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83.

Lisitza was concerned that drug switching done pursuant to

Bristol Myers'

M3l'ket Share Agreement would dramatically increase the monthly cost to the government of

ACE

inhibitor

prescriptions.

Switching

a

patient

from

captopril

to

Monopril

resulted

in

an

enonnous

price

increase

  • -

    five

times

as

much

  • -

    per

patient

per

month.

Norm

Jacobson,

Omnic3l'e's Senior Manager in the Jacobs facility, also expressed simil3l' concerns about the cost

and ethics of a kickback-induced switching program.

84.

Lisitza was rebuffed when he confronted CEO Skrabash with his concerns about

the

PAL

program.

Upon

implementation

of

the

Monopril

kickbacks-for-switches

scheme,

Skrabash emphasized to Lisitza that the PAL program was "very important" to Omnicare's

protitability and told him to expect numerous Market Sh3l'e Agreement/PAL progr3l'l1S in the

near

future.

A.

enthusiasm,

once

regional

vice

program

was

president,

echoed

Skrabash's

"a

stroke

of

genius."

Despite

Samuel

Enloe,

an

telling

Lisitza

that

Omnic3l'e

the

PAL

Lisitza's good faith efforts, Skrabash could not be persuaded to cease Omnic3l'e's unlawful

switching practices. Lisitza was ultimately retaliated against for his ethical stance - he was

shunned by management and eventually terminated by Omnicare.

D.

BRISTOL MYERS' ILLEGAL MARKET SHARE AGREEMENTS ENDANGERED THE HEALTH AND WELFARE OF LONG-TERM CARE FACILITY PATIENTS RECEIVING PHARMACEUTICALS FROM OMNICARE

85.

Medications within a therapeutic class are not interchangeable cogs. Each has its

strengths and weaknesses depending on the patient's condition, other conditions the patient may

have,

and

the

other

medications

a

patient

is

taking.

These

medications

also

have

different

concentrations and levels of effectiveness.

86.

Drug switching based on undisclosed tinancial reasons, when there is no valid

medical reason to do so, endangers the health or even the life of a patient. The efficacy and

23

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