GSK to Change the Way it Promotes Drugs
GlaxoSmithKline said Tuesday it is to scrap individual sales targets, just months after being hit by a bribery scandal allegedly conducted by its employees in China.
The pharmaceutical group also said it would stop paying doctors to promote its products at speaking engagements and providing direct financial support to health care professionals to attend medical conferences. However, it left open the possibility of funding through grants.
"It is patients' interests that always come first," Andrew Witty, the company's chief executive, insisted. "We recognize that we have an important role to play in providing doctors with information about our medicines, but this must be done clearly, transparently and without any perception of conflict of interest."
The changes come as GlaxoSmithKline PLC distances itself from the scandal engulfing its operations in China, which Witty has said was conducted by people "acting outside of our processes." In July, he insisted that "99.9 percent" of company employees play by the rules.
Chinese police allege that four employees paid bribes to doctors to encourage them to prescribe medications.
The company has also faced issues in the United States. It has paid $3 billion and pleaded guilty to promoting two drugs for unapproved uses and failing to disclose important safety information on a third. The criminal case was accompanied by a civil settlement in which the government said the company's improper marketing included providing doctors with European hunting trips, high-paid speaking tours and even tickets to a Madonna concert.
At the time, the company said it had learned from its mistakes.
Health care advocates welcomed the change in GSK's position, but some, like Tim Reed of Health Action International, said self-regulation remains a big problem in the industry.
"It is like marking your own homework," said Reed, who favors strong state regulation.
Though he did not expect huge changes, Reed said Glaxo's decision may reflect a change of thinking in the industry — away from targeting doctors and toward those who pay the bills, like agencies that make recommendations on which drugs to buy.
"It is possible that the role of health care professionals, responsible for writing prescriptions for medicines are becoming of less value to the pharmaceutical industry, in terms of the promotion of products," he said.
"Rather, it may be those with the ultimate responsibility for paying the bill for medicines, for example insurance companies and governments, so the focus of attention for sales reps may well switch to those making the therapeutic and cost-effectiveness decisions on medicines availability," he added.
Full text of GSK's Statement:
GSK today set out plans to evolve the way it sells and markets its products to healthcare professionals to further align the company’s activities with the interests of patients.
During 2014, the company will implement a new compensation system which will apply to all GSK sales employees who work directly with prescribing healthcare professionals. The company also intends to begin a consultative process towards stopping direct payments to healthcare professionals for speaking engagements and for attendance at medical conferences. At the same time, the company will increase its focus on developing its multi-channel capability and alternative approaches to enable it to continue to provide appropriate information about its products and to support medical education for healthcare professionals.
Sir Andrew Witty, CEO of GSK said: “We believe that it is imperative that we continue to actively challenge our business model at every level to ensure we are responding to the needs of patients and meeting the wider expectations of society. Over the past five years, this has seen us take significant steps to increase access to medicines in developing countries and to be more transparent with our clinical trial data. We’ve also made changes to how we work with healthcare professionals. Building on this, today we are outlining a further set of measures to modernise our relationship with healthcare professionals. These are designed to bring greater clarity and confidence that whenever we talk to a doctor, nurse or other prescriber, it is patients’ interests that always come first. We recognise that we have an important role to play in providing doctors with information about our medicines, but this must be done clearly, transparently and without any perception of conflict of interest.”
Global sales force compensation changes
The new compensation programme will have no individual sales targets. Instead, GSK’s sales professionals who work directly with prescribing healthcare professionals will be evaluated and rewarded for their technical knowledge, the quality of the service they deliver to support improved patient care and the overall performance of GSK’s business. The aim is for this new compensation system to be in place in all of the countries GSK operates in by early 2015.
These changes have been informed by a similar programme successfully introduced by GSK in the USA in 2011. The ‘Patient First’ programme bases compensation for sales professionals who work directly with prescribing healthcare professionals on a blend of qualitative measures and the overall performance of their business, rather than the number of prescriptions generated. Experiences in the last two years suggest that this more patient-focused approach has significantly improved both customer interactions and satisfaction rates with GSK’s US pharmaceutical business.
Payments to healthcare professionals
GSK also announced today the start of a two-year process during which it will make a number of changes to how it works with healthcare professionals.
GSK has an important role to play in supporting education for healthcare professionals and in providing accurate information about its medicines to help them make the best treatment decision for their patients, such as sharing new clinical data, details of label changes or safety updates. Recognising this, the company will direct additional focus and investment to:
- Strengthen its own dedicated medical and scientific capability to appropriately lead engagement with healthcare professionals
- Improve GSK’s multi-channel capability, including use of digital technologies, to ensure appropriate product and disease area information can be provided to healthcare professionals conveniently
- Support fair, balanced and objective medical education for healthcare professionals through provision of independent educational grants.
At the same time, the company will move to end the practice of paying healthcare professionals to speak on its behalf, about its products or disease areas, to audiences who can prescribe or influence prescribing.
GSK will also stop providing financial support directly to individual healthcare professionals to attend medical conferences and instead will fund education for healthcare professionals through unsolicited, independent educational grant routes.
The company intends to work through the practical details of these changes with healthcare professionals, medical organisations and patient interest groups to define how they can be implemented effectively and in line with local laws and regulations. This consultation will begin in early 2014, with the aim for the changes to be in place across GSK’s global business by the start of 2016.
GSK will continue to provide appropriate fees for services to healthcare professionals for GSK sponsored clinical research, advisory activities and market research. These activities are essential in providing GSK with insights on specific diseases; identification of symptoms and diagnosis; application of clinical trial data or medication dosage and administration; and how to effectively and appropriately communicate the benefits and risks of its medicines to help meet patient needs.
The company will also continue to invest in community programmes to strengthen healthcare infrastructure, particularly in least developed countries.
The company has committed to disclose the payments it makes to healthcare professionals and already does so in several countries including the USA, Australia, UK, Japan and France in line with locally agreed government or industry association standards. GSK will continue to disclose the payments it makes for clinical research advisory activities and market research in these countries and will also continue to work towards transparency in other countries as industry associations or governments establish specific guidelines for disclosure.