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GSK confirms probe by Chinese authorities

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f4328 (Published 03 July 2013) Cite this as: BMJ 2013;347:f4328

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Re: GSK confirms probe by Chinese authorities

GlaxoSmithKline (GSK) ’s bribery scandal[1] demonstrated at least one dark side of real sale strategy and running policy of contemporary pharmaceutical industry that involves international, domestic drug makers, as well as medical instrument companies, in China. The aim undoubtedly is to promote their products and occupy the Chinese market as much as possible.

Nevertheless, one of the most interesting things about the GSK scandal is the huge scale of bribery, involving hundreds of Chinese hospitals and physicians, and lasting at least 6 years. Therefore, it firstly indicated the extraordinary but rampant relationship between pharmaceutical companies and clinical physicians in China. Secondly, a weakness in the supervisory capacity of te local judiciary system was also suggested. Then, absence of personal ethical constraint or behavior criterion was also implicated.

Especially since the Western economic crisis in 2008, the Chinese market has become the most important profitable resource for globe pharmaceutical business and then played a more and more decisive role for enhancing shareholder value. After that, rapid expansion of the selling teams, increasing investment, strengthening collaboration with local societies, deeply ploughing the regional market and finding the key opinion leaders (KOLs) constituted the main strategies for these international companies in China.

Although strategy itself represents a very normal process, however, it can also combine with many other means, including corruption and bribery, under the cover of aggressive market promotion, which are inevitably revealed and brought to justice by Chinese government.

Besides market promotion, people should recognize in fact that these international medical enterprises have already extensively penetrated into Chinese medical professions. For example, in many issues of Chinese top medical journals, some sort of continuing medical education (CME) program were branded with drug maker's name or their related products. Recently, one company sponsored a project introducing some Chinese researchers published in international journals. In the accompanying editorial, the journal’s editor-in-chief also made some thanking address to them. Why did a professional editing team need special help from a pharmaceutical company to provide any professional information or other support?

Fortunately, many Chinese colleagues and societies already realize it and are eager to correct it. On the 14 July, a branch of Chinese medicine association (CMA), Chinese society of hepatology published a consensus [2] on keeping academic independent and justness from business sponsorship, which is also an upgrade version for its 2008 edition. In this document they made very important suggestions related to establish general principles, build self-discipline, restrict the penetration of pharmaceutical delegates or products, and decrease the influence from any sponsors.

GSK is not the only company jeopardizing the basic principle in China; the punishment was also not the final target. We truly believe, from the lessons of GSK, there is an urgent alarm for Chinese physicians and their societies to create a more transparent and healthier medical environment for themselves and all of their patients.

REFERENCES:
1.Parry J. GSK confirms probe by Chinese authorities. BMJ 2013;347:f4328
2.Chinese society of hepatology. Advices for keeping academic independent and justness from business sponsorship.http://www.heporg.com/Pnews/Detail.asp?ORD=46&SystemID=2429. (accessed Aug 26, 2013) (in Chinese).

Competing interests: Dr.med. Huang wei consulted for Merck Sharp&Dohme Chibert AG, Pfizer and Lilly (both as speaker at meeting)

22 September 2013
Wei Huang
intensivist
First Hospital of Dalian Medical University
222 Zhongshan road, Dalian, Liao Ning Province, China