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GlaxoSmithKline to end some direct payments to health care professionals
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GlaxoSmithKline announced that it will no longer pay for health care professionals to speak on the company’s behalf or to attend medical conferences, effective in 2016.
The company will continue to pay for consulting, advisory and market-research services, according to a press release.
The changes are “designed to bring greater clarity and confidence that whenever we talk to a doctor, nurse or other prescriber, it is patients’ interests that always come first,” Sir Andrew Witty, CEO of GlaxoSmithKline, said in the release. “We recognize that we have an important role to play in providing doctors with information about our medicines, but this must be done clearly, transparently and without any perception of conflict of interest.”
As part of the changes, the company stated in the release, GlaxoSmithKline will put more focus on and investment in the following areas:
- Strengthening its in-house capability to lead engagement with health care professionals.
- Improving its capability to conveniently provide appropriate product and disease-area information to health care professionals. This includes the use of digital technologies.
- Providing independent educational grants to support “fair, balanced and objective medical education for health care professionals.” In lieu of paying for medical professionals to attend conferences, the company will fund education “through unsolicited, independent grant routes.”
Paying health care professionals for consulting, advisory and market-research services will continue because “these activities are essential with providing [GlaxoSmithKline] with insights on specific diseases; identification of symptoms and diagnosis; application of clinical trial data or medication dosage and administration; and how to effectively and appropriately communicate the benefits and risks of its medicines to help meet patient needs,” the company stated in the release.
Beginning in 2014, the firm will discuss with health care professionals, medical organizations and patient interest groups how to initiate these changes effectively and in accordance with local laws and regulations, with the goal of implementing them worldwide by 2016, according to the press release.
The company also stated that it currently discloses the payments it makes to health care professionals in the United States, Australia, France, Japan and the United Kingdom, and will work toward doing so in other countries as disclosure guidelines are established. It also stated that it will continue to invest in community programs to strengthen health care infrastructure, especially in the least-developed countries.
As part of the changes, the company is also altering its global sales force compensation practice, eliminating individual sales targets for sales professionals who work directly with health care professionals, instead compensating them according to technical knowledge, quality of service to support patient care, and the overall performance of the business, the release said.
Perspective
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Uday Devgan, MD
The ways in which pharmaceutical companies interact with physicians has changed over the past 10 years, and Glaxo Smith Kline (GSK) is shifting these methods even further by changing their employee payment model and stopping payment for physician speaking engagements or attendance at meetings.
Instead of targeting individual physicians and tracking their prescriptions, GSK is proposing to compensate its sales representatives based on other metrics designed to assess the employees’ technical knowledge and level of service. Ophthalmologists can already block their prescribing data by simply registering (complimentary) at the Physician Data Restriction Program page on the AMA website (AMA membership is not required): http://www.ama-assn.org/ama/pub/about-ama/physician-data-resources/ama-database-licensing/amas-physician-data-restriction-program.page . This tends to level the playing field so that low volume prescribers are treated the same as high volume ones, but do note that GSK will still analyze “the overall performance of their business“ in order to determine employee pay.
In any promotional program, speakers are already limited to the official slide deck and on-label indications of the drug. For physician speakers, it is more financially rewarding to stay in the clinic and do surgery than it is to fly across the country to speak for a pharmaceutical company. The reason speakers choose to do these programs is for the opportunity to interact with other ophthalmologists where we can share surgical ideas and clinical experiences. I will continue to seek out opportunities to interact and learn from my fellow ophthalmologists, whether it is at a pharmaceutical company sponsored program or an independent event where we buy our own dinners.
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L. Samuel Wann, MD, MACC, FAHA, FESC
GlaxoSmithKline's decision to stop paying for practicing physicians to attend conferences or speak on the company's behalf is a positive but nuanced step in the direction of balancing the legitimate needs for product marketing while mitigating conflicts of interest and preserving scientific and professional integrity.
Notably, the company says it will continue to fund physicians using digital media to market its products, support independent educational grants and provide in-house company spokesmen. Physicians will continue to get paid to consult and advise the company and participate in market research. But the old days of paying a community physician to give a talk on one of the company's products to other local physicians invited to a nice dinner at a local restaurant may be over. The camaraderie will be missed, but not the conflict of interest.
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Mitchell A. Jackson, MD
GSK, one of the world’s leading research-based pharmaceutical and health care companies, has announced their dedicated focus on patient care with their newly developed “Patient First” program. The key initiatives in the program will affect its global sales force in terms of compensation based upon “a blend of qualitative measures and overall performance of their business, rather than the number of prescriptions generated.” It will also affect the healthcare professional compensation process by “stopping direct payments for speaking engagements and for attendance at medical conferences.”The PhRMA and Advamed guidelines were created in the U.S. to protect patients from a potential conflict of interest between a health care professional and pharmaceutical and/or surgical company’s products or devices being prescribed or utilized on patients. The Sunshine Act recently was enacted so these same companies would disclose all payments to health care professionals regarding any consulting activities performed on their behalf. GSK has taken these U.S.-based approaches to the next level, in my opinion, and putting patients first in the overall scheme of health care.
IMS has long been the reporting agency for pharmaceutical companies to determine compensation to their sales force based on projected rather than real prescriptions generated by their area health care prescriber. These numbers have never been remotely exact so changing the paradigm to an overall qualitative approach to a more patient-focused approach is a good move in my opinion. It will eliminate the need for doctors to feel pressured to write scripts for a specific company that they don’t get credit for anyway through the existing IMS system.
There are advantages and disadvantages to the way GSK plans to compensate healthcare professionals. The smaller sponsored dinner programs, for example, allow for better real life interactions amongst peers but still have a biased message. The CME programs through unsolicited independent educational grants, on the other hand, will allow for a more balanced overall messaging and even allow for real life off-label discussion of drugs and devices that aren’t allowed at corporate-sponsored programs. GSK still plans to support clinical research and advisory activities such as advisory boards to gain market research intelligence among health care professionals to improve products for better patient care.
In the end, GSK is truly implementing the guidelines and laws already in place in the US with a greater focus on patients and a reduced focus on sales force and healthcare professional compensation. Compensation for a company’s sales force and consulting activities for health care professionals is still integral to the overall stimulus of the healthcare industry but should never be at a level threatening to patient care.
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