The indictment, Deputy Attorney General Paolo Evangelista, disputes the "inappropriateness" of the prescriptions and the incorrect use of the red recipe book, the one with which general practitioners prescribe drugs paid for by the National Health Service. The defense, the lawyer Gennaro Messuti, replies: «There is a co-responsibility of the ASL of Bergamo which has never intervened against whoever it considered an over-prescriber. The doctor acted according to knowledge and conscience: there is no grave fault, at most a slight fault or rather, an excess of zeal».
The first hearing of the only proceeding that has reached the hearing in which a general practitioner, Pietro Poidomani, is accused of having prescribed too many prescriptions causing the State damage of around 93 thousand euros, dropped to 66,225 after the first counter-arguments.
Thus enters the courtroom the investigation by the Guardia di Finanza which began in 2006 on Lombard doctors accused of prescribing too much and without respecting international standards: the defined daily dose, the daily doses defined for each drug (see «Il Sole 24 Ore» of 6 January). According to data from the yellow flames, updated to 30 June and released yesterday, there are 277 white coats subject to verification for prescriptions prescribed between 2002 and 2004: they would have prescribed, for more than two years, more than double the average established by the ASL. The damage to the state coffers would be 12,379,600 euros.
Poidomani, a 53-year-old family doctor from Cividate al Piano, a municipality of 5,000 inhabitants in the province of Bergamo, is one of four white coats (out of 277) sued to whom damages of 243,000 euros are being contested. And he is one of the 57 who have been notified of the invitation to provide deductions (the equivalent of the guarantee notice in the proceeding before the Court of Auditors). Eight other doctors have chosen the path of compensation: they have not admitted responsibility but have decided to pay, allowing the State to recover 42,086.93 euros.
After the scandal of the Santa Rita clinic in Milan, where some doctors inflated medical records to obtain reimbursements from the NHS, the Guardia di Finanza which works together with the Region, Local Health Authority and Court of Auditors has released new figures on the control of pharmaceutical expenditure in Lombardy: in 2007 it would have decreased by 1.03% compared to 2006, and in the first quarter of this year it would have decreased by 0.8% compared to the same period of the previous year.
The sentence on Dr. Poidomani, accused of having prescribed anti-inflammatories from the Coxib group without need, will not arrive before the autumn, also because the defense has requested official technical advice which will extend the time.
angela.manganaro@ilsole24ore.com Il Sole 24 Ore of 07/10/2008 REGULATIONS AND TAXES p. 24
