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PMCPA Case

AUTH/2113/3/08: GP v Norgine – invitation to Movicol regional advisory forum (honorarium and hospitality)

📅 2008 | 🖉 Dr Anzal Qurbain
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Key facts

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Case numberAUTH/2113/3/08
Case referenceMO/07/1118 (invitation reference)
ComplainantGeneral practitioner
Respondent/companyNorgine Pharmaceuticals Ltd
Product(s)Movicol (macrogol 3350 plus sodium chloride, sodium bicarbonate, and potassium chloride)
Material/channelInvitation to meeting (regional advisory forum) and associated agenda/feedback form
Key issueAlleged excessive honorarium (£250) plus hospitality/transport and concern it was an inducement to promote/prescribe Movicol; appropriateness of advisory board arrangements
Dates (received/completed if stated)Complaint received 26 March 2008; Case completed 25 May 2008
AppealNot stated
Code yearNot stated
Breaches/clausesNo breach of Clauses 18.1, 9.1, or 2
SanctionsNo explicit additional sanctions stated beyond the required undertaking/corrective actions described in the report

Download the full case report (PDF)

Reviewed by Dr Anzal Qurbain (FFPM) — ABPI Final Signatory

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What happened

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  • A general practitioner complained about an invitation (ref MO/07/1118 March 2007) to a “Managing Constipation Movicol Regional Advisory Forum” to take place in Scotland on 30 May, sent by Norgine Pharmaceuticals Ltd.
  • The GP alleged the £250 fee, plus hospitality and transport, was excessive and that the meeting was not necessary or of business value; in the complainant’s view it was an attempt to pay doctors to promote Movicol using a loophole in the Code.
  • The Authority asked Norgine to respond in relation to Clauses 2, 9.1 and 18.1 of the Code.
  • Norgine said Movicol (macrogol 3350 plus sodium chloride, sodium bicarbonate and potassium chloride) was used for chronic constipation and faecal impaction and that regional advisory boards were convened to assess local issues affecting uptake in line with the evidence base.
  • Norgine stated the honorarium was for “time and input at the meeting”; no work prior to the meeting was requested; the meeting was outside normal working hours; the same fee applied regardless of professional standing.
  • The invitation said Norgine wanted views on management of chronic constipation and faecal impaction, would review prescribing patterns and discuss local issues; the Panel considered the invitation could have been clearer about the exact nature of the meeting.
  • The agenda (sent after acceptance) described a 6.30pm buffet dinner, then a 7pm–9pm meeting including: introduction to Norgine (10 minutes), evidence base for treating constipation (30 minutes) with facilitated discussion, review of therapy area and laxative market (20 minutes) with facilitated discussion, and a 45-minute group discussion on “Developing a local action plan: what do Norgine need to be doing?”.
  • The Panel reviewed a report from a similar regional advisory forum indicating interactive discussion, issues identified relevant to Norgine nationally, and action points for the local Norgine team.
  • The Panel noted the feedback form for the meeting seemed at odds with an advisory board’s purpose because it asked about educational content, relevance/interest, whether management would change, and key take-home messages; the Panel considered such questions might be inappropriate in an advisory board context, though context of use would matter.
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Outcome

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  • On balance, the Panel considered the arrangements for the meeting were not unacceptable.
  • The Panel stated it was acceptable to pay doctors to attend advisory board meetings (provided arrangements comply with the Code).
  • No breach was found of Clause 18.1 and therefore no breach of Clause 9.1.
  • The Panel did not accept the circumstances warranted a breach of Clause 2 (a clause used as a sign of particular censure).
  • Overall ruling: No breach of the Code.
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