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I’ve recently set up a PayPal account and readers have the option of making a donation towards the upkeep of this blog– should they wish to (if not- that’s totally fine too). I got the idea from reading the Guardian website (which also offers a donation option). In the digital age, broadsheet newspapers are finding it difficult to survive, and most now offer a donation option or have a paywall. I don’t expect much in the way of donations to be honest, as my blog isn’t a commercial or mainstream site, however I do believe that the research, writing, blog posts and activism, I have done over a decade here, attest to the work and dedication I have put in.

Writing and blogging, takes time and effort, and I’m proud of the work I have done for over 10 years now. I like to write anyhow, and the stuff I write about needs to be expressed. I get regular hits from the BBC and the Guardian (among many others), and I have certainly covered a wide range of controversial topics in the best journalistic manner I could over the years. I try my best to blog well, and I try to blog about interesting topics not often covered in the mainstream.

The option is there now to donate. Either way, I will continue to blog for as long as my health allows me to. I’ve recently had some health set backs, so I will be taking intermittent breaks to rest and nurture myself. There is usually always something interesting to cover on the blog, and I feel compelled to write most of the time, as it has become a passion of mine. Even if people don’t choose to donate, I will still always very much appreciate people reading, and any kind of support is always humbly appreciated.

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Even if you don’t donate, I hope you enjoy this beautiful song anyhow!…

 

 

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Where is the outrage?


https://www.bmj.com/content/362/bmj.k3948/rr-1

Pandemrix and narcolepsy

Where is the outrage? GlaxoSmithKline suppressed clear danger signals from vaccination with Pandemrix. The result, to begin with, was the suffering of a large number of children and adolescents who developed narcolepsy. Peter Doshi is to be commended for dispassionate reporting of the facts, but I am frustrated by his cool rhetoric in the face of what I believe are acts of greed and cruelty.

The facts reported by Doshi are new, but the pattern of behavior is not. The manufacturers and their professional surrogates are past masters at doing research that shows short-term vaccine efficacy but that does not reveal serious adverse effects. They always end up saying, as in this case, that “there is no proof of a causal association.” Such behavior might be forgiven if influenza vaccines were real lifesavers, but we still do not know if they have done more good than harm in the long run. I am not alone in making this assertion.

Not long ago Gaffney and Lexchin said that US and Canadian pharmaceutical systems, “…are dysfunctional. Costs are exorbitant, commercial goals distort drug development, misleading promotion fosters misuse, and medications are too often unaffordable for patients.” (BMJ 2018;361:k1039) Much the same can be said for the development and promotion of vaccines in the last 10-15 years.

I get frustrated and angry about the promotion of some drugs and vaccines, but I am saved from despair by the efforts of professionals like Doshi and his colleagues who keep plugging away at the facts.

Allan S. Cunningham

Competing interests: No competing interests

24 September 2018
Allan S. Cunningham
Retired pediatrician
Cooperstown NY 13326, USA

GSK’s Recent Drug Recalls..


Those who keep a finely tuned eye on GSK won’t fail to notice that they are involved in a lot of product recalls (see here) . Of course the Reilly versus GSK lawsuit is obviously related to GSK’s manufacturing (or lack of good manufacturing) and this malfunctioning system leads to substandard drugs being released. GSK were fined for their Cidra debacle, but how many more Cidra’s are there out there? who knows? Perhaps we will find out through another lawsuit- the blue-cross blue shield one?

In the meantime, more GSK products are recalled..

http://publicaffairs-sme.com/productrecalls/?p=1573

18-026 QA PRODUCT RECALL – GLAXO SMITH KLINE RECALLS 24 HR PREVACID DUE TO POSSIBLE MICROBIAL CONTAMINATION

Date:  4 OCT 2018                                                                                     Recall: # 18-026

Scope: WORLDWIDE RETAIL FACILITIES, DCs & ECOMMERCE

Out of abundance of caution, Glaxo Smith Kline announced a voluntary recall of Prevacid 24 Hr capsules due to possible microbial contamination. The Exchange currently sells the 14ct. capsules.

Hazard: Healthy people can develop mild illnesses from contact with some forms of microbial contamination, however; serious infections may occur in people in the hospital and/or with weakened immune systems.

Incidents/Injuries: To date, no illnesses have been reported in connection with this problem.  This recall is being conductined out of abundance of caution.

Description: The following product is affected.

Remedy: Customers who purchased the product are encouraged to return it to the store where it was purchased for a full refund.

Consumer Contact: Customers who have additional questions or concerns should contact the GSK Customer Service team at 1-800-743-4014, Option 5 for PREVACID® 24HR 15 mg Lansoprazole Capsules, Recall Event Number 134PREV18.

Sold at: Worldwide Exchange facilities, Online E-commerce and other retailers.

Manufacturer(s): Glaxo Smith Kline


 

https://www.staterbros.com/product-recalls-catalog/prevacid-24hr-capsules/

Prevacid 24HR Capsules

GlaxoSmithKline Consumer Healthcare Holdings (US) LLC Voluntary Recal Prevacid 24HR Capsules

For Immediate Release

Items affected at Stater Bros Markets are:

PREVACID 24HR CAPSULES  14 CT   3-00676-28614-3  *SP ITEM     

PREVACID 24HR CAPSULES  42 CT  3-00676-28642-6   *SP ITEM

 

GlaxoSmithKline Consumer Healthcare Holdings (US) LLC Date: September 26, 2018

184 Liberty Corner Drive
Warren, NJ 07059

Consumer Contact:

GSK Customer Service team at 1-800-743-4014, Option “5”, for PREVACID® 24HR 15 mg Lansoprazole Capsules, Recall Event Number 134PREV18.

Dear GSK Customer:

This letter is to inform you that GSK Consumer Healthcare is conducting a voluntary retail level recall of:

Prevacid® 24HR Capsules, 15 mg lansoprazole (14, 28, and 42 counts)

UCC: Please refer to Attachment 1 for full list of impacted UCC codes

UPC: Please refer to Attachment 1 for full list of impacted UPC codes

This recall is being conducted with the knowledge of the US Food and Drug Administration (FDA).

In keeping with our commitment to quality, GSK Consumer Healthcare has made the precautionary decision to voluntarily recall all Prevacid® 24HR Capsules lots within expiry at the retail distribution level. This decision is based on microbiological out of specification results obtained for one lot of Prevacid® 24HR Capsules that remains within GSK control and has not been distributed. Although all lots on the market and within expiry have met all release test specifications, current available data cannot exclude potential impact to released product. There is no evidence of a consumer safety concern based on a completed medical assessment that concludes the use of, or exposure to, the affected product is not likely to cause adverse health consequence.

Please note that product is being recalled at the retail level. This is not a consumer level recall.

Affected lots (within expiry) were manufactured between October 8th, 2015, and March 26, 2018, and distributed in the timeframe between January 7th, 2016 and September 2nd, 2018.

GSK Consumer Healthcare is committed to providing the highest quality products to our customers. We regret any inconvenience this recall may cause and appreciate your cooperation.

If you have any questions, please contact our GSK Customer Service team at 1-800-743-4014, Option “5”, for PREVACID® 24HR 15 mg Lansoprazole Capsules, Recall Event Number 134PREV18.

 

While Wendy Burn Plays Mind Games… People Die…


“…Half of all those taking antidepressants experience withdrawal problems when they try to give them up and for millions of people in England, these are severe, according to a new review of the evidence commissioned by MPs….

https://www.theguardian.com/society/2018/oct/02/antidepressant-withdrawal-symptoms-severe-says-new-report


A recent study touted in the media claims that up to 30% of people on SSRI antidepressants might experience severe withdrawal symptoms. This isn’t news to me, or the millions of people who have experienced severe withdrawal symptoms, and it isn’t news to the researchers, authors, bloggers, journalists, critical psychiatrists, documentary film makers, bereaved parents of SSRI tragedies, psychologists etc- but to the royal college of psychiatry, it seems to be.

Or is it?

It’s been known for at least 16 years in the mainstream UK (since around the time of the BBC’s Secrets of Seroxat documentary) that SSRI’s have a risk of serious withdrawals, however it seems that psychiatry, and psychiatrists (such as Wendy Burn) has been actively deflecting anything that would make SSRI’s look bad ever since.

Wendy (the Royal college of Psychiatrist’s UK president) seems to see her role not as a patient advocate as such, but more of a guardian of the psychiatric paradigm, and even the dogs on the street know by now- the psychiatric paradigm is owned by the Pharmaceutical industry, and has been for some time. Therefore, perhaps Wendy knows not who-or what- she really serves?

(or maybe she knows all too well?)

Wendy, claims that the study -touting 30% will experience severe withdrawals- is not scientific, and that also, we must

 

“…Remember this is a selected group, not randomly chosen. Terrible for those affected and we must try to help them but it is not 30% of everyone who ever takes an antidepressant…”

https://twitter.com/wendyburn/status/1049758874612506625


Let’s stop for a minute and consider that Wendy is correct (and she might be correct), let’s consider that it is not 30% of people who will have severe withdrawals, let’s bring down our guesstimate to 5% (a really low conservative guess) and let’s apply that to the real world.

A recent article in the UK press said that up to one in 6 people at any time in England will be on an SSRI drug.

….with over seven million adults (16% of the English adult population) being prescribed an antidepressant in England alone last year,” says the review….”

https://www.theguardian.com/society/2018/oct/02/antidepressant-withdrawal-symptoms-severe-says-new-report

That’s seven million adults in the UK. All on SSRI drugs.

If we take the most conservative estimate of 5%, not the 30% that has been touted in the media, and which Wendy of the college of psychiatrists, says is not an accurate number. Let’s go down by 25% to 5% as our most conservative estimate.

5% of 7,000,000 is

350,000

That’s 350,000 people who could be experiencing debilitating withdrawals, withdrawals so severe that they are ill for months, sometimes years. A Withdrawal so severe and horrific that they can’t work, they lose relationships, jobs, their lives, personalities, health and so on. Some might be in such pain from the severe withdrawal that they kill themselves. I felt that way on Seroxat, the despair in a severe Seroxat withdrawal is beyond words.

It’s Stephen King level horror… and then some.

There are no official guidelines for helping those in severe withdrawals, no supports, and outdated advice from NICE. Many people will be left alone in agony and some will die because of it.

But Wendy doesn’t see any of this as a problem.

She doesn’t see that severe withdrawals are a serious problem, and that denial of them is also a problem..

She doesn’t see conflicts of interest between psychiatry and pharma as a problem either.

Perhaps people like Wendy are the problem?

DpJgGHwWkAANesc.jpg

GSK Pandemrix jab fears reported two years before Irish recall..


Swine flu jab fears reported two years before Irish recall

Group fighting for narcolepsy sufferers ‘shocked and appalled’ by British Medical Journal report

The new UK study revealed that even in 2009 there were indications Pandemrix had a rate of adverse reactions far higher than other vaccines. Photo: PA
The new UK study revealed that even in 2009 there were indications Pandemrix had a rate of adverse reactions far higher than other vaccines. Photo: PA

Ralph Riegel and Eilish O’Regan

A leading medical journal has warned that serious safety “indicators” were raised over the swine flu vaccine Pandemrix in 2009 – almost two years before the vaccine was finally suspended from use in Ireland.

 

‘The British Medical Journal’ published a major investigation into the use of the drug across Europe where it is now linked to cases of narcolepsy or severe sleep disorders in children.

Last night, one solicitor acting for Irish children who developed narcolepsy said it was “a scandal” families have been fighting for justice for seven years while the State was aware of such data.

Support group Sufferers of Unique Narcolepsy Disorder (SOUND) said the report was “shocking and utterly appalling.”

The British report relies on multiple European investigations and ongoing legal actions over the drug, manufactured by GlaxoSmithKline (GSK).

Last August, a major Irish Independent investigation revealed some children received a double dose of Pandemrix when stocks of the vaccine were used from January 2011 amid fears there would be a shortfall for the normal winter flu jab.

Solicitor: Michael Boylan is handling many of the narcolepsy cases. Photo: Collins Courts
Solicitor: Michael Boylan is handling many of the narcolepsy cases. Photo: Collins Courts

Thousands of children received a single vaccine dose in 2009/2010 at the height of swine flu scare.

But the 2011 re-issue was almost two years after research data showed indicators that Pandemrix had a far higher rate of adverse incidents than other comparable vaccines.

Pandemrix was re-issued to GPs nationwide in 2011 despite the fact major studies were already under way in Sweden and Finland into potential links with narcolepsy.

Re-issued in Ireland on January 7, 2011, the vaccine was recalled on March 28, 2011 when both studies indicated there was a likely link to narcolepsy.

The new UK study revealed that even in 2009 there were indications Pandemrix had a rate of adverse reactions far higher than other vaccines.

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It calculated Pandemrix had a 500pc greater rate of “adverse events” reported than another swine flu vaccine.

In Ireland, Pandemrix was only made available before it had completed its testing protocols because the Government had offered GSK a full indemnity.

Almost 100 families are now suing the Government, Health Service Executive and GSK.

Many of the narcolepsy cases are being handled by solicitors Michael Boylan and Gillian O’Connor.

“The fact that the general public were not made aware by the Minister for Health or the HSE that Pandemrix was untested prior to or even during the vaccination programme as adverse data emerged is one of the reasons why we have now served the State defendants with claims for aggravated and exemplary damages,” Ms O’Connor said.

“It is a scandal and totally unacceptable that our clients have had to fight tooth and nail for accountability and appropriate redress for the dreadful injuries caused for the past seven years given that this information has been within the defendants knowledge all this time.”

GSK declined to comment given ongoing legal action.

SOUND said the group was “shocked and appalled” at the report.

“These revelations now present very serious questions for the State, the HSE and GSK as to what exactly happened with Pandemrix.

“These shocking revelations require immediate answers to who knew what and when. We need accountability now,” SOUND co-founder Tom Matthews warned.

The HSE insisted its vaccine selections in 2009 were on the basis of expert medical advice supported by an external panel of experts.

GlaxoSmithKline, Walgreen accused of negligence for allegedly selling Paxil to pregnant women


 

 

CHICAGO — A group of mothers are suing GlaxoSmithKline, which manufactured the antidepressant drug Paxil, and Walgreen Co., citing alleged strict liability.

Alexandria Hamilton, Deanna James and Kenneth West filed a complaint on Aug. 31 in Cook County Circuit Court, alleging the defendant companies failed to adequately warn of the alleged dangers of taking the drug paroxetine while pregnant.

According to the complaint, between 1998 and 2005, the mother plaintiffs were prescribed and used branded paroxetine, sold under the brand name Paxil, during their pregnancies, allegedly resulting in birth defects.

The plaintiffs request a trial by jury and seek an amount in excess of the court’s jurisdictional requisite, costs of the action and such further relief as the court deems proper. They are represented by Kenneth Brennan, Tor A. Hoerman and Steven Davis of TorHoerman Law LLC in Chicago.

Cook County Circuit Court Case number 2018L009501

Glaxo’s ‘Blue Cross Blue Shield’ Problem..


There’s a big case brewing against Glaxo, or more appropriately, a series of dozens of cases, all based in the US. The massive US health insurance firm – ‘Blue Cross Blue Shield‘ has been suing Glaxo for damages and it seems that these cases are ongoing. They stem from Glaxo’s 3 Billion dollar fine in the US, and also GSK’s fine for its messed up- Cidra facility. According to a current (separate) lawsuit (see here), there could be many Cidra’s across the world due to Glaxo’s defunct and defective manufacturing processes. It will be interesting to see how all these scandals play out for Glaxo. Please note that these Blue Cross Blue Shield cases also relate to the RICO (Racketeer Influenced and Corrupt Organizations Act).

Note the words: Racketeer, and Corrupt.

GSK are not a pharmaceutical company, they are an organized crime mafioso outfit masquerading as one. That’s what it looks like to me anyhow..

 

https://casetext.com/case/blue-cross-blue-shield-assn-v-glaxosmithkline-llc

Blue Cross Blue Shield Ass’n v. Glaxosmithkline LLC

CIVIL ACTION No. 13-4663 (E.D. Pa. Nov. 9, 2016)
0/0

Blue Cross Blue Shield Ass’n
v.
Glaxosmithkline LLC

UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIANov 9, 2016

CIVIL ACTION No. 13-4663 (E.D. Pa. Nov. 9, 2016)

MEMORANDUM Juan R. Sánchez, J.

Plaintiffs, 41 private health insurance companies that purchased billions of dollars’ worth of adulterated pharmaceutical drugs from Defendant GlaxoSmithKline LLC (GSK), bring claims against GSK under the Racketeer Influenced and Corrupt Organizations Act (RICO) and Pennsylvania law, alleging they purchased the drugs at issue based on GSK’s misrepresentations that the drugs were manufactured in accordance with federal safety and quality practices. Plaintiffs claim the adulterated drugs were worthless and had they known of the adulteration they would not have included the drugs in their formularies. GSK moves to dismiss Plaintiffs’ Complaint pursuant to Federal Rule of Civil Procedure 12(b)(6) on grounds that (1) Plaintiffs have not adequately alleged a cognizable injury to establish standing and (2) all claims are barred by the applicable statute of limitations. GSK also moves to dismiss Plaintiffs’ claims pertaining to the drug Paxil CR from April 1, 2002, through March 4, 2005, as barred by its 2009 class action settlements. Because Plaintiffs have adequately pleaded an injury for purposes of standing, and because the merits of the statute of limitations defense turn on factual issues that cannot be resolved at this stage, GSK’s motion to dismiss the complaint for failure to state a claim will be denied. BACKGROUND

GSK filed its motion to dismiss on October 11, 2013. While the motion was pending, the Third Circuit agreed to hear an interlocutory appeal in another case raising a similar issue regarding RICO standing. See In re Avandia Marketing, Sales Practices & Products Liability Litigation, No. 10-5419, 2013 WL 5761202 (E.D. Pa. Oct. 23, 2013). On May 5, 2014, the Court stayed and put this case in suspense pending the resolution of that appeal. The Third Circuit decided In re Avandia on October 26, 2015, and the parties in this case then filed briefs addressing the impact of the decision on GSK’s motion to dismiss.

The following facts are drawn from Plaintiffs’ Complaint, the well-pleaded factual allegations of which this Court must accept as true in evaluating the instant motion to dismiss. See Ashcroft v. Iqbal, 556 U.S. 662, 679 (2009).

Under federal law, pharmaceutical drugs must be manufactured in accordance with “current Good Manufacturing Practices” (cGMPs) to assure they meet safety, quality, purity, identity, and strength standards. See 21 U.S.C. § 351(a)(2)(B). The cGMPs are codified in 21 C.F.R. Parts 210 and 211, and are enforced by the Food and Drug Administration (FDA). Any drug not manufactured in accordance with cGMPs is deemed “adulterated” and may not be distributed or sold in the United States. See 21 U.S.C. §§ 331(a), 351(a)(2)(B).

Drugs are deemed to be adulterated if the manufacturer fails to comply with cGMPs to assure the drugs’ safety, quality, purity, identity, and strength and/or if they are contaminated. See 21 U.S.C. § 351(a)(2)(A), (B). Federal law prohibits a manufacturer from directly or indirectly causing adulterated drugs to be introduced or delivered for introduction into interstate commerce. See id. § 331(a).

Between 1997 and 2006, GSK distributed and sold large quantities of adulterated drugs in the U.S. market. All of the drugs at issue were manufactured at a plant in Cidra, Puerto Rico, that was owned and operated by SB Pharmco Puerto Rico, Inc., a wholly owned subsidiary of GSK. The Cidra plant was riddled with chronic and pervasive manufacturing and quality problems that violated numerous cGMPs and affected the integrity of all of the drugs manufactured there. Both GSK and SB Pharmco were aware of these problems, and deliberately cut corners to maximize profits.

The at-issue drugs in this case include Paxil, Paxil OS, Avandia, Avandamet, Coreg, Bactroban, Kytril, Compazine, Denavir, Dyazide, Dibenzyline, Thorazine, Stelazine, Relafen, Factive, Dyrenium, and Albenza. Compl. ¶ 3. Only some of these drugs—Avandamet, Kytril, Bactroban, and Paxil CR—were found by the FDA to be adulterated. Nevertheless, Plaintiffs claim that because the Cidra plant was chronically in violation of FDA regulations, all of the at-issue drugs were adulterated.

The FDA inspected the Cidra plant in 2001, finding significant deficiencies, but determined that GSK was responding adequately to those deficiencies. After another inspection in 2002 that revealed persistent cGMP violations, the FDA issued a Warning Letter to Cidra. GSK responded to the letter by committing to take specific acts to address the violations and assigned the company’s Manager of Global Quality Assurance, Cheryl Eckard, to lead a team to ensure those commitments were fulfilled. Throughout 2002 and 2003, Eckard urged GSK management to take action regarding ongoing violations at the Cidra plant. In April 2003, Eckard submitted to GSK executives a report documenting and summarizing the history of cGMP violations at the Cidra plant. The report noted certain high-risk compliance problems and called for increased monitoring by GSK management of compliance improvement initiatives. Eckard’s concerns were not addressed, and she was terminated the following month.

The FDA issues “Warning Letters” to achieve voluntary compliance and to establish prior notice” before initiating enforcement action. U.S. Food & Drug Administration, 4.1 Warning Letters, http://www.fda.gov/ICECI/ComplianceManuals/RegulatoryProceduresManual/ucm176870.htm (last visited Oct. 31, 2016). Warning Letters are “issued only for violations of regulatory significance.” Id.

Following her termination, Eckard informed the FDA of GSK’s unwillingness to address the ongoing deficiencies in the Cidra plant. The FDA ultimately commenced a criminal investigation, and in March 2005 seized all stocks of two drugs manufactured at the Cidra plant, Avandamet and Paxil CR. The following month, the FDA and GSK entered into a consent decree, and the FDA permanently enjoined GSK from directly or indirectly introducing or delivering into interstate commerce any adulterated product from the Cidra plant. In late 2007, GSK announced it would shut down the Cidra plant, which ultimately closed in late 2009. In 2010, SB Pharmco pleaded guilty to the federal crime of introducing into interstate commerce, with intent to defraud and mislead, adulterated versions of four of the drugs manufactured at the Cidra plant, Advandamet, Kytril, Bactroban, and Paxil CR, in violation of 21 U.S.C. §§ 331(a), 333(a)(2), and 351(a)(2)(B). Plaintiffs allege that the adulteration extended to all of the drugs manufactured at the Cidra plant.

Eckard also brought a qui tam suit under the False Claims Act in 2004, which was later joined by the Department of Justice. GSK eventually settled the suit for $600 million. See Pl.’s Rico Case Stmt. 5 (citing United States ex rel. Eckward v. SmithKline Beacham Corp., d/b/a/ GlacoSmithKline, et al., No. 04-CV-10375-JLT (D. Mass.)).

In July 2013, Plaintiffs filed their Complaint in state court alleging GSK violated federal and state law by fraudulently inducing Plaintiffs to pay billions of dollars for the adulterated drugs. The next month, GSK removed this case to federal court. Plaintiffs bring nine causes of action: (1) three Racketeer Influenced and Corrupt Organizations Act (RICO) violations under 18 U.S.C. § 1962(c) and (d); (2) common law fraud; (3) civil insurance fraud under 18 Pa. Cons. Stat. § 4117; (4) breach of express warranty under 13 Pa. Cons. Stat. § 2313; (5) breach of the implied warranty of merchantability under 13 Pa. Cons. Stat. § 2314; (6) common law unjust enrichment; and (7) common law negligent misrepresentation. GSK argues all of Plaintiffs’ claims should be dismissed for failure to state a claim.

DISCUSSION

To survive a motion to dismiss pursuant to Federal Rule of Civil Procedure 12(b)(6), “a complaint must contain sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.'” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)). A claim is facially plausible when the facts pleaded “allow[] the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Id. Although the plausibility standard “is not akin to a ‘probability requirement,'” the complaint must support “more than a sheer possibility that a defendant has acted unlawfully.” Id. (citation omitted). A complaint which “pleads facts that are merely consistent with a defendant’s liability . . . stops short of the line between possibility and plausibility of entitlement to relief.” Id. (quoting Twombly, 550 U.S. at 557) (internal quotation marks omitted). In evaluating a complaint’s sufficiency under these standards, a court must first “tak[e] note of the elements a plaintiff must plead to state a claim.” Santiago v. Warminster Twp., 629 F.3d 121, 130 (3d Cir. 2010) (quoting Iqbal, 556 U.S. at 675). Next, the court should “identify allegations that, ‘because they are no more than conclusions, are not entitled to the assumption of truth.'” Id. (quoting Iqbal, 556 U.S. at 679). Finally, where there are well pleaded allegations, the court “should assume their veracity and then determine whether they plausibly give rise to an entitlement to relief.” Id. (quoting Iqbal, 556 U.S. at 679).

A. Paxil CR Claims

GSK asserts Plaintiffs’ claims related to their purchases of Paxil CR between April 1, 2002, and March 4, 2005, are barred by two 2009 class action settlements. Def.’s Mot. to Dismiss 26-27. Plaintiffs contend GSK’s argument is irrelevant because the only Paxil-related claims concern Paxil and Paxil OS, not Paxil CR. See Compl. ¶ 3. Although Plaintiffs do not list Paxil CR as an at-issue drug, they do reference Paxil CR in their Complaint with regards to “GSK’s wrongdoing.” See Compl. ¶¶ 4 (noting SB Pharmco’s federal guilty plea concerned the proliferation of adulterated versions of Paxil CR), 110 (describing a March 2005 FDA seizure of all stocks of Avandamet and Paxil CR). To the extent Plaintiffs’ claims relate to their purchases of Paxil CR between April 1, 2002, and March 4, 2005, the Court will not consider Paxil CR in its analysis of the instant motion, and any purchases of Paxil CR between April 1, 2002, and March 4, 2005, will not be considered for purposes of damages.

B. Standing

GSK argues the Complaint should be dismissed because Plaintiffs have failed to sufficiently allege a cognizable injury—a necessary element of each of Plaintiffs’ claims. Although Plaintiffs allege they suffered a cognizable injury by paying for the adulterated at-issue drugs, GSK argues Plaintiffs cannot demonstrate an actual injury because they do not allege the at-issue drugs were unsafe or ineffective.

As the same injury is alleged with respect to all claims, and because the parties do not argue that the respective injury standards for Plaintiffs’ remaining claims differ in any material way, the Court will follow suit and analyze the injury issue in a RICO framework. See Toll Bros. v. Twp. of Readington, 555 F.3d 131, 139 n.5 (3d Cir. 2009).

To pursue a civil action under RICO, a plaintiff must first establish standing under Section 1964(c), which provides:

Any person injured in his business or property by reason of a violation of section 1962 of this chapter may sue therefore in any appropriate United States district court and shall recover threefold the damages he sustains and the cost of the suit, including a reasonable attorney’s fee . . . .


Thus, a RICO plaintiff must make a threshold showing that it has “suffered an injury to business or property and that [the] injury was caused by the defendant’s violation of 18 U.S.C. § 1962.In re Avandia Mktg., Sales Practices & Prod. Liab. Litig., 804 F.3d 633, 638 (3d Cir. 2015) (citing Maio v. Aetna, Inc., 221 F.3d 472, 482 (3d Cir. 2000)). To establish an injury to business or property, a plaintiff must allege and prove “actual monetary loss, i.e., an out-of-pocket loss.” Maio, 221 F.3d at 483.

Prior to the Third Circuit’s decision in In re Avandia, district courts in this Circuit followed Maio in analyzing an insurer’s standing to pursue claims relating to the purchase of misrepresented drugs. In Maio, the Third Circuit held health insurance beneficiaries had not alleged a cognizable RICO injury against their insurer, Aetna, when they alleged Aetna’s misrepresentations regarding the services included in their HMO plans caused them to “pay too much in premiums for an ‘inferior’ health care product.” 221 F.3d at 484-85. Because the plaintiffs’ alleged injury was premised solely on the possibility they would receive inferior care in the future and not on past substandard care, the Court found the plaintiffs failed to plead a tangible economic injury where they provided “no factual basis for [the] conclusory allegation” that the insurance coverage was “worth less” than what the plaintiffs had paid for it. Id. at 490. District courts have interpreted Maio to bar insurers’ claims where there were no specific allegations that the at-issue drugs were proven to be unsafe or ineffective. See In re Schering-Plough Corp. Intron/Temodar Consumer Class Action, No. 06-CV-5774, 2009 WL 2043604, at *18 (D.N.J. July 10, 2009) (finding Maio “directly on point” in case involving alleged overpayment for misrepresented drugs); Dist. 1199P Health & Welfare Plan v. Janssen, L.P., No. 06-3044, 2008 WL 5413105, at *7 (D.N.J. Dec. 23, 2008) (finding plaintiffs were “assert[ing] a substantially similar ‘overpayment’ argument as that made by the unsuccessful plaintiffs in Maio“).

These cases generally deal with allegations of fraud and misrepresentation by defendant-drug companies engaged in off-label marketing which is prohibited by the FDA.

The Third Circuit distinguished Maio in In re Avandia, in which the plaintiff-insurers alleged GSK deliberately misrepresented and concealed the safety risks associated with a diabetes drug, causing them to include the drug in their formularies and cover the drug at favorable rates. 804 F.3d at 636. The plaintiffs alleged two theories of injury: (1) the at-issue drug was worth less than the favorable rates at which they covered it (the “excess price” theory); and (2) physicians relied on GSK’s misrepresentations in deciding to prescribe the at-issue drug to more patients that they would have had GSK not concealed the risks of the drug (the “quantity effect” theory). Id. The Court of Appeals affirmed the district court’s denial of GSK’s motion to dismiss, finding the insurers’ alleged injury—prioritizing the drug on their formularies and overpaying for the drug due to GSK’s illegal or deceptive marketing practices—was a concrete economic harm. Id. at 640. That concrete injury, cognizable under RICO, was distinguishable from the injury in Maio, which was based on contingent future events concerning the quality of health care. Id.

In reaching its decision, the Third Circuit relied on In re Warfarin Sodium Antitrust Litigation, 391 F.3d 516 (3d Cir. 2004), which “offer[ed] the closest analogy” to the facts before it. Id. In In re Warfarin, the plaintiff-insurers alleged the defendant engaged in anticompetitive behavior and disseminated false and misleading information about a low-priced, readily available generic competitor, causing the plaintiffs to purchase the higher-priced brand name drug instead. 391 F.3d at 521. In affirming the district court’s approval of a class action settlement, the Court of Appeals rejected an argument that the insurers did not have standing to assert antitrust claims, finding “it well recognized that a purchaser in a market where competition has been wrongfully restrained has suffered an antitrust injury.” Id. at 531. The In re Avandia court concluded that, just as the “injury suffered by the [Warfarin plaintiffs] did not depend on the drug’s ineffectiveness but rather on the defendant’s anticompetitive behavior[,] . . . the injury suffered by the [third-party payers] in this case does not depend on Avandia’s effectiveness, but rather on GSK’s fraudulent behavior.” 804 F.3d at 640.

Defendants argue In re Warfarin, an antitrust case, is inapplicable to RICO claims. Def.’s Reply Mem. in Supp. of its Mot. to Dismiss 5 (citing In re Schering-Plough Corp., 2009 WL 2043604, at *21; Dist. 1199P, 2008 WL 5413105, at *6). The Third Circuit, however, found In re Warfarin applicable in In re Avandia, a RICO case, because “RICO’s standing requirements were modeled on antitrust law.” 804 F.3d at 649 n.32.

Under In re Avandia, an insurer’s overpayment for a drug due to the manufacturer’s deceptive market practices is a concrete economic injury. Plaintiffs have sufficiently pleaded an analogous injury here. Plaintiffs allege GSK caused injury to their business and property because they justifiably relied on GSK’s fraudulent material misrepresentations and omissions in placing “adulterated,” and effectively “worthless,” drugs on their formularies and subsequently paying for those drugs. Compl. ¶¶ 6-7. Plaintiffs allege that but for GSK’s fraudulent concealment of the myriad ongoing regulatory violations at the Cidra plant, and GSK’s misrepresentations and omissions as to the safety, quality, purity, identity, and strength of the at-issue drugs, Plaintiffs would not have paid for those drugs. Id. ¶¶ 6, 9, 178. As in In re Avandia, Plaintiffs’ injury does not depend on the at-issue drugs’ ineffectiveness, or factual speculation concerning future events, but rather on GSK’s misrepresentations concerning the production, quality, and safety of the drugs.

The parties agree the In re Avandia court held a plaintiff may adequately plead economic harm independent of whether the alleged fraud causes physical harm to the drug users. GSK, however, attempts to distinguish In re Avanadia by arguing that whereas the plaintiffs in that case alleged GSK’s misrepresentations regarding the at-issue drug’s safety profile led to higher prices (the price effect) and an increase in the quantity of drugs prescribed by physicians (the quantity effect), here Plaintiffs merely allege the at-issue drugs were rendered adulterated and worthless due to cGMP violations at the plant, but fail to allege how non-disclosure of the violations had any bearing on the quality of the drugs. GSK notes that according to the FDA, “adulterated” does not mean the drugs were ineffective, unsafe, or otherwise caused harm; rather, the term is merely a regulatory designation relating to conditions at the plant where the drug is manufactured, and the drugs may still meet their labeled specifications. Def.’s Mot. to Dismiss 17-18; Def.’s Mem. Concerning In re Avandia 5-6. GSK thus argues Plaintiffs’ description of the drugs as “worthless” is unfounded, and, therefore, so is their economic harm.

The fact that Plaintiffs alleged not overpayment, as in In re Avandia, but payment they would have not made at all due to the “worthlessness” of the at-issue drugs is of no import. In In re Avandia, GSK argued the plaintiffs’ claim that doctors relied on GSK’s misrepresentations when prescribing the at-issue drug failed because there was no allegations that an alternative prescription would have been cheaper. 804 F.3d at 644-45. The Third Circuit rejected that argument, noting the plaintiffs’ injury was not entirely contingent on the existence of cheaper alternative drugs because under plaintiffs’ “excess price” theory, they could show the at-issue drug cost too much regardless of whether cheaper drugs existed on the market. Id. at 645.

The law is unclear as to the extent to which cGMP violations, by themselves, affect a drug’s worth. According to the FDA, drugs produced under conditions that do not comply with cGMPs may nevertheless meet their labeled specifications and be fit for consumption. See FDA, Facts About the Current Good Manufacturing Practices (CGMPs) (2015), http://www.fda.gov/D rugs/DevelopmentApprovalProcess/Manufacturing/ucm169105.htm (last visited Oct. 26, 2016) (“If a company is not complying with CGMP regulations, any drug it makes is considered ‘adulterated’ under the law. This kind of adulteration means that the drug was not manufactured under conditions that comply with CGMP. It does not mean that there is necessarily something wrong with the drug.”). Regardless of whether the at-issue drugs were fit for consumption, 21 U.S.C. § 331(a) prohibits the introduction of adulterated drugs into interstate commerce, and Plaintiffs allege the at-issue drugs were rendered worthless because they were sold illegally. See Compl. ¶ 6-9.

Defendants cite several cases for the proposition that cGMP violations alone are insufficient to show a drug is defective and, therefore, resulted in economic harm to the party paying for the drug. However, the cases were decided before In re Avandia. They are also distinguishable on their facts and the standard applied. See In re McNeil Consumer Healthcare, 877 F. Supp. 2d 254, 271 (E.D. Pa. 2012) (finding plaintiffs who purchased non-recalled drugs but “claimed their losses arose at the time of sale because they paid premium prices for products that were manufactured at facilities with quality control problems” and relied on “experiences of other individuals” who suffered adverse effects failed to state a cognizable injury); Polk v. KV Pharm. Co., No. 4:09-CV-00588 SNLJ, 2011 WL 6257466, at *5-6 (E.D. Mo. Dec. 15, 2011) (holding consumer-plaintiff’s “conclusory allegation that [a drug] was adulterated and therefore worthless” did not support the inference that the drug “was anything less than what it purported to be,” where the allegation was based solely on a FDA consent decree in which the defendant disclaimed any liability); In re Digitek Prod. Liab. Litig., 821 F. Supp. 2d 822, 835-36 (S.D. W. Va. 2011) (granting summary judgment in product defect case in favor of defendants where evidence showed only single defective tablet was released, and drug recall and ongoing cGMP violations were insufficient to give rise to a reasonable inference that the drug reached the market and caused harm to plaintiffs); Myers-Armstrong v. Actavis Totowa, LLC, No. C 08-04741 WHA, 2009 WL 1082026, at *4 (N.D. Cal. Apr. 22, 2009) (dismissing consumer-plaintiff’s claims because the mere fact that the drug was adulterated due to cGMP violations was insufficient to allege a cognizable injury absent a “manifestation of a defect that results in some injury or rational fear of injury”) aff’d, 382 F. App’x 545 (9th Cir. 2010).

Moreover, because “the impact of CGMP violations depends on the nature of those violations and on the specific drugs involved,” FDA, Facts About the CGMPs, Plaintiffs are entitled to prove that the nature of GSK’s violations had a material impact on the drugs for which they paid. Even if “adulterated” is not interchangeable with “unsafe” or “ineffective,” the In re Avandia court held an at-issue drug does not itself have to be defective, but rather the plaintiffs had to show the masking of safety risks affected its value. Although Plaintiffs here do not allege the same “excess price” and “quantity effect” theories put forth by the In re Avandia plaintiffs, they do put forth a theory, with supporting facts, that includes elements of both theories: GSK’s non-disclosure rendered the at-issue drugs worthless and physicians would have not prescribed the at-issue drugs at all had GSK not concealed the cGMP violations because Plaintiffs would not have placed the drugs on the their formularies. The alleged effect is supported by Plaintiffs’ allegations of numerous issues with the at-issue drugs’ safety and effectiveness, including product mix-ups, product contamination, failure in content uniformity, and foreign particles found in certain drug products, as admitted by SB Pharmco pursuant to its guilty plea. See Compl. ¶ 132; U.S. Dept. of Justice, Oct. 26, 2010 Press Release, https://www.justice.gov/opa/pr/glaxosmithkline-plead-guilty-pay-750-million-resolve-criminal-and-civil-liability-regarding; Guilty Plea Settlement Agreement at 3-4, https://www.justice.gov/archive/usao/ma/news/2010/October/GSK%20Settlement%20Agreement10_26.pdf. Thus, contrary to GSK’s assertion, Plaintiffs have adequately connected GSK’s non-disclosure of cGMP violations, and the effect of those violations, on the quality and packaging of certain at-issue drugs, to Plaintiffs’ payment for drugs they allege had no value.

An overview of the specific nature of the problems that occurred at the Cidra plant can be found in paragraph 77 of the Complaint. These problems are subsequently addressed in exhaustive detail between paragraphs 111-174.

GSK argues that of the alleged cGMP issues, only the aforementioned four quality issues—product mix-ups, product contamination, failure in content uniformity, and foreign particles found in certain drug products—related directly to the quality or packaging of the finished drug products; the remaining allegations relate to allegedly deficient manufacturing processes and procedures at Cidra. Of those four, GSK argues, Plaintiffs failed to allege they paid for the drugs or that they were distributed into the market. Plaintiffs respond that those four issues are illustrative, not exclusive, and merely demonstrate the nature of GSK’s FDA violations.

Again, because the Court finds it premature to dismiss Plaintiffs’ claims based solely on cGMP violations, the fact that only four of the alleged cGMP violations are directly quality-related is not fatal. Furthermore, although GSK is correct that Plaintiffs did not specifically allege they paid for the drugs from the affected lots, they reiterate throughout the Complaint that they paid for the “adulterated” at-issue drugs. See, e.g., Compl. ¶¶ 3, 4, 6, 9, 10, 185, 194. They also characterize themselves as the “principal payers” for the at-issue drugs, id. ¶ 182, noting they “collectively represent approximately 70% of the U.S. market for non-governmental health insurance,” id. ¶ 3; “paid billions of dollars for [the] adulterated drugs . . . manufactured at [the Cidra plant],” id.; and “were the biggest single source of GSK’s revenues in the U.S. market” from the at-issue drugs, id. ¶ 10. Thus, Plaintiffs have plausibly alleged they paid for affected lots of the at-issue drugs, giving rise to their economic injury.

Further, contrary to GSK’s contention that Plaintiffs failed to allege the drugs from the affected lots were released to the market, they did allege some of those drugs were released. See Compl. ¶ 112 (noting approximately 17 complaints Cidra received in 2002 and 2003 regarding product commingling of Avandia, Paxil, and Coreg); id. ¶ 126 (noting SB Pharmco admitted in its guilty plea that in 2003, it “released . . . lots of Kytril that were deemed adulterated because the manufacturing processes and laboratory testing were insufficient to assure the Kytril was of the quality and purity that Kytril was represented to possess”); id. ¶ 128 (noting contaminated Bactroban ointment released to market in 2002); id. ¶ 131-32 (describing continued distribution of contaminated Bactroban to the market in 2003); id. ¶ 154 (“[I]n September 2004, Cidra rejected a batch of Avandamet due to OOS results in the content uniformity of the rosiglitazone active ingredient, but failed to investigate and released to the market 26 other batches made with the same batch of rosiglitazone.”); id. ¶ 157 (alleging SB Pharmco admitted it released to the market adulterated Avandamet that was not of the “strength, identity, quality and purity [it] was represented to possess”).

Considering the facts alleged bearing on Plaintiffs’ economic injury—the cGMP violations, quality of drug issues, FDA seizure of stocks of adulterated drugs, and the existence of a permanent injunction preventing GSK from directly or indirectly introducing or delivering into interstate commerce adulterated product from the Cidra plant in April 2005—Plaintiffs have sufficiently pleaded they suffered injury to their businesses as a result of paying for the adulterated at-issue drugs.

C. Statute of Limitations

GSK next argues all of Plaintiffs’ claims are barred by the applicable two-or four-year statute of limitations. Plaintiffs allege their injuries arose between 1997 and 2006. Compl. ¶ 12. Because Plaintiffs filed their suit on July 15, 2011, their claims are timely only if their claims accrued on or after July 15, 2007 for claims subject to a four-year statute of limitations, and on or after July 15, 2009 for claims subject to a two-year statute of limitations. GSK argues because Plaintiffs had ample notice of the cGMP violations at the Cidra plant before July 15, 2011, they knew or should have known of their claims before that date and their claims are therefore time-barred.

The limitations periods applicable to Plaintiffs’ claims are as follows: (1) RICO claims are subject to a four-year statute of limitations, see Cetel v. Kirwan Fin. Grp., Inc., 460 F.3d 494, 506 (3d Cir. 2006); (2) claims for common law fraud are subject to a two-year statute of limitations, see Beauty Time, Inc. v. VU Skin Systems, Inc., 118 F.3d 140, 143 (3d Cir. 1997) (citing 42 Pa. Cons. Stat. § 5524(7)); (3) claims for statutory civil insurance fraud are subject to a two-year statute of limitations, see State Farm Mut. Auto. Ins. Co. v. Midtown Med. Ctr. Inc., 2005 WL 627969, at *3 (E.D. Pa. 2005); (4) unjust enrichment claims are subject to a four-year statute of limitations, Harry Miller Corp. v. Mancuso Chemicals Ltd., 469 F. Supp. 2d 303, 319 (E.D. Pa. 2007); (5) negligent misrepresentation claims are subject to a two-year statute of limitations, see Cooper v. Sirota, 37 F. App’x 46, 48 (3d Cir. 2002); and (6) breach of warranty claims are subject to a four-year statute of limitations, Gunsalus v. Celotex Corp., 674 F. Supp. 1149, 1154-55 (E.D. Pa. 1987).

A district court may consider a limitations defense on a motion under Rule 12(b)(6) “only if the time alleged in the statement of a claim shows that the cause of action has not been brought within the statute of limitations.” Schmidt v. Skolas, 770 F.3d 241, 249 (3d Cir. 2014) (internal quotation marks and citation omitted). However, “if the bar is not apparent on the face of the complaint, then it may not afford the basis” for dismissal. Id.

Pennsylvania’s discovery rule “tolls the accrual of the statute of limitations when a plaintiff is unable, ‘despite the exercise of due diligence, to know of the injury or its cause.'” Mest v. Cabot Corp., 449 F.3d 502, 510 (3d Cir. 2006) (quoting Pocono Int’l Raceway v. Pocono Produce, Inc., 468 A.2d 468, 471 (Pa. 1983)). “For the statute of limitations to run, a plaintiff need not know the ‘exact nature’ of his injury, as long as it objectively appears that the plaintiff ‘is reasonably charged with the knowledge that he has an injury caused by another.'” Id. at 510-11 (quoting Ackler v. Raymark Indus., Inc., 551 A.2d 291, 293 (Pa. 1988)). “A plaintiff therefore is obligated to exercise reasonable diligence in ascertaining the existence of the injury and its cause.” Id. at 511 (internal quotation marks and citation omitted).

Similarly, in terms of RICO’s four-year statute of limitations, the Third Circuit has held courts should apply an injury discovery rule “whereby a RICO claim accrues when plaintiffs knew or should have known of their injury.” Cetel, 460 F.3d at 507 (internal quotation marks and citations omitted). When plaintiffs should have known the basis of their claims “depends on whether [and when] they had sufficient information of possible wrongdoing to place them on ‘inquiry notice’ or to excite ‘storm warnings’ of culpable activity.” Id. (quoting Benak ex. rel. Alliance Premier Growth Fund v. Alliance Capital Mgmt. L.P., 435 F.3d 396, 400 (3d Cir. 2006)). “Moreover, plaintiffs have inquiry notice ‘whenever circumstances exist that would lead a reasonable investor of ordinary intelligence, through the exercise of due diligence, to discovery of his or her injury.'” Id. (quoting Matthews v. Kidder Peabody & Co., 260 F.3d 239, 252 (3d Cir. 2001)). A court’s analysis of inquiry notice involves two steps: (1) defendant must show the existence of “storm warnings”; and (2) plaintiffs then must show that, “heeding the storm warnings, they exercised reasonable diligence but were unable to find and avoid the storm.” Id.

“Storm warnings” include “any information or accumulation of data that would alert a reasonable person to the probability that misleading statements or significant omissions had been made.” Cetel, 460 F.3d at 507. “This charge saddles the investor with responsibilities like reading prospectuses, reports, and other information related to the investments, and, additionally, assumes knowledge of publicly available news articles and analyst’s reports.” Id. (internal quotation marks and citations omitted).

GSK argues Plaintiffs were, or should have been, aware of their claims by 2003, or by early 2005 at the latest, due to the series of public disclosures of the cGMP issues at the Cidra plant, including (1) the FDA’s recall of select lots of Bactroban, and issuance of a Warning Letter regarding cGMP violations in 2002; (2) the FDA’s commencement of a criminal investigation of the Cidra plant in 2003, which was documented in pharmaceutical publications and the national media; (3) GSK’s 2003 Annual Report, disclosing that the FDA issued two Forms 483 to Cidra; (4) the FDA’s seizure in March 2005 of all stocks of Avandamet, which was widely publicized in the media and disclosed in GSK’s annual reports; and (5) publicity following the April 2005 Consent Decree between GSK and the United States, discussing the issues at Cidra, the March 2005 seizure, and the terms of the consent decree.

The FDA describes a Form 483 as follows:

An FDA Form 483 is issued to firm management at the conclusion of an inspection when an investigator(s) has observed any conditions that in their judgment may constitute violations of the Food Drug and Cosmetic (FD&C) Act and related Acts. . . . Observations are made when in the investigator’s judgement, conditions or practices observed would indicate that any food, drug, device or cosmetic has been adulterated or is being prepared, packed, or held under conditions whereby it may become adulterated or rendered injurious to health. . . . Companies are encouraged to respond to the FDA Form 483 in writing with their corrective action plan and then implement that corrective action plan expeditiously.

In making their arguments regarding inquiry notice, the parties rely on news articles and GSK’s annual reports, which they attach as exhibits. It is not clear whether the Court may consider those exhibits at this stage. However, even considering such documents, the Court cannot decide the applicable statutes of limitations bar Plaintiffs’ claims at this stage.

In response, Plaintiffs contend GSK has failed to carry its heavy burden of proof in establishing their claims are time-barred for three reasons. Pls.’ Opp’n 15 (citing Van Buskirk v. Carey Canadian Mines, Ltd., 760 F.2d 481, 498 (3d Cir. 1985)). First, they assert the public record between 2002 and 2005 is insufficient to show they had inquiry notice regarding the probability of alleged injury, as any problems at the plant were confined to specific drugs and/or batches of drugs, the FDA allowed the plant to continue operating, and GSK assured the public it was cooperating fully with the FDA. In fact, they assert the public had no notice of the truth regarding the Cidra plant until GSK announced its global settlement of Eckard’s qui tam case and SB Pharmco’s guilty plea in October 2010. Second, even if Plaintiffs were on inquiry notice, further inquiry would have been fruitless. Plaintiffs argue they could not have independently discovered the extent of the issues at the Cidra plant because GSK was actively concealing them from the FDA. At minimum, Plaintiffs argue, the question whether additional inquiry would have been fruitful is an unresolved factual issue. Third, GSK’s fraudulent concealment of those conditions tolled the limitations period.

Plaintiffs assert the Eckard case was filed under seal in 2004 and was not unsealed until July 16, 2007, less than four years before they filed suit in July 2011. Further, Plaintiffs assert the case remained unpublicized until 2010, except for brief one-sentence references to the case in GSK’s annual reports beginning in 2007. For example, in its 2007 Annual Report, published in 2008, GSK stated only that “in July 2007, the Group learned that the US District Court for the District of Massachusetts had unsealed a complaint brought by a former employee under the federal False Claims Act,” i.e., the Eckard case.

Under the doctrine of fraudulent concealment, “a corollary to the discovery rule,” the statute of limitations is tolled where a plaintiff proves by “clear, precise and convincing evidence” that “through fraud or concealment the defendant cause[d] the plaintiff to relax his vigilance or deviate from the right of inquiry.” Bohus v. Beloff, 950 F.2d 919, 925 (3d Cir. 1991) (citation omitted). “There must be an affirmative and independent act of concealment that would divert or mislead the plaintiff from discovering the injury.” Id. Once fraudulent concealment is established, “the statute of limitations is tolled until the plaintiff knew or using reasonable diligence should have known of the claim.” Id. at 925-26 (internal quotation marks and citation omitted); see also In re Schering-Plough Corp. Intron, 2009 WL 2043604, at *22 (“In addition, Plaintiffs’ allegation that Defendants concealed their illegal conduct raises the possibility that the applicable statutory periods should be tolled and, by implication, creates an additional hurdle to establishing that the RICO claims are barred.”).

The Court cannot conclude that Plaintiffs knew or should have known the extent of GSK’s misrepresentations regarding the cGMP violations at Cidra and the resulting issues concerning the quality and safety of the at-issue drugs at any time before July 11, 2007. Factual issues remain as to whether the public disclosures of cGMP issues between 2002 and 2005 constituted “storm warnings” establishing inquiry notice, especially in light of GSK’s attempts to minimize the extent of the cGMP violations, the violations’ effect on the quality and safety of the drugs produced at Cidra, and the FDA’s involvement. See Mathews v. Kidder, Peabody & Co., 260 F.3d 239, 253 (3d Cir. 2001) (“[W]e are mindful of the dangers in adopting too broad an interpretation of inquiry notice.”); In re Schering-Plough Corp. Intron, 2009 WL 2043604, at *22 (“[I]t is not clear that the FDA warning letter, public filings and newspaper articles reporting the Government’s investigation . . . provided warnings sufficient to put Plaintiffs on notice of their purported RICO claims . . . .”); Stafford Inv. LLC v. Vito, Nos. 04-3182, 06-1112, 06-4424, 2008 WL 5062136, at *3 (E.D. Pa. Dec. 1, 2008) (“Unless there is a clear basis for the court to determine when plaintiff knew or should have known of the existence of her cause of action, the issue of whether the plaintiff had a reasonable opportunity to discover the violation is a question to be resolved by a jury.”).

Defendants argue “extensive publicity” of the cGMP issues would have caused a reasonable insurance company to conduct further investigation, citing In re Diet Drugs (Phentermine, Fenfluramine, Dexfenfluramine) Product Liability Litigation, 352 F. Supp. 2d 533 (E.D. Pa. 2004). In that case, however, the district court found a consumer of a certain diet drug had inquiry notice of her potential claims following extensive publicity of the drug’s recall, including (1) “leading stories on major television network news programs;” (2) a “front-page story [in USA Today] regarding the withdrawal of [the] drugs, its effects, . . . the response by various organizations throughout the United States regarding the news,” and “potential [imminent] litigation”; (3) the defendant’s efforts to notify consumers about the recall through press releases, full-page ads in leading national and regional newspapers, and a “‘Dear Health Care Provider Letter” to approximately 450,000 physicians and pharmacists in which it informed them of the withdrawal of the drug from the market and of the potential association between use of the drugs and instances of valvular heart disease'”; and (4) the “comprehensive publicity campaign surrounding the nationwide class action Settlement Agreement with [the defendant].” Id. at 538-39. Furthermore, the court noted the plaintiff in that case admitted she had inquiry notice of a problem potentially related to the diet drug in her deposition. Id. at 538. The publications and news coverage in this case fall short of such “extensive publicity” and outreach efforts.

For example, the Bactroban recall in 2002 was followed by only an FDA Warning Letter advising of cGMP violations. In 2003, the FDA opened a criminal investigation of the Cidra plant and executed search warrants at the facility. However, although GSK argues the investigation was documented in “pharmaceutical publications and the national media,” Def.’s Mot. to Dismiss 23, the coverage was extremely minimal and vague as to the nature or extent of the investigation.

The coverage included (1) a 140-word Drug Industry Daily article noting that although the “FDA ha[d] begun an investigation into manufacturing issues at [GSK’s] facility in Cidra, Puerto Rico,” the FDA “did not tell GSK the specific nature of the investigation,” and GSK “would not interrupt the supply from the plant,” see Def.’s Mot. to Dismiss, Ex. 10; (2) an article in The Guardian, “Glaxo plant in Puerto Rico under FDA scrutiny,” which noted GSK was uninformed about the specific nature of the FDA’s investigation, and quoted finance director John Coombe as stating, “‘The issues raised [in the FDA’s Warning Letter] were fully resolved and closed up. The FDA are now back. They are being quite coy about exactly what they are looking for,'” id., Ex. 9; (3) a 253-word article from HIS Global Insight, “GSK Plant in Puerto Rico Faces FDA Manufacturing Probe,” noting ” it remains unclear precisely what the FDA is investigating;” id., Ex. 11; and (4) a 274-word article from the Glasgow Herald, “Glaxo pre-tax profits climb 22% to (pounds) 1.7bn,” which references the investigation in a single line noting “investors were also unnerved by news that the [FDA] was investigating a Glaxo factory in Puerto Rico,” id., Ex. 12.

Although the FDA’s March 2005 seizure of all stocks of Avandamet (and Paxil CR), and subsequent Consent Decree, was widely covered in the news media, GSK continued to downplay the extent of its issues and assure the public of its compliance with FDA demands. In its 2004 Annual Report, published in 2005, GSK noted the FDA’s inspection of the Cidra plant in November 2004 and subsequent issuance of two Forms 483 containing “observations relat[ing] to certain aspects of production controls, process validation and laboratory investigations.” Def.’s Mot. to Dismiss, Ex. 14. The Report further stated, “In response to the FDA’s observations, the Group, among other things, voluntarily recalled certain shipments of Paxil CR and Avandamet from wholesalers. In March 2005 the FDA initiated seizures of Paxil CR and Avandamet tablets manufactured at Cidra on grounds that those products failed to meet FDA manufacturing standards. The Group continues to cooperate with the FDA in responding to [its] observations . . . .” Id. In an April 2005 New York Times article describing the Consent Decree, GSK’s global chief of pharmaceuticals reported GSK “was able to resolve the issue [of the drug recalls] quickly because of its strong relationship with the F.D.A.” Id., Ex. 36.

GSK presented the same sentiments of resolution in its annual reports. The 2005 and 2006 Annual Reports each provided a single sentence regarding the recall (“In March 2005 the FDA halted distribution of supplies of Paxil CR and Avandamet due to manufacturing issues.”), followed by a description of the Consent Decree: the “Consent Decree provides for an independent expert to review manufacturing processes at the site for compliance with [GMP] requirements,” requires GSK to “provide[] a report to the FDA on the deficiencies identified in [its] review, setting out a corrective plan and timetable for completion,” and imposes “no financial penalties.” Id., Ex. 15 & 16. The 2006 Annual Report further states that “[i]n June 2006, the FDA confirmed that the status for the site has been upgraded to ‘voluntary action indicated,’ which means that the FDA deems the [Cidra plant] acceptable for the export of products and for routine manufacturing operations.” Id., Ex. 16. GSK continually noted its “commit[ment] to working cooperatively with the FDA to address any issues in a timely fashion.” Id., Ex. 15 & 16. In its 2007 Annual Report, GSK noted, “In March 2007, the FDA completed a general GMP inspection which resulted in four inspectional observations. The Group has been advised by the FDA that the Group’s response to the inspectional observations is satisfactory.” Pl.’s Opp’n, Ex. B.

Because factual issues remain as to whether Plaintiffs were on inquiry notice that the at-issue drugs were adulterated, and if inquiry notice existed, whether Plaintiffs exercised due diligence, GSK’s motion to dismiss Plaintiffs’ claims as time-barred is denied.

Just as the Court finds it premature to decide whether Plaintiffs’ were on inquiry notice as to their claims prior to July 2007, an inquiry into whether GSK fraudulently concealed those claims similarly would be premature. See Hoppe v. SmithKline Beecham Corp., 437 F. Supp. 2d 331, 336-38 (E.D. Pa. 2006) (“In cases involving tolling due to allegations of fraudulent concealment, the Third Circuit has encouraged and approved of allowing the factual record to be sufficiently developed before reaching the issue.” (citing Byrnes v. De Bolt Transfer, Inc., 741 F.2d 620, 626-27 (3d Cir.1984), and Urland v. Merrell-Dow Pharm., Inc., 822 F.2d 1268, 1276-77 (3d Cir.1987))). Further discovery is necessary to reveal whether GSK affirmatively concealed information that misled Plaintiffs, and whether Plaintiffs in turn exercised reasonable due diligence to stay apprised of potential wrongdoing on the part of GSK prior to 2007.

GSK argues Plaintiffs’ breach of warranty claims are barred by the statute of limitations because the discovery rule does not apply to such claims. Def.’s Mot. to Dismiss 25-26 (citing 13 Pa. Cons. Stat. §§ 2725(a)-(b), 5525(a)(2)); see also Gunsalus, 674 F. Supp. at 1154-55 (discovery rule does not toll statute of limitations on breach of warranty claims unless there is an explicit warranty of future performance). In response, Plaintiffs argue fraudulent concealment equitably tolls the limitations period for warranty claims, as it does for their other claims. Pls.’ Opp’n 27 n.23 (citing In re Ford Motor Co. E-350 Van Prods. Liab. Litig., No. 03-4558, 2008 WL 4126264, at *18-19 (D.N.J. Sept. 2, 2008), and Connaught Labs., Inc. v. Lewis, 557 A.2d 40, 43-44 (Pa. Cmmw. Ct. 1989)). Because the Court will not decide whether fraudulent concealment tolls the statute of limitations, the question of whether Plaintiffs’ breach of warranty claims are barred is also left for another day. ——–

Because Plaintiffs have adequately pled an injury for the purposes of standing, and there remain legitimate questions of fact as to whether Plaintiffs had a reasonable opportunity to discover GSK’s alleged fraudulent conduct underlying their claims, GSK’s motion to dismiss Plaintiffs’ claims is denied.

An appropriate Order follows.

BY THE COURT:

/s/ Juan R. Sánchez

Juan R. Sánchez, J.

FDA Form 483 Frequently Asked Questions, http://www.fda.gov/ICECI/Inspections/ucm256377.htm (last visited Nov. 7, 2016).

 

BMJ Editor Fiona Goldlee: “..Paid opinion leaders are a blot on medicine’s integrity, and we should make them a thing of the past…”


“…Fiona Godlee, editor in chief of The BMJ, who praised GSK’s move in 2013, said: “Sadly, this shows again that we can’t rely on industry to do the right thing. We need a Sunshine Act to ensure that payments from industry are publicly declared.

“We also need action from medicine’s leaders – the royal colleges. We don’t let judges or journalists take money from the people they are judging or reporting on: we shouldn’t let doctors do this either. Paid opinion leaders are a blot on medicine’s integrity, and we should make them a thing of the past….”

https://pharmaphorum.com/news/calls-for-sunshine-act-as-gsk-pays-doctors-to-promote-drugs-again/


Ethical psychiatrist Peter Gordon has been calling for a UK Sunshine act for years, however Royal College Head- Wendy Burn- doesn’t want to have any contact with him, despite all the work he has done to clean the swamp of UK psychiatry from conflicts of interest. Wendy- it seems- doesn’t see conflicts of interest, and drug company money- sloshing around UK medicine and psychiatrist’s coffers, as a problem at all. That’s a serious problem.

Sunlight is the best disinfectant, and psychiatry has been infected from its head to its gills for decades with Pharmaceutical influence through legalized bribery of academics and researchers. It’s arguable that this nefarious corrupting influence has cost some psych drug users their lives, and health. When key opinion leaders shill drugs like Seroxat, and help Pharma to play down side effects at product launches, people can die from misinformed consent.

That’s an even bigger problem.

 

https://pharmaphorum.com/news/calls-for-sunshine-act-as-gsk-pays-doctors-to-promote-drugs-again/

 

Calls for ‘Sunshine Act’ as GSK pays doctors to promote drugs again

Calls for ‘Sunshine Act’ as GSK pays doctors to promote drugs again

GlaxoSmithKline (GSK) will pay some doctors for promoting its drugs reversing its previous policy, sparking new calls for a US-style “Sunshine Act” requiring doctors to declare all payments from pharma.

It is five years since GSK ceased paying doctors to sell the benefits of its drugs to other physicians.

Following a bribery investigation in China in 2013, GSK had hoped to set a transparency precedent that would be followed by other drugmakers, but this did not happen, leaving GSK at a competitive disadvantage.

The UK-based pharma giant said: “We are updating our policy on working with healthcare professionals (HCPs). This policy update is being made to ensure we continue to operate responsibly and improve how we help prescribers to understand new data and clinical experience with our innovative products, so they can deliver better outcomes for patients.

“These changes are being made for a select number of innovative products in a limited number of countries and apply to restricted time periods in a product’s lifecycle.”

It went on to explain that it, in certain circumstances, it will pay global expert practitioners who speak about the new science behind GSK’s innovative products, their associated diseases and clinical practice in promotional settings.

Also, it will pay certain travel costs and expenses, but will not sponsor HCPs to travel to conferences.

GSK pledged to expand its reporting of payments to HCPs and will, starting from next year, disclose individual level payments annually in the US, Japan and other major developed markets in Europe, North America and Asia, where legally permitted.

However, some saw the move as regressive. Fiona Godlee, editor in chief of The BMJ, who praised GSK’s move in 2013, said: “Sadly, this shows again that we can’t rely on industry to do the right thing. We need a Sunshine Act to ensure that payments from industry are publicly declared.

“We also need action from medicine’s leaders – the royal colleges. We don’t let judges or journalists take money from the people they are judging or reporting on: we shouldn’t let doctors do this either. Paid opinion leaders are a blot on medicine’s integrity, and we should make them a thing of the past.”

Wendy Burn Promotes Another Pharma-Compromised Individual On Her Twitter..


https://www.theguardian.com/society/2003/mar/17/mentalhealth.politics

“….Two of the four CSM scientists, Michael Donaghy, a reader in clinical neurology from Oxford University, and David Nutt, professor of psychopharmacology at Bristol University, hold shares in GlaxoSmithKline, manufacturers of Seroxat. They have to leave the room when Seroxat is discussed, although they stay for debate on the SSRI drugs as a class.

Prof Nutt and the invited expert, David Baldwin, senior lecturer in psychiatry at Southampton University, jointly fronted the promotional press launch of Seroxat after it won a licence to be prescribed for social anxiety disorder and was popularly dubbed the “shyness pill”….”


https://www.independent.co.uk/news/the-cost-of-shyness-in-an-age-of-talk-1177169.html

“….On Thursday, I went along to a press conference at the Royal Medical Society in Wimpole Street to hear about it. Smith-Kline Beecham had been stung by a front-page piece in last week’s Sunday Times which linked Seroxat to other new “lifestyle” drugs, Viagra and Xenical (for obesity), and estimated that it could cost the NHS an extra pounds 700m a year.

Drug companies need the patronage of the NHS, and therefore public support, and the anxiety of our host, SmithKline Beecham’s corporate communications director, Dr Lynne Smith, was apparent in her opening remarks. She said the Sunday Times story “incorporated a number of errors” and implied that it had trivialised “this misunderstood illness” by calling Seroxat “a pill for shyness”. She said that social anxiety disorder was to shyness “what clinical depression is to sadness”. But as the conference went on – and it lasted for almost two hours with slides, lectures, a video, and questions – it seemed to me that the paper had got the story pretty well right. Seroxat is an SSRI, a selective serotonin re-uptake inhibitor, which works by increasing the level of serotonin in the brain and inducing feelings of confidence and well-being.

It isn’t a new drug. Since 1991 it has been prescribed for obsessive compulsive disorder and depression. But its new constituency – its marketing opportunity – is for the shy. All they have to do is recognise that they are socially phobic.

Professor David Nutt, the director of the psychopharmacology unit at Bristol University, came to the lectern. He wanted to begin with a story. That morning on the train to Paddington he’d fallen into conversation with a woman who turned out also to be in the medical profession.

“Oh, the shyness pill,” she’d said when Professor Nutt told her of the conference he was off to. “I wonder if it could help me.” She was scared of “presentations”, where you have to stand up before an audience, speak and point to the slides on the screen. Her mouth dried, she couldn’t think, her sentences were scrambled. She’d stopped doing them.

I expected the professor’s point to be: no, the drug wasn’t meant to help with such professional hazards, it was designed to treat this much more serious condition, social anxiety disorder (I imagined frightened old people behind the locked doors of tower blocks). But in fact the professor’s point was the opposite. The pill may well be able to help her. Social anxiety disorder was precisely what she had – unlike the professor, who now began to talk in a relaxed way about the procession of statistics on the screen.”…


Not long after much fuss on Twitter, about the word ‘Pharma-Whore’ and the resignation of David Baldwin because of his links to Pharma, Royal College head- Wendy Burn- seems to see no problem in promoting another Pharma-Compromised individual – Prof .David Nutt.

Either Wendy Burn is oblivious, or she just doesn’t care, about these conflicts of interests. She doesn’t seem to see that these conflicts affect public discourse, prescribing habits and (in the case of Baldwin and Nutt in the 90’s) often help drug companies to promote products and harm patients by suppressing side effects (Seroxat is but one example).

Wendy doesn’t seem to think that doctors taking money from Pharma is a problem at all (see here– she more less told me that in a private message) and this leads me to think that she is not fit to represent the interests of people with mental illnesses. At the end of the day it is us (those prescribed the pills, and not warned of Side effects etc) who have had to suffer because of these conflicts of interests of Pharma-compromised individuals- not Wendy- it doesn’t affect her personally- so perhaps that’s why it doesn’t bother her that much?

I see a big problem with Pharma-Compromised individuals, often they have Pharma’s interests- not patients- at heart and that should concern , if it doesn’t- then she is not fit to represent those with mental illnesses. She should be concerned with patient’s interests first, not psychiatrists on Pharma’s payroll.

Perhaps Wendy, on behalf of all those harmed by prescriptions, would like to ask David Nutt (and all of the other Pharma-compromised medical professionals) how much money would it take for them to feel they might be influenced by Pharma’s interests before patients interests?

Would it take 1,000 pounds? , 2,000 ? 10,000? 100,000?

Is there a limit to the price for their conscience, their ethics or their worldview?

According to a link below- David Nutt had/has 300 shares in GSK, at around 1,500 pounds a share – it seems that when Glaxo Benefits, so does David.

Maybe Wendy could find out if he has other shares in other Pharmaceutical companies?

I think that would be in patient’s interests to know..


Wendy1Wendy2


https://www.benzo.org.uk/amisc/nutt.pdf

 

“…Professor David Nutt, a man with a MissionProfessor David Nutt, Head of Community Based Medic ine and Professor of Psychopharmacology at Bristol University, is a verywell qualified, well networked and influentialman.David.J.Nutt@bristol.ac.uk
The Professor works on brain mechanisms of addiction, GABA, receptors andso on. He has expressed a belief that psychotherapies are over-hyped, potentially dangerous and possibly ineffective. He produces papers with subjects suchas ‘Why does the world have such a “down”on antidepressants?’
Perhaps with 300 shares in GSK he might be justified in asking suchquestions. Professor Nutt promoted Seroxat at Glaxos launch of Seroxat for “social anxiety disorder”. With Karl Rickels and Dan J. Stein, he produced a book in September 2002 on the subject of “generalised anxiety disorder”.
Anxiety is quite obviously a deep and vexed questionwith multiple identities, though there are those wh o think not.In 2006 there was aconsensus meetingon the use of ADHD drugs in adults and adolescents. Itwasorganised by the British Association for Psychopharmacology (BAP) and funded byCephalon, Janssen, Lilly, Shire UK and Shire US – all drug companies that manufacture ADHDdrugs – Adderall, Modafinil, Concerta and Strattera . The Consensus Group was headed byProfessor David J Nutt. Apparently there was strong evidence for wider use of the drugs for those who were missing out….”
  • Have you, in the past three years, accepted paid speaking engagements in industry supported symposia?
  • Lundbeck, Otsuka, Lilly, BMS, Janssen, GSK, Pfizer, AstraZeneca, D&A Pharma, Servier, Martindale

 

  • Have you, in the past three years, acted as a consultant to any company with an interest in psychopharmacology?
  • Lundbeck, Nalpharm, Shire, MSD, Actelion, Opiant, Orexigen, Compass, D&A Pharma, Ranvier, Mundipharma

 

  • Have you, in the past three years, had ownership or part ownership of a company with interests in the area of psychopharmacology? (This would include holding the shares of major companies in one’s own name, or those of dependent family members.)
  • P1Vital, Equasy Enterprises, Alcarelle

 

Seroxat Secrets Asks: What makes Prof David Baldwin such a bad doctor?


https://seroxatsecrets.wordpress.com/2018/10/02/what-makes-prof-david-baldwin-such-a-bad-doctor/

What makes Prof David Baldwin such a bad doctor?

So David Baldwin still insists that the vast majority of patients can stop Seroxat in a couple of weeks and they won’t experience anything more than unpleasant symptoms…

However, the All Party Parliamentary Group for Prescribed Drug Dependence review suggests half of patients have withdrawal symptoms and for half of these the symptoms will be severe.

Patients should be properly warned, it says. Official guidance says symptoms are usually mild and clear up in a week. But the reality is it’s not uncommon for side-effects to last for weeks, months or years in some cases.

The review authors, Dr James Davies, from the University of Roehampton, and Prof John Read, from the University of East London, say about four million people in England may experience symptoms when withdrawing from antidepressants, and about 1.8 million may experience these as severe.

Dr Davies said: “This new review of the research reveals what many patients have known for years – that withdrawal from antidepressants often causes severe, debilitating symptoms which can last for weeks, months or longer.”

“Existing NICE [National Institute for Clinical Excellence] guidelines fail to acknowledge how common withdrawal is and wrongly suggest that it usually resolves within one week. This leads many doctors to misdiagnose withdrawal symptoms, often as relapse, resulting in much unnecessary and harmful long-term prescribing.”

Surely by 2018 we have got to the point where doctors such as Baldwin can no longer ignore the fact that these drugs do a lot of damage to a lot of people.

1.8 million people.

Everything in the garden isn’t rosy – but Baldwin thinks it is.

He allows no room for discussion – what happened to me and so many others during withdrawal from anti depressants has no place in Baldwin’s world and that is what makes him such a bad doctor.

GSK resumes some doctor payments, backtracking on blanket ban


GSK resumes some doctor payments, backtracking on blanket ban

Now Reading:GSK resumes some doctor payments, backtracking on blanket ban

GSK resumes some doctor payments, backtracking on blanket ban
@ Copyright :

Loriene Perera(Reuters)

By Ben Hirschler

LONDON (Reuters) – GlaxoSmithKline <GSK.L>, which five years ago stopped paying doctors for promoting its drugs, said on Tuesday it would allow such payments once again in limited circumstances.

The British group’s 2013 no-payment pledge marked a first for an industry battling past scandals over sales practices. But other drugmakers failed to follow suit, leaving it at a competitive disadvantage.

Drugmakers have long used so-called key opinion leaders to promote the benefits of their products to other prescribing physicians and the decision to abandon this strategy was questioned by a number of analysts.

GSK’s new updated policy on working with healthcare professionals will now permit payments to global experts who speak about the science behind novel new medicines.

“These changes are being made for a select number of innovative products in a limited number of countries and apply to restricted time periods in a product’s lifecycle,” the drugmaker said.

Overall, the total payments under the new arrangements are expected to be significantly below pre-2013 levels, according to one person close to the company.

GSK’s 2013 ban on paying doctors came amid a major bribery investigation in China, which landed it with a record fine, and was part of an effort by former chief executive Andrew Witty to improve the company’s reputation.

There was speculation at the time that other companies would be forced to follow suit, but in the event that did not happen.

Witty was replaced as CEO in 2017 by Emma Walmsley, who has brought a sharp commercial focus to operations, including a drive to reallocate resources to priority new medicines.

In addition to payments for speaking engagements, the updated GSK policy also allows for reasonable travel costs for medics to attend company-organised meetings – except in the United States – and registration fees for remote congress webinars and webcasts.

GSK added it would still not sponsor doctors to attend medical conferences.

(Reporting by Ben Hirschler; editing by David Evans)

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