AUTH/2574/2/13: Pharmacist v Sanofi Pasteur MSD – Zostavax email emphasising 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	Email to a general practice (practice managers) with attached patient invitation letter template
Main issue	Email emphasised maximising surgery profit (£26 per dose vs ~£7 later) and encouraged vaccinating certain age groups ahead of national programme
Applicable Code year	2012
Complaint received	01 February 2013
Case completed	26 April 2013
Appeal	No appeal
Breach findings	Clause 9.1 (breach); Clauses 2 and 18.1 (no breach)
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)).
The email referenced the upcoming national shingles immunisation programme and urged the practice to order/vaccinate certain age groups ahead of it (patients 50–69 and 80 years old, and those turning 80 before September).
The email highlighted financial gain for the surgery: “£26 per dose profit now compared to enhanced payment of around £7 from September”.
The email stated any quantity purchased had “100% sale or return”; “40 doses would get you the maximum discount”; and stock expiry was 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 prescribing for profit and queried whether this was an inducement under the Code.
Sanofi Pasteur MSD said the email and template were created and sent by one representative without company knowledge or approval, contrary to company policy; the company investigated and reminded representatives about prohibitions on promotional use of emails.

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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.
No breach of Clause 2: the Panel did not consider the circumstances warranted particular censure.
Breach of Clause 9.1: high standards were not maintained; the Panel was concerned the impression given appeared to advocate vaccinating certain groups primarily on the basis of profit to the surgery.

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