Medicare Fraud

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anonymous

Guest
Pharmaceutical fraud involves activities that result in false claims to insurers or programs such as Medicare in the United States or equivalent state programs for financial gain to a pharmaceutical company.

Each time we convince a cardiologist to prescribe Onpattro for a patient that previously did not have a neuropathy indication we are committing an instance of Medicare or insurance fraud. When management trains us to point out symptoms like orthostatic hypotension and instruct a cardiologist that they should chart this as neuropathy without the patient receiving a proper neurological examination, we are committing an instance of Medicare or insurance fraud. Although I am sure this is about to be disputed here, these are indisputable facts and it will just be a matter of time before the whistle is blown. If you are a BAE and you are engaging in these activities, you will also be charged. The first person to whistle-blow gets the money. I wouldn't wait.
 






You are incomprehensible among several other adjectives- we hang our head in shame at your stupidity. Again, and we will talk slowly.........promotional activity to a specialist regardless of the indication is not in any way a violation of any federal or state law.
 






Really, you need an indication to sell a product. Going into Cardiology and offering your product and services for their patients, without the testing needed this can not be deemed as above the law. Do you actually thing anyone is going to follow the guidelines set up by the company to make this happen. They will order not get the right testing and get denied, how long do you thing that will happen before most physcian loose interest.

I agree not long before the FDA is knocking on your door. Just stupid corporate greed because they did not do the upfront work for approval initially.
 












Say what you want about any political leaning, but the facts are the facts promoting drugs without the truth, asking physicans to make an assumption about diease manifestations with out proper diagnosis is illegal. Find an attorney now, doubt oh wait I know this company will not support you when a physician reports you.
 






anonymous said:
You are incomprehensible among several other adjectives- we hang our head in shame at your stupidity. Again, and we will talk slowly.........promotional activity to a specialist regardless of the indication is not in any way a violation of any federal or state law.
Click to expand...

Wow. Look at case history. Many companies have been fined by doing this. I don’t understand why we think we are above the law. I’ll type slowly for this next part so you understand-telling a doctor a patient has a diagnosis not previously made or properly assessed just so they can prescribe a product you promote is illegal and we ask our team to do this every day on every call. It’s unethical and it’s illegal. I bet there is hATTR in OB/Gyn. Why aren’t we there? Is it because they don’t treat cardiomyopathy? Yep. We specifically target an indication outside our label and train the team to “find” neuropathy in the patients and then ask the doctor to prescribe for a diagnosis that we suggest, but they have not found or documented. Classic fraud.

To the BAE team: you all know this is true. How are you looking in the mirror?
 






There are so many flaws in your post that there is no point even entering into a dialogue with you. Whether you are an ex-employee or current one - your stupidity is mind numbing.
 






























Alnylam Cafepharma posts crack me up. They mirror our culture in that individuals post their concerns, then management automatically dismisses as "stupid", an outsider, or something else. No matter what the proof or subject matter, there is never a look inside to address real concerns. Retaliation is a real concern for employees at Alnylam, and Cafepharma has become the only safe place to bring items forward.

Lets take the subject of this post. Are we doing things that equate to Medicare fraud? I don't know, I'm not an attorney. What I do know is we expanded our sales force and stated on a conference call for all to hear that we did so to focus on cardiology. During this call our leader, AO, stated for all to hear that he knew it was a "risky strategy". Our indication is for polyneuropathy and we all know cardiologists do not treat. We have trained our team to tell cardiologists that a myriad of symptoms equate to polyneuropathy and that they could put this in the chart and suddenly Onpattro becomes indicated. There is no disputing this. Its also true that Alnylam corporate presentations of the past show very little "mixed phenotype" for V122I. That tune only changed when the cardiomyopathy label was denied and Pfizer surprised us with a drug and real data in cardiomyopathy. The tune changed because everyone knows we cannot make numbers that were committed to shareholders on polyneuropathy only.

In short, we focus on a specialty not historically known for treating polyneuropathy. A specialty that is trained to treat the more common manifestation of hATTR and V122I, cardiomyopathy. We ask about symptoms patient has and are trained to call them polyneuropathy even though we know the patient has not had a proper neurological assessment. We do all of this and our leader has overtly called it risky, yet when its brought up here the posters are dismissed as stupid or clueless.

This post will be attacked too. I'll be called stupid or worse. I will admit that I don't know if what we do is Medicare fraud, but it looks really bad and as AO says, its clearly risky.
 
























Throwing up the white flag. When AO said it was a risky strategy.....promoting to cardiology is not at all what he meant. Not even close. The mere fact that you continue to post about promoting to cardiology when you don’t understand the difference between on label and off label indicates your profound lack of understanding how commercial efforts work. No name calling needed. And not all here are miserable - don’t assume it’s management replying to your nonsensical arguments.
 












anonymous said:
Alnylam Cafepharma posts crack me up. They mirror our culture in that individuals post their concerns, then management automatically dismisses as "stupid", an outsider, or something else. No matter what the proof or subject matter, there is never a look inside to address real concerns. Retaliation is a real concern for employees at Alnylam, and Cafepharma has become the only safe place to bring items forward.

Lets take the subject of this post. Are we doing things that equate to Medicare fraud? I don't know, I'm not an attorney. What I do know is we expanded our sales force and stated on a conference call for all to hear that we did so to focus on cardiology. During this call our leader, AO, stated for all to hear that he knew it was a "risky strategy". Our indication is for polyneuropathy and we all know cardiologists do not treat. We have trained our team to tell cardiologists that a myriad of symptoms equate to polyneuropathy and that they could put this in the chart and suddenly Onpattro becomes indicated. There is no disputing this. Its also true that Alnylam corporate presentations of the past show very little "mixed phenotype" for V122I. That tune only changed when the cardiomyopathy label was denied and Pfizer surprised us with a drug and real data in cardiomyopathy. The tune changed because everyone knows we cannot make numbers that were committed to shareholders on polyneuropathy only.

In short, we focus on a specialty not historically known for treating polyneuropathy. A specialty that is trained to treat the more common manifestation of hATTR and V122I, cardiomyopathy. We ask about symptoms patient has and are trained to call them polyneuropathy even though we know the patient has not had a proper neurological assessment. We do all of this and our leader has overtly called it risky, yet when its brought up here the posters are dismissed as stupid or clueless.

This post will be attacked too. I'll be called stupid or worse. I will admit that I don't know if what we do is Medicare fraud, but it looks really bad and as AO says, its clearly risky.
Click to expand...

You only forgot one minor point, but it bears being brought up: During the name calling-posts, the long-ago departed JJ will continue to be belittled in this persons rebuttals. Now I ask: WHO here would do such a thing? Gee, I can't imagine who it could be*?

*Sarcasm eye roll
 






anonymous said:
Throwing up the white flag. When AO said it was a risky strategy.....promoting to cardiology is not at all what he meant. Not even close. The mere fact that you continue to post about promoting to cardiology when you don’t understand the difference between on label and off label indicates your profound lack of understanding how commercial efforts work. No name calling needed. And not all here are miserable - don’t assume it’s management replying to your nonsensical arguments.
Click to expand...

Feel like I need to jump in here. AO on a single call in the same sentence stated "We are expanding the sales team to enhance our focus on cardiology even though we know that is risky." Then we expanded and increased our emphasis in cardiology. Not a surprising comment from the man considering this post that has proven accurate as well. Not sure how you can make any other interpretation here.

Its no wonder everyone refers to Alnylam as the Asylum-WTF

For your other point, on label promotion for Onpattro would be promoting for the polyneuropathy of hATTR. Here is how we promote:
  • The BAE team promotes a testing program to all physicians that carries a comprehensive cardiomyopathy panel. This alone is proof that we provide materials designed to initiate a conversation on cardiomyopathy, an unappproved indication. Alnylam knows this is wrong and has hidden this program in the medical budget to make it seem not-promotional. The fact is though, it is used to gain access and to proactively discuss cardiomyopathy by the sales team and they order the kits for the physicians.
  • If a BAE is speaking to a cardiologist and is told they have a patient with hATTR cardiomyopathy, the BAE has been trained to turn the subject to possible symptoms that the patient could have that MIGHT indicate neuropathy. (Orthostatic Hypotension) Once the cardiologist states that one of the symptoms exists in the patient, the BAE has been trained to say that is polyneuropathy and the patient is now indicated for Onpattro. This is wrong on so many levels especially as it pertains to the patient. They deserve a full neurological work-up, not a BAE making an uninformed diagnosis. By example, the etiology orthostatic hypotension could be a myriad of things, not just hATTR. This is the crux of possible Medicare fraud as well. When a BAE makes the argument for treatment of an unconfirmed secondary diagnosis, they are in essence telling the physician how to order Onpattto and get it approved.
  • There is significant pressure to produce results for Onpattro not supported by the proven prevelence of the polyneuropathy of hATTR. We back this pressure with bonus dollars and sales contests that are paid to the sales team regardless of why Onpattro was written. We acknolwedge in multiple corporate presentations that V122I is the least likely mutation to have associated polyneuropathy, but it is the mutation we target. Where is your next start form coming from?
  • Cardiologists simply do not treat neuropathy. They are concerned with more immediate issues and cardiac death. When a patient is in their office they care about mortality and only tafamidis can address that based on their study.
  • We have significant presence in cardiology meetings like HFSA but very limited in neurology meetings.
  • We have significantly more speaker programs and speakers in cardiology.
  • The TLL team is focused on cardiology.
  • We have no real neurology strategy. The miniscule effort we place with the doctors that should treat our indication is very telling.
There is more but I'm out of time. Everything noted above is accurate and we all know it. The question becomes is if we are ok with it? Clearly managemnt is perfectly ok with and endorses all of this. I'm not and yes I intend to leave.

Lastly, don't assume everyone here is from the JJ era, or from the commercial team. I'm not. The dismissive tone that is taken with that group is a huge part of our issues here. This company is very divided and that is on Barry and the John's.
 






anonymous said:
Feel like I need to jump in here. AO on a single call in the same sentence stated "We are expanding the sales team to enhance our focus on cardiology even though we know that is risky." Then we expanded and increased our emphasis in cardiology. Not a surprising comment from the man considering this post that has proven accurate as well. Not sure how you can make any other interpretation here.

Its no wonder everyone refers to Alnylam as the Asylum-WTF

For your other point, on label promotion for Onpattro would be promoting for the polyneuropathy of hATTR. Here is how we promote:
  • The BAE team promotes a testing program to all physicians that carries a comprehensive cardiomyopathy panel. This alone is proof that we provide materials designed to initiate a conversation on cardiomyopathy, an unappproved indication. Alnylam knows this is wrong and has hidden this program in the medical budget to make it seem not-promotional. The fact is though, it is used to gain access and to proactively discuss cardiomyopathy by the sales team and they order the kits for the physicians.
  • If a BAE is speaking to a cardiologist and is told they have a patient with hATTR cardiomyopathy, the BAE has been trained to turn the subject to possible symptoms that the patient could have that MIGHT indicate neuropathy. (Orthostatic Hypotension) Once the cardiologist states that one of the symptoms exists in the patient, the BAE has been trained to say that is polyneuropathy and the patient is now indicated for Onpattro. This is wrong on so many levels especially as it pertains to the patient. They deserve a full neurological work-up, not a BAE making an uninformed diagnosis. By example, the etiology orthostatic hypotension could be a myriad of things, not just hATTR. This is the crux of possible Medicare fraud as well. When a BAE makes the argument for treatment of an unconfirmed secondary diagnosis, they are in essence telling the physician how to order Onpattto and get it approved.
  • There is significant pressure to produce results for Onpattro not supported by the proven prevelence of the polyneuropathy of hATTR. We back this pressure with bonus dollars and sales contests that are paid to the sales team regardless of why Onpattro was written. We acknolwedge in multiple corporate presentations that V122I is the least likely mutation to have associated polyneuropathy, but it is the mutation we target. Where is your next start form coming from?
  • Cardiologists simply do not treat neuropathy. They are concerned with more immediate issues and cardiac death. When a patient is in their office they care about mortality and only tafamidis can address that based on their study.
  • We have significant presence in cardiology meetings like HFSA but very limited in neurology meetings.
  • We have significantly more speaker programs and speakers in cardiology.
  • The TLL team is focused on cardiology.
  • We have no real neurology strategy. The miniscule effort we place with the doctors that should treat our indication is very telling.
There is more but I'm out of time. Everything noted above is accurate and we all know it. The question becomes is if we are ok with it? Clearly managemnt is perfectly ok with and endorses all of this. I'm not and yes I intend to leave.

Lastly, don't assume everyone here is from the JJ era, or from the commercial team. I'm not. The dismissive tone that is taken with that group is a huge part of our issues here. This company is very divided and that is on Barry and the John's.
Click to expand...


Ouch.....check mate!
 






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