AUTH/2574/2/13: Pharmacist v Sanofi Pasteur MSD – Zostavax email referenced surgery profit | PMCPA Case

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Key facts

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Case number	AUTH/2574/2/13
Complainant	Senior primary care pharmacist
Company	Sanofi Pasteur MSD
Product	Zostavax (varicella-zoster virus (live))
Indication (as stated)	Prevention of herpes zoster (shingles) and herpes zoster-related post-herpetic neuralgia (PHN)
Material/channel	Email from representative to general practice (practice managers) with attached patient invitation letter template
Main issue	Email encouraged maximising surgery profit and implied vaccinating certain age groups ahead of national programme; concern about inducement and standards
Complaint received	01 February 2013
Case completed	26 April 2013
Applicable Code year	2012
Breach findings	Clause 9.1 – Breach
No breach findings	Clause 2 – No breach; Clause 18.1 – No breach
Appeal	No appeal
Sanctions	Undertaking received; Additional sanctions: Not stated

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

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A senior primary care pharmacist complained about an email sent by a Sanofi Pasteur MSD representative to a general practice about supplies of Zostavax (varicella-zoster virus (live)).
Zostavax was indicated for prevention of herpes zoster (shingles) and herpes zoster-related post-herpetic neuralgia (PHN).
The email referenced the upcoming national shingles immunisation programme (starting September 2013 for patients aged 70–79).
The email encouraged ordering/vaccinating certain age groups ahead of the programme (patients 50–69 and 80 years old, including those turning 80 before September).
The email highlighted financial benefit to the surgery: “£26 per dose profit now compared to enhanced payment of around £7 from September”.
The email stated “100% sale or return”, noted that “40 doses would get you the maximum discount”, and referenced stock expiry (28 Feb 2013).
A template letter inviting patients for the shingles vaccine was attached; the email claimed the invitation had been well received and enabled dedicated clinics.
The complainant alleged it was inappropriate to encourage GPs to prescribe for profit and queried inducement under the Code.
Sanofi Pasteur MSD stated the email and template were created and sent by one representative without company knowledge or approval, contrary to company policy; the representative admitted acting alone.

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No breach of Clause 18.1 (Terms of Trade/inducement): the Panel decided the arrangement related to cost/financial terms and could benefit from the exemption for prices/margins/discounts.
Breach of Clause 9.1: the Panel ruled high standards had not been maintained, due to the impression created (vaccinating primarily on the basis of profit) and the unapproved email/template.
No breach of Clause 2: the Panel did not consider the circumstances warranted particular censure under Clause 2.
No appeal.

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