No one in healthcare aspires to win an award named after a "pharma bro."
But that's exactly where 10 individuals and organizations find themselves with the release of Lown Institute's 6th Annual Shkreli Awards. The list contains the "worst examples of profiteering and dysfunction in healthcare" ultimately decided by a panel of 18 judges who are patient activists, clinicians, health policy experts and journalists. The awards and vetting system are organized by Lown Institute, a nonpartisan think tank that measures hospitals' and health systems' social responsibility.
Martin Shkreli earned the nickname of pharma bro when, in 2015, his company Turing Pharmaceuticals acquired a 62-year-old drug called Daraprim and, overnight, increased the price from about $13.50 per pill to $750. In 2017, Mr. Shkreli was convicted in federal court on two counts of securities fraud and one count of conspiring to commit securities fraud, resulting in a 2018 sentence of seven years in prison. In 2022, a federal judge ordered Mr. Shkreli to pay $64 million for hiking the price of Daraprim and permanently banned him from serving as an executive or director at a public company in addition to a lifetime ban from the pharmaceutical industry.
"If we're ever going to get to the great health system that Americans deserve, we have to call out bad behavior," Vikas Saini, MD, president of the Lown Institute, said. "The Shkreli Awards are a mirror that's hard to look into, but we've got to do it."
Below are the recipients of the 2022 Shkreli Award, as decided by the Lown Institute.
1. Insurers that systematically manipulate Medicare Advantage. The majority of large Medicare Advantage insurers face accusations of fraud or overbilling by the U.S. government, resulting in alleged overpayments estimated to cost taxpayers up to $25 billion in 2020, The New York Times reported in October 2022. Of the top 10 Medicare Advantage providers by market share, the following have been accused of fraud or overbilling by the U.S. government or Inspector General and have ongoing lawsuits as of 2022, according to the Times: UnitedHealth Group, CVS Health, Elevance Health, Kaiser Permanente, Blue Cross Blue Shield of Michigan, Cigna, and Highmark. These insurers have disputed the claims.
2. Noble Health (Kansas City, Mo.). The private equity firm acquired two rural Missouri hospitals and closed them two years later. Between the purchase and closure of the hospitals were supply and drug shortages that threatened patient safety and the suspension of employees' health insurance despite continued deductions from paychecks for their premiums. "Some staff members now face hundreds of thousands in medical bills because they did not know they were uninsured," Lown Institute wrote. The company is under federal investigation.
3. Bon Secours Health System (Richmond, Va.). Bon Secours Health System's Richmond (Va.) Community Hospital profited from the 340(b) drug program but lacked an intensive care unit, maternity ward or functioning MRI machine. Instead, the system "has been diverting the profits from Richmond Community to its other hospitals in wealthier, whiter neighborhoods," the Lown Institute wrote, referring to a New York Times investigation published in September 2022. A spokesperson for Bon Secours Mercy Health said the system had spent nearly $10 million on improvements to Richmond Community Hospital since 2013.
4. CEO and staff of Novus Hospice (Frisco, Texas). CEO Bradley Harris and a dozen other Novus employees were allegedly involved in a scheme to heavily medicate patients to speed up their death, thereby curbing average patient stay and avoiding caps on government reimbursement. Novus staff were given pre-signed prescription pads and told to dispense powerful medications like morphine and hydrocodone to patients, without guidance or oversight from physicians, according to the Justice Department. One Novus employee allegedly received a text message from Mr. Harris with the directive, "You need to make this patient go bye-bye." Mr. Harris was sentenced to 13 years and three months in federal prison for defrauding Medicare and Medicaid in January. Other personnel and physicians involved in the scheme face upwards of 28 years in federal prison combined.
5. Johnson & Johnson. Johnson & Johnson continued selling its talc baby powder despite knowledge that asbestos could be a contaminant, resulting in lawsuits from 40,000 cancer patients. Many of the plaintiffs are Black women, "as J&J allegedly marketed its talc-based products specifically to this population," the institute argues. J&J created a subsidiary with the baby powder-related liabilities and then declared the "shell company" bankrupt, NPR reported in September 2022.
6. Philip Morris. Tobacco giant Philip Morris spent 175 years selling products linked to heart disease, chronic obstructive pulmonary disease and other health problems. It is now backing a healthcare company — Vectura Fertin Pharma — "to make more money treating the very conditions it helped create by acquiring companies that develop inhaled therapeutics," the Lown Institute wrote, referring to a special report published by STAT in September 2022.
7. Providence (Renton, Wash.). More than 55,000 patients were pursued by debt collectors when they should have been given a discount as a result of Rev Up, a Providence-led campaign to boost revenue that was developed with direction from corporate consultant McKinsey, Lown Institute wrote, referring to a lawsuit filed by Washington's attorney general and a Sept. 24 New York Times report detailing the system's alleged debt collection practices. Providence has challenged the allegations. "The New York Times coverage is not an accurate reflection of who Providence is as an organization," the system said in a statement, noting that an error when transitioning from a manual process to an automated one caused some Medicaid patients to be sent to collections after 120 days. "'Rev Up' was a short-lived program," the system said. "The intent was not to target or pressure those in financial distress. It aimed to provide patients with greater pricing transparency especially as more employers and insurers require patients to pay higher deductibles for care."
8. Three North Texas laboratories. Unified Laboratory Services, Spectrum Diagnostic Laboratory and Reliable Labs, all based in the Dallas area, paid kickbacks to induce medical professionals to order unnecessary lab tests, which they then billed federal healthcare programs, submitting more than $300 million in claims. All 11 defendants involved in the scheme pleaded guilty.
9. Catholic Medical Center (Manchester, N.H.). Although hospital leadership was aware of the poor malpractice record held by prominent cardiac surgeon Yvon Baribeau, MD, executives continued to support him, featuring him in hospital advertisements and allowing him to keep operating over the objections of other physicians, The Boston Globe reported in September 2022. Dr. Baribeau retired in 2019. Throughout his career, he tallied 21 medical malpractice settlements, including 14 related to patient deaths.
10. Scott Charmoli, DDS. Practicing out of Wisconsin, Dr. Scott Charmoli, formerly a licensed dentist, was sentenced to 54 months' incarceration for committing healthcare fraud and making false statements in July. Dr. Charmoli began a scheme in 2015 in which he aggressively sold crowns to patients and then intentionally broke their teeth with his drill to defraud dental insurance companies into paying for the unnecessary crown procedures.