally) without a script. And you may not even get the best meds prescribed based on how big of a kickback is in place with PharmaCo & Doc.

      Still wish they’d stop Rx drug TV ads – especially for all the ED drugs. Seeing fat guys jump around over getting a woody makes me ill.

  13. gedster314 says:

    Why does this shock people. It’s nothing new. You see this on Wallstreet, our Government and many other businesses. Americans have no morality when comes to money. I’m not saying Americans are the only ones but Americans love to point out how honest and above board they are and all the while they playing under the table and planning their next back stabing.

  14. ZIMMER! says:

    After working in the health care field for a long time, I could say that this does not surprise me. What surprises me if the the general public is hearing about it.
    Corruption is wide spread through out health care. From the top to the bottom, The sad thing is that people still trust their doctors, hospitals, pharmaceutical companies, The thing that everyone has to understand is they do not care about you, it is NO longer about healing and helping others, it is only about the bottom line. How much they can make from you. THEY DO NOT CARE. Health care is business. From the Secretary that takes your call, to the tech that takes your temp, to the Nurse to the Doctor, the Phlebotomist to the Pharmacist, You will not get the appointment you want when you want it, they will prescribe you medications you don’t need , redraw your blood just because, give a test/procedure that you do not need….. the list goes on. You are a bank to them, they do not care. Corruption is deep. But yet you all still lap it up believing that they care, they do not. Who will pay, is all that matters.

  15. banmojo says:

    If the drug company is giving $$ back to the patient to help defray the copayment cost, then THAT could be called a “rebate”.

    If the drug company is giving $$ to MDs for each Rx they write, then THAT’S a BRIBE, and likely breaks more than several parts of the RICO laws.

    Greedy, piece of crap, care more about $$ than their patients, kind of MDs give the other MDs a bad name, and should be forced out of this once respected profession.