Last week (2 July) the pharmaceutical company GlaxoSmithkline agreed to plead guilty to criminal charges and pay a record-breaking US$3 billion in fines for the charges brought by US federal prosecutors of promoting the antidepressants paroxetine and bupropion for unapproved uses and for failing to report safety data about the diabetes drug, rosiglitazone. The agreement also includes civil penalties for illegal marketing of a half-dozen other drugs. No individual has been charged and the CEO of GlaxoSmithKline, Andrew Witty has been quick to assign the company’s illegal activities to the past.
PLoS Medicine has previously highlighted the strategies and practices of pharmaceutical companies in marketing off-label drugs—when a specific medicine is used for a different disease, in a different group of patients, or at a different dose to that specified in the regulatory approval of the drug. One of the main tactics is encouraging physicians to prescribe the off-label use of drugs, and according to the federal prosecutors, GlaxoSmithKline had tried to win over doctors to prescribe off-market drugs by paying for trips to Jamaica and Bermuda, as well as spa treatments, concerts, and hunting excursions.
Although there has, rightly, been much criticism of GlaxoSmithkline’s illegal behaviour and activities, the physicians who allowed themselves to be used by the company are complicit in these crimes. Such self-serving behaviour does not put patients first and is an indictment on the entire medical profession. Should complicit physicians remain unscathed?