A major pharmaceutical company has sought to influence state government officials with trips, perks, lavish meals, and other payments, says an investigator from the Pennsylvania Office of Inspector General.
Investigator Allen Jones told the BMJ earlier this week that he had discovered that the drug company Janssen was sponsoring educational events for state employees, funding individuals' travel arrangements, and paying honorariums of up to $2000 (£1100; €1610) each to key officials who held influence over the drugs prescribed in state-run prisons and mental hospitals.
Yet as his investigations widened, Mr Jones was dropped from the case and told by a manager that "drug companies write cheques to politicians" on both sides of politics. Mr Jones subsequently started legal action, accusing his employer of trying to bury important evidence of wrongdoing. Although no formal report has been released, many of his findings were reported in the New York Times last Sunday (p BU1).
Janssen is the subsidiary of healthcare giant Johnson & Johnson that markets risperidone, the atypical antipsychotic medication widely used in the treatment of schizophrenia.
Along with other drug companies that make new antipsychotics, in the late 1990s Janssen funded the development of state based guidelines for the treatment of schizophrenia, heavily favouring the newer more expensive medications over older cheaper ones. The guidelines, initiated first in the Texas prison and psychiatric systems, are currently being adopted in other states, including Pennsylvania.
A spokesman for Janssen, Doug Arbesfeld, confirmed to the BMJ that the company had made payments to state officials and helped to sponsor the guidelines, but he flatly rejected claims that the company was seeking influence. "We provided funding to the Texas Department of Mental Health so their officials and physicians could share their experience with the guidelines in other states—professional to professional." Referring to the scientific debate about the relative merits of the newer versus older drugs, Mr Arbesfeld said some guideline groups were more aggressive in their support for the new medications, and some more conservative, but the Texas guideline was somewhere in the middle.
In 2002 the journal Psychiatric Services published an article comparing four different schizophrenia guidelines, concluding that the Texas medication algorithm project was the easiest to use, but far less scientifically rigorous than two of the others (Psychiatric Services 2000;53:888-90).
A spokesperson for the Office of Inspector General could offer the BMJ no comment on allegations of improper influence or on why Mr Jones was dropped from the case. However, Stephanie Suran, from the Pennsylvania Department of Public Welfare, although defending the guidelines as being good for patient care, said the allegations of improper influence were now before the state Ethics Commission.
Federal health authorities are also understood to be investigating, and Janssen last week received a subpoena for documents relating to risperidone.