The top management of the Italian branch of GlaxoSmithKline (GSK) is under investigation together with more than 2900 physicians, most of whom are general practitioners.
Based on the preliminary conclusions of an inquiry by police, who collected more than 13000 hours of phone conversations in 15 Italian regions and seized several computers, 72 people have been charged with corruption (37 employees of GSK Italy and 35 physicians and health service managers).
In addition, 80 sales representatives and managers are accused of illicitly compensating doctors for agreeing to prescribe or recommend to colleagues the company's products instead of the generic equivalents or analogues made by other companies.
The investigation started last June in Verona when the police, during a routine examination, found in the GSK's yearly budget the amount of €100m (£67m; $108m) for “medical promotion” and “other promotion.” Since the only forms of self promotion that pharmaceutical companies are allowed to use are limited to gadgets of low commercial value, the amount seemed disproportionate.
GSK Italy expressed surprise and offered to collaborate with the investigators. “We think we acted according to the standards fixed by the law,” declared Giuseppe Recchia, its medical director.
The police discovered the existence of a complex software system called Giove (Jupiter), which allowed GSK's sales representatives to closely monitor the prescribing behaviour of the doctors they had paid, through the orders in the neighbouring pharmacies.
Some of the recordings of the phone conversations between sales representatives and doctors are very explicit about the strict relation between the money or benefit offered to individual doctors and the expected rise in their prescriptions.
In this regard, the 26 chiefs and assistant chiefs of hospital departments, the five university professors, and the four heads of hospital pharmacies were considered much more valuable than the general practitioners. These people were invited to “medical tours” to places such as Monte Carlo in the days of the Formula 1 Grand Prix or to Sharm el Sheik or Damascus, or they received tens of thousands of pounds cash with fictitious justifications, whereas the general practitioners often received only medical manuals.
The national accounting court (Corte dei Conti) has opened its own investigation to determine if the national health service suffered damages, and the minister of health, Girolamo Sirchia, has invited the regulatory medical boards to act quickly. “They must intervene with severity,” he said. “Suspension and cancellation of medical licences should be used more often.”
The bad news for GlaxoSmithKline did not end with the investigation in Italy. Three days after the announcement by the Italian police, the state of New York filed a suit against the company, together with Pharmacia, alleging they both engaged in fraud and commercial bribery and made false statements to government health plans, all practices that would have resulted in overpayments.