Glaxo To Disclose Payments To Docs & Professors
14 CommentsBy Ed Silverman // October 23rd, 2008 // 8:03 am
Andrew Witty wants to board the transparency train. After a few rival drugmakers - such as Lilly and Merck - vowed to disclose payments to doctors, Glaxo is now saying it will do the same.
And so the ceo promises to make public the level of advisory fees it offers to doctors and medical academics, and will strictly cap the payments they can receive in the US to $150,000 a year, according to The Financial Times. He tells the paper that he will impose a cap “without exception” on payments and promised to publish the amounts. Although, a timetable has not been revealed. [Our thought: $150,000 is a lot of money, Andrew. Why so much?]
The move comes after Glaxo has been caught up in pair of publicized debacles. In the US, Charles Nemeroff received about $1 million in payments from Glaxo, and is being investigated by the US Senate Finance Committee for failing to make sufficient disclosure while accepting federal grants to reseach Glaxo drugs. He recently stepped down as chair of the Emory University psychiatry department (take a look).
And in the Netherlands, the health inspectorate is investigating concerns about payments from Glaxo to academics who sit on the Health Council, an advisory body that recommended the use of Cervarix, the drugmaker’s new HPV vaccine (back story). Glaxo denies any committing any misconduct.
“It’s appropriate that we have a limit on what we pay. In the past, whatever has happened has happened, but in the future there will be strict adherence to these caps, which will be clearer to everybody,” Witty tells the FT. However, the “timing and infrastructure” of publishing details of its payments had yet to be determined. [Another thought: Why not, Andrew?]
Pharma has taken voluntary steps to limit certain activities that critics say influence prescribing, but in the US, the PhRMA trade group issued guidelines that do not cap consulting or speaking fees (see here).
PharmaLiterate
So I am a little confused. PhRMA and its member companies just recently announced a new revamped Code on Interactions with Healthcare Providers to address growing concern that their gifts and payments influence prescribing. I can assume that this was in the works for many many months. But surprisingly it never addresses the issue of transparency of payments. They sort of just missed it. Strange. Now we have Lilly, Merck and Glaxo all announcing their own individual transparency initiatives. Let’s not kid ourselves, these are three companies in lots of trouble. But still it is strange that PhRMA and the rest of its members would fail so openly to address it when they had the perfect opportunity. It’s just difficult to imagine that it sort of just didn’t come up. So hopefully reporters will be asking the rest of the companies where they stand. What is the transparency stance from J&J, Pfizer, Novartis, SanofiAventis, Roche, AstraZeneca, Bristol-Myers, Abbott and Bayer?
harpy
The PhRMA Code is to make the companies look good - so they can say “look, we have a code!” You can judge for yourself how well it’s worked so far. The payment transparency is in response to Sen Grassley’s “Physician Payment Sunshine Act” that is gaining support in Congress. Lilly, Merck, and GSK being in dire straits already have nothing to lose by trying to stay ahead of the curve, and possibly forestalling passage of Grassley’s bill if they can show that it’s unnecessary. They are also desperately trying to buy back some of the public’s goodwill that they foolishly squandered in their quest for money. Some pharma companies are ready to admit how unethical they’ve been and pay the price to try to woo us back. Others haven’t gotten the message yet and are kicking against the pricks.
atlex
Harpy,
I believe that most of the companies you named have announced their support of the Grassley Bill.
http://www.fiercepharma.com/story/merck-joins-lilly-disclosure-pledge/2008-09-25
Atlex
Marilyn Mann
If that’s a strict limit I’d hate to see a loose one.
Former Big Pharma
This means very little! Do you really think that Big Pharma will come clean? No way! They should be made to disclose all payments exceeding a nominal amount (> $25000) over the past 10 years. I can imagine that many KOLs have been paid hundreds of thousands, if not millions, by these companies. I’ve seen it happen at a couple companies. It’s downright disgusting! It’s huge and much of it is hidden through third parties - “academic research organizations”, “consulting firms”, or other KOL-owned entities. The taxes and the penalties that the IRS could collect alone should make the effort profitable for the government.
atlex
FBP,
Just because there wasn’t transparency regarding payments doesn’t mean that taxes weren’t paid on those payments. All KOLs receiving payments would have received a 1099 form, with a copy sent to the IRS. Thus, taxes were being paid. The lack of transparency concerns what is publicly reported regarding these payments.
Atlex
BPW
I think the cap should be in the range of $10,000-15,000 rather than $150,000. The proposed cap is way too high, by at least a factor of 10. Let’s get realistic. Many of these KOLs get paid by multiple companies!
Dave
Altex - A very recent post by Ed indicates that the psychiatrist at Emory di not accurately declare how much he was receiving from GSK. If he wasn’t truthful with his own university, can he be trusted to be truthful with the federal and state government? It just causes one to wonder how much of the payments are truly above board?
atlex
Dave,
The reason he has to be truthful to the IRS is that 1099s were being sent by the pharma company to the IRS. Thus, the IRS has an easy means of tracking this miscellaneous income. I’m pretty sure that Grassley’s investigation uncovered these payments by reviewing the pharma company records (which would be linked to the 1099s sent out). This is standard accounting procedure.
Atlex
PharmaLiterate
atlex
Regarding PhRMA’s so-called support for the Sunshine Act:
(1) Show me that in writing. The PhRMA Code was one place they could have done it and failed. Yes, there have been many companies pleadging to disclose CME grant money and charitables. But the Sunshine Act will require them to disclose Speaker and Consultant fees and that’s a very different issue.
(2) If PhRMA truly supported it they would be lobbying to see it passed. That certainly is not happening. What really happened is that PhRMA realized that they had no really good publicly acceptable way to OPPOSE it. So the so-called support is really a fear to oppose. So the spon doctors call that “support.” It is what it is.
(3) Again, if they really believed in it and supported it then THEY WOULD SIMPLY DO IT. Why wait for legislation. They can be transparent tomorrow. We are ready for some company to take a leadership stance. Come on Pfizer show us the list of cardiologists who receive speaking fees for Lipitor. Astrazeneca show us the list of physicians who receive speaking fees for Crestor and Nexium. Come on Novartis disclose the list of speakers for Diovan. Sanofi and BMS show us the list of Plavix speakers. How about it Amgen and Wyeth, since PhRMA supports it I assume we will soon be seeing the list of speakers for Enbrel.
Get real. There is no support for transparency or the Sunshine Act. What you have is an industry understanding that it cannot support a position. And they are in a delay game. In two years Lipitor and some of these other products will go off patent and they will never have to disclose the lists of hundreds of speakers making hundreds of thousands of dollars. Just think about the companies imposing new so-called caps in the range of $150,000. We need to ask, what were the speakers making before the caps? Yikes.
Guaranteed we will never see a list of the speakers above. It will never happen, unless there’s a whistleblower who releases them.
I repeat. If PhRMA supports it then PhRMA should do it. Now.
Chloe
This disclosure of $150k is for advisory fees. This may be different than the promotional fees that Dr Nemeroff received from GSK that you see in the chart that has been published along with the Emory debacle. Advisory fees are traditionally along the lines of what a doctor receives from Ad Boards, consulting arrangements, such as clinical consulting, etc. This does not include the $3000 per talk honorarium Dr Nemeroff commanded. With this compensation, in one year, this translates to roughly 50 talks or only 25 days away from home as he would ensure he would do at least 2 at a time.
We have a whole language that is our own and it’s really the media’s job to decifer it and realize that this $150K is unfortunately peanuts.
Atlex
Pharmailliterate,
The attachment in my previous comment includes a press report discussing support for Grassley’s bill.
Atlex
Ed Silverman
Hi Chloe,
Sorry for not replying sooner, but I was giving a talk. Anyway, you could be right about the fees, but Witty didn’t actually say and as I indicated in an earlier comment, Glaxo isn’t making anyone involved in this effort available to talk just yet. So I couldn’t really decipher this. For all I know, the cap may be designed to apply to all kinds of payments. Hopefully, we’ll hear more sooner than later.
Regards
ed
harpy
Hi Atlex - yes, I know they’ve come out in support of the bill. I never said they were stupid, only that if they could show enough reform to make the bill moot they could forestall passage. The new PhRMA Code is certainly stricter than the last but, as I’ve said before, it’s completely voluntary and there are no - make that NO! - consequences for not following it. Which standard would you rather be held to?