Translating GSK's Exec-Speak on the Persecution of the Drug Industry
GlaxoSmithKline (GSK) president Dierdre Connelly gave a speech yesterday in which she bemoaned the endless persecution of drug companies and asked, "What's going on? Why is this happening?" It was a cry from the heart, and the speech was more candid than many given by top pharma brass.
But the unspoken subtext was that all the problems Connelly mentioned in her speech are to be found inside her own company. GSK may well be reforming itself from within, as she says, but that's only because the company is also the cause of the problems Connelly is complaining about.
Here's a line-by-line translation of what Connelly actually said, and what she might have been referring to when she said it:
Consider this: since January of 2009, the Justice Department has reached settlements totaling nine billion dollars against healthcare companies. These cases involved alleged false claims, fraud, and FDA violations. ... what's going on? Why is this happening?In the same timeframe, GSK has set aside $5.8 billion for legal charges stemming from its marketing of diabetes drug Avandia, a product its own executives suspected as early as 1999 was more dangerous than existing drugs on the market.
In a recent Harris poll, only 11% of people said the pharmaceutical industry is generally honest and trustworthy. So what went wrong?In 2010, the Department of Justice obtained $2.5 billion in health care fraud judgments and settlements, 1,116 new criminal health care fraud investigations involving 2,095 potential defendants, and 726 defendants were convicted for health care fraud-related crimes during the year. That's not GSK's fault, of course, but that's the context. Healthcare is a dirty business.
The answer, I believe, is that, in some ways our industry lost its way, and failed to fully appreciate the evolving expectations of our stakeholders.GSK lost its way in 2001 when its workers began using their non-sterile hands to literally scrape the bottom of the barrel in an attempt to get every last scrap of medicine out of their production tanks in an effort to save $128,000. FDA violations eventually cost GSK $750 million.
Yes, in the 90's and the early 2000s, we did take customers on trips, like many industries, and our customers enjoyed that. Yes, we did bring pads, pens, textbooks, medical models and other items to customer's offices. And, like in many industries, those "gifts" were appreciated.
Note that "gifts" is set off in quote marks! What could that possibly be a euphemism for? Only a cynic would suggest it means "bribes."But negative perceptions remain. Some of this has to do with long"running government investigations, litigation over past practices, and the resulting news coverage that makes it look like we still take doctors on trips to exotic locations -â€" which we don't.Long running? This one started last year.
Some of it is because industry bashing is good politics.Some of it is good economics, too.
Some of you may be wondering why I should be talking about values, when my own company has borne its share of allegations and has been in the news lately for settlements and legal charges. I'm here precisely because my company and the people I work with are not what are often portrayed publicly.Er, this is former CEO Jean-Pierre Garnier worrying about Avandia heart attacks -- and then doing nothing about them -- for 11 years, isn't it?
I rode with a sales representative a few days ago, and in every discussion we had with a physician, the sales representative repeated the label restrictions. In several cases, the doctor would refer to an off label use, and each time, our sales representative came back to the label. One physician said he heard us, he understood the label, but he still thought it would be appropriate to prescribe the medicine for that particular patient. And, that's fine. That's his job to determine the appropriate drug for the appropriate patient in his medical opinion. But it's our job to make sure that every physician clearly understands the approved information so they can make the right decisions for their patients.Wow, that was uncomfortable! The doc was virtually begging the rep to make an illegal off-label sale.
Other practices that the public sometimes views as inappropriate are actually very important to good healthcare. For instance, we believe properly engaging doctors to share their knowledge with other physicians in peer"to"peer education programs helps them keep up with advances in medicine.Although paying doctors to promote our drugs looks bad, we're still going to do it.
We've also been criticized by some physicians who are unhappy that our strict guidelines mean they can't use their own slides in speaker programs.We don't allow docs on our payroll to say what they want.
We market a drug that treats erectile dysfunction. ... it certainly is not a condition parents, aunts, uncles, and grandparents want to explain to children while watching a football game on Thanksgiving. ... we make every effort to avoid advertising in places that are easily accessible to children.
Or at least, we do now. Back in 2003 we ran Levitra ads inside any football game we could get our hands on. Besides, Levitra is now also-ran in its category and any money spent advertising it is probably a waste.So, we hold our management accountable for explaining "the why" and emphasize it in all our formal and informal communications. We also encourage employees to speak up and ask "why" if we have not sufficiently explained the rationale to them.Historically this has helped us identify people like former GSK quality assurance chief Cheryl D. Eckard, so we can force them out of the company if they complain about our sloppy practices.
At every one of my staff meetings, the first item on our agenda is compliance with our values. I co"chair that discussion. It usually lasts well over an hour because my team is fully engaged and takes that as an opportunity to address any issues we need to tackle.A lot of coffee is served at this meeting.
By doing these things, we can assure the public that our industry â€"- an industry that has brought so much benefit to so many â€"- is conducting its business with focus on the patient, with transparency, with integrity and with respect. In this way we will be worthy of trust.Except at GSK HQ, where I've banned my staff from reading web sites I don't like.
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