Homer J. Simpson, M.D.

I imagine most of my 4 1/2 faithful readers are already up to speed on the Serostim settlement, but here's a synopsis.

The drug maker Serono developed a hormonal treatment marketed for the wasting syndrome associated with AIDS. Unfortunately, the same year they got the patent, 1996, was about when fairly effective drugs to control HIV disease came on the market, and the number of people who suffered HIV-related wasting in the rich countries, who could have afforded Serostim, plummeted.

What to do? They started pushing a test on doctors to measure patients' "body cell mass," which would conclude that some patients were "wasting" even though they did not appear to be, and so needed Serostim -- at a modest cost of 21,000 bucks. (Yup.) Now, body cell mass is a real concept (it essentially means everything that isn't fat), but this test was not approved by the FDA and there was no evidence whatsoever that these patients actually needed treatment for wasting or benefited from Serostim.

Serono also gave a free trip to Paris for doctors who prescribed Serostim. Now, that I can understand. Doctors can be criminals, just like drug company executives. But what about all those doctors who didn't get a free trip to Paris, but just took the company rep's word for it that they should use this magical device and follow its instructions to give people $21,000 worth of hormones? Do they also smoke Marlboros because it makes them manly men, and drink Dr. Pepper so they can do what they do, and drive Dodge Ram pickups so they can grab life by the horns?

Serono has admitted that "this device was not approved for the purposes of diagnosing AIDS wasting." It also admitted to the free trips to France, but the DOJ has not identified the physicians who accepted them. (Wouldn't want to embarass the good doctors, now would we? Not that their patients have any right to know that their doctors are criminals who give them useless and possibly dangerous drugs in order to win free trips.) The scheme was uncovered by whistleblowers who worked for the company. I applaud their ethical passion, but also note that they are getting $10,000,000 each in bounty money -- which can motivate a lot of virtue. However, thousands of people were prescribed Serostim, which means we are probably talking about hundreds of doctors.

Next time you visit your doctor, you might want to check for dementia.