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Thursday, June 26, 2014

Hey Glaxo, Guess Who's Been Talking?



GSK Whistleblower Blair Hamrick & Bob Fiddaman

I started writing this blog back in 2006. I had some issues with the antidepressant drug manufactured and marketed by British pharmaceutical giant GlaxoSmithKline. I also had some issues with the way drugs were regulated in this country by the British drug regulator, the MHRA.

Eight years on and I have learned so much about GlaxoSmithKline... I learned more about them yesterday evening as I sat down to dinner with Blair Hamrick, one of the whistleblowers who blew the lid on Glaxo's fraud in the US, a blow which, after 11 years of legal wrangle, Glaxo settled for a record breaking $3 billion.

Blair is a very brave soul for going up against the company that he once worked for. His life is now back on track after Glaxo sacked him then muddied the waters so he couldn't get a job elsewhere in the pharmaceutical field. Yes, he was paid handsomely for his bravery and is now living a life that most could only dream of. 

Despite the publicity, fame and riches Blair is one of the most down to earth people you could ever wish to meet, a trait that became evident when he just couldn't bring himself to promote the antidepressant Wellbutrin off-label to doctor's.

Wellbutrin is an antidepressant and indicated to treat adults that are depressed. Blair, whilst working for GSK, was prompted by senior management to promote it off-label to doctors for treating children. He just couldn't bring himself to do that. One of the side effects of Wellbutrin is seizures and Blair envisaged kids going into seizure. "It was wrong, it wasn't indicated for kids and I just couldn't bring myself to tell doctor's it was okay for kids to take," Blair told me over a glass of wine in the plush settings of one of Westminster's finest hotels in London. "They also tried to market it as the happy-horny-skinny pill because they had learned through post marketing that patients taking it for depression were losing weight and reporting high sex drives." [increased libido] Wellbutrin was not indicated for this but the Glaxo marketing team came up with the "happy-horny-skinny pill" line so reps could convince doctors to prescribe it to patients who were overweight and also those who were experiencing a low sex drive [decreased libido]

Blair also spoke about the doctors who were paid by GlaxoSmithKline, a staggering 48,000 doctors were paid speaker fees, attendance fees and given lavish gifts, all in an attempt to get them to prescribe more of Glaxo's drugs.

"We'd pay doctor's between $2-4000 to give a talk to other doctor's.
"6 or 7 doctors would be invited out for dinner, sometimes with their spouses in tow, they'd be wined and dined and then the speaker would talk about the wonders of drug a or b, of course these were off-label "wonders" - that's how Glaxo rolled.
"Our marketing team would send them a slide-show and a carefully scripted narrative so they could convince other doctor's that it was okay to prescribe a number of drugs off-label.
"Some doctor's, whose basic annual salary was around $150,000, could give 2 or 3 talks in a week, giving them a potential to earn up to an extra $12,000 per week.
"I was also given luxury private box tickets for sporting events, these would be given to doctors as a 'thank-you' or incentive to prescribe more and more of Glaxo's drugs."
Glaxo, at some point during these wanton violations, caught wind that their off-label promotion had been leaked and reps were told to be careful what they added to their call-notes.

Call-notes are what pharmaceutical reps use to familiarize themselves with a doctor.

"The way it worked was that a doctor would be visited by a rep who would  then add notes to a hand-held device.
"It was useful because we knew what these doctor's liked, be it a particular football, baseball team or if he had a sweet tooth - on the next visit we would bring in a small token of gesture, be it tickets to the game or sweet tasting delicacies - it was just a way to keep them prescribing more drugs."

Blair recalled a meeting where reps were told to be careful what they wrote in the call-notes, the crux of the meeting was basically to tell reps to "write right", in other words write down the legal stuff and not the violations.

I asked Blair about Glaxo's recent announcement that they are going to be more transparent.

"The whole transparency thing wasn't a conscious decision by Glaxo, their hand was forced, it was all part of the settlement - it makes me laugh when I now read how they are claiming to offer up the results of their clinical trials, they were told that's what they had to do as part of the agreement they entered into with the Department of Justice."

Regular readers of this blog will note the tagline I use, "It's perverse when GSK claim that they are going to be more transparent when they do not offer transparency when writing about their transparency."

I could have listened and talked to Blair all night, alas I had a train to catch back home, a train that I almost missed due to losing track of the time.

Blair Hamrick, along with the other whistleblowers in this particular case, should be applauded for their efforts. It's no coincidence that Glaxo are now being investigated for the same type of violations in other countries. 

Blair blew the whistle and it almost took the roof off GSK, for that he deserves a future of happiness. His conscience not to promote a drug that could cause kids to have seizures was frowned upon by senior management at GSK - what kind of human being could promote a drug that could be potentially harmful to children, moreover, what type of human being could sanction such a promotion?

On a side note, I wasn't just in London yesterday to meet Blair. Earlier on I met with a film-maker who is in the process of making a documentary about antidepressants. The film-maker also dined with myself, Blair and his partner. More about the documentary in a future post.

I now have something to tell my grandchildren.

I once had dinner with Blair.

Bob Fiddaman





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