Ethics in Today’s Healthcare System on Life Support

In today’s society, many people think chivalry is dead, and many others would argue ethics in our healthcare system is on life support and not far behind.

There is evidence everywhere we turn that businesses put profits ahead of people and sacrifice consumer safety to boost the bottom line. Unfortunately, the healthcare, pharmaceutical and medical device industries are not immune from this same practice. Stories abound of hospitals and doctors performing unnecessary surgeries, drug companies stretching the truth about what a particular drug will cure, and medical device manufacturers overstating the intended and approved use of their devices…all in the name of profit.

Don’t misunderstand our objections: we are not against profit or averse to businesses being successful, but we do not agree with money being made at the expense of consumer safety.

What’s fueling this industry-wide absence of ethics is the all-mighty dollar. Pharmaceutical companies have agreed to pay fines of over $13 billion dollars since January 2009 to settle civil and criminal claims that violated states’ consumer protection laws by illegally marketing drugs and medical devices for purposes and medical treatments not approved by the FDA. Yet these fraudulent business practices have still netted hundreds of billions of dollars in that same time frame, rendering the billions in fines a mere drop in the proverbial bucket. This kind of cost-benefit analysis puts consumer safety on the losing side of the equation.

And these deceptive marketing practices go beyond mere “puffery”, a marketing term used to describe how a corporation “puffs” up the appeal of its product, and become outright fraud where salespeople are taught to ignore state consumer protection laws and given financial incentives to recommend drugs and devices for things and conditions that are not FDA-approved, and in some instances may be harmful or deadly to a patient.

That $13 billion paid out over the last five and one-half years represents claims settling allegations of:

  • Fraudulent marketing of drugs and products for unapproved uses;
  • Paying kickbacks to doctors to recommend certain drugs or products;
  • Keeping less costly drugs off the market and unavailable to consumers;
  • Concealing negative clinical data and evidence of adverse effects that may prove harmful or deadly to consumers;
  • Falsifying clinical data to gain FDA approval;
  • Overcharging government healthcare programs

To see a breakdown on the 10 biggest pharmaceutical settlements over the last several years, follow this link: http://www.drugwatch.com/2013/12/06/big-pharma-settlements/.

Unethical behavior is not limited to pharmaceutical and medical device manufacturers and their salespeople but is spilling over into the practice of medicine as we recently reported in our blog “Allegations of fraudulent billing, financial kickbacks, and unnecessary medical procedures infect Kentucky hospitals.”

Hospitals are providing financial incentives to doctors to perform unnecessary surgeries to bring in patients and money. Medical and surgical decisions are being made based on the financial well-being of the hospital and doctor, and not necessarily that of the patient.

Since a self-imposed code of ethics seems to be wanting in many boardrooms, we must entice the healthcare and pharmaceutical industries to choose patient safety ahead of financial gain by changing behavior not only in the boardroom but also in the salesroom and the operating room by eliminating the influence of the almighty dollar from medical decisions.

This “Patient First” type of settlement was recently achieved when GlaxoSmithKline agreed to pay $105M as part of a multi-state settlement for illegally promoting asthma and antidepressant drugs, and agreed to change its financial incentives to salespeople as a way to help reduce unapproved, off-label marketing of its products, and also agreed to stop paying kickbacks to doctors to promote its products.