Wyeth found guilty of paying to boost use of a specific medicine

[Guest guest]

There is a variation on this that is practiced in the U.S. When a patent is

close to expiring and an extended release product has been given a patent,

drug companies have been known to access patients' records and change

patients to the extended release formulation. This happened in some states

with Prozac. --

BMJ 2004;328:1515 (26 June), doi:10.1136/bmj.328.7455.1515-a

Wyeth found guilty of paying to boost use of a specific medicine

Zosia Kmietowicz

London

http://bmj.bmjjournals.com/cgi/content/full/328/7455/1515-a?etoc

Drugs giant Wyeth has suspended a programme of offering to switch patients

on GPs' lists from a version of a drug that is soon to lose its patent to

one with a longer patent life, after a ruling by the pharmaceutical

industry's regulatory body.

According to Des Spence, a GP in Glasgow, Wyeth started to offer GPs in his

area a service to change the repeat prescriptions of patients taking the

proton pump inhibitor Zoton (capsules of lansoprazole) to Zoton FasTab

(orodispersible tablets of lansoprazole) about six months ago. The reason

the company gave for the switch to FasTab was that the newer drug was 10%

cheaper than Zoton and equally effective, so the switch represented a cost

saving for practices.

Under the switching programme GPs were asked to sign a consent form that

allowed an outsider, a " GP system specialist " sponsored by Wyeth, to search

GPs' databases to identify patients taking Zoton and make the change of

drug.

Dr Spence complained to the Association of the British Pharmaceutical

Industry about the practice two months ago, claiming that the reason for the

switch was highly misleading.

" Zoton is due to come off patent in the next few years. When this happens

the NHS will benefit from generic prescribing. Branded Zoton FasTab will

have 10 to 15 years of patent to run and is being promoted to maintain the

company's market share, " he claimed. " Lots of doctors are not aware of this

activity, but it is nothing more than marketing. "

The Prescription Medicines Code of Practice Authority, which administers the

association's code of practice, ruled that Wyeth had breached two clauses of

the code.

The first breach was paying a third party to change repeat prescriptions of

patients on GPs' list from Zoton. " Companies could of course promote

products on the basis of cost, and it was not unreasonable to note savings

that a practice might make by switching from one product to another, " the

authority's ruling said.

" The difficulty was when the company paid directly or indirectly for those

changes to be made because then the company's actions amounted to it paying

to boost the prescription of a specific medicine. In the Panel's view it was

immaterial that the two medicines at issue were marketed by the same

company.

Dr Des Spence: the scheme is " nothing more than marketing "

" The provision of the service by Wyeth would benefit a practice by saving it

the expense of carrying out the switch itself. The arrangements amounted to

a pecuniary advantage given as an inducement to prescribe Zoton FasTab, "

concluded the authority.

Wyeth breached another clause of the code because " high standards had not

been maintained, " it ruled.

A spokesman for Wyeth said the company had accepted the panel's ruling

regarding a breach of clauses 18.1 and 9.1 of the code of practice and had

complied with the requirements of the undertaking given in relation to it.

The company was found not to be in breach of two other clauses.

The company's statement said: " Clause 18.1 concerns no gift, benefit in kind

or pecuniary advantage being offered or given to healthcare professionals as

an inducement to prescribe. The supplementary information to this Clause

does not prevent the provision of a medical service which will enhance

patient care or benefit the NHS if such provision is not done in such a way

as to be an inducement to prescribe.

" Wyeth is committed to working in partnership with healthcare professionals

to help ensure that patients receive the most appropriate care, in line with

the patient-centred focus of the NHS. "