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Rutherford Institute Interview: Allen Jones reveals TMAP drug scam linked to then Governor George W. Bush

Fri, 14 Oct 2005

An in-depth interview by John Whitehead of the Rutherford Institute with Allen Jones,*a former inspector with the Pennsyvania Office of Inspector General, who initially blew the whistle on Pennsylvania's version of the Texas Medication Algorithm Project (TMAP), a psychiatric prescription drug formulary and prescribing guideline for professionals. TMAP ensures that hundreds of millions of dollars in state funds are used to pay for high priced, dangerous - and mostly ineffective psychotropic drugs. TMAP is the most audacious prescription drug rip-off scam ever devised.

TMAP was cooked up in Texas by a coalition of manufacturers of patented antipsychotic and antidepression drugs; prominent University of Texas psychiatrists; and state officials in the department of mental health . The manufacturers financed the project, the psychiatrists--whose published reports claiming these drugs to be "safe and effective" were later shown to be false; and Texas state officials.  Although it's a felony for Pennsylvania public officials to take money for presentations in an official capacity, Jones uncovered documents showing "state officials accepting $2,000 honorariums." See: http://www.rutherford.org/PDF/TMAP_Project.pdf

TMAP was born under the stewardship of George W. Bush, then governor of Texas: "the pharmaceutical industry started lavishing a lot of money on the Texas university system and Texas mental health officials during Bush's tenure in the 1990s."

"It was revealed that TMAP personnel may have tampered with research results through a process known as "Retrospective Analysis." Patients who had previously been treated with the new medications were researched, and files showing positive results were selected and reported on. Unsurprisingly, TMAP research "confirmed" that the new drugs were safer and more effective than older treatments. Ignoring the increasing body of contrary findings, TMAP employees referred to their algorithm as being "Evidence Based Best Practices." Dr. Peter J. Weiden, a member of the project's expert consensus, stated that the guidelines promoted by the programs are based on "opinions, not data" and that "most of the guideline's authors have received support from the pharmaceutical industry."

"These flawed results are the basis for President Bush's New Freedom Commission on Mental Health, which has announced its intent to administer a nationwide mental health screening. Bush also backs the controversial TeenScreen program, which is designed to diagnose mental illness in teenagers but has been shown to be coercive and unreliable. Jones firmly stated that "the same political/pharmaceutical alliance that generated the Texas project was behind the New Freedom Commission" and was "poised to consolidate the TMAP effort into a comprehensive national policyŠwith expensive, patented medications of questionable benefit and deadly side effects."

Multiple state investigations are underway.

*In the spirit of full disclosure: Allen Jones has joined the board of directors of the ALLIANCE FOR HUMAN RESEARCH PROTECTION (AHRP).

Contact: Vera Hassner Sharav
212-595-8974
veracare at ahrp org

http://www.rutherford.org/oldspeak/articles/interview/oldspeak-jones.htm
Rutherford Institute interviews: A Lone Wolf Talks on the Drug Leviathan
An interview with Allen Jones
By John W. Whitehead
10/13/05

When Allen Jones was appointed lead investigator in July 2002 in a case concerning off-the-books payments from pharmaceutical companies, he had no idea that his discoveries would cost him his career and propel him to the core of President George W. Bush's national drug policies. An investigator for the Pennsylvania Office of the Inspector General (OIG), Jones' findings in the case showed that the drug company Janssen had paid honorariums to key state officials who held significant influence over the prescriptions issued for state institutions such as prisons and mental health hospitals. Although the accounts receiving these payments were marked for "educational grants," funds were being channeled to state employees who developed guidelines recommending new, more expensive drugs rather than older, cheaper drugs with safe, proven effects. These companies were influencing officials with trips, perks and lavish travel accommodations as a means of inducing the officials to endorse their products. Jones discovered that one of the new drugs being recommended, Risperdal, has been shown to have potentially lethal side effects such as ketoacidosis, coma and possibly death.

After initially revealing his discoveries to OIG managers, Jones was taken off the case but told that he could pursue it on his own. In the words of the OIG supervisor who took Jones off the case and participated in threatening him, "Drug companies write checks to politiciansŠ on both sides of the aisle." When Jones went public with his findings, he was escorted out of his workplace and told not to reappear on OIG property. Jones then filed a suit against his supervisors, claiming that OIG's policy of barring employees from speaking to the press is unconstitutional. Jones also claims that he is being harassed by his superiors and Pennsylvania governmental institutions in order to "cover up, discourage, or limit any investigations or oversight into the corrupt practices of drug companies and the corrupt public officials who have acted with them." Jones' attorney, John Bailey, has called the case "a critical test of the right to a free press." Bailey said, "If they shut the employee up and they have all the documents locked up in a drawer, there is no free press."

The Pennsylvania formulary investigated by Jones (known as PennMap) is based on the Texas Medication Algorithm Project (TMAP), which was named as a model program by President Bush's New Freedom Commission on Mental Health. It has been revealed that TMAP personnel may have tampered with research results through a process known as "Retrospective Analysis." Patients who had previously been treated with the new medications were researched, and files showing positive results were selected and reported on. Unsurprisingly, TMAP research "confirmed" that the new drugs were safer and more effective than older treatments. Ignoring the increasing body of contrary findings, TMAP employees referred to their algorithm as being "Evidence Based Best Practices." Dr. Peter J. Weiden, a member of the project's expert consensus, stated that the guidelines promoted by the programs are based on "opinions, not data" and that "most of the guideline's authors have received support from the pharmaceutical industry."

Just as Jones feared, the corruption extends much further than the Pennsylvania state health care systems. These flawed results are the basis for President Bush's New Freedom Commission on Mental Health, which has announced its intent to administer a nationwide mental health screening. Bush also backs the controversial TeenScreen program, which is designed to diagnose mental illness in teenagers but has been shown to be coercive and unreliable. Jones firmly stated that "the same political/pharmaceutical alliance that generated the Texas project was behind the New Freedom Commission" and was "poised to consolidate the TMAP effort into a comprehensive national policyŠwith expensive, patented medications of questionable benefit and deadly side effects."

Allen Jones has become the poster boy for the battle against the government as he pursues his case against OIG officials. He is hopeful that his efforts fighting industry and governmental corruption will not go to waste.

John Whitehead: Explain TMAP and the PennMay programs.
Allen Jones: Basically, they are treatment protocols. They are comprised of charts and text to guide the commission in prescribing practices for mental health.

JW: Prescribing drugs?
AJ: Yes, prescribing drugs. TMAP is totally a medication protocol. It has nothing to do with treatment or therapy with other means of dealing with illnesses. It is strictly medication.

JW: Does this tie into a drug formulary?
AJ: Yes. Each state has a menu of drugs from which a doctor can prescribe, which is called the formulary. That is the list of drugs that have been approved for use within a state. But before a drug can be prescribed by a state physician for somebody in the state system, it has to be on the list. TMAP and PennMap essentially create formularies within the formulary. If you walk into a drugstore and go to the pain relief section, there are 30, 40 or 50 headache remedies on the shelf which make up that particular drugstore's menu of treatment for that ailment. However, when a new drug comes out, the pharmacist or clerk puts it on the shelf, along with the rest of them. It might be much more expensive, but the person can choose it if they like. What TMAP did was essentially take all the old generic drugs off the shelf and require exclusive usage of brand-new patented, very expensive medications.

JW: Expensive medications purchased from the pharmaceutical industry?
AJ: Yes. TMAP has the pharmaceutical industry's fingerprints all over it - from inception to development through exportation to the different states and internationally.

JW: How did the pharmaceutical industry create TMAP? Wasn't it conceived when George Bush was governor of Texas?
AJ: Yes. It was born under Bush's stewardship as governor of Texas. The pharmaceutical industry started lavishing a lot of money on the Texas university system and Texas mental health officials during Bush's tenure in the 1990s. And when you look at the TMAP project management team that was appointed to shepherd the program, you will find individuals who all have very strong personal financial ties to the drug industry. (See: http://www.rutherford.org/PDF/TMAP_Project.pdf). The program began with the $1.6 million grant from the Robert Woods Johnson Foundation. It is the charitable arm of Johnson and Johnson, which owns Janssen Pharmaceutical, which had some of the principal drugs in the TMAP formularies in the TMAP algorithms.

JW: What year was this?
AJ: The 1990s were the formulative years. Although it was jumpstarted in Texas, it soon reached out elsewhere. By 1998, they were being sent to Beijing to push it internationally.

JW: To push what?
AJ: To push the TMAP and TMAP programs. This includes the medications, algorithms, the medication protocols that require the exclusive usage of the new atypical antipsychotic drugs and so on.

JW: When these drugs are administered to patients, for example in mental hospitals in states such as Texas, I assume it's the taxpayer who pays for these expensive drugs.
AJ: Yes. In fact, the Medicaid program picked up the tab for a lot of these drugs. Moreover, money was pushed toward drugs at this time in the absence of any solid science whatsoever proving they were effective or safe.

JW: Are you saying there were no studies done?
AJ: I am saying there were studies done, but there was no conclusive science saying these drugs were better. 
JW: Well, if they were no better than the present drugs, what was the motive?
AJ: The motive pushing it was profit, pure and simple. 
JW: Are you saying that the pharmaceutical industry is making money off people's illnesses without really helping them?
AJ: Absolutely. The pharmaceutical industry is not your friendly neighborhood pharmacist. These are multinational corporations with a cool eye on the bottom line, which is making money. They have made blockbuster drugs out of chemical compounds that not only are no more effective than what is on the market, they have evolved a deadly side effect profile that is more deadly than the existing drugs. Are you familiar with the recent release of the CATIE trials? The National Institute of Mental Health recently completed a multi-year, multi-sided study in which they put the new atypicals head to head against 50-year-old drugs. Atypical is a specific term for a new class of anti-psychotic medication used for treating schizophrenia, and it was touted through TMAP as being safe and far more effective than the old drugs. This is in the absence of any science to support that. The CATIE trials proved that they have no advantage over the older drugs. (See: http://www.ahrp.org/infomail/05/09/20.php)

JW: They are just more expensive.
AJ: Hundreds of times more expensive. Another study that was done in the Veteran's Administration Hospital showed that Haldol, an old drug at five cents per pill, performed as well as Risperdal and Zyprexa at $8 per pill. I mean, we are talking multiples.

JW: Hasn't Risperdal been shown to have lethal side effects? 
AJ: Absolutely. You can get all manner of deadly side effects. In fact, I looked at some material from the state of Pennsylvania that showed weight gains of up to 240 pounds with the psychotics and a high incidence of new onset diabetes. When they were bringing these drugs into Pennsylvania, they knew that they caused diabetes before the FDA made the official announcement. Risperdal in particular causes stroke in geriatric populations. What is key here is that such drugs were foisted upon people in the absence of science. What they did to establish the drug menu in TMAP was use a process they call the "expert" consensus process. A project management team tied to the industry selected other doctors whose opinions were then analyzed or accessed by the TMAP. They determined from that process that these drugs were safer and more effective, and that became their mantra. But they used a pseudo-science. And of the 55 doctors pooled for the first schizophrenia consensus, 27 had ties to the pharmaceutical industry.

JW: Was Texas the pilot state for all this?
AJ: Absolutely.
JW: Why was this?
AJ: Texas has the highest population of mental health and criminal justice prisons in the country. They have huge prison populations and overcrowded mental hospitals. And just before TMAP came into play, the Texas legislature placed the responsibility for medical treatment of all prisoners and mental health patients in the state with the University of Texas medical branch. Thus, all of a sudden, the drug industry had access to a few key decision-makers and into vast populations of captive persons who were potential customers for their drugs. Add to this the fact that the Texas legislature is biannual, meeting only 140 days every two years. There are two or three drug lobbyists for every legislator in the state of Texas. So the typical legislative oversight is not present. There was a situation in Texas where by influencing a few key decision-makers, the drug industry could have their sway and say.

JW: Is there any indication that George Bush knew or was involved in what was going on?
AJ: I don't know if he was lied to. I don't know if he was deceived. I don't know if he thought it was a good idea. But he did endorse the legislation. He used his support of TMAP, even in his presidential campaign and debate with Al Gore. He was definitely on board.

JW: We now see this with Bush's New Freedom Commission on Mental Health.  
AJ: The New Freedom Commission on Mental Health is an out and out sham. They appointed 22 people to study the mental health service delivery system over our entire nation in a year. These people went here and there. They conducted a few public appearances and public meetings where people got to contribute three minutes of testimony. Supposedly, this commission of 22 people then put their minds together and all contributed to a report. If you read the report, it is absolutely seamless, which means it was written with one voice. Yet, it suggests and recommends programs that were already in place, already in place with the drug industry support and money. It's another expert consensus project. If you look at the composition of the Board, many had direct or indirect ties with the pharmaceutical industry, to George Bush, to TMAP. And they were disproportionately Texans on that committee.

JW: You worked on the PennMap program, which was based on the TMAP program.
AJ: Yes. And the pharmaceutical industry was giving "educational grants" to Pennsylvania to bring people from Texas to Pennsylvania to sell the program and to send Pennsylvanians to meet with Texans. The industry was directly funding the importation of TMAP into Pennsylvania.

JW: When you were appointed the lead investigator in 2002, you uncovered some accounts marked for educational grants. What were the suspicions that led you to where you are today?
AJ: I discovered that an account had been set up "off the books" without registering with the Comptroller of the state. At the instruction of the people above her, a secretary took a check to a bank and opened a checking account, like you or I would do.

JW: And who was opening these educational grants?
AJ: The educational grants were what would be deposited into this account. The pharmaceutical industry would give grants, and checks would be made out to Harrisburg State Hospital. Thus, the chief pharmacist would get the money, endorse it and deposit it into this account. The checkbook was kept in his secretary's drawer. From this account, flights and trips to New Orleans and other places were paid for, lavish dinners and the like, in order to meet with TMAP personnel and to import the program into Pennsylvania. And it was all off the books. It was the type of thing the drug industry could not do legally on its own. For instance, from some of the documents it was obvious that the drug industry was using this account and these people to float through money to further their objectives in ways that they could not legally have done directly. And it was all done for profit so the taxpayer eventually foots the bill. It is sad that they would tamper with critical practice just for profit. But the fact is that they were mandating the usage of hideously expensive drugs that are deadly, for heavens sakeŠ..cutŠ.

see complete interview at: http://www.rutherford.org/oldspeak/articles/interview/oldspeak-jones.htm

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