NEW YORK (AP) - The pharmaceutical industry is under fire for bankrolling campaigns in several states that cultivate a grass-roots image while lobbying for drug makers.
Tactics have ranged from funding an obscure group that reached out to advocates for the poor to telemarketing blitzes that urge voters to contact health departments and lawmakers. The common goal is to defeat legislation creating lists of preferred, lower-cost drugs for Medicaid patients.
Many advocates and public officials said they were caught off-guard by the effort. Noting that the industry traditionally uses a more polished approach to lobbying, they see it as an effort to hide the drugmakers' involvement.
"I've never seen anything so sophisticated and done so deceitfully," said Adam Searing, project director of the North Carolina Health Access Coalition.
He compared the campaign to "somebody collecting money in a pot for the poor at Christmas and then spending it on a sports car for themselves."
At least one activist who participated in events sponsored by industry-funded groups was unaware of the connection. Rev. Timothy McDonald, president of the Concerned Black Clergy of Atlanta, didn't know the Consumer Alliance received money from the industry when he joined a news conference in March.
"Taking money from the pharmaceutical industry does beg questions of the group's integrity," he said. He said knowing of their involvement would not have affected his opposition to the drug lists, known as formularies, but he added: "It makes me really uneasy they didn't tell us."
Pharmaceutical representatives say they intended no deceit, noting that they had issued a news release announcing their relationship with the Consumer Alliance.
Still, the industry has pledged to be more forthright in lobbying against formularies.
"We'll have to be more upfront about our conducting an educational campaign," said Jeff Trewhitt, a spokesman for the Pharmaceutical Research and Manufacturers of America, the industry's Washington D.C.-based trade organization.
The industry argues that formularies are an unfair form of price control and also infringe on doctors' decisions to choose the best drug.
Several states including Florida, Michigan and California have already adopted them as a way to curb spiraling Medicaid costs. Under their programs, pharmaceutical companies agree to provide discounts in exchange for having their products included. Doctors need special permission to prescribe unlisted drugs.
"We don't think doctors should have to call a state bureaucrat to prescribe a drug," said Trewhitt.
The industry has spent about $520,000 in eight states over the last several weeks to derail formulary legislation, with Georgia, Indiana and Virginia among the targeted states.
Washington D.C.-based lobbying firm, Bonner & Associates, is working on the effort. Known for creating "corporate grassroots" campaigns, it provided $16,000 to Consumer Alliance after working with it on a campaign in Michigan.
Consumer Alliance claims a base in Lansing, Mich., but has no office or listed phone number. Its president and only employee, Don Rounds, said this is to save money. He denies charges by advocates that his group is a front for drug companies' lobbying efforts.
He acknowledged that Consumer Alliance had not previously campaigned on health care issues, but had focused on other areas such as telecommunications. He said its budget is less than $50,000 and won't specify the donors - but insists he has been forthcoming about industry funding.
"I never tried to mask or hide it," he said. "I'm not an arm of the industry. We are just working on the same issue."
Other advocates say they don't object to Consumer Alliance's message, but how it is delivering that message.
Donna Jones Stanley, director of the Associated Black Charities in Baltimore, received a fax marked "urgent" from the Consumer Alliance asking her to endorse a statement rejecting new state efforts to restrict the poor's access to drugs. The handwritten fax has an amateurish appearance, complete with errors in spelling and grammar.
Not an expert in health policy, Stanley inquired with another advocacy group, The Maryland Citizen's Health Initiative, about Consumer Alliance. Its links with the drug industry were then uncovered.
"These tactics just made me angry," said Stanley. "I've never seen an effort as elaborate as this."
The Maryland Citizen's Health Initiative asked for an investigation by the State Ethics Commission, to determine if pharmaceutical industry lobbyists were violating disclosure laws.
"I have no problem with PhRMA (the industry trade organization) raising its objections. But don't use front groups and don't try to deceive people," Vincent DeMarco, the Initiative's head, told The Associated Press.
In North Carolina, the industry sponsored a telemarketing drive, in which callers offered to patch residents through to the health department or to the governor to complain about the issue.
Debbie Crane, spokeswoman for the Department of Health and Human Services, fielded some of the calls. "It is obvious from talking to (residents) they have no real clue" who's behind the campaign, he said.
A similar campaign was waged in Minnesota, where callers read from scripts identifying themselves as representatives of the 60-Plus Association, a Virginia-based senior citizens group. The association said Bonner & Associates organized the effort.
Bonner & Associates wouldn't comment on the Minnesota campaign, but Pfizer Inc. said it donated the lobbying company's services.
The 60-Plus group's president, Jim Martin, denies anyone was misled. "The callers had an outline," said Martin. "This is an important issue that impacts people's health."
Some legislators objected to the campaign's doomsday message for the elderly. Medicaid is a program for the poor but covers low-income senior citizens.
"I think voters were subjected to scare tactics," said Francis Bradley, a Republican legislator who supports the formularies. "It is sleazy and people are being used."
The campaigns have had mixed results. New Mexico recently passed formulary legislation, but lobbying kept a vote from reaching Washington's state legislature.
In Maryland, some predict a backlash against drug makers' efforts.
"I think because of the deceit showed by the pharmaceutical industry, the law in favor of formularies will pass," said Bishop Douglas Miles, Executive Director of the Baltimore Ministerial Alliance.
The industry disagrees.
"This is much ado about nothing," said industry spokesman Bruce Lott. "It shouldn't detract from the real issues at hand."