Unfair practices: Pharma cos
GlaxoSmithkline, Pfizer, Johnson & Johnson and others fined $13 bn in 4
years 16 JUL, 2012,
11.03AM IST, SUBODH VARMA,TNN NEW DELHI:
In the past four years, leading members of Big Pharma like GlaxoSmithkline, Pfizer,
Johnson & Johnson, AstraZeneca, Merck, Abbot, Eli Lilly and Allergen have
paid about $13 billion in fines to settle charges of misleading marketing, promising
what drugs don't do, bribing doctors to get their drugs prescribed, causing
sometimes fatal side-effects, and other crimes. The patients targeted by them
ranged from children to dementia afflicted senior citizens. An analysis of
their total revenues and the income from the drugs they are charged with shows
that while huge, the fines are at best slaps on the wrist - their jaw-dropping
revenues far outweigh the penalties. Here are the facts: GlaxoSmithKline was
fined $3 billion by the US
justice department for marketing drugs for unapproved uses, paying kickbacks to
doctors and Medicare system, downplaying known risks of certain drugs. They
sold Paxil, an antidepressant, to children for whom it was not shown to work. They
sold Wellbutrin, another anti-depressant, as a pill for weight-loss and
erectile dysfunction. They sold the anti-diabetic pill Avandia concealing data
that showed it increased cardiac risks. But in the years it took for all this
to come through GlaxoSmithkline had made $11.6 billion on Paxil, $5.9 billion
on Wellbutrin and $10.4 billion on Avandia. That's $27.3 billion - about 9
times the fine they are paying now to settle investigations. Pfizer, the world's
biggest pharma company with annual revenue of over $67 billion last year, paid
up $2.3 billion in 2009 to settle a similar investigation. The drugs involved
were Bextra, Geodon, Zyvox and Lyrica. Pfizer had been using illegal methods to
sell them, like giving junkets and cash to sales reps for pushing the anti-arthritic
pain killer Bextra as an all-purpose pain killer. The reason for Pfizer's huge
fine was that it included $1.3 billion for criminal liability - because this
was the second time they had been caught. Earlier, in 2004, their subsidiary
Warner-Lambert had been fined $430 million for the same violations, and they
had promised never to repeat. All four of Pfizer's controversial drugs had
topped $1 billion in sales before coming under a cloud. And so it goes on. Johnson
& Johnson has appealed against an Arkansas
judge's ruling to cough up $1.2 billion for off-label marketing of Risperdal, Medicaid
fraud and paying kickbacks to nursing care provider Omnicare. But industry
experts say that J&J is going to settle with justice department for $2.2
billion and avoid nationwide penalties which would run into billions. Risperdal
is estimated by industry analysts to have earned $24 billion for J&J since
it went on sale in 2003 as an antipsychotic drug. Abbott Laboratories
aggressively pushed the anti-epilepsy blockbuster drug Depakote on elderly
dementia patients saying that it helped control their agitation. There was no
evidence that it did so. In fact, there was evidence of adverse effects. They
also sold it as an anti-schizophrenia drug whereas it was approved only for
seizures and bipolar mania. This year, Abbott agreed to settle all claims for $1.6
billion. Abbott had $38.85 billion sales last year. In 2011, Merck agreed to
pay a fine of $950 million for selling Vioxx, a painkiller for four years
before withdrawing it in 2004. It earned about $11 billion from Vioxx, but left
behind a trail of patients with heart seizures and strokes.
Blowing the Whistle on Illegal
Behavior in Big Pharma By discovering the next "miracle" pharmaceutical, drug companies
not only improve many people's lives, but also stand to earn substantial
profits. OAKLAND, CA, July 09, 2012 /24-7PressRelease/ -- By discovering the
next "miracle" pharmaceutical, drug companies not only improve many
people's lives, but also stand to earn substantial profits. While it is
important that companies be compensated for the time and effort spent
developing and testing new drugs, the desire to earn profit can also lead drug
companies to cut corners while investigating the safety of new drugs, cherry-pick
data, mislead about test results and ultimately put many people at risk of
being catastrophically injured by new drugs. The law does, however, provide
protection for employees and scientists in the pharmaceutical industry who blow
the whistle on unethical and illegal behavior. It is illegal to retaliate
against these whistleblowers.
PanHER Case While the drug PanHER was being
tested by Pfizer as a cancer treatment, an executive discovered problems with
the research, reports Courthouse News Service. Specifically, the executive
found hundreds of instances of prohibited drugs being used by people in the
study and also noticed that adverse events caused by PanHER were not reported
to the Food and Drug Administration. Because of the use of prohibited drugs by
the test patients, the result of the study of PanHER was misleading, and
potentially grossly inaccurate. The executive brought these findings to her
superiors at Pfizer, who reportedly did nothing to rectify the errors. The
executive claims that after the findings were reported, the company created a
hostile work environment. The executive did transfer out of the PanHER program,
but was ultimately fired from the drug company. After being fired, the
executive filed a lawsuit, Ferretti v. Pfizer, claiming that Pfizer retaliated
against her for doing the right thing and blowing the whistle on the test results.
GlaxoSmithKline's bribes are
evidence that Big Pharma isn't working The inadequacies of relying solely on
market forces for our drugs are clearer than ever. This scandal should prompt a
rethink Philip Ball guardian.co.uk, Wednesday 4 July 2012 14.45 BST GSK's anti-depressant
drug for adults, Paxil, which the company was promoting to under 18s. Photograph:
Joe Raedle/Getty Images Perhaps the most shocking thing about the latest
GlaxoSmithKline drug scandal is that malpractice among our overlords still has
the ability to shock at all. Yet despite popular cynicism about doctors being
in the pockets of the drug companies, there remains a sense that the people
responsible for our healthcare are more principled and less corruptible than
expenses-fiddling politicians, predatory bankers, amoral media magnates and
venal police. If this were a junk food company lying about its noxious products,
or a tobacco company pushing ciggies on schoolkids, we'd be outraged but hardly
surprised. When a major pharmaceutical company is found to have been up to
comparable misdemeanours – bad enough to warrant an astonishing $3bn fine – it
seems more of a betrayal of trust. This is absurd, of course, but it shows how
the healthcare industry benefits from its proximity to the Hippocratic oath.
"Do more, feel better, live longer" GSK purrs. How can we doubt a
company that announces as its priorities as "improving the health and
wellbeing of people around the world" and "being open and honest in
everything we do"? Now GSK admits that, in effect, it risked damaging the
health of people around the world, and was secretive and fraudulent in some of
what it did. Among other things, it promoted antidepressant drug Paxil, approved
only for adults, to people under 18. It marketed other drugs for non-approved
uses; it suppressed scientific studies that didn't suit (for example over the
heart attack risks of its diabetes drug Avandia), and over-hyped others that
did. It also hosted outings for doctors in exotic locations and showered them
with perks, knowing that this would boost prescriptions of its drugs. I'm
incensed. Not because this vindicates a conviction that pharmaceutical companies
are staffed by profit-hungry liars and cheats, but precisely because I know
that they are not: that so many of their scientists, and doubtless executives
and marketers too, are decent folk motivated by the wish to benefit the world. They
have been degraded. It is precisely because Big Pharma really has benefited the
world – making life a great deal more tolerable and advancing scientific
understanding – that the industry has acquired the social capital of public
trust GSK has been busy squandering. But it's time we accepted that it is a
business like any other, and does not operate on a higher, more altruistic
plane than other multinationals. It will do whatever it can get away with, whether
that means redacting scientific reports, bribing academics and physicians, or
pushing into "grey" markets without proper consent or precaution. After
all, this has happened before. All the giants – AstraZeneca, Bristol-Myers
Squibb, Merck, Eli Lilly, Pfizer – have been investigated for bribery. One of
the most notorious episodes of misconduct involved Merck's anti-inflammatory
drug Vioxx, withdrawn in 2004 after the company persistently played down its
risk of causing cardiovascular problems. History suggests that GSK's chief
executive Andrew Witty's assurances that lessons have been learnt are
meaningless. As with the banking scandals, GSK's downfall is partly a failure
of management – those at the top (some of the malpractice predates Witty's
incumbency) weren't watching. It's partly a failure of culture: the jollies and
bribes came to seem normal, ethically unproblematic, even an entitlement, to
both the donors and recipients. And it's partly a failure of regulation. The US
Food and Drugs Administration has seemed at times not just toothless but
actually collusive. Meanwhile, some American academics, having enjoyed Big
Pharma's kickbacks for decades, are now shrieking about the Physician Payments
Sunshine Act – a part of the ObamaCare package that would make it mandatory for
physicians to declare any perks or payments received from drug companies
greater than $10, whether as speaker fees, theatre tickets or Hawaiian holidays.
The protesters claim they will drown in bureaucracy. Harvard physician Thomas
Stossel claimed in the Wall Street Journal that the backhanders don't harm
patients. The GSK ruling shows otherwise. In reality they will be forced to
reveal how much these things supplement their already healthy income. But the
problems are still deeper. You don't have to be an anti-capitalist to admit the
inadequacies of relying solely on market forces for our drugs – not least for
those that, being urgently needed mostly by poor countries, will never turn a
profit. Incentives for Global Health, a non-profit organisation at Yale
University, has argued the case for a global, public sector drug development
agency, funded for example by a Tobin tax. In the unlikely event that our
leaders should dare to demand such genuine recompense for the moral bankruptcy
of the financial world, there would be few better uses for it – and freedom
from the corrupting influence of the profit margin adds another argument to
this already compelling case. One way or another, some rethinking of how drugs
are discovered, developed, sold and used is needed, before the noble art of
medicine comes to look more like Mr Wormwood selling a dodgy motor for whatever
he can get away with.
Big Pharma is in big trouble –
or at least it should be By DR ROBERT LEFEVER PUBLISHED: 10:00
GMT, 11 July 2012 | UPDATED: 12:57 GMT, 11 July 2012 Unprincipled: The drugs
giant has been fined a record amount for offenses that often seem close to
bribing doctors to use their products Two pharmaceutical giants –
GlaxoSmithKline and Roche - have serious questions to answer as a result of
investigations by The Medicines and Healthcare Products Regulatory Agency (MHRA).
GSK has been fined £2bn in the USA
for activities that include the following:
- giving doctors free trips,
- giving a medically qualified
host of a radio show £150,000 to promote one of its antidepressants for uses
other than for those for which it is approved,
- paying for articles to appear
in reputable medical journals when they support the use of their drugs,
- encouraging the prescription
of an antidepressant drug, Paxil (marketed in the UK as Seroxat) to children even
though trials by the MHRA showed that children and teenagers given this drug
were significantly more likely to have suicidal thoughts. Roche has been called
to account for 15,000 deaths and 65,000 adverse drug reaction reports not being
forwarded from its USA
subsidiary, Genentech, to Roche’s drug safety team. PETER HITCHENS: They sold
us 'happy pills' - but all we got was suicide and misery GlaxoSmithKline to pay
$3billion fine after pleading guilty to healthcare fraud - the biggest in U.S. history
So far no direct link has been established between the use of Roche’s drugs and
the deaths and side-effects. Roche themselves say, “The non-assessment and non-reporting
of these adverse events was not intentional and we are taking comprehensive
steps necessary to address the findings of the MHRA inspection”.
Landmark: GlaxoSmithKline Plc
has agreed to plead guilty to criminal charges and pay $3billion to settle the
largest case of healthcare fraud in U.S. history Big Pharma is big
business – massively big business. Mistakes can occur in any business; the
bigger the business the bigger the implications of the mistakes. Roche may have
made a simple mistake but how on earth could a mistake of that particular
nature be made? Something is definitely wrong in their management and
monitoring systems. GSK are not able to say that the activities for which they
were fined were anything other than deliberate. And, if this is the behaviour
of two of the giants in the industry, what is likely to be the behaviour of the
others? Is it just coincidence that these two companies were caught out, in one
way or another, by the MHRA or is this behaviour typical of all major
pharmaceutical companies? Over many decades, the pharmaceutical companies have
made magnificent strides in helping doctors to treat patients more effectively.
Anaesthetics, antibiotics, hormonal treatments, mono-clonal antibody treatments
and many miracles of modern science have transformed lives We need to remember
these wonderful benefits when the pharmaceutical companies
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