AUTH/2443/10/11: Anonymous v Genus Pharmaceuticals — conduct of Apo-go nurse advisor (No breach) | PMCPA Case

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Key facts

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Case number	AUTH/2443/10/11
Complainant	Anonymous, uncontactable (“concerned pharmacist”)
Company	Genus Pharmaceuticals Ltd
Product	Apo-go (apomorphine hydrochloride)
Issue	Alleged inappropriate conduct by company-employed nurse advisor (alleged medicine changes without authority/communication) and whether the nurse support programme constituted an inducement or improper good/service
Clauses considered	Clauses 2, 9.1, 18.1 and 18.4
Outcome	No breach of the Code
Appeal	No appeal
Complaint received	14 October 2011
Case completed	23 November 2011
Applicable Code year	2011

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

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An anonymous, uncontactable complainant (describing themself as a “concerned pharmacist”) raised concerns about an Apo-go (apomorphine hydrochloride) nurse advisor employed by Genus Pharmaceuticals.
The complainant alleged the nurse advisor (not a nurse prescriber) was changing oral Parkinson’s disease medicines and increasing apomorphine doses, and was not informing local Parkinson’s Disease Nurse Specialists (PDNSs) about changes or patient responses.
The Authority asked Genus to consider Clauses 2, 9.1, 18.1 and 18.4 of the Code.
Genus responded that the nurse advisor operated within a formal patient support programme (with programme agreement, trust honorary contract, and patient consent), and that any medication changes were only at the clear instigation of the prescriber with documentation and communication back to NHS professionals.
The Panel reviewed the nurse support programme as linked to Apo-go and considered whether it was an inducement (Clause 18.1) or a medical/educational good or service (Clause 18.4), and assessed the nurse advisor’s conduct (Clauses 9.1 and 2).

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No breach of the Code was ruled.
No breach of Clause 18.1 (Package deals/inducements): the arrangements were considered a bona fide package deal and not a gift/benefit/pecuniary advantage to induce prescribing etc.
No breach of Clause 18.4 (Medical and educational goods and services): the service bore the name “Apo-go” and was inextricably linked to the product, so it was not considered a Clause 18.4 good/service; therefore no breach was ruled.
No breach of Clause 9.1 (high standards): evidence showed the nurse advisor consulted the consultant neurologist before altering medication and documented changes.
No breach of Clause 2 (bringing discredit): the complainant provided no supporting evidence for the serious allegations; evidence indicated the nurse advisor was well respected.

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