GlaxoSmithKline: Silencing Critics Through Intimidation

The Intimidation of Dr Buse

In November 2007, The United States Senate Committee on Finance (Committee) issued a report detailing GlaxoSmithKline’s (GSK) intimidation of an independent scientist who criticized Avandia (a drug GSK manufactures to control glucose levels in diabetics) .

The Committee investigated allegations that GSK company executives had intimidated a research scientist in 1999. In 1999, GlaxoSmithKline was known as SmithKline Beecham.

When the Committee contacted GSK about the allegation, GSK issued a press release to repudiate the allegation. An article the Wall Street Journal wrote that GSK called the suggestion ‘absolutely false.’ However, the Committee report that the internal company documents that they examined ‘seem to contradict that claim and reveal what appears to be an orchestrated plan to stifle the opinion of Dr. John Buse, a professor of medicine at the University of North Carolina who specializes in diabetes’.

The Committee report that ‘GSK’s attempt at intimidation appears to have been triggered by speeches that Dr. Buse gave at scientific meetings in 1999. During those meetings, Dr. Buse suggested that Avandia may carry cardiovascular risks’.

Heart Attacks

The report continues:

‘The effect of silencing this criticism is, in our opinion, extremely serious. At a July 30th 2007, safety panel on Avandia, FDA scientists presented an analysis estimating that Avandia caused approximately 83,000 excess heart attacks since coming on the market. Had GSK considered Avandia’s increased cardiovascular risk more seriously when the issue was first raised in 1999 by Dr. Buse, instead of trying to smother an independent medical opinion, some of these heart attacks may have been avoided’.

Orders from the Top

Following Dr Buse’s speeches in 1999, GSK tried to silence his concerns about Avandia by complaining to his superiors and threatening a lawsuit. The Committee report that they are troubled by the fact that the documents revealed to them (which called Dr Buse an ‘Avandia Renegade’) included discussion of plans to silence Dr Buse by executives at the highest levels of GSK including Dr. Tachi Yamada (GSK’s head of research ), Dr. Jean-Pierre Garnier (GSK’s CEO) and David Stout (a senior GSK executive).

‘ Instead of acknowledging the misdeed to investors, apologizing to patients, and pledging to change corporate behavior, GSK launched a public relations campaign of denial’.

GSK also exerted great pressure on Dr Buse to sign a letter claiming that he was no longer worried about cardiovascular risks associated with Avandia. Dr Buse is reported to have ‘caved in’ under the pressure and signed the letter which was then used by GSK as evidence of retraction for their PR offensive.

Telling Scientists what to Think

The report also revealed how a GSK official had suggested that GSK should both provide and interpret information provide to Dr. Buse:

‘Our chances on having Buse reflect our views and messages will be enhanced greatly if we tell him what they are rather than relying on him to development on his own accord via examining data…. There is no evidence that Dr. Buse will come to these views without some guidance and support. Of course care will need to be taken to work any overview pieces in a way that appears academic rather than too commercial to enhance the probability that Dr. Buse will adopt our views as his own’.

The report also revealed that Dr. Buse had been informed by his superiors that GSK executives perceived him as “being for sale” as he received speaking fees from Takeda.

Culture and Prevalence of Intimidation

In concluding, the Committee reported that the evidence ‘raise serious concerns about the culture of leadership at GSK. Even more serious perhaps is our fear that the situation with Dr. Buse is part of a more troubling pattern of behavior by pharmaceutical executives’.

They go on to compare Dr Buse’s experience with that of Dr. Gurkirpal Singh of Stanford University in 2004, who testified at a Committee hearing that an executive at Merck & Co had sought to intimidate him by calling his superiors.

‘Merck also warned Dr. Singh that they would make life very difficult for him, if he persisted in his request for data on Merck’s drug, Vioxx. It was later discovered that Vioxx increased the risk of heart attacks and it was withdrawn from the market’

The Committee report that:

‘Merck’s intimidation of Dr. Singh as it sought to protect Vioxx bears striking similarities to apparent threats by GSK against Dr. Buse to protect Avandia. The Committee is very concerned that this behavior may be more prevalent in the pharmaceutical industry than is evidenced by these two cases. Corporate intimidation, the silencing of scientific dissent, and the suppression of scientific views threaten both the public well-being and the financial health of the federal government, which pays for health care... Had Dr. Buse been able to continue voicing his concerns, without being characterized as a “renegade” and without the need to sign a “retraction letter,” it appears that the public good would have been better served’.