Wednesday, November 11, 2009

Uptown Doctor Had Lucrative Ties To Drug Firm

Via Chicago Breaking News Center

Executives inside pharmaceutical giant AstraZeneca faced a high-stakes dilemma.

On one hand, Chicago psychiatrist Dr. Michael Reinstein was bringing the company a small fortune in sales and was conducting research that made one of its most promising drugs look spectacular.

On the other, some worried that his research findings might be too good to be true.

As Reinstein grew irritated with what he perceived as the company's slights, a top executive outlined the scenario in an e-mail to colleagues.

"If he is in fact worth half a billion dollars to (AstraZeneca)," the company's U.S. sales chief wrote in 2001, "we need to put him in a different category." To avoid scaring Reinstein away, he said, the firm should answer "his every query and satisfy any of his quirky behaviors." Continue Reading


  1. I work in the mental health field. I have seen Dr R in action and talked to numerous other people that have worked with him. I am only shocked that this has taken so long to surface.
    There are good people that work in this field and they really care about the well being of others. However, the state of mental health care is often more terrifying than mental illness.

  2. So someone making money is bad? Sounds like BS to me.

  3. "In an interview and in response to written questions, Reinstein said industry payments he has received for speeches and other engagements have had no bearing on his research results or patient care."

    Every research project involving humans must have an independent IRB (Institutional Review Board) that is charged with reviewing the research protocol for any conflict of interest. They must also identify and address any potential damaging effects on the subjects. I'm certified to provide consents for research and I have many major concerns, so I'm curious how involved the independent IRB was with this research project.

    People with mental illness are highly vulnerable. Extreme caution in research is paramount with any vulnerable population and it's not clear to me that such caution was used in this situation.

  4. "During that period, Reinstein ordered Seroquel for as many as 1,000 Chicago-area Medicaid patients per year at a total cost of $7.6 million to taxpayers."

    So much for the Hippocratic Oath. What a malicious trifecta! Patients were harmed (overmedicated, exploited and restigmatized), taxpayers were fleeced, and the research community was dinged.

  5. I am not defending this physician’s research, but it is not accurate to say if patients were not on Seroquel so much money would have been saved. There is a good chance that they might have been on some other type of medication, if not Seroquel. People with the level of illness that he appears to work with are often going to need strong medication to achieve some stability. These medications, although often beneficial often have side effects. Thank goodness many have less problems on them then with the older medications that were used in the 60’s and 70’s. Sometimes taking patients off the medications may reduce side effects but opens the door to increased disorganized thoughts, including false perceptions and repeated hospital admissions. That was not really mentioned in the article. These are issues every mental health professional struggles with. Guess who gets blamed when someone makes the choice to stop taking their medication and hurts themselves or someone else? The same physician who is criticized for giving the meds with known possible side effects is the one who gets sued. I find it somewhat concerning that so many of the people in this article criticizing the doctor where not physicians or even mental health professionals. People have a right to their opinions but take with a grain of salt those opinions provided by people without extensive training in the field of mental health. I don’t think even a very good “Nursing Home Case Manager” should be allowed to comment on what types of medication a physician is giving to treat mental illness

  6. Uptown Vegetarian wrote " is not accurate to say if patients were not on Seroquel so much money would have been saved."

    You're right. My criticism though is less about what might have been saved but what was spent and who benefited (and who didn't).

    This doctor's income was tied to the brand he was prescribing. Even the pharmaceutical company that makes the med becomes suspicious.

    Personally, I hope Case Managers question all sorts of things, including what physicians prescribe. Good, confident doctors take the time to explain medication options---and not just to patients but to caregivers as well.

    The ethical breaches here are significant and, like the Tuskegee syphilis experiment, are most likely to be addressed when others, specifically non-medical personnel, become the press.