Former State Pharmacist (Pennsylvania) Faces Criminal charges

Business Week reports (below) that Fiorello is charged with accepting money and other perks from companies who have vested interests in having their drugs on the Pennsylvania drug formulary.  Consulting relationships with Pfizer, maker of Geodon and Janssen, makers of Risperdal were noted in the court documents.

Fiorello was the head of the Pennsylvania State Formulary Committee charged with  selection of psychiatric drugs used in Pennsylvania’s health programs, including clinics,  mental, juvenile and penal institutions.  He was instrumental in bringing the Texas Medication Algorithm Project (TMAP) to PA in the form of PennMAP.  This program ensured that the atypical antipsychotics including Geodon, Risperdal, Seroquel, Zyprexa and Abilify would be used extensively within the Pennsylvania network of care for the mentally ill.

TMAP was heavily supported by the pharmaceutical industry and was touted as a panacea for mental health treatment.  It spread from Texas to other states largely through the pattern of corruption alleged in the Fiorello case.  Pharmaceutical companies ensured almost exclusive use of their patented expensive drugs in state institutions and programs by   improperly influencing—i.e., bribing—a few key government decision makers. Makers of SSRI antidepressants and ADHD psychostimulants stimulants joined the TMAP bandwagon amidst false and misleading claims of superior safety and efficacy over older, much cheaper, drugs. 

Today, most of the TMAP drugs carry Black Box warnings for deadly side effects: antipsychotics trigger potentially fatal metabolic syndrome, diabetes, and cardiovascular disease—they have NOT demonstrated greater efficacy than Haldol.  SSRI antidepressants increase the risk of suicide—1 in 50 children are at risk. An FDA review of the adverse reports re: psychostimulants found the drugs to cause children to become psychotic and hallucinate. The federal Substance Abuse and Mental Health Services Administration (SAMHSA) has withdrawn it’s support of TMAP and states like OHIO have abandoned the program.  In other states TMAP remains as a relic of drug industry/political corruption.

Pennsylvania Attorney General Tom Cabbot says:
"Pennsylvania law very clearly prohibits state officials from using their public positions for personal financial gain," said state Attorney General Tom Corbett. "Accepting illegal payments and then failing to report them is not only a conflict of interest, but also a violation of the public trust."

Four years ago, AHRP Board Member Allen Jones was hot on the trail of Fiorello when he was employed as a fraud investigator for the Pennsylvania Office of Inspector General.  Jones brought evidence of impropriety closely matching what is outlined in the current AG criminal complaint against Fiorello, to his OIG superiors.  Instead of acting on the evidence, the OIG responded by ordering Jones to back off of the investigation because “Drug companies write checks to both sides of the aisle.”  Jones refused to back off taking his evidence to the New York Times and British Medical Journal.  Jones was ultimately fired for bringing the evidence to public attention. His story can be found here: http://ahrp.org/cms/index.php?option=com_content&task=view&id=5&Itemid=147

One can find reason to hope that the prosecution of Fiorello signals a change in the political winds that have filled the drug industry sails for so long. But it must be a cautious hope for now. The law has not changed since Allen Jones was shut down and fired. Something else has changed. If this change reflects a growing political will to halt Big Pharma’s excesses, we will begin to see more prosecutions of corrupt officials, and their industry counterparts. 

We believe that the prosecution of Steven Fiorello is a sign of hope for reclaiming public servants on behalf of the public interest, not an indication that our work is done.
 
Contact: Vera Hassner Sharav
veracare@ahrp.org
 
 

 http://www.businessweek.com/ap/financialnews/D8LHLGN00.htm
 BUSINESS WEEK 

 Former state pharmacist charged
 By PETER JACKSON
 HARRISBURG, Pa.
 
 The former chief pharmacist for the state Public Welfare Department, who earned extra income from sources that included two drug manufacturers, was charged Tuesday with crimes that carry potential prison time.

 Steven J. Fiorello, of Palmyra, was fined more than $27,000 last year by the State Ethics Commission for using his position to get consulting work. He was arraigned Tuesday on criminal charges for the same activity.

 "Pennsylvania law very clearly prohibits state officials from using their public positions for personal financial gain," said state Attorney General Tom Corbett. "Accepting illegal payments and then failing to report them is not only a conflict of interest, but also a violation of the public trust."

 Fiorello was arraigned Tuesday on two felony counts of conflict of interest, which each carry a maximum five-year prison term and $10,000 fine, and misdemeanor counts of accepting honoraria and failing to disclose income on annual statements of financial interest.

 A preliminary hearing was set for Dec. 1, but Fiorello's lawyer, Joseph Metz of Harrisburg, said it is likely to be postponed.  "I think both sides want to sit back and take a look at what we have here," Metz said.

 Fiorello, 59, served as pharmacy director for the welfare department's Office of Mental Health and Substance Abuse Services for several years. He left state government and now works in the pharmacy industry as a consultant, his lawyer said. He already paid Ethics Commission fines totaling $27,269 in April 2005.

 Fiorello allegedly accepted more than $10,000 for consulting work he did and trips he took between 1998 and 2003 for various companies, including the Pfizer and Janssen drug companies, according to court papers.

 Two of the Pfizer payments, totaling more than $2,100, covered Fiorello's speaking fees and expenses at company conferences in 1999 in Dublin, Ireland, and Orlando, Fla., where Fiorello presented the results of a state-financed study. The study of antidepressants found Zoloft — a Pfizer product — to be among the least expensive drugs of that type, according to the Ethics Commission.

 The commission cited repeated conflicts between Fiorello's unofficial business and his official duties, which included serving on a department panel that decided which medications may be given to patients at nine state mental hospitals.

 The second felony count involves private work Fiorello allegedly did on state time supervising pharmacy-student interns at Duquesne University in Pittsburgh in 2000, 2001 and 2003. Fiorello received checks totaling $2,400 from the university, according to court papers.

 Fiorello was released on his own recognizance, a court official said.

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