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‘Greed is a powerful weapon’: Are illegal kickbacks in Ontario driving up the cost of your generic drugs?

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A hidden camera investigation and confidential documents obtained by CBC’s The Fifth Estate raise questions about whether Canada’s largest pharmaceutical distributor is profiting from illegal kickbacks on sales of generic drugs in Ontario.

Studies have shown this practice drives up the cost of generic drugs for all Canadians.

McKesson Canada, which distributes pharmaceutical drugs to more than 8,000 pharmacies in this country and recently purchased more than 400 Rexall pharmacies, denies the allegation.

The Canadian company is a subsidiary of the San Francisco-based McKesson Corporation, which is No. 6 on the Fortune 500 and the largest pharmaceutical distributor in North America, delivering one-third of all medications used every day, according to its website.

AFifth Estate hidden camera investigation captured conversations with three independent pharmacists at two pharmacies who suggest McKesson is breaking the law in Ontario, where kickbacks on generic drugs are illegal.

“[McKesson] gives the numbers to [our buying group], they consolidate the numbers and give me 50 per cent back,” one Ontario-based pharmacist told a generic drug salesperson working undercover for The Fifth Estate.

The conversation raises the question of whether this pharmacist is getting a 50 per cent kickback from McKesson Canada.

In other words, for every $10 in drugs this pharmacist sells, he would be able to put $5 in his pocket. In exchange, the pharmacist or his buying group would agree to stock the generic drugs McKesson distributes, giving the company sales ahead of a competitor.

McKesson Canada is a subsidiary of the U.S. McKesson Corporation, which is No. 6 on the Fortune 500 and the largest pharmaceutical distributor in North America. (John Badcock/CBC)

It’s a practice that studies have shown dramatically inflates the prices of generic drugs for Canadians, who pay some of the highest generic drug prices in the world.

“Greed is a powerful weapon,” said Paul Bailey, president of the Police Pensioners Association of Ontario, a group with many members who live on tight budgets with small police pensions.

He reviewed hidden camera footage captured by The Fifth Estate that also showed several pharmacists in Ontario asking for kickbacks.

“Once again, the taxpayer takes it on the chin,” he said.

Banned in 2013

The practice of paying or receiving rebates or kickbacks in exchange for stocking a particular brand of generic drug was regulated in Ontario starting in 2006 as part of efforts to reduce the price of generic drugs.

A full ban on rebates — direct or indirect — in the province came into effect in 2013. Quebec is the only other province or territory in the country that has restrictions on rebates.

Generic prices have come down since 2006, but Canadians are still paying the second-highest amount among OECD countries for their generic drugs, according to a recent government report.

Along with conducting the hidden camera investigation, The Fifth Estate obtained an internal McKesson presentation given to its employees, as well as a confidential document filed in a hearing at the Ontario College of Pharmacists.

Both documents raise the same question: Is McKesson Canada profiting from illegal kickbacks in Ontario?  

Are they giving kickbacks to independent pharmacists in Ontario in order to secure sales or collecting kickbacks from generic drugs manufacturers in exchange for stocking a particular brand in their own Ontario stores?

“People don’t know they’re getting ripped off and the reason they’re paying the high drug costs,” said Bailey.

McKesson Canada denies allegations

The Police Pensioners Association of Ontario first became interested in rebates in 2009 when several generic drug makers, wholesalers and a pharmacy were caught in a rebate scheme.

Bailey, a former police detective, called for a criminal investigation at the time. He’s now more convinced than ever that drastic action is required.

Paul Bailey, a former police detective and current president of the Police Pensioners Association of Ontario, says a public inquiry is needed into pharmaceutical rebates. (John Badcock/CBC)

“The only way we’re ever going to get to the bottom of this is to have a public inquiry.”

The Fifth Estaterequested an interview with McKesson Canada president Paula Keays, but she would only provide a written statement.

Keays acknowledged the company makes payments to the pharmacies it supplies with generic drugs, but denied they are illegal kickbacks or rebates.

McKesson Canada president Paula Keays acknowledged in a written statement that the company makes payments to the pharmacies it supplies with generic drugs, but denied they are illegal kickbacks or rebates. (McKesson Canada)

“McKesson Canada does not pay rebates in Ontario and any assertion to the contrary is blatantly false,” she said in the statement.

The payments its company makes, she said, are “fully in line with all current provincial regulations and [are] one of the ways independent pharmacies operate and improve services for patients, like installing blood pressure monitoring stations, introducing new technologies and automating services to allow for patient counselling. These are standard business agreements and are entirely appropriate.”

Going undercover

A Fifth Estate investigation in March 2018 revealed that Costco was demanding millions of dollars in illegal rebates from a generic drug manufacturer.

After that story aired, The Fifth Estate received an email from someone with many years of experience in pharmaceutical sales suggesting the problem goes far beyond Costco:

“It’s not just Costco…. Every single pharmacy across the country takes kickbacks in a monetary form still to this day. I am a former rep and can definitely say that this happens. It is still happening and will continue to happen.”

In order to test whether pharmacists in Ontario would ask for illegal kickbacks or disclose if they are receiving kickbacks, the insider agreed to help The Fifth Estate and go undercover as a salesperson. Because he still works in the industry, The Fifth Estate agreed to protect his identity.

CBC’s graphics department created a fake drug company website for The Fifth Estate’s hidden camera investigation. (David Abrahams/CBC)

“The problem is, everyone’s driving these rebates up. It’s a competition,” he told The Fifth Estate in an interview.

“Basically it’s a race to the bottom, if you will. You know, I’ll offer more points than the next guy that just came in before me. And that’s driving the cost of the pills up. It’s just not fair.”

The Fifth Estate created a fake generic drug company called Dari Pharmaceuticals and made business cards, a product list and a website.

Over three days, The Fifth Estate visited 17 independent pharmacies in Kitchener, Cambridge and Hamilton and spoke to nine pharmacy owners who were interested in buying generic drugs. All but one asked if the fake company paid illegal rebates.

‘Incentives to move their stuff’

Several pharmacists also openly discussed their current arrangement, claiming they received illegal kickbacks from large companies.

“Let’s say if you buy 1,000, for example, there is a rebate of 50 per cent,” one pharmacist told The Fifth Estate‘s undercover salesperson, referring to his current arrangement with McKesson Canada.

“[Other companies] go higher [than 50 per cent] to give incentives to move their stuff,” said another pharmacist. “Some days they go to 60 [per cent], some days they go to 70 [per cent].”

Some pharmacists wanted to know how The Fifth Estate‘s fake company would deliver its kickbacks while others talked about technical wording that could be used to hide a kickback and get around the law in Ontario.

So basically [a middle company] cuts us a cheque every month and it’s … not technically a rebate, it’s more … for professional services and what have you, right,” another pharmacist said. “That’s how most people are wording it nowadays.”   

Business cards and a product list were created for the fake generic drug company called Dari Pharmaceuticals. (CBC)

An internal McKesson Canada document obtained by The Fifth Estate suggests the company also uses a variety of terms to describe payments it makes to pharmacists.

The PowerPoint presentation from 2017 instructs employees to remove the word “rebate” from their “vocabularies,” while other terms like “professional allowances” should be “used with caution.”

The presentation does say rebates are illegal in Ontario but goes on to say the pharmacy brands McKesson owns, like Guardian or IDA, make payments to pharmacies under a variety of circumstances.

“All four main McKesson banners make payments to its pharmacies, but for different things, under different names and under different circumstances. Sometimes we use the same words to mean different things.”

CBC asked McKesson about the presentation and the company denied the document suggests it’s paying kickbacks or rebates that are illegal in Ontario.

“As could be expected, our various retail banners compensated their respective members for different things, under various names, prior to their acquisitions by McKesson Canada,” the company said in a statement.

“Accordingly, a main driver of the project reflected in the presentation was to ensure McKesson Canada’s rigorous corporate practices are mirrored across all McKesson Canada banner operations. The references to Ontario throughout the document reinforce the fact that rebates are illegal, and McKesson Canada does not pay them.”

A senior pharmacy insider interviewed by The Fifth Estate doesn’t buy it.

“You have to have so many terms because you want to complicate it,” the former executive said. The Fifth Estate agreed to protect his identity because he still works in the industry.

“You don’t want people to follow the money. No matter what you call it,” he said, “money that is going from the manufacturer to the pharmacy at the end of the day is a rebate.”

Rebates disguised as advertising?

When Costco was caught demanding kickbacks, a document filed at a hearing of the Ontario College of Pharmacists alleged that other pharmacy chains were also potentially breaking the law.

The Fifth Estate filed a motion to see exhibits filed at the hearing and after many months received most of the documents.

A letter from Costco’s lawyer to the investigator for the college said: “It should be noted that advertising in the form challenged by the complainant are common for pharmacies in the industry generally.”

The lawyer goes on to allege that four other large pharmacy chains that operate in Ontario pay potentially illegal rebates disguised as advertising fees, including Guardian and Rexall.

Guardian is one of McKesson’s independent retail pharmacy banners and Rexall is fully owned and operated by McKesson.

CBC was unable to confirm the allegations, so approached McKesson for an explanation. Again, McKesson Canada said it’s not doing anything to break the law in Ontario.

“To be abundantly clear: McKesson Canada does not pay prohibited rebates in the province of Ontario,” the company added in its statement. “Any reporting otherwise would be false and inaccurate.”

Millions could be saved

Canadians have for decades paid some of the highest prices for generic drugs in the world. In the mid-2000s, the Competition Bureau of Canada was one of the first to take a detailed look at why.

“Lots of people had theories but we wanted to clarify how the generic market was working and functioning and how it was broken,” said lead investigator Mark Ronayne.

Two reports, one in 2007 and another in 2008, determined the practice of paying kickbacks was widespread in Canada and was costing Canadians hundreds of millions of dollars every year.

“The rebates paid to the pharmacies have accounted for a large portion of payers’ generic drug costs, 40 per cent or more of generic drug expenditures,” the reports concluded.  

Mark Ronayne was the lead investigator on two reports for the Competition Bureau of Canada in the mid-2000s that looked at competition practices in the Canadian generic drug sector and made recommendations for changes. (John Badcock/CBC)

“Canadian taxpayers, consumers and businesses could save up to $800 million a year if changes are made to the way private plans and provinces pay for generic drugs. The potential savings could climb to over $1 billion per year in coming years, as several blockbuster brand name drugs lose patent protection.”

Ronayne believes “powerful interests” blocked change in Canada, which is why the practice of paying kickbacks continues to this day.

“If there’s money to be made by providing a lower price somehow to pharmacies to somehow get your product on the shelf, then companies will look for some way to do that,” said Ronayne.  

“Maybe not necessarily consistent with legislation or could be consistent with legislation but they’re going to try to do it. And they’ve been doing that for a long time and if they are continuing to do that, I wouldn’t be terribly surprised.”

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BRAINWASHING THE YOUNG: Cry Babies dolls allow children to “vaccinate” their dolls, causing measles-looking red dots on their face to vanish

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Awareness seems to be growing about the dangers and ineffectiveness of vaccines, so much so that a children’s doll product known as “Cry Babies” was designed to brainwash innocent kids into believing that vaccination is the way to “cure” disease.

A commercial spot for Cry Babies shows two little girls playing with a doll named “Kristal” that develops strange red spots on her face. When the girls notice the spots, their response is to immediately inject the doll with a vaccine, which makes the red spots disappear on contact.

“Look, she has spots!” the one girl says to the other.

“Give her the injection!” the other responds.

On the Cry Babies website, the description for the Kristal doll explains that she “is sick” and needs “the right medicine” in order “to help her feel better.”

“If she gets a cough, give her the medicine to help her stop coughing,” the description adds. “If she gets a fever, you will need to dab her forehead with the wet cloth to help cool her down.”

“When red spot will appear on her face, give her the injection to make them disappear!” it is further explained. “Like all Cry Babies, Kristal also cries real tears when you remove her dummy and makes realistic baby sounds. 6 accessories included; a dummy, a stethoscope, an injection, a cloth, cough syrup and a thermometer.”

Normalizing vaccines for every ailment is the ultimate goal

The Kristal doll, along with the rest of the Cry Babies lineup, is reportedly available in the United States at Target, Walmart and Amazon. The company that manufactures them, IMC Toys, is based out of the United Kingdom.

Brainwashing young kids into believing that vaccines are “science-based medicine” is only part of the agenda, by the way. The ultimate goal is to convince the next generation that vaccines are the “cure” for pretty much every ailment and addiction, whether it be plandemic viruses like Covid-19 or alcohol addiction.

Vaccines are the be all, end all “solution” to whatever ails you, in other words. This is the true agenda behind children’s products like Cry Babies, which parents need to be aware of and avoid while doing their Christmas shopping this year.

On Twitter, vaccine truth advocates jested at Kristal, pointing out that the doll probably does not come with real-life side effects such as diarrhea, asthma and seizures.

“The doll gets some autoimmune / allergic rash and they inject some high-dose corticosteroid / immunosuppressants and the rash goes away (for some time at least). Just like real doctors!” wrote one, making a great point about how the Kristal doll is ill-equipped to teach children the intricacies about how injections really work.

Another noted that such propaganda has been a mainstay of American programming for many decades, though in the past it was primarily geared towards an adult audience.

“Since the late 40s / early 50s, TV has spread the disease of excessive consumerism throughout societies worldwide,” this person wrote. “Add to that its use as a highly effective propaganda tool and it didn’t take long for the corporate world to realize the propaganda with products such as this.”

Perhaps the best advice came from one user who encouraged parents to program their children with the truth rather than allow them to be programmed with pro-vaccine propaganda.

“Show your kids the vaccine-injured babies and their parents’ stories,” this individual added, stressing that the next generation of youth need to recognize that vaccines are unsafe and harmful, and are not a risk worth taking under nearly any circumstance.

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Johns Hopkins published, then deleted, study showing COVID-19 had no measurable effect on deaths in the United States

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The Wuhan coronavirus (COVID-19) is not even close to being the threat that Anthony Fauci and others in government continue to claim it is. And Johns Hopkins University agrees – or at least it did agree before the school deleted a study it published showing that the novel virus has had “relatively no effect on deaths in the United States.”

Thanks to the Wayback Machine, we were able to pull up the now-deleted original paper, which delineates that so-called “infection” with COVID-19 is really no big deal.

When it comes to the death rate this year, there has been almost no change compared to previous years, despite the presence of COVID-19. Things are essentially the same as they have always been, the exception being all the panic, mask-wearing, and eager anticipation among some of a soon-coming vaccine.

“The reason we have a higher number of reported COVID-19 deaths among older individuals than younger individuals is simply because every day in the U.S. older individuals die in higher numbers than younger individuals,” stated Genevieve Briand, assistant program director of the Applied Economics master’s degree program at Hopkins.

After compiling and analyzing the death rate among all age groups both before and after the pandemic was declared in the United States on March 13, Briand found that the death rate among older people, who are said to be most susceptible, remained the same.

So while it is said that COVID-19 mainly affects the elderly, significantly increasing their risk of death supposedly, data from the Centers for Disease Control and Prevention (CDC) disagrees.

More of the latest news about COVID-19 can be found at Pandemic.news.

No, COVID-19 has not increased the death rate among Americans

Briand further found that COVID-19 has not increased the death rate among younger people, either. In every age category, the death rate has remained roughly the same both before and during the pandemic, suggesting that all the panic and hysteria is completely unfounded.

In every year prior to 2020, the death rate from all causes has remained the same. Even this year when accounting for so-called COVID-19 deaths, the overall death total has not changed.

“This is true every year,” Briand says about the seasonal increases in death that usually occur in the fall and winter months, 2020 being no exception. “Every year in the U.S. when we observe the seasonal ups and downs, we have an increase of deaths due to all causes.”

What has changed this year is that all other causes of death, including heart disease, respiratory illness, influenza, and pneumonia, have mysteriously declined, while COVID-19 deaths have increased.

This proves that deaths from all causes are now being categorized exclusively as deaths from COVID-19. Meanwhile, nobody is dying anymore from heart disease, respiratory illness, influenza or pneumonia.

A data chart included in Briand’s study illustrates this clearly, showing that the total decrease in deaths by other causes almost exactly equals the increase in deaths by COVID-19.

“This suggests, according to Briand, that the COVID-19 death toll is misleading,” the paper explains. “Briand believes that deaths due to heart diseases, respiratory diseases, influenza and pneumonia may instead be recategorized as being due to COVID-19.”

In other words, if a person tests positive for COVID-19 and dies at some point in the future from any cause, that death is tabulated as caused by COVID-19 for political and financial purposes.

“All of this points to no evidence that COVID-19 created any excess deaths,” Briand reiterated. “Total death numbers are not above normal death numbers. We found no evidence to the contrary.”

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Expert points out “shaky science” behind AstraZeneca’s coronavirus vaccine trial results

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An expert has warned that results from AstraZeneca’s coronavirus vaccine trials are based on “shaky science.” Scientist-turned-writer Hilda Bastian pointed out that data on the British drugmaker’s COVID-19 vaccine, developed with the University of Oxford, has been “patched together” and excludes groups with the highest COVID-19 risk. Bastian wrote in a piece for Wired that AstraZeneca’s data came from two separate studies – one in May and another that commenced at the end of June – that were substantially different from each other. She remarked: “The fact that they may have had to combine data from [these] two trials in order to get a strong result raises the first red flag.”

Bastian mentioned that a dosing error contributed to a higher success rate: Experts accidentally gave some volunteers one and a half doses of the vaccine instead of two full doses. She added the trials were never designed to test this method of dosing, and scientists only caught the “mistake” when some participants did not exhibit the usual high rate of adverse effects. Bastian noted in her Wired article that “of the only two regimens … the mistaken first half-dose, followed by a full dose at least a month later came in at 90 percent [efficacy], and the … two standard doses at least a month apart [regimen] achieved only 62 percent efficacy.”

The expert also mentioned that the trials by AstraZeneca and Oxford appear to include only a small amount of people aged 55 and above – despite this particular age group being vulnerable to COVID-19. The June vaccine trial held in Brazil did not originally permit people over 55; on the other hand, a separate trial by Pfizer and BioNTech had 41 percent of volunteers over 55 who participated.

A number of experts have also voiced out concerns against AstraZeneca’s presented data

Former Pfizer Global Research and Development President John LaMattina raised the prospect that AstraZeneca’s vaccine may not receive approval from U.S. authorities. He tweeted Nov. 24 that it was “hard to believe” the Food and Drug Administration will issue an emergency use authorization for a vaccine “whose optimal dose has only been given to 2,300 people,” adding that “more data” was needed.

SVB Leerink investment analyst Geoffrey Porges told the Financial Times that the British pharmaceutical firm’s coronavirus vaccine candidate was likely to be rejected because it had “tried to embellish [the trial’s] results” by highlighting its effectiveness in a “relatively small subset of” participants in the study.

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