Healthcare-reform legislation is not the only federal initiative that is affecting pharmaceutical manufacturers these days. US Attorney General Eric Holder is cracking down on healthcare fraud, including false claims against Medicare and Medicaid. AstraZeneca (London) felt the sting of Holder’s campaign when it agreed last week to pay $520 million to resolve accusations that it marketed its atypical antipsychotic Seroquel illegally.

The Justice Department charged that AstraZeneca improperly influenced the content of continuing medical-education programs that it sponsored so that it could promote unapproved uses of Seroquel. The US also alleged that, in an attempt to influence physicians’ prescribing habits, AstraZeneca paid doctors to give promotional lectures to other healthcare professionals about unapproved uses of Seroquel. Such payments violated the federal Anti-Kickback Statute, according to Justice.

In addition, Justice alleged that AstraZeneca paid to use doctors’ names as authors of articles that were ghostwritten by medical-literature companies. The articles described studies that the doctors had not conducted, and they formed the basis for promotional messages about unapproved uses of Seroquel.

In a press statement, AstraZeneca denied these allegations but noted that it had entered into a five-year corporate integrity agreement with the US Department of Health and Human Services’s Office of the Inspector General.

The alleged AstraZeneca payments are quite similar to the kinds of payments that drugmakers would have to report under a transparency bill in Connecticut. As I noted last week, Pfizer (New York) is fighting the Connecticut bill, but similar provisions are already part of federal law.

The public does not appear to be on Pfizer’s side. According to an analysis of previous studies that the Journal of the American Medical Association published last week, a majority of patients and research participants believe that financial relationships between medicine and industry should be disclosed because they may influence research and clinical care. “In clinical care, patients believed financial ties decreased the quality and increased the cost of care,” according to the authors of the analysis. “In research, financial ties affected perceptions of study quality. In two studies, readers’ perceptions of journal article quality decreased after disclosure of financial ties,” said the authors.

Bills like Connecticut’s seem to enjoy broad support, and news of AstraZeneca’s settlement might strengthen it. I think that companies such as Pfizer should overcome any reservations they might have about reporting payments to physicians. They stand to gain the public’s trust, which is a valuable commodity in a competitive market.