jmj11 Posted September 16, 2011 Share Posted September 16, 2011 I've been a close associate to Allergan for about a decade as they are a powerful force (due to FDA approval for Botox in migraine) in the headache world. They are setting up a huge network of headache providers for patients to use to find "quality providers." Oddly, despite me being poised to spend 50K on their products this year, stopped responding to me as soon as I opened my clinic. Finally, yesterday a friend (or a past friend at least) who is an executive with Allergan e-mailed me that the reason she has not gotten back to me is because she has a corporate gag order. They have been told to have no contact with PAs or NPs from this point on simply because they see all NPs and PAs giving inferior care and they want Allergan to be associated with "quality care." So, because of that, they can not help me even order their products or help me get paid for them by the insurance companies. I advised them that I would make sure their foolish corporate decision was made known to the PA world . . . so that's what I've done. Mike Link to comment Share on other sites More sharing options...
aprillh Posted September 16, 2011 Share Posted September 16, 2011 Wow. I wonder what they feel about all the PAs and NPs (and nurses) who perform cosmetic Botox injections. Surely they don't think that is inferior care too... especially with the millions we have made for their company. I'm disappointed. Link to comment Share on other sites More sharing options...
jmj11 Posted September 16, 2011 Author Share Posted September 16, 2011 Wow. I wonder what they feel about all the PAs and NPs (and nurses) who perform cosmetic Botox injections. Surely they don't think that is inferior care too... especially with the millions we have made for their company. I'm disappointed. They probably don't mind who is injecting behind the scenes, but they policy is that they will not speak to or acknowledge us. Link to comment Share on other sites More sharing options...
mikejfox Posted September 16, 2011 Share Posted September 16, 2011 I just called the company and told them how disappointed I was concerning their company statement on PA and NF care. I advised her they may see a country-wide boycott of their products. The number is 1.800.433.8871. You have to punch upteen dozen buttons, but I think it is worth it. This goes to show how OUR national organization is NOT doing its job. I think we need to wake up and take a stand for ourselves. It seems like the more I visit this forum, the more negative I hear being said about us or being done to us. It is frightening. At least, it deserves our attention. Link to comment Share on other sites More sharing options...
mikejfox Posted September 16, 2011 Share Posted September 16, 2011 PS--"They have been told to have no contact with PAs or NPs from this point on simply because they see all NPs and PAs giving inferior care and they want Allergan to be associated with "quality care." Can't a company be sued for making that comment? Me! I am not no lawyer. I have no clue. Link to comment Share on other sites More sharing options...
jmj11 Posted September 16, 2011 Author Share Posted September 16, 2011 PS--"They have been told to have no contact with PAs or NPs from this point on simply because they see all NPs and PAs giving inferior care and they want Allergan to be associated with "quality care." Can't a company be sued for making that comment? Me! I am not no lawyer. I have no clue. I think it is a clear violation of the Restraint of Commerce and this time I have it in writing on their e-mail. However, every time I start talking to my business lawyer about it, his eyes goes glassy and his mind starts to dream of malpractice, bodily injury and incorporation law. He says it would take 6 years, a huge amount of emotional effort, possibly loose or settled for 10K. BTW, that was a kind action to call them. I spent quite of bit of time yesterday leaving voice mails (I think they know its me and won't pick up). Link to comment Share on other sites More sharing options...
mikejfox Posted September 16, 2011 Share Posted September 16, 2011 The whole affair makes me angry. I don't use their products and probably never will. However, I think more than me and you need to get angry. BTW, there are other lawyers!! Link to comment Share on other sites More sharing options...
jmj11 Posted September 16, 2011 Author Share Posted September 16, 2011 The whole affair makes me angry. I don't use their products and probably never will. However, I think more than me and you need to get angry. BTW, there are other lawyers!! Actually, I'm done of being angry. Have you ever seen a humming bird going from flower to flower collecting nectar. That's what it has been for the past year for me, going from firefight to firefight over being a PA. I will continue fighting this. If possible I will take all my business to Medicis (makers of Dysport, Botox's rival). Just a week ago today I was sitting at the Group Health Cooperative Headquarters in Seattle doing a presentation of why I, a mild-mannered PA, can be a headache specialist. That was a three month battle to get to that point. So, for my own mental-health's sake, I have to know when to not get too emotionally invested in these affairs. Link to comment Share on other sites More sharing options...
mikejfox Posted September 17, 2011 Share Posted September 17, 2011 Is there anything I can do to help you? I hear a lot of talk around here, but I have not seen much action. Link to comment Share on other sites More sharing options...
Dobbyrocks Posted September 17, 2011 Share Posted September 17, 2011 Mike, I work in Derm and Allergan has been a thorn in the side of several derm PA's over the years. Evidently, there is a free practice management program for big Botox providers provided by Allergan. This practice manager people have then told SP's their derm PA's are overpaid, over-utilized, all kinds of meddlesome and undocumented comments that evidently have caused some real hardship between the PA's and their docs. My understanding is the salary numbers Allergan suggested were WELL below industry standard (but try telling that to your boss who now thinks you're seriously overpaid). I personally have not had any of these issues...guess we're not a big enough botox seller. All the same, we've switched to Dysport for 99% of our paralytics. I think it works better, faster and (best of all) it's cheaper! Good luck to you! \ Link to comment Share on other sites More sharing options...
jmj11 Posted September 17, 2011 Author Share Posted September 17, 2011 Mike, I work in Derm and Allergan has been a thorn in the side of several derm PA's over the years. Evidently, there is a free practice management program for big Botox providers provided by Allergan. This practice manager people have then told SP's their derm PA's are overpaid, over-utilized, all kinds of meddlesome and undocumented comments that evidently have caused some real hardship between the PA's and their docs. My understanding is the salary numbers Allergan suggested were WELL below industry standard (but try telling that to your boss who now thinks you're seriously overpaid). I personally have not had any of these issues...guess we're not a big enough botox seller. All the same, we've switched to Dysport for 99% of our paralytics. I think it works better, faster and (best of all) it's cheaper! Good luck to you! \ I'm seriously considering switching to Dysport (i've done 18 Dysport treatments for migraine). They (Medicis Pharm) is much more PA positive. It would be a non-brainer but, Dysport does not have the indication for Migraine and Botox does. So this could influence our reimbursement. But I will make the argument that it is $400.00 cheaper per patient. Link to comment Share on other sites More sharing options...
Joelseff Posted September 17, 2011 Share Posted September 17, 2011 Wow when i was working in Physiatry/Pain med, I remember the Allergan rep was all "up on deez" to try to get me to start treating my Migraine pts with Botox. She went on to say they would provide the training blah blah blah and thought it would be great to expand my practice to offer Botox.....I wonder where this seemingly sudden about-face about non-physician care came from? Is this a sx of a more serious situation with more to come down the pipe from other directions? Link to comment Share on other sites More sharing options...
jmj11 Posted September 17, 2011 Author Share Posted September 17, 2011 Wow when i was working in Physiatry/Pain med, I remember the Allergan rep was all "up on deez" to try to get me to start treating my Migraine pts with Botox. She went on to say they would provide the training blah blah blah and thought it would be great to expand my practice to offer Botox.....I wonder where this seemingly sudden about-face about non-physician care came from? Is this a sx of a more serious situation with more to come down the pipe from other directions? I was their best friend until April . . . when they threw me under the bus per corporate order. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 17, 2011 Moderator Share Posted September 17, 2011 I'm guessing they just got an anti- pa/np doc on their board.... Link to comment Share on other sites More sharing options...
physasst Posted September 17, 2011 Share Posted September 17, 2011 I just called the company and told them how disappointed I was concerning their company statement on PA and NF care. I advised her they may see a country-wide boycott of their products. The number is 1.800.433.8871. You have to punch upteen dozen buttons, but I think it is worth it. This goes to show how OUR national organization is NOT doing its job. I think we need to wake up and take a stand for ourselves. It seems like the more I visit this forum, the more negative I hear being said about us or being done to us. It is frightening. At least, it deserves our attention. "OUR" national organization was probably not even aware of this.....but they are now. Link to comment Share on other sites More sharing options...
jmj11 Posted September 18, 2011 Author Share Posted September 18, 2011 I am only speculating but reading between the lines I think it went down like this. Botox was approved for Migraine treatment in Nov 2010. Allergan saw $$$$$$$$$$$$$. The insurance companies also saw $$$$$$ but debits not credits. So, the insurance companies said, okay, we will approve reimbursement for Botox for chronic migraine but we don't want to open the floodgates for every jo-blow PCP doing Botox for migraine. So Allergan smiled and said, "Okay, we will raise the bar really high, so well will throw all those lessor skilled (in their thinking) providers, such as PCPs, NPs, PAs under the bus and we will pretend they don't even exist, event though they've been our good friends for decades." The insurance companies then said, "Okay, we will play ball with you." Link to comment Share on other sites More sharing options...
alleycat Posted September 20, 2011 Share Posted September 20, 2011 jmj11.. I just called the # given by mikejfox. they directed me to Allergan.com & 'how to contact us." did so. got rebooted back to original #. th 2nd cust rep suggested the legal dept, so I went there. spoke with paralegal Judy Cobin 714 246 2188. she has asked that you contact her regarding your treatment by Allergan. she wanted to have direct contact and not just my 3rd party comments. she asked what exactly happened & I read her your post re their treatment of you. she may be able to help. alberta Link to comment Share on other sites More sharing options...
jmj11 Posted September 20, 2011 Author Share Posted September 20, 2011 jmj11.. I just called the # given by mikejfox. they directed me to Allergan.com & 'how to contact us." did so. got rebooted back to original #. th 2nd cust rep suggested the legal dept, so I went there. spoke with paralegal Judy Cobin 714 246 2188. she has asked that you contact her regarding your treatment by Allergan. she wanted to have direct contact and not just my 3rd party comments. she asked what exactly happened & I read her your post re their treatment of you. she may be able to help. alberta Thanks. I was preparing a letter to be sent out to all NPs and PAs who work in headache in this matter. I was going to send the letter to my friend, I guess ex-friend since she is not allow to talk to me, and have run it by Allergan legal before I sent it out. Link to comment Share on other sites More sharing options...
jmj11 Posted September 27, 2011 Author Share Posted September 27, 2011 Update with Allergan It has been an interesting couple of weeks with Allergan. When their field reimbursement specialist told me that she had orders from corporate not to have contact with me because I was a PA, I protested firmly. I started with her, and didn’t hear back. Then I spoke to Allergan’s legal department. They promised to “get right back” and I never heard back from them. I wrote a short paper telling them I was prepared to launch a campaign among my NP and PA colleagues to switch our neurotoxin to abototlinumtoxinA (Dysport®). Dysport® is made by Ispen. I spoke to Ispen last week and they, 1) allow PAs and NPs to order their products, 2) call on NPs and PAs, 3) help PAs and NPs get reimbursement . . . all of which Allergan refuses to do. You would think that it would be a no-brainer to just switch to Dysport®. However, Dysport® does not have migraine indication, which adds a lot of complexity to using it (mostly insurance reimbursement). I wrote a three page paper over the week end clarifying the issue and This morning I had a call from the regional reimbursement director (the boss of the lady I first was dealing with previously). I wasn’t reassured as he tried to justify their policy; “They have priorities because they don’t have a lot of employees so they focus on the greatest need . . . neurologists.” I argued that it was pure discrimination because they will give full support to a neurologist that uses Botox once a month yet ignore my account when I was using Botox twice a week. This afternoon I had a call from the national VP of Allergan, and in charge of all US sales. We had a thirty minute conversation. He confessed that he was totally unaware that NPs and PAs see headache patients. So, in conclusion he was going to review their policy and see if they can change it on four points: 1) Designate all PAs and NPs as headache specialists who belong to the American Headache Society, or prove their specialty by other training or activities, 2) If # 1 then they will start to call on NP/PA headache specialist, 3) They will then support Botox® among NPs and PAs, as they now do with neurologists, with scientific materials, 4) Include us on their lists of specialists, 5) Allow us to personal order Botox® under our own names rather than the physicians’ names (as they now do). He said he was going to have to meet with the legal department to make sure none of the above violates any state laws. He promised to get back to me by the end of the week. I will keep you posted. Link to comment Share on other sites More sharing options...
andersenpa Posted September 27, 2011 Share Posted September 27, 2011 Good work Mike Hopefully it pans out Link to comment Share on other sites More sharing options...
alleycat Posted September 27, 2011 Share Posted September 27, 2011 halleluja! sounds promising. hope it continues forward for you with a positive beat . ah, this makes you a standard bearer:heheh: Link to comment Share on other sites More sharing options...
rcdavis Posted September 27, 2011 Share Posted September 27, 2011 Great news, Mike. The tortise seems to be winning... Link to comment Share on other sites More sharing options...
delco714 Posted October 3, 2011 Share Posted October 3, 2011 Allergan is sponsoring a dinner for upper arm spasticity here on long island (ny). Just got an email from the state society (nysspa) inviting all members to it... Don't know exactly what to think, considering one of the attached brochures is all about botox and how to use it in a plethora of problems... Link to comment Share on other sites More sharing options...
jmj11 Posted October 3, 2011 Author Share Posted October 3, 2011 Allergan is sponsoring a dinner for upper arm spasticity here on long island (ny). Just got an email from the state society (nysspa) inviting all members to it... Don't know exactly what to think, considering one of the attached brochures is all about botox and how to use it in a plethora of problems... I had a very pleasant conversation with the VP of Neuro sales in the US a week ago. He promised to resolve the problem and get right back to me. It has been a week and I'm still waiting. I will give a report when I hear. Link to comment Share on other sites More sharing options...
delco714 Posted October 3, 2011 Share Posted October 3, 2011 My professor is direct past president of the society, kind of wanted to know what he thought, hm. I wanted to email the society and be like, ...um allergan doesn't support us, what's going on here? Link to comment Share on other sites More sharing options...
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