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Doctors in Italy's perks-for-scripts probe

By John Hooper

May 28, 2004

One of the biggest inquiries into marketing practices in the drug industry ended yesterday with Italian police asking for almost 5000 people to be put on trial.

Those facing charges include more than 4000 doctors and at least 273 employees of the British pharmaceuticals giant GlaxoSmithKline.

Some face up to five years in jail if tried and convicted.

Italy's tax police, the Guardia di Finanza, said that GlaxoSmithKline and its predecessor firm had spent 228 million ($A389 million) on "sweeteners" for doctors, chemists and others over four years to 2002.

The alleged bribes ranged from cameras, computers and holidays to cash payments.

The Guardia di Finanza said GlaxoSmithKline "should be held responsible for corporate crime as its managers and other employees acted in the company's interest".

A GlaxoSmithKline spokesman said last night the company had co-operated closely with the authorities. "GSK is committed to ensuring that all its business practices are of the highest standards and any breach of that is unacceptable," he said.

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A British-based pharmaceuticals analyst said yesterday that such practices were common among global drug companies. "It goes on all over the world - but in parts of Europe these things are absolutely rife," he said. "For example, doctors may be given 'research grants' - but there are no limits on how they can spend them."

Italy's Adnkronos news agency reproduced what it said was a letter written by a GlaxoSmithKline district manager contained in the 10,000 pages of evidence assembled by the Guardia di Finanza. The letter urged sales representatives to approach specialists directly to get them to prescribe a cancer drug produced by the company. "The initiative can work well with oncologists who have congresses, investments from us... and who have not given us anything in return," the letter said.

Illicit incentives were said to have been disguised in the firm's accounts under the headings of "field selling", "other promotion" and "medical phase IV".

Of the 4713 people from all parts of Italy facing charges, 4440 are doctors. They include more than 2500 family doctors and about 1700 specialists.

The most serious accusations have been levelled at doctors, pharmacists and sales representatives alleged to have been involved in a program intended to promote Hycamtin, a drug used to treat lung and ovarian cancers. In some cases, it is claimed, specialists received a cash payment based on the number of patients treated.

Evidence gathered during the investigation has been passed to the chief prosecutor of the northern Italian city of Verona. He will decide whether to seek indictments from a judge.

Tax police are investigating other drug firms in Rome, Milan and Florence.

- Guardian