Novartis is under investigation for allegedly bribing thousands of Greek doctors

BMJ 2017; 356 doi: (Published 09 January 2017) Cite this as: BMJ 2017;356:j130
  1. Owen Dyer
  1. Montreal

Greece’s financial police have raided the Athens headquarters of Novartis, and a team of agents from the US Federal Bureau of Investigation have flown in to study seized company records, as part of an expanding probe into claims that the drug company has bribed over 4000 Greek doctors to prescribe or support the reimbursement of its drugs.

US investigators have been probing Novartis’s foreign marketing practices for two years. Greece’s investigation, ordered by the country’s supreme court prosecutor, was announced by the government after intense media speculation following a public suicide attempt on New Year’s Day by a Greek Novartis executive.

The executive had requested a meeting with Eleni Raikou, the head of Greece’s anti-corruption prosecutor’s office, at the Athens Hilton but became distraught and threatened to jump out of a window. Local media reported that his family were brought and that a police negotiator persuaded him to come back inside.

According to Greek media reports, last year two Novartis executives in Greece gave documents to investigators of the US Securities and Exchange Commission indicating that more than 4000 public and private doctors were bribed to prescribe expensive cutting edge Novartis cancer drugs or to promote their use in the public system.

Despite its extremely tight public finances, Greece has done less than most EU members to rein in spending on the costliest drugs. Revenue from Greece accounted for 0.35% of Novartis’s income last year.

Under the terms of the Foreign Corrupt Practices Act, the US considers itself to have jurisdiction to punish bribes paid to foreign officials by any company trading securities in the US. Doctors working for public hospitals and agencies are counted as foreign officials.

The US investigation has already produced a Securities and Exchange Commission suit alleging that Novartis bribed Chinese doctors; the company paid $25m (£20m; €24m) last March to settle the case. The US is also suing Novartis over 79 236 “sham” educational events, which it claims were disguised kickbacks paid to American doctors.1

Novartis in Turkey is investigating itself after receiving a whistleblower’s complaint from last year, which accused the company of giving jobs to relatives of high prescribers and of paying bribes to have its products added to government hospital formularies. The anonymous whistleblower forwarded the allegations to US authorities.

In South Korea, six Novartis Korea executives, including the president and chief executive officer, were indicted in August over alleged physician kickbacks, along with 15 doctors and the publishers of five medical journals.

Novartis is not alone in falling afoul of increased US scrutiny of overseas trading practices. AstraZeneca, Bristol-Myers Squibb, Eli Lilly, and Pfizer have all paid out to resolve US allegations of bribery overseas, and the Israeli generics giant Teva last month agreed to pay roughly $520m to settle US allegations that it violated the Foreign Corrupt Practices Act in Russia, Ukraine, and Mexico.

Novartis said in a statement that it was seeking further information on events in Greece, adding, “We are fully cooperating with requests from local and foreign authorities. Novartis is committed to the highest standards of ethical business conduct and regulatory compliance in all aspects of its work and takes any allegation of misconduct extremely seriously.”


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