THE CMG VOICE

Endoscope Maker Settles Bribery Case: The Business of Medicine

It is less common now than it used to be, but doctors would often accept gifts, trips, or other forms of largesse from manufacturers for using or prescribing a medical product or drug. Recent news reports set out the story of Olympus Corp. Of America, a leading manufacturer of endoscopes, which admitted bribing doctors and hospitals to buy its products. The rewards: trips to Japan, winery tours, spa treatments, and unrestricted “research grants” awarded by sales representatives.

The company, which is a subsidiary of a Japanese Corporation, reportedly allowed one doctor at a leading New York medical center to use $400,000 of its endoscopies and other equipment in his private practice, without charge. The U.S. Attorney for New Jersey brought charges against the company, which agreed to pay over $600,000,000 to avoid both criminal and civil charges under federal anti-kickback statutes and state false claims laws. The charges were brought after a former employee, acting under the federal whistle-blower law, brought detailed information to the authorities.

Interestingly, the same company manufactures a specialized kind of endoscope, called a duodenoscope, which has intricate mechanisms that are very hard to clean and disinfect, and which have caused a number of deaths around the country. Numerous lawsuits have been filed against the company and various health care facilities that used this equipment over a period of years without the instruments ever being completely sterilized.

Perhaps the most striking aspect of all of this is how it illustrates the “big business” aspect of medical care. If instrument companies can pay hundreds of millions of dollars in fines and still stay in business, think how much money they must have been making from health care providers who bought their products. More and more, health care costs are being driven by the high price of the technologies and equipment that everyone wants and expects in their health care, whether it be specialized MRI machines, robotic surgery devices, or other equipment that can cost millions of dollars.