GlaxoSmithKline to Quit Paying Doctors for Promotional Talks
GlaxoSmithKline to Quit Paying Doctors for Promotional Talks
Company will stop paying millions in order to end conflict of interest

In a major departure from industry practice, GlaxoSmithKline, the sixth-largest global drug maker, announced Tuesday that it will no longer hire doctors to promote its drugs.

The company will also stop tying compensation for sales representatives to the number of prescriptions written for drugs they market. The changes will be made worldwide over the next two years.

Glaxo’s move is more evolutionary than revolutionary, the last step in a dramatic reduction in its spending on physician speakers in recent years. Some competitors have shown no signs of letting up.

Glaxo first began reporting its payments to doctors in 2009. During the last nine months of that year, it spent an average of $15.4 million per quarter on paid promotional talks, according to ProPublica’s Dollars for Docs database of pharmaceutical company payments to physicians.

Spending on promotional speaking dropped to $13.2 million per quarter in 2010, to $6 million per quarter in 2011, and to $2.5 million in each of the first three quarters of 2012, data shows.

That’s an overall decline of more than 80 percent.

By comparison, Forest Labs, a much smaller drug maker, spent more than $9 million a quarter on physician speakers last year.

Earlier this year, Glaxo spokeswoman Mary Anne Rhyne wrote in an email to ProPublica that the company’s promotional spending tracks with new drugs or new uses for existing products. “That activity has been relatively low in the past year, so spending for speaker programs has been lower, too,” she said.

Glaxo’s Business 

Glaxo’s well-known drugs include Advair for asthma, Lovaza for high triglyceride levels, and Avodart for prostate enlargement. It also makes the diabetes drug Avandia, which was subjected to tough restrictions from the FDA in 2010 because of concerns about heart risks. The FDA recently eased those restrictions after reconsidering the risks.

The top recent speaking programs for Glaxo involved Advair and Jalyn, which treats problems with urination for men with enlarged prostates, Rhyne said earlier this year.

In an email this morning, Rhyne said the company had taken a number of steps to change its sales and marketing practices in recent years. “This is the next step of that evolution,” she wrote.

Pharmaceutical companies have faced increased pressure as their payments to doctors have been made public, in part through efforts like Dollars for Docs. More than 15 drug companies report their payments to doctors for speaking, consulting, meals, travel, and research under Corporate Integrity Agreements with the federal government that arose from settling lawsuits alleging unlawful marketing.

Full Disclosure

Beginning next year, every drug and medical device company will have to make payments to doctors public under the Physician Payment Sunshine Act, a provision of the 2010 Affordable Care Act. Some experts have said that such transparency will discourage doctors from accepting payments, a contention supported by some doctors themselves.

“Many people have wondered, what difference will it make?” asked Susan Chimonas, a research scholar at the Center on Medicine as a Profession at Columbia University. “Will it clean up practices, or just allow the status quo to continue so long as there is transparency? Glaxo’s move is giving us an early answer—and reason for optimism. The saying about sunlight being the best disinfectant—that’s exactly what we’re seeing here. The Sunshine law is working.”

The American Medical Student Association has called on medical schools to adopt strict policies limiting pharmaceutical company interactions with faculty. And some doctors themselves are calling on peers to be transparent with patients. They have created a website called Who’s My Doctor: The Total Transparency Manifesto.

Still, some doctors continue to accept hundreds of thousands of dollars in payments from the pharmaceutical industry.

Glaxo’s chief executive Andrew Witty told the Times yesterday that the changes were being made “to try and make sure we stay in step with how the world is changing. We keep asking ourselves, are there different ways, more effective ways of operating than perhaps the ways we as an industry have been operating over the last 30, 40 years?”

“Today we are outlining a further set of measures to modernize our relationship with healthcare professionals,” Witty said in a press release. “These are designed to bring greater clarity and confidence that whenever we talk to a doctor, nurse or other prescriber, it is patients’ interests that always come first. We recognize that we have an important role to play in providing doctors with information about our medicines, but this must be done clearly, transparently and without any perception of conflict of interest.”

Lawsuits

The British drug maker has faced intense criticism of its business practices. In July 2012, Glaxo agreed to pay $3 billion, a record, to settle criminal and civil claims “arising from the company’s unlawful promotion of certain prescription drugs, its failure to report certain safety data, and its civil liability for alleged false price reporting practices,” the U.S. Justice Department announced.

Glaxo also agreed to plead guilty to two counts of introducing misbranded drugs, Paxil and Wellbutrin, into interstate commerce and one count of failing to report safety data about Avandia to the Food and Drug Administration.

The company also has been under fire for bribing doctors in China to prescribe its drugs and using travel agencies to cover it up. In July, the company said that some senior executives in China appeared to have violated Chinese law.

Amid these troubles, Glaxo has also been more transparent than some of its peers. In October 2012, the company said it would disclose its clinical trial data to researchers—another industry first.

“We’re increasingly realizing that the more you can make this an open enterprise, the more likely you are to be able to get an advance which allows you to make a medicine,” Dr. Patrick Vallance, president of pharmaceuticals research and development at GlaxoSmithKline, told The New York Times. “I think we recognize that you learn as much about the medicine after it’s launched as you knew before.”

Health care journalist Charles Ornstein won the Pulitzer Prize for Public Service, the Robert F. Kennedy Journalism Award, and the Sigma Delta Chi Award for public service in 2005. He wrote this article for ProPublica. 

  • sandramonday77

    it’s about time drug companies stopped bribing doctors to pedal their poison, how many suicides and preventable deaths from anti-depressants and adhd drugs to we need, before we say enough is enough?

    • Robin S Summertown

      The response you will get from the money people is free enterprise. You never see an explanation for why its OK when something like this is brought to light, they just climb on their desks and scream its free enterprise.

    • EmpressL

      Exactly! See my post just above you for part of your answer!

  • Jasmine starlight

    First do no harm, its not first cash the check…

  • EmpressL

    Pharmaceutical PUSHERS CAUSE Pharmaceutical Homicide:

    Columbine Eric Harris – Luvox

    Thurston High, Ore Killed 2 + parents (1989) Kip Kinkel – Prozac & Ritalin

    Winnetka (1988) Laurie Dann (killing 1 wonding 6) – Anafranil & Lithim Paducah,

    Ky (1997) 14-year-old Michael Carneal killing 3 – Ritalin

    Red Lake Indian Reservation (2005) Jeff Weise killed 9 – Prozac

    Standard Gravure Ky Joseph T. Wesbecker shot 20 workers – Prozac

    Kurt Danysh, shot his own father – Prozac

    John Hinckley shot President Reagan took four Valium 2 hours before

    Andrea Yates – Effexor

    Virginia Tech – Cho – Paxil

    Christopher Pittman – shot grandparents – Paxil and Zoloft

    GlaxoSmithKline paid $6.4 million Donald Schnell murdered wife, daughter and granddaughter – Paxil

    Columbine – 1999 Harris – Prozac, Paxil, Zoloft, Effexor & Klebold – Luvox

    Arora, Colorado Theater Shooting James Holmes – Sertraline, a generic version of Zoloft & Clonazepam, a benzodiazepine

    Stockton, Calf 1989 Purdy, murdered five children and wounded 30, had been on Amitriptyline

    Sandyhook – Newtown – Adam Lanza – “Fanapt” – antipsychotic

    They don’t know what the hell they are doing!

  • LaFemmeNikitty

    “Will it clean up practices, or just allow the status quo to continue so long as there is transparency” — Personally I hope it helps doctors see patients as people instead of as revenue potential. GSK has other resources of income besides just manufacturing drugs. They are pretty huge in the drug testing industry. Those little drug tests you have to take so often before getting a new job are pretty lucrative.

    • imusintheevening

      Sunshine is the best disinfectant…………a doctor told me! 😉

      • HeyJude

        I think I recognize your dog! Are you a Huffpogee, and was this your name there? I think I might have been your fan….

        • imusintheevening

          HeyJude, you are correct. 😉

          • HeyJude

            Fantastic! It’s helpful that people are keeping their same pictures, even more helpful than the names sometimes. And a dog picture? Even better. :-) Glad you made your way here, too. The community is growing so quickly it’s easy to miss someone when they first come in.

          • Cougar90210

            I recognize you, as well. Greetings! My av is slightly different for this account – couldn’t locate my pic of the two cougars. Oh well, Bagheera will have to do. HP really disappointed me with how they pulled off their little “policy change.” So, I bailed. Happy Holidays! And perhaps we’ll cross paths here again.

          • imusintheevening

            to you as well!

      • LaFemmeNikitty

        Then global warming is just what we need, the sun’s so bright it will kill every parasite known to man!

    • Granite Skyline
      • LaFemmeNikitty

        Was that a link to an article? It took me to a temporary chat room … I’m still riding a tricycle … not ready to try a two wheeler that moves so fast :)

  • HeyJude

    I have so many issues with the drug companies, I don’t know where to start. The hub and I own a senior residential facility, (for 26 years) highly involved in healthcare needs of our residents. The drug companies are so underregulated, and what regulations they do have, they write themselves. And we hand it to them…GWB not requiring any form of price controls or ability to bargain with them after handing them multibillions of dollars with Medicare D was insane. No other country in the world pays as much as we do for our drugs, their governments insist on reasonableness. The result of Medicare D, although helpful to many, is that it is now your insurance provider who is your real doctor. The insurers will refuse to authorize any drug they deem too expensive, and will insist the doctor substitute something “like” what they actually want to prescribe. Another thing I hate about drug companies is their right to market directly to consumers. “Ask your doc if Plutonium Cancerate is right for you!”

    • Pony

      I have stood behind seniors who were literally buying a few pills at a time.
      I’ve also had to have the pharmacy call back the doctors office to ask them to prescribe another medication for my husband as the one HE chose as the best for his condition was not on the formulary and out of reach to provide on a regular basis. It’s doubly worse when you see online that the very same exact drug is pennies on the dollar in Canada.
      As I looked up at the clock in the DR’s waiting room last time I realized it was an advertisement for a drug.

      • HeyJude

        It’s horrendous. That’s why we all get “pills from canadian pharmacy” spam, they really do pay pennies to the dollar for the same exact drugs from OUR manufacturers. They and many others have negotiated prices, which we are not allowed to do. I’m not sure how much in bed with the drug companies most doctors are….but I must say that my personall experience with our house physician shows that even HE is disgusted with the whole thing. He jumps through hoops to make sure he is writing Rx’s for things people can actually get, and many times he doesn’t know what is until his first decisions are rejected. If someone can get something but it needs a pre-auth, he has to waste many valuable hours filling out paperwork to justify the pre-auth. He too has many drug company freebies…. the salesmen literally swarm doctors offices, throwing out pens, clocks, bringing in lunches, sending goodie baskets, it’s ridiculous. They take the stuff, but doesn’t necessarily guarentee the doc is writing for their meds, although I’m sure that happens.

        • Pony

          I dearly wish that when Obama passed healthcare reform it had been to a socialized one payer system. Instead we were sold to big pharma and the for profit insurance companies. My personal opinion is while everyone may now be forced to have coverage the cost and quality of healthcare is in peril. I’m anything but a liberal, I just believe in common sense solutions. We didn’t get one.

          • HeyJude

            Agree 100% Pony. I am a liberal and Obama is my guy, but was terribly disappointed that he caved on so many issues before even getting to the table. Single payer is the only way to go. Medicare is one of the most efficient and cost effective things (not to mention socially responsible things) we have ever done. Single payer is the system most of the rest of developed nations use. It was GWB that sold us out to Pharma with bungling Medicare D., and Obama who did the same by not making enough demands of medical insurers.

  • Devey Elise

    Drugs don’t cure for the most part. They just treat symptoms of what ails you. Western medicine is all about prescribing drugs unless you’re a surgeon or an obgyn. That’s it. It’s all baloney and most of the drugs are more dangerous than they are helpful and too many of them are addictive. Coincidence? I think not. And hoards of pharmaceuticals are funneled into the food supply…to the point where we have created drug resistance to many harmful pathogens. Are the drug corps working on THAT little problem? No. Why? There’s no profit in it. So even if you don’t take any meds of any kind, you end up eating them in food and drinking them in the water. We’re being poisoned. THAT is the real story….not this “lookit what an ethical drug company we are” nonsense.

    • Cougar90210

      The entire concept of “health care” has become so skewed over the years that the notion of promoting healthy choices (e.g., dietary choices, exercise, environmental considerations) has become a sidebar consideration. When people speak of health care today they are talking about medicines, procedures, and treatments, and this is what our insurance-brokered “health care” delivery system thrives upon. I have very little patience with or sympathy for big pharma, but they do only make up one part of this monstrosity of a “health care” system(?) we have today. Of course, it is the one under discussion on this thread, so I’ll leave it at that.

  • VincentTPackhorse

    Miracle cure:

    Take two pharma reps and call me in the morning.

  • Nick Vanocur

    “First, do no damage to my bank account.”

  • kcinca

    It’s so sad that the people who are supposed to help you are bought and paid for. I hope this will be the beginnings of a trend towards not paying doctors to be spokespersons for big pharma.

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