GlaxoSmithKline has become the first big drugmaker to stop paying doctors to promote its products in response to mounting pressure on the pharmaceuticals industry over conflicts of interest with medical professionals.
The UK group will no longer pay medics anywhere in the world to make presentations on its behalf at medical seminars — setting it apart from rivals which still routinely hire senior doctors to educate their peers about drug brands.
The new policy, which came into force this week after two years of planning, marks the latest step by GSK to clean up its reputation after a damaging corruption scandal in China and a record $3bn US fine for illegal marketing.
GSK predicts other companies will eventually be forced to follow its lead in severing some of the financial ties with healthcare professionals that have eroded public trust in the pharmaceuticals industry.
Other drugmakers continue to argue that paying doctors to speak about their products at medical meetings — ranging from international conferences to local workshops — are a legitimate way to share knowledge about the latest treatments.
However, Murray Stewart, GSK’s chief medical officer, says doctors paid in this way are increasingly viewed by society as “hired guns”. He says the best way to avoid conflicts of interest is for presentations to be provided by a manufacturer’s own employees.
GSK is building in-house teams to carry out speaking duties previously conducted by outside doctors. Last year, it recruited more than 150 medics for this purpose, including several top global experts in vaccines and respiratory diseases. The company is also training some of the 1,000 physicians it already had on staff to add to its roster of speakers.
While GSK will still use these doctors to promote its products, it believes the fact they will always be company employees makes the process more transparent. Critics have long argued that payments to practising doctors by drugmakers risk influencing their decisions on patients’ treatment.
Amount GSK paid to doctors in the US in 2014. Data show that overall $6.49bn was paid to more than 600,000 doctors
Adriane Fugh-Berman, associate professor of pharmacology at Georgetown University in Washington and an activist for more transparency in drug marketing, says that while GSK’s reforms remove the conflict of interest for individual doctors they do not remove the wider problem of industry influence over medics. “I would be much more impressed if they were getting out of medical education altogether,” she says.
Speaking fees are one of several ways in which doctors receive money from the pharmaceuticals industry on top of their regular salaries. Others, which GSK will continue, include payments for work on research and clinical trials.
Since 2013, all payments to doctors from drugmakers and medical device makers in the US must be disclosed annually, under the so-called Sunshine Act. The latest data, for 2014, show $6.49bn of payments to more than 600,000 doctors. GSK was among the biggest payers at $213m, mostly for research and development activities. A similar disclosure system is due to launch in Europe this year.
Banning speakers’ fees for doctors is the latest move in a broader overhaul of GSK’s marketing practices in response to ethical concerns. The company has also scrapped the link between sales volume and pay for its drug reps to reduce the incentive for employees to engage in illegal marketing practices to boost bonuses.
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The reforms carry risks for GSK as it abandons tried-and-tested methods at a time when the company is battling to revive performance after declining sales. Sceptics would say the company had no choice but to change its ways after the bruising encounters with US and Chinese prosecutors.
GSK paid $3bn to the US Department of Justice in 2012 to settle allegations that it made “cash payments disguised as consulting fees, expensive meals, weekend boondoggles and lavish entertainment” to encourage doctors to prescribe drugs for unapproved uses. This was compounded by a Rmb3bn ($488m) fine in 2014 for the bribing of doctors in China — a scandal for which the company could yet face further punishment from US and UK authorities.
Speaking fees were one of the covers used for funnelling bribes to Chinese doctors and GSK says that eliminating them will reduce the potential for corruption in future. The company is also gradually reducing the number of medical seminars it holds — another way in which questionable hospitality and travel expenses have been paid to medics in the past. Instead, it is increasingly communicating with doctors via webcasts. Some 400,000 healthcare professionals took part in “webinars” hosted by GSK experts last year.
Neil Barnes, head of respiratory medicines for GSK, says the days of drug companies paying for doctors to attend conferences to listen to doctors paid to speak are coming to end. “It is going to be like smoking on aeroplanes. People will look back and say ‘did we really used to do that?’ ”