Big Name in Big Pharma Ceases Its Unsavory Drug Payments

We’ve been among the many voices decrying the practice of pharmaceutical companies paying doctors to promote their drugs. Now, in a welcome announcement, GlaxoSmithKline says that it’s not going to grease those palms anymore.

As reported by the New York Times, in addition to not paying doctors to hawk their wares, the Big Pharma big player is not going to tie the compensation of its sales representatives to the number of prescriptions doctors write for its drugs. That can promote the inappropriate – and illegal – use of drugs for nonapproved purposes.

Both practices have been widely criticized as conflicts of interest with the real potential of causing patient harm.

Glaxo is among the largest drug companies in the world, according to The Times, with third-quarter sales of more than $10 billion.

The decision to clean up its act is refreshing in the pharmaceutical industry and comes, as The Times points out, at a “sensitive” time for the British company. It’s under investigation for bribery in China, where accusations have been made that Glaxo paid doctors and government officials to boost drug sales.

We’ve written about the billions of dollars in fines Glaxo has paid for paying kickbacks, illegally marketing drugs and withholding safety information. Now, one hopes, the company has developed a corporate conscience.

Glaxo said sales representatives would be paid based on their technical knowledge, the quality of service they provide to clients to improve patient care and the company’s business performance — changes it made in the U.S. in 2011 and must continue according to a corporate integrity agreement with the Justice Department. Now it says it will extend those practices globally.

The company’s chief executive, Andrew Witty, told The Times that the proposed changes were not related to the China situation, but were part of a years-long effort “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?”

Um … it took 40 years to know that? To know that paying doctors to speak on your company’s behalf at conferences and professional meetings might be exploiting the trust practitioners have for their peers? That such behavior might have unfair influence in doctors’ prescribing habits? That a drug might be prescribed inappropriately because someone got paid to pimp it?

And are we cynical to wonder if Glaxo’s change of heart has anything to do with the provision of the Affordable Care Act (ACA, or “Obamacare”) that all payments by pharmaceutical companies must be made public? (See our blog, “Dollars for Docs: Learn How the Big Bucks Flow From Manufacturers.”)

Many companies, including Glaxo, report many such payments now, but the new ACA requirements might seek more info than what’s already being provided, and will be searchable on a government website.

Whatever. Glaxo has decided that by 2016, no longer will it pay health-care professionals to speak on its behalf about its products or the diseases they treat “to audiences who can prescribe or influence prescribing,” according to a statement. It will stop subsidizing doctors to attend medical conferences, which is prohibited in the U.S. by an industry-imposed ethics code but that still happens in other countries.

But Glaxo will continue to pay consulting fees to doctors for market research because it needs to know what practitioners think about its products. The company said that effort would be limited.

The Glaxo news was welcome in the medical community. One Times source, Dr. Raed Dweik, chairman of the innovation management and conflict of interest committee at the Cleveland Clinic, told the paper, “As a physician, I periodically meet with these sales reps and they usually come in armed with information about me that I don’t even know,” he said, like the number of prescriptions he writes for the drug company’s product. “I feel that’s not really a comfortable interaction to have.”

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