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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Phillipa on August 13, 2014, at 19:15:29
In this case the med was clozapine. Phillipa
Psychiatrist Suspended for Antipsychotic Overprescribing
Pam Harrison
August 12, 2014EDITORS' RECOMMENDATIONS
Psychiatrist Accused in Alleged Prescription Kickback Scandal
The medical license of Illinois-based psychiatrist Michael J. Reinstein, MD, has been suspended indefinitely by state regulators for prescribing irregularities, notably, fraudulent overprescription of the antipsychotic clozapine, ProPublica's Charles Ornstein reports.The state of Illinois has the authority to permanently revoke a physician's license but usually does so only if a physician has been convicted of a sex crime or an assault on a patient. Dr. Reinstein had been practicing in the Chicago area since 1973.
The state's medical disciplinary board recommended the suspension of Dr. Reinstein's medical license in May of this year after determining that the Illinois psychiatrist had received "illegal direct and indirect remuneration" from makers of clozapine.
The disciplinary board also accused Dr. Reinstein of not considering alternative treatments for his patients and of disregarding his patients' well-being. Clozapine has well-established side effects, including seizures.
As reported by ProPublica and the Chicago Tribune in 2009, Dr. Reinstein had prescribed more clozapine to patients in the Illinois Medicaid program in 2007 than all doctors in the Medicaid programs of Texas, Florida, and North Carolina combined.
At least 3 patients under the psychiatrist's care had died of clozapine intoxication at that time. Dr. Reinstein reportedly defended his use of the drug, arguing that it is effective and underprescribed.
In 2013, ProPublica reported that Dr. Reinstein had prescribed even more clozapine under Medicare's prescription drug program for seniors and the disabled.
The program apparently continued to let Dr. Reinstein prescribe the drug even after the US Department of Justice accused him of fraud and the Illinois Medicaid program suspended payments to him.
A federal fraud lawsuit against the Illinois psychiatrist is currently pending in the US District Court in Chicago.
View Report >
Prosecutors allege that Dr. Reinstein's long-term pattern of prescribing clozapine was motivated by money and perks from pharmaceutical companies.As previously reported at the time by Medscape Medical News, Dr. Reinstein was accused of submitting at least 140,000 false claims to Medicare and Medicaid for clozapine prescriptions that involved illegal kickbacks from a string of manufacturers of the drug.
According to the complaint, Dr. Reinstein based his prescriptions to mentally ill patients not on evaluations and assessments of their psychiatric needs but in exchange for compensation agreements, first with Novartis and then with IVAX Pharmaceuticals as well as Teva Pharmaceuticals.
In March of this year, Teva Pharmaceutical Industries Ltd, which makes generic clozapine, agreed to pay over $27.6 million to settle state and federal allegations that they induced Dr. Reinstein to prescribe their drug.
ProPublica Inc. Published online August 11, 2014. Full text
Posted by Christ_empowered on August 13, 2014, at 21:51:51
In reply to Pdoc Suspended for over prescribing antiphychotis, posted by Phillipa on August 13, 2014, at 19:15:29
wow. nothing against clozapine--I mean, if it works, take it--but...
...its rough stuff. Its bad enough when shrinks rx anything for $$$, but something this potentially dangerous? They could've been on any number of possibly less expensive, certainly safer meds.
Posted by baseball55 on August 14, 2014, at 19:41:08
In reply to Re: Pdoc Suspended for over prescribing antiphychotis, posted by Christ_empowered on August 13, 2014, at 21:51:51
What's odd about this is that clozapine is old and long since generic. So who is paying kickbacks to a prescriber?
Posted by Phillipa on August 14, 2014, at 20:37:21
In reply to Re: Pdoc Suspended for over prescribing antiphychotis, posted by baseball55 on August 14, 2014, at 19:41:08
Good point and is old now? Phillipa
Posted by Christ_empowered on August 14, 2014, at 21:16:17
In reply to Re: Pdoc Suspended for over prescribing antiphychotis, posted by baseball55 on August 14, 2014, at 19:41:08
apparently, Teva. I guess with a drug like clozapine, you can only have so many generic producers, because of the pharmacy registration program. So...I guess they can charge more for the pills and such, and then they gave him monies.
Weird. Way to kill mentally ill people, dude.
Posted by pontormo on August 16, 2014, at 12:17:16
In reply to Re: Pdoc Suspended for over prescribing antiphychotis, posted by baseball55 on August 14, 2014, at 19:41:08
The real scandal is that this issue of doctors' overprescribing -- and promoting the safety and usefulness of-- these newer anti-psychotics was really wide-spread. Pharma paid huge amounts of money to many very respectable pdocs to represent to the psychiatric community that these drugs were the new standard. And in return the drugs were well-received and frequently prescribed by the profession.
---~~~
DOCUMENTS produced in recent litigation and in Congressional investigations show that some leading academic doctors have worked closely with corporate benefactors to expand the use of antipsychotics."The most well-known is Joseph Biederman, a Harvard medical professor and Massachusetts General Hospital researcher. His studies, examining prevalence of bipolar psychological disorders in children, helped expand practice standards, leading to a fortyfold increase in such diagnoses from 1994 to 2003. The increase was reported in a 2007 study by the Archives of General Psychiatry.
"Between 2000 and 2007, he also got $1.6 million in speaking and consulting fees some of them undisclosed to Harvard from companies including makers of antipsychotic drugs prescribed for some children who might have bipolar disorder, a Senate investigation found in 2008. "
NY Times http://www.nytimes.com/2010/10/03/business/03psych.html?pagewanted=all&_r=0
--~~~This guy is by no means a lone malefactor-- the whole profession is riddle with this sort of misbehavior, and while some small extreme fringe group has been sanctioned, undoubtedly the effects of their labors on behalf of Big Pharma are still being felt.
Posted by Christ_empowered on August 16, 2014, at 14:26:01
In reply to Re: Pdoc Suspended for over prescribing antiphychotis, posted by pontormo on August 16, 2014, at 12:17:16
so true. I did a pro-publica search (dollars for docs) once, and most of my former docs names came up. One for over 100,000 over a couple of years. Yes!
Posted by baseball55 on August 16, 2014, at 19:19:18
In reply to Re: Pdoc Suspended for over prescribing antiphychotis, posted by pontormo on August 16, 2014, at 12:17:16
This is so true. Biederman admitted to receiving $1.6m, but evidence from Grassley's committee suggests he got much more. He opened a clinical facility at Mass General funded by the maker of risperdal (then on patent, can't remember the company). Then there's this guy Nemeroff at Emory who took millions from drug companies while telling his college and the FDA that he got no more than $10,000 (the maximum allowed while on FDA contract).
I talked a length once to my psychiatrist about this. He said he's not perfect on this - attends dinners, meets with drug reps. But even if he tried to limit his info sources to journals, studies find the journals themselves are completely corrupted by pharma. Articles and research are underwritten by drug companies and only positive studies are submitted for publication.
The whole system is rotten. And it's not limited to psych drugs.
> The real scandal is that this issue of doctors' overprescribing -- and promoting the safety and usefulness of-- these newer anti-psychotics was really wide-spread. Pharma paid huge amounts of money to many very respectable pdocs to represent to the psychiatric community that these drugs were the new standard. And in return the drugs were well-received and frequently prescribed by the profession.
>
> ---~~~
> DOCUMENTS produced in recent litigation and in Congressional investigations show that some leading academic doctors have worked closely with corporate benefactors to expand the use of antipsychotics.
>
> "The most well-known is Joseph Biederman, a Harvard medical professor and Massachusetts General Hospital researcher. His studies, examining prevalence of bipolar psychological disorders in children, helped expand practice standards, leading to a fortyfold increase in such diagnoses from 1994 to 2003. The increase was reported in a 2007 study by the Archives of General Psychiatry.
>
> "Between 2000 and 2007, he also got $1.6 million in speaking and consulting fees some of them undisclosed to Harvard from companies including makers of antipsychotic drugs prescribed for some children who might have bipolar disorder, a Senate investigation found in 2008. "
>
> NY Times http://www.nytimes.com/2010/10/03/business/03psych.html?pagewanted=all&_r=0
> --~~~
>
> This guy is by no means a lone malefactor-- the whole profession is riddle with this sort of misbehavior, and while some small extreme fringe group has been sanctioned, undoubtedly the effects of their labors on behalf of Big Pharma are still being felt.
Posted by baseball55 on August 16, 2014, at 19:24:48
In reply to Re: Pdoc Suspended for over prescribing antiphychotis, posted by Christ_empowered on August 16, 2014, at 14:26:01
> so true. I did a pro-publica search (dollars for docs) once, and most of my former docs names came up. One for over 100,000 over a couple of years. Yes!
Massachusetts requires docs to file annual disclosures of money/gifts received by drug companies. My p-doc reported $75 a couple of years ago. I asked him about it. It was for a dinner at a ritzy restaurant. MA has since prohibited these dinners.
The interesting thing is, my p-doc opposes the MA law. He says that the dinners are the only way to meet with other prescribers and get info on what people are doing, what works, etc. He has tried to organize dinners at his home that aren't organized by drug companies, just getting takeout food. But hardly anyone comes.
This is the end of the thread.
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