Tuesday, December 17, 2013

GSK Announces Major Changes--Is This for Real?

Hot news coming off the NPR wires:
Normally I like to take a while to report on breaking news, to be sure that things are as they seem and also to gather reactions from other observers, but this is big enough to warrant immediate comment in my view.

GlaxoSmithKline has already made history within the drug industry by changing its practices in the US for paying its sales reps--no longer paying bonuses purely on volume of sales. Now the firm announces that it is changing global practices--no more paying reps on volume anywhere; no more hiring doctors as paid speakers; no more paying doctors to attend medical meetings.

In short, the company has announced that it is discontinuing many of the business practices that industry critics have held most responsible for threatening the professional integrity of medicine, and in turn making pharmaceuticals a public health threat rather than a benefit.

Why now? asked NPR. Some theories--no point launching huge marketing campaigns when there are fewer important new drugs rolling off the industry pipeline anyway; pharmascolds have been successful in getting more docs to pull back from schmoozing with sales reps and taking their bribes; the Internet is turning out to be a more effective way of getting industry-friendly information to docs without the expense of a big rep sales force; the looming Federal Sunshine Act will cause docs to think twice about accepting industry largesse in the very near future.

Are we to take this announcement at face value? It's hard, when the industry has such an extensive track record of lies, to believe that at long last, Lucy is going to hold the football and actually allow Charlie Brown to kick it. Yet folks like me have been preaching for some time now that this is what the industry should do, and that it might even be in the industry's interests to do it. So it hardly seems appropriate then to take potshots at the industry if they actually do what we've been asking. If it's real.

We need, in short, better research on what's actually changing. For example, the last big "ethics" reform of the industry took place in 2009 when the US firms voluntarily gave up handing out the pens emblazoned with drug logos and all the other "reminder" items that used to clutter physicians' offices. And what was the actual impact of those changes? I can't point to any research studies that tell us. Of course, if change occurs today, it will naturally take a while for an investigator to do the research on the consequences, and even longer for the results to then be published. So we can cautiously welcome GSK's latest statements while withholding judgment till we see the evidence.

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