News
Anti-Glaxo
campaign
heats up in
United States
Ray Moynihan Washington
186, 218, 357
Pharmaceutical giant Glaxo-
SmithKline is facing a growing
backlash over its decision to cut
supplies to Canadian pharma-
cies selling cheap drugs into the
United States.
In recent years elderly
Americans have been making
much publicised bus trips across
the border and using online
pharmacies to buy drugs from
Canada, where they cost any-
thing from half to a sixth the
price in the United States.
In late January GlaxoSmith-
Kline announced it was suspend-
ing sales to Canadian wholesalers
and pharmacies that exported
drugs to prevent what it described
as “illegal, potentially unsafe
imports of prescription drugs.”
Just three weeks later, in mid-
February, a full page advertise-
ment appeared in the New York
Times, urging people to boycott
GlaxoSmithKline’s products,
divest themselves of company
stock, and lobby politicians in
Italian police investigate
GSK Italy for bribery
Fabio Turone Milan
25, 186, 130
The top management of the Ital-
ian branch of GlaxoSmithKline
(GSK) is under investigation
together with more than 2900
physicians, most of whom are
general practitioners.
Based on the preliminary
conclusions of an inquiry by
police, who collected more than
13 000 hours of phone conversa-
tions in 15 Italian regions and
seized several computers, 72
people have been charged with
corruption (37 employees of
GSK Italy and 35 physicians and
health service managers).
In addition, 80 sales repre-
sentatives and managers are
accused of illicitly compensating
doctors for agreeing to prescribe
or recommend to colleagues
the company’s products instead
of the generic equivalents or
BMJ VOLUME 326 22 FEBRUARY 2003 bmj.com
Washington about their concerns.
“This is just the beginning,”
said Michael Burgess, executive
director of State Wide Senior
Action Council, a New York
based, grassroots organisation
that is one of 10 community and
pharmacy groups from Canada
and the United States sponsoring
the advertisements and a wider
campaign against the company.
He said that actions were
being planned across the United
States—including a protest out-
side GlaxoSmithKline’s offices in
Philadelphia—and that his group
would soon meet New York state
retirement fund authorities to
urge the divestment of millions
of the company’s shares.
In a statement in response to
the boycott GlaxoSmithKline
said: “We understand patient
concerns about access to afford-
able medicines but do not
believe illegal cross border sales
of medicines are the way to
address the issue.” The company
is arguing instead for a new
national scheme to provide drug
coverage for elderly Americans.
GlaxoSmithKline also claims
that its own scheme for elderly
people already offers eligible
Americans discounts equivalent
to Canadian prices, though the
claim is rejected by boycott organ-
isers. A company spokeswoman,
Nancy Pekarek, said that internet
analogues made by other
companies.
The investigation started last
June in Verona when the police,
during a routine examination,
found in the GSK’s yearly
budget the amount of €100m
(£67m; $108m) for “medical
promotion” and “other promo-
tion.” Since the only forms of
self promotion that pharmaceu-
tical companies are allowed to
use are limited to gadgets of low
commercial value, the amount
seemed disproportionate.
GSK Italy expressed surprise
and offered to collaborate with
the investigators. “We think we
acted according to the standards
fixed by the law,” declared
Giuseppe Recchia, its medical
director.
The police discovered the
Ten organisations representing senior citizens and Canadian mail
order companies took out this advertisement in the New York Times
purchasing was “undercutting the
relationship between patients,
physicians, and pharmacists.”
Responding to suggestions
that the boycott is being run
by self interested pharmacy busi-
nesses, campaign organiser Mike
Pirages said independent com-
munity groups were also involved,
along with Canadian pharmacy
firms.
Burgess said his organisation
had explicitly rejected offers of
sponsorship from Canadian
existence of a complex software
system called Giove (Jupiter),
which allowed GSK’s sales rep-
resentatives to closely monitor
the prescribing behaviour of the
doctors they had paid, through
the orders in the neighbouring
pharmacies.
Some of the recordings of
the phone conversations
between sales representatives
and doctors are very explicit
about the strict relation between
the money or benefit offered
to individual doctors and
the expected rise in their
prescriptions.
In this regard, the 26 chiefs
and assistant chiefs of hospital
departments, the five university
professors, and the four heads of
hospital pharmacies were con-
sidered much more valuable
than the general practitioners.
These people were invited to
“medical tours” to places such as
Monte Carlo in the days of the
Formula 1 Grand Prix or to
Sharm el Sheik or Damascus, or
they received tens of thousands
pharmacy companies, in order
to remain independent. “Our
members are so upset, they feel
like the drug companies have
them cornered. Our message to
Glaxo is clear: if you want to
pursue these policies there is
going to be a reaction.”
A meeting of regulatory
groups from Canada and the
United States was due to take
place in Ottawa on 21 February,
to clarify the legality of the cross
border drugs trade.
of pounds cash with fictitious
justifications, whereas the gener-
al practitioners often received
only medical manuals.
The national accounting
court (Corte dei Conti) has
opened its own investigation to
determine if the national health
service suffered damages, and
the minister of health, Girolamo
Sirchia, has invited the regulato-
ry medical boards to act quickly.
“They must intervene with
severity,” he said. “Suspension
and cancellation of medical
licences should be used more
often.”
The bad news for Glaxo-
SmithKline did not end with the
investigation in Italy. Three days
after the announcement by the
Italian police, the state of New
York filed a suit against the com-
pany, together with Pharmacia,
alleging they both engaged in
fraud and commercial bribery
and made false statements to
government health plans, all
practices that would have
resulted in overpayments.
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