One the biggest inquiries carried out into marketing practices in the drugs industry ended on Wednesday with Italian police asking for almost 5,000 people to be put on trial, including more than 4,000 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 revenue guard, the Guardia di Finanza, said in a statement that GlaxoSmithKline (GSK) and its predecessor firm had spent euros 228 million (US$275.9 million) on "sweeteners" for doctors, pharmacists and others over four years to 2002. The alleged bribes ranged from cameras, computers and holidays to outright 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 spokesman for GSK said last night it had been "cooperating closely with the authorities to facilitate their investigations.
"GSK is committed to ensuring that all its business practices are of the highest standards and any breach of that is unacceptable," the spokesman added.
But a British-based pharmaceuticals analyst said on Wednesday the type of activity the Italian authorities allege to have uncovered is common practice 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."
He cited cases in which doctors have been offered cars or holidays as inducements to prescribe a particular brand.
Italy's Adnkronos news agency reproduced what it said was a letter written by a GSK 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 district manager was quoted as writing.
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 4,713 people from all parts of Italy facing charges, 4,440 are doctors. They include more than 2,500 family doctors and some 1,700 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 mainly used in the treatment of lung and ovarian cancers.
In some cases, it is claimed, specialists received a pro rata cash payment based on the number of patients treated with the drug.
At a press conference yesterday, a senior revenue guard officer, Giovanni Mainolfi, estimated that the two-year investigation -- codenamed Operation Jupiter -- was costing GSK's Italian subsidiary euros 400 million a year in lost sales.
"In 2002, the firm had a turnover of around euros 1.5 billion. The following year, it lost more than 20 percent [of its sales], with a turnover cut back to euros 1.1 billion," he said.
Evidence gathered during the investigation has been passed to the chief prosecutor in Verona. He will decide whether to seek indictments from a judge.
Other drug firms are being investigated by revenue guard units based in Rome, Milan and Florence.
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