U.S. tells drug makers
not to use incentives
Robert Pear
New York Times (U-WIRE)
WASHINGTON — The govern
ment warned pharmaceutical com
panies on Monday that they must
not offer any financial incentives to
doctors, pharmacists or other
health care professionals to pre
scribe or recommend particular
drugs, or for switching patients from
one medicine to another.
The warnings came as the gov
ernment informed the industry that
many practices commonly used in
the marketing and sale of prescrip
tion drugs could run afoul of federal
fraud and abuse laws.
Specifically, the government said
that drug makers could not offer in
centive payments or other “tangi
ble benefits” to encourage or re
ward the prescribing or purchasing
of particular drugs by doctors,
health plans or companies that
manage drug benefits for employers
and insurers.
Aggressive marketing is the norm
in the pharmaceutical industry. For
years, drug makers have treated
doctors to free Broadway plays,
weekend trips, expensive meals and
other lavish perks. Many companies
have rewarded middlemen, known
as pharmacy benefit managers, for
putting their products on lists of
recommended drugs, known as for
mularies. Some companies have
also rewarded doctors and drug
stores for switching patients from
one medication to another.
Similarly, doctors in a position to
influence the prescribing of drugs
for large numbers of patients have
been retained as advisers and con
sultants to drug manufacturers.
The government said it was con
cerned about such arrangements
because they could improperly
drive up costs for Medicare and
Medicaid, the federal health pro
grams for 75 million people who are
elderly, disabled or poor. The feder
al government spends #400 billion a
year on the two programs com
bined, and the cost is expected to
double in 10 years.
The new standards, the first of
their kind, were issued by Janet
Rehnquist, inspector general of the
Department of Health and Human
Services, as guidance to the phar
maceutical industry. While the stan
dards do not have the force of law,
drug makers that flout them are
more likely to be investigated and
prosecuted for violations of federal
fraud and kickback statutes.
“In today’s environment of in
creased scrutiny of corporate con
duct and increasingly large expendi
tures for prescription drugs,”
Rehnquist said, “it is imperative for
pharmaceutical manufacturers to
establish and maintain effective
compliance programs.”
The public will have 60 days to
comment on the standards. The
government may revise them in the
light of those comments.
Rehnquist said that every drug
company should appoint a compli
ance officer, establish a hotline
to receive complaints of fraud
and abuse and consider paying
rewards to employees who report
misconduct.
Under the new standards, com
panies are responsible not onlv for
their own employees, but also for
sales agents and contractors who
“engage in improper marketing
and promotional activities” on
their behalf.
Drug gangs seize
parts
Patrice M. Jones
Chicago Tribune (KRT)
RIO DE JANEIRO — Drug gangs
ordered schools and businesses
shut down across large swaths of
Rio de Janeiro on Monday in what
officials said was an unprecedent
ed show of force by criminals in an
increasingly public war with
Brazil’s police.
From the ritzy shops in the
city’s famous Ipanema neighbor
hood to Rio’s ghettos, business was
brought to a virtual standstill in at
least 10 neighborhoods.
Schoolchildren were released
from classes early or told not to
come. Tourists at some hotels
were warned to stay inside.
Thousands of police officers
spilled into the streets.
No major injuries were report
ed, but an atmosphere of fear per
vaded much of the city.
“This is all to make it very clear
who has the power in the city.
Everyone is very afraid,” said Luis
Neto, a 59-year-old retiree who was
discussing the city’s problems with
neighbors in Rio’s posh south zone.
Residents said young people
and bandits armed with machine
guns passed out letters ordering
stores and Schools shut in several
neighborhoods.
Local media reported that
Brazil’s most powerful criminal,
convicted drug trafficker Luiz
Fernando da Costa, known as
Seaside Freddy, was behind the
shutdown.
Da Costa, who was Hunted down
in Colombia’s jungles last year, has
been placed in isolation in a Rio
prison and has been demanding
better conditions since early
September, when he allegedly led
an uprising in Rio’s maximum
security Bangu I prison. The upris
ing ended with four drug traffick
ers dead, including a main da
Costa rival.
On Monday, police arrested at
least nine people circulating the
warnings. News of the threats
spread anyway, from downtown
diners to tourist shops.
Police said bandits set off at
least two homemade explosives in
front of a private Rio university,
forcing the cancellation of exams.
Many hospitals were barely
functioning.
“A few workers did arrive at the
hospital but as they began hearing
the news, everyone started calling
home to cheek on their children
and many left,” said Vilma Soares.
53, a psychologist at a public hos
pital in downtown Rio. “People are
very nervous.”
Rio’s state governor dispatched
police across the city to encourage
shop owners to defy the gangs.
But most were too afraid to open.
“I want the population to know
that we are in control,” Gov.
Benedita da Silva said at a news
conference. “We are providing
cover everywhere and our com
manders are on the streets.”
But many residents, such as
Zeferino de Oliveira, 72, disagree.
“I have lived here for 67 years
and I have never seen stores
forced to close like this,” said de
Oliveira, the owner of a hair salon
and a store in Leme.
“We need a (Rudolph) Giuliani
in Rio. That is what we need,” de
Oliveira said, referring to the for
mer New York mayor. “The police
have lost the authority because of
the bandits. The bandits are say
ing, 'We will show you who is in
charge whenever we want.’”
© 2002, Chicago Tribune. Distributed by
Knight Ridder/Tribune Information
Services.
Pentagon video
shows Iraq firing
on U.S. warplanes
Eric Schmitt
New York Times (U-WIRE)
WASHINGTON — Senior Penta
gon officials on Monday showed pre
viously classified video footage of
Iraq’s efforts to shoot down Ameri
can and British warplanes patrolling
Iraqi no-flight zones, in an apparent
effort to build support for a tough
new U.N. Security Council resolu
tion on Iraqi weapons.
Defense Secretary Donald H.
Rumsfeld and Gen. Richard B. My
ers, the chairman of the Joint Chiefs
of Staff, gave reporters an unusually
detailed briefing, using a slide show
of footage from warplane gun cam
eras and unmanned Predator
drones, to underscore that there has
been a growing number of Iraqi fir
ings on allied planes.
In the two weeks since Iraq said it
would allow the unconditional re
turn of U.N. inspectors, it fired on
coalition aircraft 67 times — 28
times in northern Iraq and 39 times
in the south — including 14 times
this past weekend, Rumsfeld said.
“Here you have U.S. and British
planes flying daily to enforce the
U.N. resolutions, putting their lives
at risk, these pilots and air crew, day
after day after day for years, and the
U.N. not enforcing its own resolu
tions,” Rumsfeld said. “With each
missile launched at our air crews,
Iraq expresses its contempt for the
U.N. resolutions — a fact that must
be kept in mind as their latest
inspection offers are evaluated.”
But in Moscow, the Russian For
eign Ministry suggested that the most
recent allied raids on Iraqi air de
fense sites had been timed to influ
ence talks opening in Vienna, Aus
tria, on procedures for allowing U.N.
weapons inspectors back into Iraq.
“Anglo-American bombing raids
in ‘no-fly zones’ not only deepen the
complicated atmosphere around
Iraq but create obstacles in the
search for a political-diplomatic set
tlement of the Iraq question,” the
statement said.
Rumsfeld rejected the Russian
criticism, saying it was “nonsensi
cal” to blame the United States
and Britain for responding to in
creasing attempts by Iraq to shoot
down allied warplanes patrolling
no-flight zones in northern and
southern Iraq.
Martin Merzer
Knight Ridder Newspapers (KRT)
Now a hurricane, Lili closed in
Monday on Cuba’s western tip and
Isle of Youth, the same region
slammed 10 days ago by Hurricane
Isidore. Cuban officials prepared to
order mass evacuations.
The government of Cuba issued a
hurricane warning for the provinces
of Matanzas, Pinar del Rio, the Isle of
Youth and the city and province of
Havana. A tropical storm warning re
mained in effect for the rest of Cuba.
Forecasters also began raising
alarms about the danger to the U.S.
Gulf Coast, which is likely to sustain
a direct strike Thursday night, pos
sibly in Texas or Louisiana. They
said Lili has the potential to become
an intense hurricane capable of in
flicting massive damage.
“Lili appears poised for some fair
ly significant strengthening,” said
forecaster James Franklin of the Na
tional Hurricane Center in West Mia
mi-Dade County. “The waters in the
northwestern gulf are high octane,
with a good inner core structure.
“Bottom line is that we should
have a major hurricane nearing the
Gulf coastline in three days’ time. ”
Lili’s center was expected to graze
the Isle of Youth early Tuesday and
slice across the western end of the
main island a few hours later. At that
point, its sustained winds could
reach 100 mph.
Monday morning, strong wind
reached the Cayman Islands, where
all schools and most offices were
closed. About half of the 1,200
residents of the eastern island of
Cayman Brae lost electricity when a
power plant malfunctioned. Hun
dreds of people moved to shelters.
One man was feared dead in
Jamaica, where dozens of homes
were damaged by raging floods. Fire
brigades rescued dozens of flood vic
tims, who where taken to emergency
shelters.
© 2002, The Miami Herald. Distributed
by Knight Ridder/Tribune Information
Services.
' i \ w ■*** v & ^
LF
9 HOLES $10
Students Only. Must show ID. (Monday - Friday)
M iddlefielD
Gouh course
942-8730
OA
AY
484-1927
009813
75
50*OFF
any 1/2 sub
expires 10/14/02
0 Foot long Sub
OFF
HOMEY HILL FARMS*
Come in and get a
sub for less at
CAMPUS
SUBSHOP
1225 ALDER • 345-2434
MON-SAT 11AM-8PM •SUN 11 '.30-8PM
OFF
Any Yogurt
(’Except small
cones and tinies.
Expires 10/14/02)
Campus
SUBSHOP
Mon.-Sat. llam-8pm
Sun. 11:30am-8pm
1225 Alder
345-2434
Not valid with any other discounts or coupons. One
coupon per customer.
_^
HOMEY HILL FARMS,