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Bad medicine

Saturday June 12, 2004
The Guardian

The decision by New York's attorney general to sue GlaxoSmithKline for "persistent and repeated fraud" represents a more dramatic challenge to the major pharmaceutical makers than first realised. Distracted by the modesty of the lawsuit's demands - a fine equivalent to the profits Glaxo made from sales of its antidepressant Paxil (called Seroxat in the UK) to children - there is temptation to dismiss the case as small beer. Glaxo's sales of Paxil to under-18s are estimated to be around 140m, a piffling fine for a company worth 67bn.

If that were all Glaxo had to worry about, then this would be an embarrassing episode. But in choosing to charge the company with fraud, the New York suit may change the way pharmaceutical companies market and sell their drugs. At the heart of the suit are allegations that Glaxo deliberately downplayed several studies that showed Paxil to be ineffective and liable to provoke suicidal impulses. Eliot Spitzer has a smoking gun in the form of memos from Glaxo, including one which says the company wanted to "manage the dissemination of these data in order to minimise any potential negative commercial impact".

Glaxo rejects the suit, and says it had not covered up anything. Yet Mr Spitzer argues the company is guilty of fraud if it fails to inform doctors of the full spectrum of results for a drug. There are some recent cases that should encourage the New York suit: Pfizer, the world's largest drug manufacturer, recently paid a 240m fine for promoting a product with no benefits. Glaxo itself is under investigation in Italy for an estimated 150m worth of gifts to doctors there.

Mr Spitzer has an impressive record in calling Wall Street's banks to account for their misdeeds, and changing their less wholesome practices. His attempt to clean up "big pharma" is just as worthy of support, all the more because the UK sorely lacks an equivalent to Mr Spitzer and his wide-ranging powers. The drug industry must not be allowed to act like West End theatre advertisers, cherry-picking the reviews that suit them. The stakes are far too high.

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