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GSK to stop doctor incentive schemes

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GSK to stop paying doctors to make speeches

Editor of the British Medical Journal Fiona Godlee: “Doctors need independent, unbiased information about drugs”

GlaxoSmithKline (GSK) is making major changes to its incentive schemes following a damaging corruption scandal in China.

The pharmaceuticals firm will stop paying doctors to promote its products through speaking engagements.

Members of its sales force will also no longer have individual sales targets.

Earlier this year, Chinese police said GSK had transferred 3bn yuan ($489m; £321m) to travel agencies and consultancies to help bribe doctors.

But the company says the latest measures are not related to that continuing investigation. Instead, it says, they are part of a wider effort to improve transparency.

‘Greater clarity’

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There is a long way to go if we are truly to extricate medicine from commercial influence”

Fiona Godlee Editor, British Medical Journal

In a statement, Sir Andrew Witty, chief executive of GSK, said: “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.”

As well as stopping payments to doctors for making speeches, GSK is also ending payments to healthcare professionals for attending medical conferences.

A spokesperson told the BBC that there were “perceived conflicts of interest with that way of working”.

GSK plans a new system under which independent organisations, such as universities, can approach GSK for a grant if they want a particular doctor to attend a medical conference.

Doctors ‘satisfied’

In a statement, Dr Vivienne Nathanson, head of science and ethics at the British Medical Association (BMA), which represents doctors, said: “Whilst we agree that GSK should not directly sponsor doctors going to meetings, we are satisfied that they will continue to financially support education.

“It is pleasing to see a large pharmaceutical company like GlaxoSmithKline recognise that it can reduce the possibility of undue influence by rewarding employees for providing high-quality information and education for doctors, rather than for their sales figures.”

GSK says sales representatives will be rewarded for “technical knowledge” and the “quality of the service they deliver to support improved patient care”. Their compensation will also be linked to the overall performance of GSK.

Salespeople in the US have already been working under those conditions since 2011.

A spokesperson from GSK said: “It was always our intent to roll it out globally.”

Paying doctors to make speeches and attend conferences is common in the pharmaceuticals industry, but there is growing demand for reform.

“Where GSK leads we must hope that other companies will follow,” Fiona Godlee, editor of the British Medical Journal and a campaigner against industry influence in medicine, told the Reuters news agency.

“But there is a long way to go if we are truly to extricate medicine from commercial influence. Doctors and their societies have been too ready to compromise themselves.”

‘Non-trivial’

Ben Goldacre, author of the book Bad Pharma, is concerned about the quality of advice received by doctors.

He told BBC Radio 4: “Doctors get a lot of their education about which treatment works best from the pharmaceutical industry itself – from doctors who have been paid to give lectures about which drug is best.

“This free education has been shown to be be biased in research and it’s non-trivial.”

Andrew Powrie-Smith, director at the Association of the British Pharmaceutical Industry, told BBC Radio 4: “A number of companies I think are looking at this area and different models of education are emerging.”

He stressed that by 2016 companies would have to disclose how much they pay individual doctors.

Use of ADHD drugs ‘increases by 50% in six years.

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There has been a 50% rise in England in the use of drugs for attention deficit hyperactivity disorder in six years.

NHS prescriptions for methylphenidate drugs, including Ritalin, rose from 420,000 in 2007 to 657,000 last year, the Care Quality Commission said.

The watchdog warned health workers to “carefully monitor” their use as they have the potential to be “abused”.

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The drugs are one of a number linked to the “smart-drug” craze, where students take medication to help them focus.

Methylphenidate is known as a psychostimulant.

While it is not completely clear how it works, it is thought to stimulate a part of the brain that changes mental and behavioural reactions.

The CQC report – its annual review of controlled drugs – said the number of prescriptions for both children and adults for such medications rose by 11% between 2011 and 2012.

Private prescribing also rose during the period going up from just under 2,000 in 2007 to just under 5,000 last year. But as the numbers of these are a small fraction of the NHS prescriptions the belief is that the rise has been driven by an increase in the number of ADHD diagnoses.

‘Worrying’ trend

The commission said: “As in previous years, we believe that this reflects increased diagnosis of, and prescribing for, the treatment of ADHD.

“We are also aware of the possibility that methylphenidate could be diverted and abused, and for this reason we recommend that its use should be monitored carefully.”

Consultant psychiatrist Professor Tim Kendall, who has compiled national guidelines on treating ADHD, told BBC Radio 4’s Today programme the increase in prescriptions was a worry.

 

He said: “I think it’s a real trend. I think it’s too big to be ignored.”

Asked if there are any dangers to people who take methylphenidate drugs over a long period, Prof Kendall said: “In children, without doubt. If you take Ritalin for a year, it’s likely to reduce your growth by about three-quarters of an inch.

“I think there’s also increasing evidence that it precipitates self-harming behaviour in children and in the long term we have absolutely no evidence that the use of of Ritalin reduces the long-term problems associated with ADHD.

“Having said that, if you’ve got a kid with severe ADHD, it’s very difficult to treat them psychologically without using Ritalin as well.”

Common symptoms of ADHD include inattentiveness, hyperactivity and impulsiveness. Symptoms tend to be first noticed at an early age and it is normally diagnosed between the ages of three and seven.

It is estimated that the condition affects 2% to 5% of school children and young people – although less than half of those have the severe form that requires medication. However, it can be a lifelong condition and many people continue to show symptoms in adulthood.

The CQC report also found there has been large increases in the use of other controlled drugs.

Methadone prescriptions in the NHS rose from 1.8m to 2.3m over six years, while buprenorphine, which like methadone is used as a pain relief, more than doubled to over 2.2m

However, use of temazepam, which is often used to sedate patients – the so-called chemical cosh, fell from 3.2m to 2.3m.

Source: BBC