
GlaxoSmithKline fined $3B after bribing doctors to increase drug sales (2012) - KerryJones
http://www.theguardian.com/business/2012/jul/03/glaxosmithkline-fined-bribing-doctors-pharmaceuticals
======
fezz
"...the company paid $275,000 to Dr Drew Pinsky, who hosted a popular radio
show...Pinsky, who had not declared his GSK income to listeners, said
Wellbutrin could give women 60 orgasms a night."

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Fede_V
Ben Goldacre's excellent book, Bad Pharma, discusses doctor-pharma bribery in
detail.

One fact which stuck with me was how, doctors are universally concerned about
how _other_ doctors are constantly being gifted and dined by other pharma
reps, but they are convinced that they are personally immune from these
attentions because obviously these things don't work on them.

------
danso
I don't want to say this is just old news, because we should always be
watching for the possibility that this kind of loophole allows this behavior
to persist...but things have changed a bit since even a few years ago.

For starters, the Centers for Medicare & Medicaid Services finally implemented
the law that required healthcare companies to submit records of their payments
to doctors:

[https://www.cms.gov/openpayments/](https://www.cms.gov/openpayments/)

This law came about after several massive Justice Dept. settlements around
2008 to 2010. In 2009, at the time Pfizer paid the largest health care fraud
settlement in history at $2.3B: [http://www.justice.gov/opa/pr/justice-
department-announces-l...](http://www.justice.gov/opa/pr/justice-department-
announces-largest-health-care-fraud-settlement-its-history)

...and that fine was much less than the profits it made. However, the move
towards posting payments online (which happened just last year) has made
doctors less enthusiastic about hanging out with sales reps. This is not to
say there isn't another way profit motive can push the rules, of course, just
that attitudes pre-2012 may be different compared to now.

edit: Just in case I'm getting downvoted for sounding blasé about the
issue...I launched this investigative project in 2010:
[https://projects.propublica.org/docdollars/](https://projects.propublica.org/docdollars/)
\-- so I've read a lot about the topic and about this particular lawsuit back
in the day ...but even before then, scrutiny of pharma ties was gaining
momentum and causing doctors and companies to rethink having blatant
relationships. In the OP, the 2012 suit is based off of investigations of
activities years before...Dr. Pradko receiving $2M, for example, happened in
2001-2003 [1]

This is not to say there won't be corruptive influences ever again...just that
it probably won't be so obvious in the fashion described in this 2012 lawsuit.
If Dr. Pradko had gotten $2M post-2010... _that_ would be shocking.

[1] [http://www.pharmpro.com/news/2012/07/complaint-doctors-
were-...](http://www.pharmpro.com/news/2012/07/complaint-doctors-were-paid-
large-sums-glaxosmithkline)

------
hackuser
Two concerns:

1) Shouldn't people be going to jail?

2) Shouldn't the bribe-takers also be punished, and have their licenses
revoked?

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petra
"Over the years, thousands of people taking or withdrawing from Paxil or other
psychiatric drugs have committed violent acts, including suicide, experts
said, though no firm statistics are available. Because many factors could have
contributed to that behavior, it is still far from clear who is at risk — and
for whom the drugs are protective."[1]

So we have a case where thousands of people we're put at a big risk,with
clearly illegal practices , and nobody is going to jail ? and on the other
hand, no major systemic change has happened - like taking the responsibility
for clinical testing , and drug advertising out of drug developer's hands ?

How will anybody learn ?

[1][http://www.nytimes.com/2015/09/17/health/antidepressant-
paxi...](http://www.nytimes.com/2015/09/17/health/antidepressant-paxil-is-
unsafe-for-teenagers-new-analysis-says.html?ref=health&_r=0)

~~~
danso
Not playing devil's advocate here, but just to point out why things that seem
obviously black-and-white don't seem to be nipped in the bud. Drug companies
are not allowed to advertise drugs for any reason than what they were
officially approved for. _However_ , doctors are allowed to have discretion in
this matter...for example, if they know a certain drug prescribed only for,
say, hair loss, is also good for erectile dysfunction, and they've read enough
of the literature to prescribe this confidently...then they don't have to go
strictly by FDA regulations.

This freedom is not a bad thing in itself...I mean, it reflects the reality
that have effects (good and bad) that are independent of a regulatory process.
One extreme case that I can remember is when Avastin -- originally prescribed
to fight cancer -- was found to be as effective for treating eye disease at
$50 a pop as a drug that cost $1,950 [1]...and so there was controversy over
whether doctors should be allowed to prescribe Avastin before it was
officially approved by the FDA for this usage.

So it became obvious to drug companies that if they advertise/befriend
doctors, they could influence them to prescribe drugs for these off-label
uses. Maybe some of those uses were completely legitimate (and profitable).
Some obviously should not have been pushed for off-label use, such as highly-
addictive painkillers approved only for use by the most serious cancer
afflictions being prescribed to people with migraines. When you consider that
highly competitive pharma sales reps had the ability to basically know exactly
how much each doctor prescribed on a weekly (daily?) basis, and thus, how much
to visit and chat them up...you basically have a bunch of not- _technically_
-illegal-things that were maybe fine on their own, but added up, eventually,
to what the Justice Dept. considered to be fraudulent activity.

[1]
[http://www.wsj.com/articles/SB100014240527023048680045773763...](http://www.wsj.com/articles/SB10001424052702304868004577376310954390608)

------
ypcx
Article may be older, but it begs the question - can you trust anything the
big pharma produces? How about vaccines which could be safe but aren't,
because they simply don't have to? How about a true cancer cure being
suppressed? Do you still find it hard to believe?

------
mikehotel
This article is from 2012.

> Tuesday 3 July 2012 12.19 EDT Last modified on Wednesday 1 October 2014
> 07.41 EDT

~~~
dang
So it is. Added. Thanks!

------
littletimmy
Fine for Corruption < Profit from Corruption

Nothing to see here. Move along, citizen.

~~~
evanpw
Presumably somewhat less than 100% of the profits made on those drugs was due
to corruption.

------
jijojv
2012

------
interpol_p
I thought the fine sounded large, but the last paragraph of the article puts
it in context:

> _Despite the large fine, $3bn is far less than the profits made from the
> drugs. Avandia has made $10.4bn in sales, Paxil took $11.6bn, and Wellbutrin
> sales were $5.9bn during the years covered by the settlement, according to
> IMS Health, a data group that consults for drug makers._

~~~
MichaelGG
Not really, we don't know what the profit margin is. A quick search says from
10-20%, though another site says 40%. So it may have wiped out a significant
chunk of profit.

~~~
interpol_p
Yeah that's true — I was a bit misled by that sentence. I read "sales" as
"profit," thinking that the author quoted those numbers because they were able
to be used as a comparison to gauge the severity of the fine.

------
mjcohen
As always, why aren't these crooks in jail?

~~~
stephengillie
The US Justice Dept has publicly said that Justice is better served by seeking
huge fines against banks (and presumably other large organizations) instead of
criminal prosecution against individuals.

~~~
scintill76
I was going to be devil's advocate and say they technically haven't said that,
but since they cited collateral consequences of prosecution like costing
thousands of jobs[1], that pretty much is them saying their way was the most
just way. [1] [http://www.theguardian.com/commentisfree/2012/dec/12/hsbc-
pr...](http://www.theguardian.com/commentisfree/2012/dec/12/hsbc-prosecution-
fine-money-laundering)

I think threats to "jobs" are right up there with pedophilia and terrorism.
Won't somebody please think of the jobs?!!

PS Does anyone have video of that press conference? I think I found the
documents here ([http://www.justice.gov/opa/documents-and-resources-
december-...](http://www.justice.gov/opa/documents-and-resources-
december-11-2012-hsbc-press-conference)) but it would be interesting to see
the questions and answers that The Guardian summarized.

------
dkural
Btw this is a big reason why drugs are more expensive in the US vs other
countries: US Doctors essentially demand bribes in the form of CME-credit
holidays, post-FDA fake clinical trials as a kick-back, lucrative consulting
and speaking gigs etc. Pharma then increases price relative to other
countries. Best of all, the US medical community, with specialists making
300K-1M+, gets to blame evil Pharma for higher drug prices, while being one of
the primary beneficiaries of the price bump. Hypocrisy at its "best".

My advice is explicitly ask your doc if they receive any incents / cash from
any company whose drugs they prescribe you. Get this in writing.

~~~
wyldfire
No reason to ask them, just search for their name -- it's all public in the
US.
[https://projects.propublica.org/docdollars/](https://projects.propublica.org/docdollars/)

> CME-credit holidays

Many/most healthcare companies do not allow pharmaceutical and device
manufacturers to reimburse their providers for their travel/accommodations for
CME anymore.

Market segmentation is a big part of the difference in costs between here (US)
and there (everywhere else) -- not because the cost of marketing their drug is
more here, but that people/insurance plans are willing/able to pay more than
they are elsewhere.

~~~
klenwell
I'm currently in the process of scheduling my first annual physical in a few
years and had narrowed down my choice of in-network providers who are
accepting new patients to two physicians.

Using the link you provided, I see one received $988 in drug company money for
the period covered, the other $669. The one recommended to me by a friend who
is no longer accepting new patients: $1387.

So I guess I can combine that information with a handful of 3 and 4 star
reviews for each on healthgrades.com and throw a dart at a map.

------
Gatsky
I often wonder - why do doctors fall for this? Why do they participate in what
is clearly a manipulative scam? When they know that patients and the community
and even their taxes go to paying for expensive marketing budgets?

Part of the problem is that there is an unfortunate climate of entitlement
among doctors. This issue has probably been studied rigorously but I suspect
that being treated as 'special' all your life combined with difficult and
prolonged training in often less than friendly environments breeds the feeling
that you are entitled to special treatment.

I think, honestly, the other problem is that Americans don't take any holidays
(in general, compared to Europe, Australia, New Zealand). I know lots of
doctors that just take Thanksgiving off. So when you offer a very busy person
an educational conference that is actually a holiday in disguise, they are
going to be quite susceptible. Not to say that doctors elsewhere don't
willingly travel to pharma fantasy island at every opportunity.

~~~
harkyns_castle
They're not falling for anything, its just plain and simple greed. My father
was in the radiology area and he constantly received 'bribes' (didn't accept
them, but had the offers).

~~~
Gatsky
I think we're talking about the same thing.

~~~
harkyns_castle
Perhaps, it just sounded like you thought these very intelligent (for the most
part) doctors, were unaware of what they were accepting, which isn't the case.

It's very clear in the industry that it goes on, and anyone that partakes is a
scumbag, in full knowledge of what they're doing.

This in an industry that is meant to heal people, not be part of the problem
we're facing with rampant corporatism and out of control greed.

