Healthy Skepticism Library item: 15200

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Jack A.
Roche censured for gift vouchers to children
Financial Times 2009 Feb 28
http://www.ft.com/cms/s/0/9ac2a3c4-0523-11de-8166-000077b07658.html

Full text:

Roche, the Swiss pharmaceutical company, was on Friday sharply rebuked by British regulators for offering £10 ($14) gift vouchers to children to persuade them to take one of its medicines. The Prescriptions Medicines Code of Practice Authority, the self-regulatory body, ruled Roche had “brought discredit” on the industry for a serious breach of its ethical rules of conduct.

Between 2004 and 2007, the company gave gift vouchers for use in Toys R Us, Tesco and Boots to children and teenagers prescribed Pulmozyme, its inhaled medicine to prevent lung infections for patients with cystic fibrosis. For a year after Roche decided to stop the voucher scheme in September 2007, it failed to recognise that the agency contracted to run the voucher scheme was still operating it, and to end it.

The case highlights the difficulties for the National Health Service and pharmaceutical companies in finding ethical ways to persuade patients to take their medicines. Poor compliance is widespread, and sharply reduces benefits of treatment. However, the judgment raises broader questions about Roche’s operations in the UK, after other reprimands including one that led to its suspension from its trade body for six months, one of the most severe sanctions. That ban was lifted only in February.

Roche tried to boost compliance with Pulmozyme by giving a voucher to children for every 30 caps of medicine received. Its agency told the company the names of participating doctors, who received no incentive.

A Roche employee raised concerns with regulators, arguing the company was “effectively … paying children to continue with a prescription-only medicine”; and that the incentive could threaten the child’s safety by persuading it to keep taking the medicine despite side-effects. The whistleblower voiced worries that the children could simply remove the caps to exchange for vouchers without taking the medicine, in the process wasting NHS money.

Roche accepted the ruling, but argued the benefits in promoting compliance outweighed any adverse consequences for public health.