Italian doctors face criminal allegations over bribes
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《英国医生杂志》
Milan
More than 4700 Italian doctors, managers, and employees of the British pharmaceutical giant GlaxoSmithKline (GSK) are to face allegations of crimes ranging from giving and receiving illicit compensation for prescribing or recommending a specific drug through to corruption and criminal association.
These allegations are the result of a two year investigation by the tax police in Verona ( BMJ 2003;326: 413). GSK itself is accused of fiscal fraud and corporate crime.
The inquiry involved all 94 Italian provinces and brought to light a complex monitoring system that allowed GSK's sales representatives to monitor prescription attitudes of each individual doctor closely. This enabled them to evaluate the "return" from the various forms of compensation distributed to doctors, which varied in importance in strict relation to their chances of increasing the prescriptions of particular drugs. The most expensive antineoplastic, topotecan, for example, costs about 1800 (￡1200; $2195) per 4 ml phial.
"We have an `extra-budget' allowing us to offer to oncology centres a contribution of around 400 euros per patient," reads an intercepted email entitled "War bulletin" sent by a district manager to his representatives. The alleged tax evasion for the period 1999-2002 amounts to 159m.
The police confirmed that GSK has been cooperating with the authorities since February 2003 and is now a completely different company after radical changes in the top management.
Dr Vittorio Agnoletto has been criticising drug industry's practice for 10 years
Credit: ANDREA STACCIOLI/GRAFFITI
Several other investigations—targeting Pfizer, Sanofi, and Sigma Tau—are under way in various parts of Italy. And many suppose that GSK is not an isolated case: "It is just the tip of an iceberg," said Dr Vittorio Agnoletto, president of the Italian League Against AIDS (LILA) and former spokesperson of the Social Forum. "I have been denouncing practices damaging public health and patients, particularly in the field of AIDS therapies, for over 10 years."
Many specialists whose names were leaked said they received only funds for research and that they regularly invoiced for them, and Dr Giuseppe Del Barone, president of the National Medical Council for Physicians, Surgeons, and Dentists, criticised the clamour over the results of an investigation, well before a court verdict.
"Besides cases of straight corruption, the undue pressure by industry on Italian physicians must be denounced as well," commented Professor Silvio Garattini, director of the Mario Negri Institute of Pharmacological Research in Milan.
GlaxoSmithKline said it awaited full details of the exact allegations. The company said it had never released fraudulent tax declarations and say the directions it gave would make it impossible for such corruption to be widespread.(Fabio Turone)
More than 4700 Italian doctors, managers, and employees of the British pharmaceutical giant GlaxoSmithKline (GSK) are to face allegations of crimes ranging from giving and receiving illicit compensation for prescribing or recommending a specific drug through to corruption and criminal association.
These allegations are the result of a two year investigation by the tax police in Verona ( BMJ 2003;326: 413). GSK itself is accused of fiscal fraud and corporate crime.
The inquiry involved all 94 Italian provinces and brought to light a complex monitoring system that allowed GSK's sales representatives to monitor prescription attitudes of each individual doctor closely. This enabled them to evaluate the "return" from the various forms of compensation distributed to doctors, which varied in importance in strict relation to their chances of increasing the prescriptions of particular drugs. The most expensive antineoplastic, topotecan, for example, costs about 1800 (￡1200; $2195) per 4 ml phial.
"We have an `extra-budget' allowing us to offer to oncology centres a contribution of around 400 euros per patient," reads an intercepted email entitled "War bulletin" sent by a district manager to his representatives. The alleged tax evasion for the period 1999-2002 amounts to 159m.
The police confirmed that GSK has been cooperating with the authorities since February 2003 and is now a completely different company after radical changes in the top management.
Dr Vittorio Agnoletto has been criticising drug industry's practice for 10 years
Credit: ANDREA STACCIOLI/GRAFFITI
Several other investigations—targeting Pfizer, Sanofi, and Sigma Tau—are under way in various parts of Italy. And many suppose that GSK is not an isolated case: "It is just the tip of an iceberg," said Dr Vittorio Agnoletto, president of the Italian League Against AIDS (LILA) and former spokesperson of the Social Forum. "I have been denouncing practices damaging public health and patients, particularly in the field of AIDS therapies, for over 10 years."
Many specialists whose names were leaked said they received only funds for research and that they regularly invoiced for them, and Dr Giuseppe Del Barone, president of the National Medical Council for Physicians, Surgeons, and Dentists, criticised the clamour over the results of an investigation, well before a court verdict.
"Besides cases of straight corruption, the undue pressure by industry on Italian physicians must be denounced as well," commented Professor Silvio Garattini, director of the Mario Negri Institute of Pharmacological Research in Milan.
GlaxoSmithKline said it awaited full details of the exact allegations. The company said it had never released fraudulent tax declarations and say the directions it gave would make it impossible for such corruption to be widespread.(Fabio Turone)