Athletes are no strangers to corporate endorsement income. Soccer royalty David Beckham shills for Adidas, Giorgio Armani and Motorola. Here in hockey-mad Canada, we have Wayne Gretzky teabags (seriously) and Sidney Crosby flogging his signature turkey sandwich for Dempster’s bread. We’re used to celebrities who are paid to lend that celebrity to major marketing campaigns. So it should come as no surprise that Swiss-based drug giant Novartis ($44.3 billion in revenue last year), hired sports icons as lures to get doctors to attend free dinners where the company could pitch its drugs to them, writes Tracy Staton of FiercePharma.
“As the Washington Times reports, athletes such as New York Giants quarterback Eli Manning and Baseball Hall-of-Famer Johnny Bench would show up at Novartis-hosted doctor events, give short speeches, answer questions about their careers, and then pose for individual photos with the 50-100 physicians attending each dinner. Drug sales reps would later bring the photos when they went to call on the doctors to sell their products.”
She quotes Paul Thacker, an investigator for the nonpartisan watchdog group Project on Government Oversight, who told The Times that the sports figures were not the villains in this scenario:
“Whether it’s sneakers, beer or pharmaceuticals, there’s nothing wrong with athletes trying to make a buck off their fame. But I hope someone at the company got a fat bonus, because this is one of the most clever schemes I’ve seen to provide gifts to doctors. If you shove a bag of cash in a doctor’s pocket, he might feel like a common streetwalker, but if you give him a picture of his childhood idol, then he might feel like everyone is just being pals.”
The drugmaker paid 150 former and current sports idols a total of $3.6 million (up to $35,000 a pop) to show up at these doctor dinners from 2006 to 2009, Times-obtained documents show.
A spokesperson for Novartis refused to respond to The Times about the athlete dinners, claiming only:
“Novartis is committed to promoting its products in an ethical and compliant manner.”
Really? How then to explain the $422.5 million settlement Novartis agreed to pay to address U.S. Justice Department civil claims that it paid illegal kickbacks to doctors to induce them to prescribe six of their drugs?
Novartis pleaded guilty to a misdemeanor charge of illegally marketing its anti-epilepsy drug, Trileptal, from 2000 to 2004 to psychiatrists and pain specialists for the off-label treatment of bipolar disease and neuropathic pain, even though the FDA had not approved it for those uses.
The company paid a combined criminal fine and forfeiture of $185 million. It also agreed to pay $237.5 million to settle civil claims from its off-label marketing of Trileptal, and kickbacks to promote it and five other drugs: Diovan, Exforge, Sandostatin, Tekturna, and Zelnorm.
The U.S. Justice Department determined that from January 1, 2002, to December 31, 2009, Novartis paid the kickbacks “through mechanisms such as speaker programs, advisory boards and gifts (including entertainment, travel and meals) to health care professionals to induce them to promote and prescribe their drugs,” according to the legal settlement.
While the settlement does not specifically single out these drug dinners with athletes, those events were used to help promote three of the drugs that are part of the Justice Department kickback charges.
You may be thinking:
“So what? These drug company dinners with celebrity atheletes don’t mean doctors attending will necessarily prescribe more of that company’s drugs!”
Well, in fact, they do.
Drugmakers do not host expensive events like this out of the goodness of their hearts. In fact, demonstrably increased prescribing is the only reason Big Pharma spends $3-4 billion every year (yes, that’s billion with a ‘B’) on sponsoring professional meetings and events like these dinners. This figure also includes sponsoring courses and talks that doctors can attend (or watch online) in order to satisfy requirements for continuing medical education (CME) – although this practice is increasingly criticized by both academics and doctors themselves for its clear conflict of interest connotations.
Surprisingly, and despite most physicians’ insistence that they are not influenced at all by receiving Big Pharma gifts like these dinners, a review published in the Journal of the American Medical Association shows that even the smallest of gifts does indeed influence the prescribing choices physicians make.
Psychologists call it reciprocity—the natural human tendency to want to give something back to the gift-giver. It’s the same phenomenon that prompts charitable organizations to fill our mailboxes with those return address labels so we’ll be more likely to feel obligated to make a donation.
They do this for only one reason: it works.
Novartis now joins a growing list of pharmaceutical companies that have settled government investigations into health care fraud in the last few years, including:
- Pfizer, which paid a record $2.3 billion (after pleading guilty to criminal charges)
- Eli Lilly, $1.4 billion (pleaded guilty)
- Allergan, $600 million (pleaded guilty)
- AstraZeneca, $520 million
- Bristol-Myers Squibb, $515 million
- Forest Laboratories, $313 million (pleaded guilty)
In 2002, the drug industry through its trade group, the Pharmaceutical Research and Manufacturers of America (PhRMA), adopted a voluntary code barring companies from providing entertainment to doctors, including tickets to concerts and athletic events. The code also prohibited the companies from allowing the physicians to bring their spouses or staff to marketing events, and from giving non-medical related gifts.
Dr. Jerome Kassirer, a professor at Tufts Medical School and an expert on the conflicts between physicians and the drug industry, had this to say to The Washington Times about the Novartis sports dinners:
“They [the drug companies] will do anything to attract doctors to meetings to promote their drugs. They [the doctors] are clearly taking some kind of gift, the dinner and the photo and the prestige of meeting with the athlete in exchange for sitting through and listening to a pitch.”
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