Omnicare consultant pharmacists to convmce physicians to sIgn PALs authorizing wholesale switches.
Requiring Omnicare to develop computerized electronic capability to accurately track levels ofparticipation in the illegal PAL solicitation program by site and by prescribing clinician.
Rewarding Omnicare for the proportion of patients switched to Accupril via illegal switching payments based in part on the success of the switching scheme.
Market Share Agreement would induce Omnicare to engage in unauthorized medication
substitution, replacing the independent medical judgment of a patient's physician with that of
Omnicare pharmacists, consulting pharmacists, and other Omnicare employees, by changing
physicians' orders for specific ACE inhibitors to Accupril.
Failing to disclose kickbacks and other financial interests to physicians in helping
Omnicare solicit PALs. kickbacks to Omnicare medications.
Pfizer did not disclose to physicians that it for switching certain types of medications
was providing to "preferred"
disadvantageous for many patients, wholesale switching to Accupril placed patients at risk in
First of all, contrary to AMA policies, Pfizer and Omnicare effected switches for
patients who had been stabilized on other ACE inhibitors for years and for patients who had been
switched once before from other ACE inhibitors to Monopril.
Furthermore, Aeeupril was often not the "drug of choice" for a given individual
patient. For stable patients with congestive heart failure with a history of myocardial infarction,
ramipril and trandolapril were indicated as preferable to Accupril. Captopril and trandolapril are
preferentially indicated for stable patients who have had a heart attack and have sustained left