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Novartis Paid Kickbacks to Doc Lecturers Even If They Couldn't Speak English

Novartis (NVS)'s $422 million settlement for paying kickbacks and off-label marketing contains some hidden gems about how the company promoted Diovan, a blood-pressure drug: Sales reps paid thousands of dollars in speaking fees to doctors who couldn't speak English, and sometimes speakers would address an audience that consisted of just one other doctor, according to a whistleblower suit.

The suit, brought by former pharmaceutical sales rep Jeremy Garrity, describes Diovan as a drug that was not superior to the others on the market, which was dominated by Merck (MRK)'s Cozaar, so Novartis was required to pay doctors to prescribe it. Payments took the form of recruiting docs to give presentations to other physicians about the drug, with both the speaker and the attendee receiving a fee. Some highlights from the suit:

  • Sometimes the audience for a speaker programs was limited to a single physician in attendance.
  • The contract between the Novartis salesperson and the physician speaker was discretionary, and it enabled sales representatives to include double and triple payments to the speaker physicians.
  • Physicians who did not prescribe would not be paid.
  • If a physician speaker was recruited as a moderator, they were paid $1,000 - $1,500 each time. Their job was to basically read through a book prepared by Novartis with the audience.
  • Speakers were used and paid even though several speakers had difficulty with English. Other speakers were simply very poor communicators.
  • By 2007, Novartis' slush fund for doctors was $9.5 million. One doctor was paid $101,500 in honoraria fees.
You can read the names of a few dozen doctors who received payments from Novartis on page 14 and 15 of the suit.

Award yourself a brownie point of you noticed that all the Diovan allegations Novartis is pleading guilty to today were previously detailed on this thread in CafePharma, way back in 2007. Two anonymous commenters wrote:

Nofartis is very clever in how they pay the docs. How do you do it anyway? $3000 speaker payments, $500 5-star restaurant gift certificates? $1500 protege payments to let the reps follow the doc around for half a day? Or the 'oops I accidentally dropped a check for $1000 in the doc's office' payment?

I agree with some of the other posts, Avapro is not the issue, Cozaar and Hyzaar are, they have much more impressive data. I have a plan to sign up their top three writers this year. If I can pull this off, pay them to speak, I dont even care if they speak at funerals, just pay them what we promise them, I will have an awsome year. I know merck will not pay local speakers to speak, they have to sell on data alone. This should be a slam dunk! if I can pull this off.

Related: Image by Flickr user neubie, CC.