Medicaid Heavily Influenced By Drugmakers

An ugly story of how weak regulations are allowing big pharma to exploit a system that is in desperate need of changing.The story is long but worth while.


Meet Dr. Mohamed Ramadan. He "volunteers" at the Arizona committee that decides what drugs go on the list for medicaid patients. He also earned over $700,000 from drug companies since 2013.

Dr. Mohamed Ramadan volunteers on the 16-member Arizona committee that decides the state's list of preferred drugs.

He also earned more than $700,000 since 2013 from drug companies, federal data show, a healthy supplement to his $259,000 salary as a psychiatrist at a mental health clinic.www.npr.org...

Ramadan who spoke an average of once a week for the last 4 1/2 years about pharma drugs said healthy interaction with the drug companies is important-he was also paid $500,000 for his three hundred and thirty three speeches. Pretty healthy.

Some of the drugmakers' payments to Ramadan came in the form of lunches, dinners, travel, and consulting fees. But the bulk of it — more than $500,000 — was compensation for work such as speaking at events promoting certain drugs. Pharmaceutical companies paid Ramadan for these types of events 333 times over four and a half years — an average of more than once a week.

"Healthy interaction with pharmaceutical companies is important," Ramadan said. "I try to do my best to educate myself and my colleagues in a way that would spread knowledge."https://www.npr.org/sections/health-shots/2018/07/18/629575118/medicaid-under-the-influence-how-drugmakers-sway-medication-options-for-pati ents

Ramadan is in favor of 2 drugs (from the pharma co. that paid him $700,000+) that have generic equivalents, but are $2,000 more a month more that the generics.
Oh and Ramadan only showed up (volunteered) to the Arizona Drug committee when his 2 very expensive drugs were reviewed. But he did say he phoned into one other meeting.

Most of Ramadan's payments were related to two drugs, Janssen Pharmaceutical's Invega Sustenna and Otsuka's Abilify Maintena. Both are powerful schizophrenia drugs that are injected monthly, replacing a daily pill. They cost roughly $2,000 more than generic pill forms of the same drugs.

Even though meeting minutes show Ramadan has missed nearly half of the Arizona drug committee meetings since he joined in 2016, he has shown up to the ones that reviewed Invega Sustenna and Abilify Maintena. After reporters' questions, he abstained from voting on those and similar drugs in a meeting Tuesday.www.npr.org... s

And finally, the system set up along side the for profit system is of course going to be exploited. Dr.s are being bought by big pharma.

But three out of five doctors voting on state Medicaid decisions nationwide received perks from pharmaceutical companies. www.npr.org...

The US health system is teetering on collapse. We pay much much more than any other industrialized nation and not everyone is even covered with no proof our system is better. Our for profit system is a dismal failure when compared to other countries. Seems there maybe no easy answers though.

It is absolutely absurd. Just one example. I have quite a few patients on short acting and long acting insulins. Just in the past 3 months I have had to switch formulary multiple times.

First humalog is covered, next month nope. Switch to novolog. Next month nope, switch to a brand new drug called admelog that is now magically preferred.

Long acting is worse. First lantus, then switch to tresiba, then toujeo....holy hell is it bullcrap.

It is the same with new meds that come out that offer very little new therapeutically over others already out in the same class, and it is magically preferred first tier because reasons

a reply to: annoyedpharmacist

Seems regulations are in order to curtail the makers of drugs from buying customers.

a reply to: annoyedpharmacist

you'd think that switching from one drug to another like that, even if they are similar wouldn't be too beneficial for the patients. as a patient, I think I'd just go with the cheap generic before I'd expect my body to continuously adapt to the constant changes.
but then, what do I know, medical care is a budget killer I can live, or die, without.

The whole practice should be banned.

My own hospital instituted such a ban in 2006. Pharmacy reps are not allowed on campus unless its to speak to the pharmacy panel. They cannot accept gifts or anything. I believe John Hopkins has similar policy.

The MD will not tell you but an easy way is to look at the nurses. if you name tags on stethoscopes that has a pharma company on them or notepads and pens scattered about the nurses station you know when the pharma reps are out in force.

Just as a side note they also lobby Nurses, RT, pharmacists etc as well. Not as lavishly mind you but its not unheard of to fly nurses out to a conference as well (again NOT in my facility)

California which is one of the worst offenders in terms of this graft is taking steps and a bill is underway to clamp down on this. www.policymed.com...

This is just the tip of the iceberg. Pharma companies are conditioning people to ask for expensive drugs, the more that ask, the more chance that medicare and medicaid will approve it. Some of these drugs are no better than the cheap ones they replaced, the Pharma companies get to decide what comparisons they want to compare the drugs to the older drugs with. Sometimes the old drugs have a way better overall rating than the new ones, but choosing what to compare against makes the new drug sound better.

Not all drug companies are corrupt, just the majority of them. My idea of corrupt is not what our government considers illegal though, it is perfectly acceptable to them as long as the drug companies keep feeding the FDA income.

a reply to: atsgrounded

Just another example of half your income taxes being blown.



Here's the breakdown of where it goes

a reply to: CriticalStinker

If we were to move to a single payer system (Canada) would we see the almost $.29 cents go down? From what I have seen it would be reduced by 1/2.

originally posted by: atsgrounded
a reply to: CriticalStinker

If we were to move to a single payer system (Canada) would we see the almost $.29 cents go down? From what I have seen it would be reduced by 1/2.

How would it go down if it covered all Americans?

You're putting a lot of faith into our government.

a reply to: CriticalStinker

Other countries cost per head is no more than 1/2 ours (pretty easy research project for your Sunday afternoon).

And perhaps you are putting too much faith is monopolized sectors of the economy.

originally posted by: atsgrounded
a reply to: CriticalStinker

Other countries cost per head is no more than 1/2 ours (pretty easy research project for your Sunday afternoon).

And perhaps you are putting too much faith is monopolized sectors of the economy.

Do they have the same levels of obesity, diabetes, ect.?

a reply to: CriticalStinker

How am I supposed to know? I imagine they are similar, but just a guess. The fact of the matter is tons and tons of people love the system in the US, but fail to realize that there are other much much more efficient ways that are working.

And this ins't a slam against pro US medical people ( I assume you are one). It is a measured researched opinion. Just look into the cost of an MRI (as one of thousands of examples) in the US and in any other industrialized nation. It is very costly in the US because it is allowed to be.

a reply to: atsgrounded

I'm not pro/against the current system. I just know a couple of things that make it harder than many of the anti-US health care system don't realize.

If you made the switch we would have to make a new agency for overhaul Medicare.

Doing either would decimate a huge private sector, where do those people get jobs? (And no they don't want to work for the goverment.)

Contrary to what you think, we have far higher obesity rates than most developed countries.

And finally, if we spend so much on healthcare from income taxes already, for the sake of argument 7~ of each pay check for everyone, most of whom don't pull benefits. Why would they suddenly be able to take on everyone at a feasible rate?

I think the only way to achieve it is to place a luxury tax on consumables that are unhealthy to pay for the system. It would ensure those who put the greatest strain on the system are helping to fund that strain.

That said, imagine how many companies in the US would dissolve, what would that do for tax revenue for federal, state, and local governments? Along with jobs.