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Health Care Software Firm Fined $145M In Opioid Scheme With Drug Companies


A health care software company has agreed to pay $145 million to the Justice Department. The firm Practice Fusion admitted taking kickbacks from drug companies as part of a scheme that led doctors to overprescribe opioid pain medications. As North Country Public Radio's Brian Mann reports, public documents link the secret project to Purdue Pharma.

BRIAN MANN, BYLINE: Practice Fusion, based in San Francisco, makes the software many doctors see on their smart devices. When you go into the exam room, your electronic medical records pop up on their screens. Here's co-founder Matt Douglass in a video posted by Practice Fusion in 2017.


MATT DOUGLASS: We're used by about 32,000 practices in the U.S. That's about 100,000 people logging in every day to manage tens of millions of patient records. So you're talking about e-prescriptions...

MANN: One feature offered by Practice Fusion was a pop-up alert screen that appeared to offer doctors independent medical advice. In real time, while you were describing your symptoms, an alert might nudge your physician towards certain kinds of treatment. But Practice Fusion now admits it took millions of dollars from drug companies, allowing them to secretly shape when those pop-ups appeared and what they said. Here's U.S. attorney Christina Nolan speaking at a press conference this week in Vermont.


CHRISTINA NOLAN: Practice Fusion decided to monetize its presence in the physician's exam room by selling to pharmaceutical companies the opportunity to prompt physicians to take certain clinical actions.

MANN: A bunch of drug companies allegedly took part. Nolan says one major player was an opioid manufacturer that paid Practice Fusion roughly a million dollars to develop pop-up advisories known as CDS prompts that shaped how doctors treated pain.

NOLAN: For the $1 million, Pharma Company X got to help Practice Fusion create a pain CDS designed to manipulate physicians nationwide.

MANN: Nolan says the Justice Department isn't naming the opioid-maker involved because that company hasn't been indicted, but public documents reviewed by NPR indicate the company in question is Purdue Pharma, maker of OxyContin. The documents detail a joint effort by Purdue and Practice Fusion launched in 2016 that produced the kind of screen prompts described in this criminal settlement. The marketing effort happened at a time when doctors were becoming more aware of the dangers of opioid addiction. That meant declining sales for drug companies, including Purdue Pharma.

Data compiled by the Justice Department found doctors seeing Practice Fusion's CDS prompts reversed that trend, prescribing more opioids, sometimes to patients who didn't need them. U.S. attorney Nolan says the opioid-maker also rejected a plan to include addiction warnings in the pop-up screens viewed by doctors.

NOLAN: Instead, Pharma Company X wanted a CDS that would help achieve its marketing goal of increasing sales of extended-release opioids.

MANN: In a statement to NPR, Purdue Pharma, which filed for bankruptcy last year, declined to confirm their involvement in this case but said they are cooperating with the Justice Department on criminal investigations now underway. Practice Fusion will pay $145 million. And those medical advice pop-ups shaped secretly by drug companies - Practice Fusion tells NPR they were deleted from the firm's software last year. This settlement means none of the company's executives will face prosecution.

Brian Mann, NPR News.

(SOUNDBITE OF SKALPEL'S "SO FAR") Transcript provided by NPR, Copyright NPR.

Brian Mann
Brian Mann is NPR's first national addiction correspondent. He also covers breaking news in the U.S. and around the world.