Evelyn Pringle February 19, 2006
In Pennsylvania, whistleblower, Dr Kruszewski, discovered cases where adults and children in state care were prescribed as many as 5 psychiatric drugs at the same time. When he went to his superiors to report the over-prescribing and warned of the potential liability to the state if it was allowed to continue, he was told "it is none of your business."
According to Dr Kruszewski, it was polypharmacy at its worst. "They were putting almost all the patients on the same concoction of antipsychotic and antiseizure drugs," he reports.
But the discovery he found most disturbing was that many of the patients taking the drugs had never had seizures and had never been psychotic.
The fact is that drug companies are making a fortune off drugging patients who are covered by tax payer funded government programs. The drug pushing begins with preferred drug lists maintained in most states. Once a drug is added to the list, it is prescribed as a first line of treatment for all people in state run institutions and all patients in the general population who are covered by programs like Medicaid and Medicare.
The lists represent a goldmine to drug companies. For instance, if Eli Lilly's one antipsychotic drug Zyprexa, was to be removed from the preferred drug list in Florida, the company would lose $70 million annually, according to the November 2005 Indianapolis Business Journal.
In 2004, Lilly billed Florida Medicaid over $20 per pill for Zyprexa according to a Presentation to Senate Health and Human Services Appropriations Committee on January 13, 2005.
Pharmaceutical companies will go to any lengths to get their drugs added to the lists, including the use of financial incentives to influence state officials and policy makers involved in compiling and maintaining the lists.
Whistleblower, Allen Jones, was an Investigator in the Pennsylvania Office of Inspector General, Bureau of Special Investigations, when he discovered drug company money was being used to influence state officials and policy makers when the preferred drug list was being implemented in that state.
To put the amount of money involved in perspective, the drug Zyprexa is prescribed for schizophrenia, and according to Mr Jones' estimates, Pennsylvania has approximately 9,000 schizophrenics in state run prisons and mental hospitals on any given date.
"And based on the average length of stay, an additional 4,000 patients move through the system each year resulting in the potential recruitment of 13,000 customers, worth about $6,000 each per year," he reports.
"Once these folks left institutions with prescriptions in hand," Mr Jones adds, "many are supported through Medicaid."
During his investigation, when examining the payment of money to state employees, Mr Jones said, "I began to look at the overall issue of Pharma marketing and immediately became alarmed that tactics used in marketing to the private sector were being replicated with state employees."
He was suspicions about the drugs on the list because: (1) the recommended drugs were exclusively new, patented and expensive; (2) they were selected by expert consensus of persons with financial ties to Pharma; and (3) claims of increased efficacy and safety by drug companies and state employees were contradicted by scientific studies.
"These new "miracle" drugs did not live up to their hype," Mr Jones said, "they have proven to no better than generics."
"Most importantly," he explained, "most of the new drugs have been found to cause serious, even fatal side-effects, particularly in children."
"It is a statistical certainty," he added, "that many lives have been lost and many others irreparably damaged."
During his investigation Mr Jones discovered an off the record account used to funnel drug company money to state officials and policy makers who were being treated to lavish meals and expensive travel and were receiving consultant fees and honorariums.
"Some state employees were paid up to $2,000 for speaking in their official capacities at drug-company sponsored events," Mr Jones said. "It is illegal for a public employee to accept honorariums and to consult with industry without permission, yet it was happening openly," he explained.
When he went to his superiors with his report, Mr Jones says, "I was limited, shut down, ordered to limit my investigation and ultimately threatened when I refused to set aside what I was finding."
"They maintained a deliberate ignorance of what was going on, they did not want to know," he said, "the word came down to kill my investigation and rein me in."
He refused to be reined in and continued his investigation on his own time. When he finally went public with his findings to the New York Times, Mr Jones was fired. He has since filed a whistleblower lawsuit.
Psychiatrist, Dr Stefan Kruszewski, was hired by the Pennsylvania Bureau of Program Integrity in the Department of Public Welfare to oversee the mental health and substance abuse programs.
During his investigation, Dr Kruszewski uncovered serious abuses, including the deaths of four children and one adult while in state custody, due to substandard care and the off-label prescribing of atypical antipsychotics.
The people most vulnerable to medicating for profit were the disabled, dependent children in state care, the prison population, and children hooked into the state juvenile justice system.
In June 2003 Dr Kruszewski, traveled to an out-of-state inpatient facility that housed 24 children from Pennsylvania whose placement in the center had been facilitated by the Pennsylvania Office of Medical Assistance and whose oversight was, in part, the responsibility of the Bureau of Program Integrity.
"The reasons for that trip," he said, "was another unexpected death of a child."
On July 9, 2003, Dr Kruszewski's written preliminary assessment on the investigation revealed children who were severely overmedicated with antipsychotics, antidepressants and anticonvulsants were housed in deplorable living arrangements and receiving 'treatment' that often violated their emotional, mental and physical well-being. The investigation also revealed that children were being sexually abused by staff personnel.
Dr Kruszewski recommended the removal of the children from the facility and also advised his superiors to consider removing children and adults from several other facilities "in order to protect other innocent individuals from morbid and mortal consequences of severe over-medication, including chemical restraints, emotional, physical and sexual abuse, seclusion, and dirty and inadequate living conditions," he advised.
Dr Kruszewski was fired in July 2003 when he refused to be silenced after his discoveries.
In his whistleblower lawsuit against Pennsylvania officials and several drug companies, Dr Kruszewski describes corrupt practices, that include fraudulent billings, overmedicating of adults and children, and the misuse of medication that resulted in death to persons under the care of the state.
The lawsuit, also says drug companies have "distorted statistics, violated regulations and misrepresented the effects of the use of their psychotropic drugs simply to make money."
According to Dr Kruszewski, in order to sell more drugs, pharmaceutical companies have misrepresented their effectiveness, "by knowingly reporting incomplete and inaccurate research results of their safety profiles, and by off-label promotion."