Compliance News in Review, March 24, 2015

Oregon considers the idea of requiring pharma companies to disclose pricing information, CMS offers Open Payments updates, Sandoz settles with the OIG over alleged pricing data misrepresentations, the DOJ beefs up its FCPA enforcement team, and Public Citizen petitions the FDA on the issue of companies distributing peer-reviewed articles.

It’s time to dance everyone! March Madness is here. And what a dance it has been so far. As per usual, a couple of Cinderella moments wreaked havoc on brackets far and wide. Now it is onto the Sweet 16. Is your team still in the mix? While there’s a momentary break in the action, let’s take a look at the stories that filled our dance card this past week. Time to tipoff this week’s Compliance News in Review.

Our first story takes us to the home of the Oregon Ducks. Perhaps taking a cue from its neighbor to the south, a bill has been introduced in the Oregon legislature to require pharmaceutical companies to disclose information related to drug pricing. California introduced similar legislation recently, and like the California proposal, Oregon’s proposal would apply to drugs with an annual wholesale acquisition cost of $10,000. Companies would be required to file an annual report with the State, detailing information such as the manufacturer’s costs related to R&D, and costs paid for distributing the drug. Representatives from industry groups, PhRMA and BIO, testified before a committee, saying that the proposed law would harm patients and industry companies.

The clock is running down for 2014 data submission to Open Payments. With that in mind, CMS recently held a Q&A session to deal with any burning questions from Applicable Manufacturers and GPOs. During the call, CMS suggested that companies that have United States spelled out in their files deleted their records, change to “U.S.” and resubmit. So far the work around has proved largely successful. The agency also noted that it can trace deleted manufacturer records and said in order for companies to avoid audit issues and possible penalties, companies should separate rejected records from accepted records.

Sandoz was called for a costly foul when the company agreed to settle with OIG for $12.6 million over allegations it misrepresented drug pricing data. According to the OIG, between 2010 and 2012, Sandoz misrepresented the Average Sales Price (ASP) to CMS. As part of the settlement, Sandoz had to certify that it has established a government pricing compliance program.

The DOJ is adding quite a few new players to its FCPA enforcement team. The agency has confirmed it is adding 30 new agents specifically to deal with FCPA violations. More hands on the DOJ deck raise the stakes for companies in their compliance efforts. Legal experts say companies need to take a look at their internal and external anticorruption programs, and conduct reviews of internal controls, risk assessment, and third-party due diligence.

The SEC plans on beefing up its FCPA enforcement schedule. At the Corporate Counsel Institute conference, the SEC’s enforcement director, Andrew Ceresney, said that the agency’s regulatory focus would be on internal controls, and more FCPA enforcement actions. He pointed out that the SEC has already brought more FCPA cases in the five months of the 2015 fiscal year, than it did in all of 2014.

Public Citizen is asking the FDA to withdraw a proposal that would allow pharmaceutical companies to distribute peer-reviewed articles containing data stating a drug is not as risky as indicated on the label. The group sent a letter to Health and Human Services, saying the proposal would allow drug companies to “sell more drugs by making them appear safer than the FDA judged them to be.” Public Citizen has obtained and published all the comments the FDA has received on the proposal. Most of them are in opposition to the idea.

That about wraps it up for this edition of the Compliance Week in Review. Here’s hoping your favorite college squad is still in the hunt for a Final Four – we’ll be here wondering what exactly happened to our Villanova Wildcats (there’s always next year…again).

Have a great week everyone!

The 2015 Pharmaceutical Compliance Congress: A Review and Recap

The 12th Annual Pharmaceutical Compliance Congress provided an overflow crowd of rapt attendees with two days of best practices and updates on critical compliance-related topics. While the usual array of content was covered, the focus often turned to two key topics – Speaker Programs and the FCPA.

Day 1

The conference kicked off with a keynote speech from Michael Shaw, Vice President and Chief Compliance Officer for GlaxoSmithKline. Shaw’s presentation was focused on the idea that instilling a culture of compliance is not enough in today’s regulatory environment. He emphasized the importance of ‘explaining the why’ behind the values, and the need to hold individuals accountable for compliance. As an example, at GSK, while Compliance is responsible for facilitating the process, Brand Directors are held accountable for managing the risk. As Shaw says, “compliance programs are important, but they’re not enough. The elements of the programs need to have traction.”

Otsuka ‘s Regina Gore Cavaliere and Brian Miller showcased their use of humor as a core tool for compliance training. Cavaliere and Miller have integrated a variety of creative elements, including a mock mini-series called The Pharm, comic books, and live talk shows, into their curriculum to keep the training fresh and appealing. Much of what was presented was indeed witty and engaging, and it showed that comedy can clearly be an effective tool when developed professionally and integrated carefully into a blended campaign.

In the Chief Compliance Officer Panel titled, Working with the Business – Ensure Compliance Adds Value to Operational Success, Jeffrey Rosenbaum from Vertex, Sujata Dayal from J&J, and Sumita Ray from Pharmacyclics, offered their perspectives on the keys to an effective program. With limited resources and time, Rosenbaum starts with his company’s business objectives while managing the issues with the highest risks. Ray agreed, saying she evaluates what risks she has to address on a daily basis, making training her first priority. As part of a large global company, Dayal begins with a formal risk assessment and conducts testing on a regular basis to ensure that mitigation is working. Rosenbaum also emphasized the importance of recruiting allies in the company when resources are stretched, as with Sunshine Act reporting, while Ray echoed Michael Shaw’s points about the importance of holding businesses accountable for their actions and results.

The presentations shifted to a governmental and regulator’s perspective with Doug Brown from CMS updating the audience on the state of Open Payments, a panel of US Attorneys addressing trends and top priorities in healthcare enforcement, and Andrew Ceresney, Director of Enforcement at the SEC covering disclosure issues relevant to the pharmaceutical industry.

What stood out during the enforcement panel was the increased amount of cases the regulators are seeing involving small to mid-size companies. Greg Shapiro, from the District of Massachusetts added that the audience should expect to see more criminal liability with those cases. Jacob Elberg, from the District of New Jersey encouraged those who identify a problem to self-report since “it sends the right message to employees and regulators.” More than one panel member delved into the risks of Speaker Programs, with Shapiro calling them “areas prone for abuse” and William Killian from Tennessee reminding the audience that Speaker Programs must not be tied to any promotion of business.

Ceresney covered the FCPA and the risks particular to the pharmaceutical industry. According to Ceresney, the SEC is focusing on three enforcement areas: pay to prescribe, pay to get on formularies, and charitable contributions. He emphasized the need for risk assessments and training, and the need to take measures when issues are identified.

After lunch, the sessions were divided into smaller groups, and I opted to stay with the FCPA theme in the session titled, Strengthen your FCPA Compliance through Smarter Training. David Nicoli, former VP, Corporate Affairs, AstraZeneca, and a panel of vendors walked through the steps they consider to be crucial when training on the FCPA. Collaboration is key, Nicoli claimed, and during his tenure at AZ he partnered on training initiatives with key allies, such as the Heads of Human Resources and Social Responsibility, who truly understand the work environment. The panel stressed the need for short, quick hits in FCPA training, and the fact that bad decisions make for good stories that stick in learners’ minds.

After the FCPA session, I jumped into the track dedicated to Product Promotional Compliance. Paul Silver from Huron presented statistics from a recent industry survey on company interactions with HCPs. For example, 86% of companies reimburse for HCP travel time and 1/3 of the companies surveyed have a limit on hotel expenses. Overall, the statistics presented a strong baseline for how the industry handles HCP travel time and I highly recommend the data for those interested in knowing what their peers are doing.

The session on overseeing the relationships between Sales, MSLs, and Managed Care Reps, was highlighted by one powerful statement from Kevin Stark, Director of GHH Compliance, at Merck, which could be considered a compelling theme for the entire conference, build a culture where it’s okay for people to admit when they made a mistake.”

Day 2

The second day opened with Tom Abrams of the FDA and his annual update on enforcement trends at the Office of Prescription Drug Marketing. In the area of policy and guidance development, OPDP has released six draft documents since January 2014, and three draft guidance documents on social media.

Abrams’ agency continues to allocate resources and priorities based on potential threats to public health. The most common violations over the past year were related to omission and minimization of risks, and unsubstantiated superiority claims.

Day 2’s enforcement panel, titled, A View from the Outside —Mitigate Risk and Prepare for the Future featured a panel of defense attorneys well-versed in the areas of risk for small and large pharmaceutical companies. Scott Lieberman of Loeb and Loeb stressed the need for sales representatives to know exactly how to handle off-label questions when dealing with HCPs. Matthew O’Connor, of Covington & Burling warned smaller companies to allocate enough resources to monitoring, an area often neglected. When asked about the relationship between Compliance and Legal, Allison Shuren from Arnold & Porter said Compliance should be the “boots on the ground, moving issues up the food chain,” and John Richter, from King & Spalding, noted that Compliance should be ‘setting the policy and evaluating the balance between costs and risks.’

I was particularly interested in the Life After a CIA — Impact on Internal Team Structures and Resource Allocation panel, so I attended the breakout session: Compliance Program Structure and Effectiveness.

Sujata Dayal, from J&J, stressed the need to continue the conversation between the businesses and Compliance but that dialogue needs to change as the role of the business shifts from one in which the businesses mandates company priorities to one in which they influence actions and decisions. Gregory Beeman, from Eli Lilly, said the first step was to see what can be streamlined and continued post-CIA. In other words, what was under OIG oversight that could be eliminated now that the CIA has expired?

In Successful Promotional Programs — How to Use Data Analysis & Market Research to Drive Compliant, Effective Results, Mark Dizon from Actelion, and David Gilman from Huron led a spirited discussion on the use of data and analytics to assess risks and results of Speaker Programs. The idea of whether Speaker Programs should be evaluated against Return on Investment was of particular interest as audience members and the panel members debated the merits and risks associated with acknowledgement of the ROI.

The final session I attended was focused on the challenges faced by small to mid-size businesses as they struggle to allocate compliance resources. The panel, consisting of Timothy Ayers of Porzio, Bromberg & Newman, Katrina Church of Merz North America, Jeff Rosenbaum from Vertex, Sarah Whipple from Aegerion, and Greg Moss from Kadmon, offered a diverse set of best practices based on their experiences with limited resources and time. The perspective offered by those who are literally ‘departments of one,’ and those, like Church from Merz, whose departments are growing rapidly, had enough content, suggestions, and tips to fill a conference unto itself. As one example, the panel and audience debated the benefits and challenges of live training versus eLearning. While live training offers the opportunity to work face-to-face with each trainee, which is easily achieved in very small companies, Church was quick to point out that as Merz grew, a shift to more eLearning, with its streamlined tracking, became a necessity. And, like their colleagues from larger companies, these participants emphasized the need to include the Board of Directors and the C-Suite in the importance of compliance training; and in getting buy-in at all levels of the company.

To sum up, the details brought forth over two days by many well thought out presentations and panel sessions in this year’s Pharmaceutical Compliance Congress offered veteran attendees and new comers alike a wealth of practical and impactful information, making attendance not only a good idea, but crucially important to staying abreast of new developments and best practices in life sciences compliance.

Compliance Week in Review, March 15, 2015

A French court overturns the fee for service exclusion from Loi Bertrand, a dental company settles with the Vermont AG’s office over failure to report charges, an internal investigation at Teva reveals potential FCPA violations, and a representative from the SEC discusses the FCPA with a group of life sciences compliance professionals.

Well, we’ve survived another shift to Daylight Saving Time and we’ve had a few days to adjust and reset our internal clocks…yeah right. There isn’t enough caffeine in the world, is there? That spring forward thing certainly leaves us here at the Week in Review offices feeling anything but springy! As it is, we’re in Daylight Saving Time now, like it or not (unless of course you live in AZ, or a handful of U.S. Territories that have the good sense not to jump on this bandwagon), and while the clock may shift, the news waits for no one. So sit back, relax, but not too much, as we spring into this week’s News Week in Review.

The times they are a changing, and so is the French Sunshine Act. The top French administrative court reversed the decision by the Ministry of Social and Health Affairs to exclude the amount paid to healthcare professionals and organizations for fee for service contracts from manufacturer reports. Currently, manufacturers only need to report the existence of the contract. The court said that Ministry overstepped its bounds with the decision. The Ministry is evaluating the implications of court’s decision, and will issue new regulations at some point in the future.

Better make time to send in those disclosure reports to Vermont! A dental company settled a case with the Vermont Attorney General’s office for $45,000 over its alleged failure to submit disclosure reports. This is the second settlement in a month involving the disclosure law.

Through a securities filing, TEVA revealed it had uncovered information that some of its actions may have violated the FCPA. The company’s investigation began after it received subpoenas from the DOJ and SEC. The investigation centered on business practices is in Russia, Eastern Europe and Latin America.

A representative from the Securities and Exchange Commission (SEC) shed some light on the subject of FCPA risks for life sciences companies at the recent Pharmaceutical Compliance Congress. Andrew Ceresney, Director of Enforcement athem nt the SEC, focused on three key areas of risks, pay-to-prescribe arrangements, (rewarding doctors for writing prescriptions), payment of bribes in exchange for being placed on a formulary, and the payments of bribes disguised as charitable donations.

Ceresney also pointed out the importance of establishing internal controls specific to the business, and updating the internal controls when the business changes or grows. He referred to dealings with the FDA as the “lifeblood” of the industry, and emphasized the importance of investors having accurate information when making critical decisions.

And that brings us to the end of this Daylight Saving Time edition of the Compliance Week in Review. Remember, if you’re compliance training curriculum is in need of a wakeup call, the PharmaCertify™ suite of solutions offers up-to-date compliance training and reference content where your team needs its most – in the field and at their fingertips.

Have a great week everyone, and don’t forget that extra cup of coffee.

Week in Review, March 6, 2015

A potential new law in California calls for greater drug pricing transparency, consumer advocacy groups and industry trade groups in Europe argue over clinical trial data transparency, a Maine law allowing the purchase of pharmaceuticals from foreign pharmacies is overruled, and the issue of off-label speech and free speech is back in the news.

In like a lion and out like a lamb; it’s hard to believe March is here. The really good news…spring is almost here as well (although looking at the seven inches of fresh snow outside the Week in Review windows, we find that hard to believe). Whether you subscribe to the meteorological or astronomical start of spring, one way or another it is/will be here this month, and that alone is reason to celebrate! We are on the downward slope of winter, folks and we couldn’t be happier. Another thing that makes us happing is sharing the news of the week with all of you, so let’s spring in to action and get this week’s Week in Review underway!

Nothing says spring like some sunshine, and nothing says sunshine like transparency laws. A California assemblyman has proposed a law that would require the disclosure of information related to the pricing of drugs. The law would apply to drugs costing $10,000 or more for a course of treatment, and companies would have to report information such as production costs, sales and marketing costs, and financial assistance provided through prescription assistance programs. If the law is passed, companies would submit annual reports to the state, and the information would be made available to the public.

Speaking of transparency and disclosure, there seems to be a kerfuffle blooming in Europe over clinical trial data transparency. Proposed rules by the European Medicines Authority (EMA) have prompted comments from industry trade groups and others regarding the confidentiality of commercial information. Industry groups have said certain data related to clinical trials could reveal trade secrets and compromise patient privacy. Consumer advocacy groups insist the more transparency the better in the name of protecting patients. In a press release, a Germany-based advocacy group accused the EMA of writing such a broad definition of commercial confidential information that the determination of what is confidential is left up the study sponsor. Two bio industry trade groups released a statement saying there should be a “deferral” for the disclosing information from Phase I trials due to the “commercial sensitivity” of the information.

Medical device manufacturer, ev3, had to spring for some past promotional issues allegedly committed by one of its recent acquisitions. The company agreed to pay $1.25 million to settle allegations that it violated the False Claims Act. The government claimed Fox Hollow Technologies, which was acquired by ev3, caused hospitals to improperly bill Medicare and Medicaid for medically unnecessary inpatient stays for patients undergoing atherectomies using a Fox Hollow device. The government alleged the company suggested the inpatient procedures in order to drive sales of the device to hospitals, thereby causing hospitals to be reimbursed more than they were entitled.

There’s been a late freeze on the Maine law that allows individuals to purchase prescription drugs from select foreign pharmacies. A federal judge has ruled the Maine law is overruled by federal law, which prohibits importing drugs from foreign countries. The decision nullifies the Maine law. The state can appeal if it chooses.

The seeds are being planted for another free speech case involving off-label statements. A federal district court in California is considering a whistleblower False Claims Act case against Millennium Pharmaceuticals in which the whistleblower claims that Millennium and Schering-Plough (now Merck) promoted a heart drug for off-label uses. In a motion to dismiss, Merck argued that the False Claims Act cannot be interpreted to prohibit the truthful, non-misleading exchange of scientific information. In making the argument, Merck sited both the Sorrell v. IMS Health and U.S. v. Caronia cases. The DOJ filed a brief with the court saying that truthful speech could be used as a basis for the False Claims Act. PhRMA filed a friend of the court brief in support of Merck’s argument.

With that, we end this “almost spring, we hope” edition of the Week in Review. Have a great week everyone!

 

News Week in Review, February 18, 2015

Several companies announce settlements of charges related to the False Claims Act, CMS releases new information to help with system registration and data submissions, and the National Coalition on Healthcare holds a lively panel session on the Sunshine Act.

Laissez les bons temps rouler, y’all! The end of the Carnival season is here and yesterday was the big send off…Fat Tuesday! Or as you may know it, Mardi Gras. Yes, a time of frolic, frivolity, and according to Turbo Tax, a number of incidents that can affect the filing of your taxes for the next year. Whether you partied until the wee hours in NOLA, or just enjoyed the simple fun of a pancake dinner at home, we hope it was a great celebration. Now it’s time for our regular look back at some of the “celebrated” compliance news of the week, with this edition of the Compliance News in Review.

We start today’s parade with settlement news for several industry companies. Medtronic agreed to pay $2.9 million to settle allegations it violated the False Claims Act. The government alleges the company caused claims to be submitted to Medicare and Medicaid for an investigational procedure. Next, AstraZeneca paid $7.9 million to settle charges it violated the False Claims Act. The company is alleged to have paid kickbacks to PBM Medco in exchange for Nexium’s “solely and exclusively” being maintained on Medco’s formulary. The government claims the kickbacks were provided as prices concessions on other AstraZeneca drugs. Finally, a physician has pled guilty to accepting kickbacks from two pharmaceutical companies in exchange for prescribing the drug, Clozapine. The physician received nearly $600,000 in kickbacks and benefits from IVAX and later, Teva. He also agreed to pay over $3 million to settle a parallel civil case.

The Centers for Medicare & Medicaid Services has been busy tossing beads and doubloons to the industry in the form of advice and consultation. Another Open Payments Q&A session was held just this past week, and in advance of the Q&A session, CMS released several new resources covering system registration and data submissions. The agency has also posted the audio from the January Q&A session.

Speaking of the Q&A session, the February session covered a couple of important topics for industry stakeholders. First, it was announced that a fix would occur over the Valentine’s Day/Presidents Day weekend that should resolve most of the problems that companies are having with submission of the 2013 data. On the downside, attendees were notified that the release of the Validated Physician List has been delayed. CMS is hoping to have the list ready by February 20. Those on the call were reminded that this list is only comprised of physicians for whom a 2013 record was submitted. CMS is scheduling a full day to take stakeholder questions. As soon as a date is nailed down, it will be announced on the Open Payments website and via a listserv email.

It wasn’t exactly cause for great celebration, but a recent briefing held by the National Coalition on Healthcare led to the call for expanded requirements under the Sunshine Act. The panel was comprised of individuals from the government, physician groups and the Pew Charitable Trust. A representative from Senator Grassley’s office explained that ultimate goal of the Sunshine Act was to spur an open discussion between patients and their doctors. The founder of PharmedOut, an organization that advocates against pharmaceutical marketing influence in medicine, took the harshest stance, saying the law wasn’t strict enough. She accused companies of seeking out the family and friends of physicians as an avenue for delivering marketing messages, and expressed grave concern about the industry engaging in disease state awareness. Drug samples were a hot topic. A representative from the AMA says there is a gap in transparency where the provision of samples is concerned and he believes providing samples is “misdirected and unsafe.” The founder of PharmedOut agreed, stating that patients should refuse samples and ask for older drugs that have stood the test of time.

That’s about it for the edition of our weekly look back on all the news fit to blog. As we get closer to spring (albeit, slowly for those of us in the Northeast), and the annual POAs are in the rear view mirror, this is as good as time as any to clean up your commercial compliance training. With transparency extending beyond the U.S., shouldn’t your training do the same? The newest addition to our PharmaCertify™ suite of off-the-shelf eLearning modules, Global Transparency: Reporting HCP and HCO Transfers of Value covers the key provisions of the EFPIA Disclosure Code, French Sunshine Act (Loi Bertrand) and the Medicines Australia Code of Conduct. Contact Sean Murphy at smurphy@nxlevelsolutions.com to learn more and see a content outline.

Have a great week everyone!

News Week in Review, January 26, 2015

Senator Warren looks to use pharmaceutical company penalties to support research at the FDA and NIH, a new report reveals that a significant amount of businesses in China pay bribes, a physician lobbies for a Sunshine Act in Scotland, and a bill is introduced in the House to exclude CME and medical texts from Sunshine reporting.

Comedy, drama and just a dash of controversy thrown in for good measure. No, we’re not referring to this year’s Oscar nominations – although one does have to wonder how The Lego Movie was snubbed for Best Animated Picture – we’re talking about the NFL’s annual supreme slugfest, the Super Bowl. This Sunday, millions will park themselves in front of their television sets to see the Patriots and Seahawks fight it out for the Lombardi Trophy (and of course, the cursory trip to Walt Disney World). If you’re ready for a brief respite from the politics of “Deflate-gate,” we offer all the compliance news fit to blog, with this week’s News in Review.

Starting on offense in our first story is Senator Elizabeth Warren. During a conference hosted by a health advocacy group, the Senator said she intends to introduce legislation that will create a fund to support research at the FDA and NIH. The fund, which Warren referred to as a “swear jar” for the industry, would be financed through fines imposed on large pharmaceutical companies that break the law. Fines will only be imposed on companies with at least one blockbuster drug, and would equal 1% of a company’s total profits for each blockbuster drug it sells.

PhRMA quickly lined up on the other side of the ball to oppose the issue. The organization pointed out that the industry spends billions of dollars on research each year and is responsible for 20% of all funding of domestic research. The statement went on to say the work of the NIH is important, but to “siphon funding from the groundbreaking medical research happening in the biopharmaceutical industry will have devastating consequences for patients and society.” Those consequences would ultimately include fewer medicines and loss of jobs.

If you think Deflate-gate is controversial, it doesn’t compare to a recent report that found 35% of businesses in China pay bribes in order to do business in the country. One CEO participating in the research called bribery the “unspoken rule.” The problem is more common in foreign companies than those based on the mainland, and the real estate and construction sectors have the highest instances of bribery. The vast majority of research participants describe bribery in China as a “plague,” and just over 60% of the participants would like to see action taken to stave off the problem. Unfortunately, a third of participants are not optimistic about that happening.

It’s third down and goal for a transparency initiative in Scotland. A physician will have his petition for a Sunshine Act in Scotland heard by the Scottish Parliament for the third time. The physician is petitioning the government to create a law that establishes a searchable database of payments from pharmaceutical companies to National Health Service healthcare workers.

We’re back in the transparency replay booth here in the U.S. as well. A bipartisan bill was introduced in the House of Representatives to exclude the value of CME and medical texts from reporting, under the Sunshine Act. This is the second go around for the bill in the House.

Well, that’s it for this Super edition of the Compliance News in Review. Whether you’re rooting for the Seahawks or Patriots, or just a great halftime show by Katy Perry, enjoy the game and we’ll see you right back here next week. Have a great week everyone!

2014 Year in Review

2015 is upon us! It seems like only yesterday we were posting our 2014 Compliance Year in Review. Time sure does fly! We here at the Compliance News in Review wish you and yours the best for a happy and healthy 2015. But don’t toss out that warm glass of sparkling cider or noisemaker yet. It’s time to take a look back at a year’s worth of news, with the Compliance News Year in Review2014 Edition.

Our countdown begins with what had to be the big story of 2014 – the never ending saga of Open Payments and the Sunshine Act. The year began with a two-phase registration and data submission process for Applicable Manufacturers and GPOs. Phase 1 opened in February and Phase 2 was supposed to start in May. As it turned out, Phase 2 was delayed until June and was deployed in two phases itself, and not without some technical difficulty. So much so that PhRMA petitioned CMS to extend Phase 2 by as much as 30 days.

The registration of physicians and the opening of the review and dispute period represented the next big milestones. That’s when the fireworks really started. Physicians had problems registering, and when they could finally view the data, there were significant problems – confusing “error” messages, missing payments, payments attributed incorrectly. CMS took the system down to correct the problems, and extended the review and dispute period to accommodate for the time the system was down. When Open Payments opened back up for physicians, almost one-third of manufacturer records were “missing.” Eventually, CMS said the records were withheld due to data matching problems. A number of issues were identified that caused the data to disappear. The primary offenders appeared to be state license numbers and NPI numbers submitted by manufacturers and GPOs that did not exactly match what CMS had in its database for those identifiers. Despite all the delays and problems, CMS said the September 30th date for making payment records public would stand, minus the withheld records. Those records would be published by June 30 of the next year.

September 30th came, data was published, and all was right with the world, right? Onward to 2015! Not so fast there dear readers. As we all spent time regretting those unfortunate photos taken at the office Christmas party, CMS elves were busy at work. The agency released 68,000 records that were previously withheld, notified users that Open Payments would be unavailable for most of January to allow time for system maintenance, and announced it will be hosting an Open Payments Q&A in early 2015.

Yes, it was a full year of Open Payments fun, but the news surrounding the data was not all CMS had up its transparency sleeve. The agency notified stakeholders that changes were on the way for Sunshine’s Final Rule. The one change that sparked the most debate was the removal of the exemption for payments to physicians speaking at accredited CME events. Medical societies, physician groups and CME providers were staunchly opposed to the change, but it was still made official in October. The change will take effect in 2016 but it may not be the end of the road for the exemption. A bipartisan bill was proposed to exempt indirect CME payments, as well as the value of medical textbooks and reprints.

Other news of note on the transparency front for 2014 included the passage of a law in Connecticut that requires the reporting of industry payments to nurse practitioners; Minnesota making good on the Board of Pharmacy’s notification that payments to nurse practitioners and others would be required in 2015 reports; and the changes in transparency requirements to the Medicines Australia Code of Conduct.

The cork popped on GSK’s bribery woes in 2014. The company was one of several pharmaceutical companies under investigation by the Chinese government for allegations of bribery. The company announced it was investigating potential bribery in Iraq, Jordan, Lebanon, Poland, and Syria. GSK enhanced its compliance efforts in China and fired several employees over failure to adhere to expenses rules. In the fall, it was able to close the book on the Chinese investigation with a fine of close to $500 million dollars. The head of China operations and four other executives were sentenced in the matter, but all had their jail sentences suspended and avoided actual jail time. The head of China operations, a British national, was deported. The company could still face legal action from the U.S. Department of Justice and the U.K.’s Serious Fraud Office for violating bribery laws.

The FDA resolved it would make the July 2014 deadline for social media guidance, and it actually did! Three draft guidance documents related to social media were published. One document is related to the submission of advertising content, and the other two dealt with actual postings on social media platforms. The guidance on correcting misinformation on social media platforms applies to correcting independent user-generated content, and not content generated by a company, its employees or agents.

The more anticipated document, and the one that drew the most criticism, deals with the posting of information on character-limited platforms, such as Twitter. Some companies feel the FDA has basically restricted them from using character-limited platforms to promote their products due to strict requirements around presenting risk and benefit. The Washington Legal Foundation and the Medical Information Working Group said the guidance infringes upon manufacturers First Amendment rights.

And there you have it, our choices for top stories of 2014. What will be the “big news” of 2015? If we were betting people, we’d put money on Open Payments and Sunshine being the stories that generate the most headlines. With a full year’s worth of spend data hitting the system for the first time, expect more hiccups. Also, a full year’s worth of data is likely to reveal even more issues and have the pundits buzzing. Transparency overseas will likely make news in 2015, as EFPIA member associations and Medicines Australia members begin collecting data for disclosure in 2016.

There was a noticeable lack of big dollar enforcement cases in healthcare fraud and FCPA cases last year. While the DOJ could boast upwards to $2 billion in healthcare fraud recoveries for the 2014 fiscal year, there were no billion or multibillion dollar settlements with life sciences companies. The crystal ball is a little cloudy on that front. Was 2014 the calm before the next storm, or has the season of the multimillion to billion dollar settlements with pharma and med device companies come to an end?

FCPA enforcement actions were in a bit of a lull through at least the first half of 2014 compared to years past. The DOJ ended the year on a big note though, with its Alstom settlement. As far as we’re concerned, it’s been a little too quiet lately where FCPA enforcement is concerned, so we wouldn’t be surprised to see more activity in 2015. Don’t be surprised if we see actions against the handful of pharma companies that were accused of passing bribes in China in 2013.

Whatever 2015 brings, we’ll be writing about it through our weekly Compliance News in Review. Have a great year everyone and as always, thanks for reading!

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