Anonymous doctor v Lilly and Boehringer Ingelheim: sponsored journal supplement found to be disguised promotion

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Key facts

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Case number	AUTH/2213/3/09 and AUTH/2214/3/09
Case reference	AUTH/2213/3/09; AUTH/2214/3/09
Complainant	Anonymous doctor
Respondent/company	Eli Lilly and Boehringer Ingelheim
Product(s)	Cymbalta (duloxetine); Zyprexa (olanzapine)
Material/channel	Journal supplement/paid-for insert distributed with Progress in Neurology and Psychiatry (report of a promotional symposium at the time of the ECNP congress)
Key issue	Disguised promotion: company-run promotional meeting proceedings presented as an independent-looking sponsored journal supplement; alleged off-licence promotion not upheld
Dates (received/completed if stated)	Complaint received: 11 March 2009. Completed: AUTH/2213/3/09 on 20 April 2009; AUTH/2214/3/09 on 14 April 2009.
Appeal	Not stated
Code year	Not stated
Breaches/clauses	Breach of Clause 12.1; no breach of Clause 3.2; breach of Clause 2
Sanctions	No explicit additional sanctions stated beyond the required undertaking/corrective actions described in the report

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

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An anonymous doctor complained about a journal supplement distributed with Progress in Neurology and Psychiatry (volume 13, issue 1, 2009).
The material was described as “A Progress supplement sponsored by Eli Lilly and Boehringer Ingelheim” and as a report from the “2008 UK Psychiatry Forum”.
Abbreviated prescribing information for Cymbalta (duloxetine) and Zyprexa (olanzapine) was included.
The complainant alleged the supplement looked like the journal and that the sponsorship statement was small/easily missed, making it appear independent.
The complainant alleged the “UK Psychiatry Forum” appeared to have significant standing and that the report misrepresented the event, which the complainant believed mirrored a Lilly promotional meeting held during the 2008 ECNP congress.
The complainant alleged off-licence promotion because a case described “atypical” depression and Cymbalta was not licensed for atypical depression (alleged breach of Clause 3.2).
The Panel found the supplement reported proceedings of a promotional symposium run by Lilly and Boehringer Ingelheim at the time of the ECNP congress.
The Panel noted: 90 delegates were sponsored by the two companies to attend ECNP; speakers were chosen by the companies; presentation titles were mutually agreed; the companies derived the supplement concept, paid for production/distribution, reviewed final papers for Code compliance, and certified the material.

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The Panel ruled the material was disguised promotion: it was not merely a “sponsored supplement” but a paid-for insert detailing proceedings of a company meeting which promoted Cymbalta and Zyprexa.
The Panel ruled the sponsorship statement and reference to the UK Psychiatry Forum disguised the promotional nature and created a misleading impression of an independent meeting report; it was not stated the meeting was effectively a closed meeting run by the companies and the forum had no recognised national standing.
No breach was ruled for off-licence promotion: the Panel considered the insert did not promote Cymbalta for an unlicensed indication (atypical major depressive disorder was considered a subtype of major depressive disorder, for which Cymbalta was indicated).
The Panel ruled the presentation reduced confidence in and brought discredit upon the pharmaceutical industry.

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Clause 12.1: Breach ruled (disguised promotion / misleading presentation of a paid-for insert as a sponsored supplement and independent forum report).
Clause 3.2: No breach ruled (no off-licence promotion found regarding atypical major depressive disorder).
Clause 2: Breach ruled (material reduced confidence in and brought discredit upon the pharmaceutical industry).

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