Tag: 2016 News

The Los Angeles County District Attorney’s Office announced. that a Rancho Palos Verdes physician charged with illegally prescribing drugs to undercover operatives was convicted,

The downtown Los Angeles jury deliberated about two hours before finding Dr. Richard Seongjun Kim, 44, guilty of 17 felony counts of unlawfully prescribing controlled substances without a legitimate medical need to undercover operatives working with the Drug Enforcement Administration. Kim was a 1998 graduate of the University of Alabama School of Medicine. His prescription rights have been suspended by court order since July 15, 2015.

Deputy District Attorney Emily Street of the Major Narcotics Division, who prosecuted the case, said Kim would ask the operatives to bring in prior medical charts and X-rays to justify the prescribing.

On one occasion, an operative brought in a chest X-ray of a dog, including its tail, that was used to justify his prescriptions, prosecutors said.

Over the course of three months in 2014, Kim wrote prescriptions for Norco, Xanax, Soma and Adderall without ever conducting a physical exam, taking any vital signs or completing any medical charts at his clinic on Western Avenue in Rancho Palos Verdes, prosecutors said.

Defense attorney Steve Meister said he was disappointed by the verdict and planned to argue to keep Kim out of jail. “My client has always been a caring and competent physician,” Meister said. “While the jury may have concluded that he unlawfully prescribed, custody in this case would be wholly unreasonable.”

The case against the general practitioner was investigated by the Drug Enforcement Administration, whose operatives posed as patients at Kim’s Western Avenue clinic over the course of three months in 2014. Deputy Dist. Atty. Emily Street, the prosecutor who handled the case, said that Kim asked patients to bring in previous charts and X-rays to the sham medical exams. “He wanted a lot of records – not because he was interested in patients’ ailments, but he wanted to cover himself,” Street said.

His office had no staff and he typically exchanged text messages with patients to arrange appointments. He didn’t accept insurance – only cash or credit cards, the prosecutor said. “He would open up his office and lock the door behind him, and meet with the patient in his office,” Street said.

Without examining patients or writing out medical charts, he issued prescriptions for Norco, Xanax, Adderall and Soma, prosecutors said. During appointments, Kim sat behind a desk and engaged in mostly small talk, Deputy Dist. Atty. John Niedermann said in an earlier interview with The Times.

The undercover appointments were recorded by hidden cameras, and the video footage was shown to jurors. “It was all on video, which was really the crux of the case,” Street said. “There was no exam whatsoever – no vitals, very little history, if any, taken. It was not much of anything resembling the practice of medicine.”

He faces up to 13 years, four months in local custody when he returns on Sept. 30 for sentencing in Department 71 at the Foltz Criminal Justice Center. He had been free on $100,000 bail during his trial, but was immediately remanded after the verdict was read.

Emerging markets have lost their luster for Big Pharma making drug firms ever more dependent on the United States for growth just as American anger over high medicine prices is building.

A few years ago, the developing world was seen as a savior as patent after patent expired across the United States and Europe, but a report in Reuters Health says that emerging market sales growth at the top drug firms slowed to less than two percent in the latest quarter.

Forecasts from independent experts IMS Health now suggest the United States will account for 55 percent of sales growth between 2016 and 2020, with emerging markets only contributing 30 percent.

The slowdown in China and other top emerging markets is being driven by a number of factors: government pressure on drug prices, slowing economies and in some cases significant currency devaluations.

But the end result is that prescriptions for Americans will fund an even greater slice of the $1 trillion-a-year pharmaceuticals industry.

Company executives insist markets from China to Colombia to Mexico to Myanmar are an important engine of long-term growth, given rising populations, increasing wealth, and the global march of diabetes, heart disease and cancer.

But the short-term picture is not pretty. Emerging market growth is the slowest since drug companies started breaking out such regional sales numbers about seven years ago, with GSK languishing at the bottom of the class.

GSK’s drug sales in China fell 14 percent in the three months to the end of June as the company continued to reshape its business following a damaging corruption scandal in 2013, leaving a question mark over whether it can return to growth this year as hoped.

Others are doing better in China, which is now the world’s second biggest drugs market behind the United States, but all are struggling with slowing sales growth, which slipped to its lowest rate since 2008 in July.

“Across the board, we are seeing emerging markets register lower growth in local currency and in many cases there have also been big currency devaluations,” said Murray Aitken, IMS Health senior vice president and executive director.

By comparison, the United States offers rich pickings at the moment thanks to hugely profitable new drugs for diseases such as cancer and hepatitis C.

Many companies’ sales in developing economies come from so-called branded generics, or off-patent medicines that command a premium to those made by local suppliers because the Western drugmaker’s name is a proxy for quality.

That business is now under threat as governments promote cheaper unbranded products as a route to universal healthcare.

One sign of the tougher times is the relative dearth of acquisitions in emerging markets by international players after a slew of multibillion-dollar deals between 2008 and 2011.

With the final defendant receiving a prison term this week, six defendants who participated in a multi-million dollar health care fraud scheme or helped launder the illicit proceeds have now been sentenced to federal prison.

Edgar Pogosian, also known as “Edgar Hakobyan,” 32, of Glendale, was sentenced to 18 months in prison. Pogosian was found guilty earlier this year of conspiring to commit money laundering and one count of money laundering.

“Over the course of nearly seven years, this defendant engaged in a wide-ranging money laundering conspiracy in which he received 150 checks and personally laundered over $700,000 in health care fraud proceeds,” said United States Attorney Eileen M. Decker. “All of the defendants in this case played a vital role in a scheme that bilked the taxpayers who finance Medicare and utilized sophisticated money laundering techniques to hide their crimes.”

Over the past month, United States District Judge Philip S. Gutierrez sentenced two other defendants involved in the scheme:

Karen “Gary” Sarkissian, 44, also of Glendale was sentenced on September 12 to 57 months in federal prison after the same jury that convicted Pogosian found him guilty of conspiring to commit money laundering, six counts of money laundering and five counts of health care fraud; and

L’Tanya Smith, 58, of Ladera Heights, was sentenced on August 22 to 57 months imprisonment after she pleaded guilty to five counts of health care fraud.

Pogosian and Sarkissian were found guilty in February by a federal jury following a four-week trial before Judge Gutierrez. Smith pleaded guilty on the eve of trial.

Sarkissian operated a clinic on Sunset Boulevard in Echo Park and worked there with Smith, a physician’s assistant. Between July 2009 and March 2010, Smith prescribed or ordered medically unnecessary tests and services, some of which were never provided to the patients. Those prescriptions and orders led to more than $1.2 million in fraudulent claims to Medicare from the Sunset clinic. Other providers that received referrals from the Sunset clinic submitted another $10 million in fraudulent claims to Medicare.

Sarkissian also participated in a scheme that laundered the fraudulent proceeds generated through the Sunset Clinic through five bogus corporations set up by two other men, Khachatour Hakobyan (Pogosian’s uncle) and Aram Aramyan, who were previously convicted and sentenced in this case.

Hakobyan, 48, of Glendale, who prosecutors argued was the overall leader of the scheme, was sentenced in January 2016 to 57 months in prison and was ordered to pay $606,681 in restitution after he pleaded guilty to conspiring to launder health care fraud proceeds through the five sham corporations and underreporting his income from the conspiracy on his federal income tax returns. Aramyan, 60, of Glendale, was sentenced in November 2015 to 51 months in prison on similar charges and was ordered to pay $353,669 in restitution.

Hakobyan and Aramyan deposited millions of dollars in fraudulent proceeds into bank accounts for the five sham companies and then wrote checks from these corporations to themselves and their relatives, including Pogosian, who was found guilty based on evidence that he received more than $700,000 in checks from the sham corporations that he either cashed or deposited in his own bank accounts.

With these most recent sentences, six defendants have now been sentenced in relation to a health care fraud scheme related to multiple medical clinics, a durable medical equipment supplier and an independent diagnostic testing facility.

The sixth defendant, a doctor associated with one of those clinics – Claude R. Cahen, 74, of Santa Monica – pleaded guilty to conspiring to commit health care fraud and was sentenced to 12 months and one day of imprisonment in March 2016.

The United Nations scheduled a pivotal meeting to combat antibacterial resistance during its General Assembly session, in a move that some are calling a “wakeup call” in the war against deadly infections that kill thousands of people a year.

The meeting in New York, is part of the week-long General Assembly, which convenes leaders from around the globe. It is the first high-level global meeting on antibiotic resistance and only the fourth time that the General Assembly has taken up a healthcare issue, with other meetings focusing on outbreaks such as Ebola.

“The disturbing truth is that the end of the antibiotic era is upon us in many parts of the world. But we are not too late,” said Michael Craig, senior adviser for antibiotic resistance coordination and strategy for the Centers for Disease Control and Prevention. “We need to continue to build on the momentum of our global commitment.”

Ahead of the United Nations General Assembly (UNGA) High-Level Meeting on Antimicrobial Resistance (AMR), 13 leading pharmaceutical companies today presented a new roadmap that lays out four key commitments they will deliver by 2020 to reduce AMR. The commitments follow the principles identified and agreed upon in the Industry Declaration made at the 2016 World Economic Forum in Davos earlier this year, and reflect the companies’ intent to continue to proactively contribute to the global efforts to address AMR. This unprecedented collaboration between the pharmaceutical companies marks a major milestone in the fight against AMR.

In presenting this roadmap, the signatory companies claim to demonstrate their shared ambition to overcome the staggering threat AMR represents for our society, economies, and citizens. The companies say they are committed to working to reduce the development of antimicrobial resistance, improve access to high-quality antibiotics, vaccines, and diagnostics, invest in R&D, and collaborate with governments and stakeholders to sustain those investments.

They hope to ensure antibiotics are used only by patients who need them, recognizing this requires concerted efforts from many stakeholders, through continued provider and patient education, an examination of the companies’ promotional activities, sharing of surveillance data with public health bodies and healthcare professionals, and collaboration with stakeholders to reduce uncontrolled antibiotic purchase;

Companies that have signed up to the scheme include leaders in both branded and generic drug production, including Pfizer, Merck, Novartis, GlaxoSmithKline and Allergan, as well as Indian drugmakers Cipla and Wockhardt.

Johan S. Bakken MD, PhD, FIDSA, President, Infectious Diseases Society of America, said: “Infectious diseases (ID) physicians see firsthand the devastating impact of antimicrobial resistance on our patients and public health. We are out of treatment options for increasing numbers of patients. IDSA welcomes the commitment of industry to address AMR and invest in the research and development of urgently needed new antimicrobial drugs, diagnostics and vaccines. Robust public private collaboration is essential for effective solutions to AMR.”

Though the problem of drug-resistant bacteria has been a feature of medicine since the discovery of penicillin in 1928, it has grown in recent years with the emergence of infections resistant to multiple drugs, such as MRSA.

Between 2006 and 2012, antibiotic use in hospitals in general did not change, and the use of a class of drugs tied most closely to antibiotic resistance actually increased, according to a new study published in the JAMA Internal Medicine and reported in Reuters Health.

“We believe the increases in the use of more powerful and ‘last resort’ antibiotics should prompt further exploration and, where indicated, actions to improve the use of these antibiotics,” said lead author James Baggs, of the U.S. Centers for Disease Control and Prevention in Atlanta.

“While the optimal level of antibiotic use or distribution of classes is not really known for every hospital, we know from other studies that inpatient prescribing of antibiotics for some infections is often inappropriate,” Baggs told Reuters Health by email.

The researchers reviewed adult and pediatric antibiotic use from 2006 to 2012 in 300 participating acute care hospitals. More than 34 million patients were discharged from these hospitals over the six-year period.

Over the whole period, 55 percent of patients left the hospital having taken at least one dose of an antibiotic. Overall, for every 1,000 days of hospitalization, 775 days included antibiotic therapy.

“In some cases, providers might be unaware of treatment guidelines,” Baggs said. “In others, infections are misdiagnosed, for example, a provider thinks a patient has an infection when they do not. We also know that in many cases for hospitalized patients, antibiotics are started before all of the clinical information is available.”

Although overall antibiotic use stayed level over time, use of third- and fourth-generation cephalosporins, macrolides, glycopeptides, carbapenems and tetracyclines increased significantly, as reported September 19 in JAMA Internal Medicine.

“In the hospital, where the sickest patients are, there’s been an increase in broad-spectrum antibiotics,” said Dr. Ateev Mehrotra of Harvard Medical School, who coauthored a commentary in the journal.

Broad-spectrum antibiotics act against a wide variety of bacteria. “Those are the big guns, and with increased use of them the worry is that that’s leading to the bacteria that’s broadly resistant,” Mehrotra said.

Antibiotic overuse has been a problem for decades, Mehrotra told Reuters Health by phone.

“We don’t believe the reason broad spectrum antibiotics are overused is that physicians aren’t educated,” he said. “Doctors are human, they’re worried, they’re behind, they’re concerned about what the patient wants.”

“What we’re proposing is that the strategies to address this should come from a psychological perspective,” and should target doctors who give out the most antibiotics, he said. If social pressure leads to overprescribing, maybe it can also curb prescribing rates.

“Send them an email or letter saying, you’re not a top performer, why is that,” Mehrotra said.

Antibiotic use guidelines are already in place and don’t need to be changed, he said.