Pharmaceutical companies have paid billions of dollars in fines in the US for giving bribes and kickbacks to doctors. Are their drug sales representatives behaving any differently in Victoria?
“Dinner and Yankee game with family. Talked about Paxil studies in children.” That note, written by a drug sales representative about his evening with a doctor and his family, was one of many records that forced GlaxoSmithKline (GSK) to pay a $3 billion fine to the U.S. government in 2012.
According to Public Citizen, since 1991, there have been 239 legal settlements between U.S. regulators and pharmaceutical companies adding up to $30.2 billion in penalties—a third of those in the past two years. Over half related to the kinds of activities that drug sales reps were doing in the GSK case: Reps promoted drugs with misleading information or for unapproved uses (the antidepressant Paxil carries government warnings against use in children), and gave doctors “expensive meals, weekend boondoggles, and lavish entertainment,” “trips to Bermuda and Jamaica, spa treatments and hunting trips,” and “cash payments” disguised as administrative reimbursements or consulting fees, all “to induce physicians to prescribe GSK’s drugs.”
The sheer scale of these cases is overwhelming, collectively involving dozens of multinationals, thousands of drug reps, and seemingly tens of thousands of doctors (although doctors have rarely been charged). And it shows no signs of abating, when such fines seem to be just the cost of doing business in a sector where profits rank with those of the oil and financial industries.
Notably, these same multinational pharmaceutical companies spend billions of dollars promoting the same drugs to Canadian doctors. And surveys show many Canadian doctors meet with reps monthly, weekly, or more often, regularly attend their educational events, and regard them as a primary source for information about newer drugs. Yet there’s never been any similar lawsuits in Canada. Do drug companies play nicer here, or are we just bigger dupes?
There are over 200 drug reps registered to visit Vancouver Island Health Authority facilities, and more visiting private doctors’ offices, but there’s no central tracking of what they’re doing. However, two former sales representatives who worked in Victoria and Vancouver for four different pharmaceutical companies agreed to interviews with Focus, and they make the case that most Canadians are dangerously in the dark. (Both men requested anonymity, which required removing identifying details of companies, drugs, and doctors.)