UPDATES FROM BARATZ & ASSOCIATES, P. A. FOR THE HEALTHCARE INDUSTRY
ASTRAZENECA PAYS $520 MILLION PLUS 5 YEARS CORPORATE
The Department of Justice (DOJ) announced on April 27, as authors of articles written by AZ and its agents”. Also, 2010 that AstraZeneca LP (AZ) and AstraZeneca
AZ “offered and paid illegal remuneration to doctors to
Pharmaceuticals LP will pay $520 million to resolve
travel to resort locations to “advise” AZ about marketing
allegations that AZ illegally marketed the anti-psychotic messages for unapproved uses of Seroquel, and paiddrug Seroquel for uses not approved as safe and effective
doctors to give promotional lectures to other health care
by the Food and Drug Administration (FDA). AZ signed a
professionals about unapproved and unaccepted uses of
civil settlement to resolve allegations that, by marketing
Seroquel” and “that these payments were intended to
Seroquel for unapproved uses, AZ caused false claims for
induce the doctors to prescribe Seroquel for unapproved
payment to be submitted to federal insurance programs
uses in violation of the federal Anti-Kickback Statute.”
including Medicaid, Medicare and TRICARE programs, and tothe Department of Veterans Affairs, the Federal Employee
If we think through the logic and thought process of the
Health Benefits Program and the Bureau of Prisons.
government’s contentions, it can be applied to a vast areaof the health care industry and not just “off-label” use of
In this discussion, we are not going to focus on the main
pharmaceuticals. The inference is that HCPs and HCIs are
issue of “off-label” use, but instead, discuss the role of
in a position to influence the flow of health care dollars
Health Care Professionals (HCPs) and Health Care
and, therefore, are prime targets for vendors, suppliers,
Institutions (HCIs) and the requirements outlined in the 5
manufactures, medical facility providers, etc. to impact on
year Corporate Integrity Agreement (CIA) that was required
In the CIA that AZ agreed to, there are very specific areas
The United States contends that AZ promoted the
that address the financial relationships and dealings with
unapproved uses “by improperly and unduly influencing the HCPs and HCIs. content of, and speakers, in company-sponsored continuing medical education programs. The Company also
Below we have summarized some relevant areas of the CIA
engaged doctors to give promotional speaker programs on
that we think clearly delineates the government’s
unapproved uses for Seroquel and to conduct studies on
approach to relationships with HCPs or HCIs. These
compliance polices required, clearly outline the government’s position that duties and responsibilities be
The DOJ release stated, “in addition, the company recruited
clearly defined, be appropriate and in compliance with
doctors to serve as authors of articles that were
applicable federal health care program and FDA
ghostwritten by medical literature companies and about
requirements, and that fair market value rates be
studies the doctors in question did not conduct. AZ then
determined and preset. In addition, an ongoing review of
used those studies and articles as the basis for promotional
the arrangements should be performed to insure that the
messages about unapproved uses of Seroquel” and “that AZ actual work is performed appropriately. violated the federal Anti-Kickback Statute by offering andpaying illegal remuneration to doctors it recruited to serve
Page 2 UPDATES FROM BARATZ & ASSOCIATES, P.A.
The CIA states that the policies and procedures of AZ must
address the following areas as it relates to HCPs and HCIs:
1) Consultant or other fee for service arrangements
entered into with Health Care Professionals (HCP) or
Health Care Institutions (HCI) (including but not
limited to speaker programs, speaker training
programs, presentations, consultant task force
meetings, advisory boards, and ad hoc advisory
activities and any other financial engagement or
arrangement with an HCP or HCI and all events and
arrangements. These Policies and Procedures shall
U.S. based Physicians and related entities.
be designed to ensure that the arrangements andrelated events are used for legitimate and lawful
The above information gives valuable insight as to
purposes in accordance with applicable Federal
what the government believes companies should be
health care program and FDA requirements The
doing while conducting business. To ignore this insight
Policies and Procedures shall include requirements
is at your own peril. At the end of the day you must
about the content and circumstances of such
be able to appropriately answer the following:
2) Programs to educate sales representatives, including
but not limited to presentations by HCP’s at sales
meetings, preceptorships, tutorials and experience
Compensation (including through salaries, bonuses
and contests) for Relevant Covered Persons who are
sales representatives shall be designed to ensure
that financial incentives do not inappropriately
motivate such individuals to engage in improper
promotion, sales and marketing of AZ government
objectively in advance and reviewed at the
To the extent that AZ engages U.S. based HCP’s orHCI’s for services other than for speaker programs,
If you do the above, it will go a long way to ease your
tutorials, preceptorships, or research related
functions that relate to Promotional Functions or to
Product Related Functions (e.g., as a member of an
Ending note: The whistleblower in the qui tam lawsuit
advisory board or to attend consultant meetings),
will receive more than $45 million from the federal
such HCPs or HCIs shall be referred to herein as
consultants. AZ shall require all consultants to enter written agreements describing the scope of work to
be performed, the fees to be paid, and compliance
obligations for the consultants. Consultants shall be
www.justice.gov/opa/pr/2010/April/10-civ-487.html
paid according to a centrally managed, preset rate
structure that is determined based on a fair market
NOTE: FOR ADDITIONAL INFORMATION AND RESOURCES MAKE SURE YOU CHECK OUT OUR WEBSITE: http://www.baratzcpa.com
Copyright 2009 Baratz & Associates, P.A. E-mail: simmonsc@baratzcpa.com
4A Eves Drive, Suite 106 Marlton, NJ 08053 (856) 985-5688 Clifford Simmons, CPA Disclaimer:
The information included in this correspondence is for reference use only and does not constitute the rendering of legal, financial or other
professional advice by Baratz & Associates, P.A.
Informazioni Generali Premessa Dal 1974, data dell’invasione turca, l’isola di Cipro è formalmente divisa in due comunità, quella greca, che è la più numerosa, e quella turca. L’unico Stato internazionalmente riconosciuto è la Repubblica Cipriota formata dalla comunità greca, poiché la Repubblica Turca di Cipro del Nord è riconosciuta solo dal Governo turco. La presente sche
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