GlaxoSmithKline Money Trail Down Under Part One

Gary Hughes and Liz Minchin follow the big pharmaceutical money trail to reveal who is really behind the health advice we are getting.

Many of us with chronic health problems rely on advocacy groups and peak medical bodies for independent advice and support. But just how independent is that advice and are we being given the full picture?

The Age has found that many advocacy groups are becoming hooked on sponsorship dollars from drug companies and these international corporations are in turn using them to promote their products in Australia's booming $5 billion drug market.

Gary Hughes and Liz Minchin follow the big pharmaceutical money trail to reveal who is really behind the health advice we are getting.



Meet Puff the purple dragon. Last year Puff became the public face of a new National Asthma Council awareness campaign to encourage asthmatics to better manage their medications.

But Puff had an earlier existence. He began life as the registered trademark used by international pharmaceutical giant GlaxoSmithKline to market one of its asthma drugs, Seretide, to doctors. His colour matches the packaging for Seretide.

It was GlaxoSmithKline's idea for the NAC to use its symbol and give Puff a new, much more public role encouraging asthmatics to update their medication regimens.

GlaxoSmithKline, which is the world's biggest seller of asthma medications, also provided financial support for the television campaign and to develop an interactive internet quiz for the NAC website to check whether someone's asthma was under control. Even if you answer "no" to the initial question "do you have asthma?" and say you have no symptoms, Puff advises you that your asthma appears to be under control, but you should visit your doctor anyway for a medical review.

NAC chief executive Kristine Whorlow defends the use of a pharmaceutical company logo to spearhead a supposedly independent campaign, saying market research before the campaign showed there was no public recognition of Puff. The board of the council, which is the peak asthma body in Australia, also discussed potential conflicts of interest.

"When GSK was talking to us and we were talking to them about doing another consumer campaign and they came up with the idea of using Puff, we discussed that very thoroughly here at our board meetings and we decided to go ahead with it," she said.

"But we only went ahead with it when we looked at the consumer research showing that the consumers were not aware of the dragon at all."

Ms Whorlow said the Puff campaign, every word of which was vetted by the NAC, had been especially successful in targeting children.

It is not surprising that the NAC and GlaxoSmithKline should work so closely together on such a campaign.

GlaxoSmithKline was the founding sponsor of the council when it was launched more than a decade ago and remains its principal source of funds. According to the NAC's website, other sponsors in 2002 included the pharmaceutical companies AstraZeneca, Aventis, Boehringer Ingleheim, Schering-Plough, Merck, Novartis and Proctor and Gamble.

According to Ms Whorlow, up to 60 per cent of the council's annual budget of between $800,000 and $1 million comes from the pockets of international pharmaceutical companies.

When the council launched a new edition of its Asthma Management Handbook in March last year, GlaxoSmithKline was there again as sponsor of the publication. A Newspoll survey released at the launch showing 50 per cent of asthmatics were not taking their medications as prescribed had been provided by GlaxoSmithKline's public relations company, Hill and Knowlton.

The strategy of targeting patient groups to increase its market has been a successful one for GlaxoSmithKline. In December last year a briefing paper prepared by Hill and Knowlton internationally boasted how GlaxoSmithKline had become the "number one partner" in patient groups and associations, established strong relationships with physicians and "did the same lobbying in the clinical development of the product" to become the market leader in selling respiratory products.

Ms Whorlow accepts that pharmaceutical companies view sponsorship as a marketing exercise.

"The reality of having a sponsorship, whether it's with a pharmaceutical company or a broom company, is that they want an advantage out of it as well," she says. "It may be general good corporate citizenship, but more often nowadays, to be absolutely realistic about sponsorship, it is because of increased market share.

"The old days of philanthropy have by and large gone. You get some companies which wish to have a focus on good corporate citizenship, although there is less of that around now.

"Companies want to sponsor causes allied to their marketing potential."

Ms Whorlow said the NAC and its sponsors shared a common goal "because we want more people on long-term preventative medication so they don't experience serious asthma symptoms".

The independence of the council was protected by a set of strict guidelines, including the retention of editorial control over publications and the ability of NAC spokespeople to speak freely. But the guidelines also provide for details of individual sponsorship contracts, including the amounts involved, to be kept secret.

"We would never be associated with anything that put forward a wrong or incorrect message," Ms Whorlow said. "Our credibility, our reputation, is the most important thing to us."

The NAC also uses World Asthma Day, held in May each year, as a key part of its strategy to raise community awareness. Since 1998, World Asthma Day has been run by an organisation called the Global Initiative for Asthma, or GINA.

GINA, according to its website, is sponsored entirely by international pharmaceutical companies, including GlaxoSmithKline. It is operated by an American company called Medical Communication Resources, (no link to url can be found) which describes itself as helping the pharmaceutical industry "find solutions to significant marketing and education challenges" through promoting, repositioning or launching products.

Medical Communications Resources also does the behind-the-scenes co-ordination of World Asthma Day and the company's chief, Dr Larry Grouse, is listed as a member of GINA's executive committee.

GINA's sponsors provide money to leading international asthma experts to gather several times a year, normally at four or five-star hotels in Europe, to discuss the latest research as part of their role in drawing up international treatment guidelines for asthma.

Most of those same sponsors are also the financial backers of another international group, the Global Initiative for Chronic Obstructive Lung Disease or GOLD, that is almost a mirror of GINA and also operated by Medical Communications Resources.

Like GINA, GOLD also runs a World Chronic Obstructive Pulmonary Disease Day each year and has Dr Grouse listed as an executive committee member. Websites for the two groups, that are maintained by Medical Communications Resources, are virtually identical.

Indeed GINA and GOLD operate so closely that at a meeting of GOLD sponsors in London in February it was suggested that future meetings for drug company supporters of the two groups be combined for convenience.

Global treatment guidelines developed by GINA and GOLD medical advisers for asthma and chronic obstructive pulmonary disease have been used as models for treatment guidelines issued by Australian medical organisations that have links to the two groups.

To help promote the adoption of its international asthma treatment guidelines, GINA set up another group called the International Asthma Quality of Care Initiative. The group is also run by Medical Communications Resources and is funded by GINA's pharmaceutical company sponsors.

The latest asthma treatment guidelines will be launched in Melbourne in February at the annual conference of the International Primary Care Respiratory Group, a global umbrella group for respiratory care organisations.

The IPCRG is sponsored by six international drug companies, including GlaxoSmithKline, Boehringer Ingelheim, Novartis and Merck. The IPCRG's Melbourne conference, which is being hosted by the National Asthma Council, is also being sponsored by pharmaceutical companies.

Ms Whorlow said she was unaware of Medical Communications Resources' role in helping drug companies market their products, but defended the integrity of treatment guidelines developed by GINA and GOLD.

The guidelines had been developed by "the world's experts in asthma" and they would never compromise themselves with pharmaceutical companies, she said.

The reality was that not-for-profit organisations such as the NAC found it hard to raise money, particularly as it did not have tax deductibility status to help it attract public donations.

"There are no other options. We've got to have corporate sector support," she said.

Source: http://www.theage.com.au/articles/2003/12/12/1071125658355.html