Healthy Skepticism Library item: 18727

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Electronic Source

Silverman E
Novartis Whistleblower Speaks: ‘We Wasted Money’
Pharmalot 2010 Oct 1
http://www.pharmalot.com/2010/10/a-novartis-whistleblower-speaks-we-wasted-money/

Full text:

For six years, Jeremy Garrity worked for Novartis promoting various cardiovascular medicines, such as Diovan and Tekturna. But he was fired in 2008 and later filed a whistleblower lawsuit, one of four that prompted the federal government to launch an investigation into off-label marketing. Yesterday, the drugmaker agreed to pay $422.5 million to settle civil and criminal charges. Garrity, who no longer works in the pharmaceutical industry, revealed in his lawsuit several interesting practices: some doctors who served as speakers read from prepared scripts; some doctors were recruited as speakers even if their English was poor; both doctor and event attendees were paid honoraria, and doctors who did not prescribe did not get paid. We spoke with the 35-year-old Garrity, who lives in the Midwest and was represented by Nolan and Auerbach, an established healthcare fraud whistleblower law firm, and asked him to reflect on his stint…
Pharmalot: At what point did you feel uncomfortable with the way Novartis conducted business?
Garrity: We had a meeting in Las Vegas in 2006 and the president of sales stood on the stage and said one of our biggest goals was to have the most programs of anyone in the industry. Dinner programs, medical education programs. We’d gotten beaten out earlier by Benicar, it’s a (Daiichi) Sankyo drug. They had more events than we had. And they had a higher market share than Diovan, so it was presumed that if we had more events, we would have more market share. That was a turning point for me…The only true programs were few and far between. By that I mean where you would have a respected physician who knew the disease state very well and a lot about the drugs and the class of drugs, not a physician who would spew out a commercial. The reps saw this decision as the company cramming programs down our throats. You had to have a certain number each month. I was putting in extra hours. I was sick of it. The work was exhausting and I was burning out.
Pharmalot: And this was a change from what you experienced previously?
Garrity: When I started at Novartis, there wasn’t the push for programs. So you’d get a legitimate turn out. But that changed over time. You would have your bogus programs where no one would show up and you would still have to pay the honorarium. You would have two programs in the same small town in the same week. They pressured reps to get speakers and turn out these new drugs. It snowballed and continued to go in the wrong direction. One of the other irritating things was you had to buy a lunch for an entire office in order to see anyone. These are all the complaints of a drug rep. But things had started to get worse, probably in 2004.
One of the issues that really bothered me was the waste of money. That was a gradual thing. You just don’t notice it right away. Like how much honorariums were paid out for physicians. I knew how much the dinners cost and for what? So you could outdo other companies with dinners? At the time, there was no data at all to support switching a patient over to Tekturna. And you want to convince doctors to write prescriptions for Tekturna over a generic ace inhibitor that you can get for 10 bucks at Walmart? We wasted hundreds and hundreds of thousands of dollars that could have been spent on something better. It could have been spent on a program to give less fortunate patients access to medicine.
Pharmalot: What happened after the Vegas meeting?
Garrity: Around the same time of that meeting, I had interviewed for a spot that I was told would be more in medical science. Those folks would talk to key opinion leaders, but I ended up as an area scientific sales consultants, or ASSC. They work congruently with medical science liaisons. I had wanted to get away from the marketing stuff. My forte was the science. I started at Bristol-Myers Squibb in 1999 and by ‘06, I was tired of the marketing aspect. But this didn’t turn out to be the kind of job I had hoped. I ended up being a liaison for the speakers in my area. So I was in limbo. I wasn’t a rep but I wasn’t on the medical science team.
When I was a rep. I was isolated to a fairly small geographic area. When I took this job it was almost the third of a state, so I saw a lot more of what was going on. And I had to make sure these guys (the speakers) were trained, that they had their slide decks, and we were the ones who looked after the money, the budgets. How much guys got paid. That’s all I was doing. I thought it was a waste. I thought maybe it could change from the inside. It was not the job that I signed up for.
Pharmalot: What led you to become a whistleblower?
Garrity: I had an excel spreadshseet that had everybody’s payments – all these physicians across the US. It was a lot of money and I knew the quality of what had gone on at these medical education events. There would be a doctor who could barely speak English, but wrote a lot of Tekturna (prescriptions). He had a pretty high market share relative to another physician in the same practice who didn’t speak for Tekturna. So he would be a speaker and get paid. It’s not very hard to put together the numbers, especially when you launch a drug and track it…But management would say you couldn’t use someone (as a speaker) if they didn’t write a lot of Tekturna, even if the person was an authority.
Pharmalot: Did you approach anyone inside Novartis and talk about what you saw and whether it may have been illegal?
Garrity: That stuff came up in a discussion at a manager’s meeting at the regional office…I had the info. I just thought, ‘Hey, it’s worth a shot if they’ll stop this nonsense.’ These things we were doing were a colossal waste of time…No, I didn’t have discussions where there was mention about the law. I did have discussions saying that it wasn’t what I signed up to do. And what are we doing here? It wasn’t right. He said we work within the constraints we’re given. Maybe things will change in the future but this is the job we’re doing now.
Pharmalot: Some people say whistleblowers are only in it for the money. What’s your reaction to that?
Garrity: Not at all. I remember talking to (my lawyer) for the first time and she said a lot of times, this (type of lawsuit) goes nowhere. And I said that’s allright. I’m willing to do that because I honestly believe what they were doing was wrong. It’s wrong to pay doctors to write prescriptions for drugs that were proven no better than the generic. I mentioned I was selling Tekturna and there was no data to support switching a patient. But that’s the problem with industry…But I feel like justice has been served. I think Novartis should be punished for what they did because it was wrong…I’ll pay bills, give to charity. And save some for my family.
Pharmalot: What would you say to someone who wants to be a rep?
Garrity: I’d say don’t do it. This isn’t a sales job. I mean it’s changed a bit since I left the industry. There are supposed to be new rules in place. But it wasn’t a real sales job. You may be disappointed if what you’re looking for is a pure sales job. I call it marketeering.