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The BMJ Today: GSK and paying doctors to speak on its behalf

15 Apr, 14 | by BMJ

Deborah CohenOn 17 December last year, UK pharmaceutical giant, GlaxoSmithKline, made a bold pledge. From 2016, the company said, it will stop paying doctors to speak on its behalf or to attend conferences to end undue influence on prescribers.

Not only that, drug reps were no longer going to be paid according to the number of prescriptions they solicited from the doctors they saw. The announcement drew both plaudits and scepticism.

The BMJ’s editor, Fiona Godlee, praised the move. “Where GSK leads we must hope that other companies will follow. But there is a long way to go if we are truly to extricate medicine from commercial influence.”

But Richard Vautry, GP and a member of the BMA’s Council, was slightly more circumspect about their rationale. GSK’s move, he told the WSJ, “may be a sign that companies recognize that the investment now made in that direction doesn’t influence doctors in terms of their prescribing.” He added: “It’s probably a business decision rather than for any other reasons.”

GSK have not just been at the vanguard of removing sales targets, they were the first drug company to publicly state their commitment towards greater clinical data transparency by signing up to the AllTrials campaign.

The actions partly led to a feature in The BMJ profiling GSK’s CEO, Andrew Witty. It ran with the title: “Andrew Witty: the acceptable face of big pharma?”

To some extent they have honoured their word so far: in the past year, they have released their clinical study reports on their influenza drug zanamivir (Relenza) to the Cochrane collaboration for systematic review—the results of which were published last week.

This, by all accounts, was no mean feat. Patrick Vallance, GSK’s president of pharmaceuticals research and development, told The BMJ: “These are studies going back a long way, stored in all sorts of different parts, in all sorts of different places. People don’t expect to have to go and pull out everything again.” GSK estimates 15 to 20 people worked on the file part time over three years.

Not everyone is convinced by their public show of goodwill. In his regular column, Sidney Wolfe, founder and senior adviser in the Health Research Group at Public Citizen, in Washington analysed all civil and criminal penalties paid to the US federal and state governments by pharmaceutical companies from January 1991 through 18 July 2012.
“GSK topped the list of repeat offenders with total criminal and civil penalties of $7.56bn since 1991, comprised six different federal settlements and an additional number with states,” he wrote.

But it seems as though bad news follows the company as they try to build its image. Following investigations in China and Iraq, Shelley Jofre, BBC Panorama correspondent, has found that GSK is under investigation in Poland for allegedly bribing doctors there.

In a feature, she writes that it’s alleged that GSK sales reps in the region of Lodz, Poland’s third largest city, paid doctors as recently as 2012 to boost prescriptions of some of the company’s best known drugs.

A spokesman for the Lodz public prosecutor’s office, Krzysztof Kopania, said that one GSK regional manager and 11 doctors have been charged in connection with corruption allegations for offences committed in 2010-12.

In response, GSK said: “Following receipt of allegations regarding the conduct of the programme in the Lodz region, GSK has investigated the matter, using resources from both inside and outside the company,” the company added. “The investigation found evidence of inappropriate communication in contravention of GSK policy by a single employee. The employee concerned was reprimanded and disciplined as a result. We continue to investigate these matters and are co-operating fully with the CBA [the anti-corruption bureau in Poland].”

Whilst such problems arise, GSK’s ability to shake off past reputation and build one of trust and scientific integrity, might be made that bit tougher.

Deborah Cohen is investigations editor, The BMJ.

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