AUTH/2714/5/14: Hospital consultant v Pfizer — representative conduct, disputed patient anecdote and CRM gaps | PMCPA Case

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Key facts

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Case number	AUTH/2714/5/14
Parties	Hospital consultant rheumatologist v Pfizer
Issue	Conduct of a representative (including disputed reference to an ITU patient on competitor medicine and concerns about professionalism)
Product(s)	Enbrel (etanercept); competitor medicine referenced: golimumab (Simponi)
Applicable Code year	2012
Complaint received	07 May 2014 (also stated in report text as 8 May 2014)
Case completed	07 November 2014
Panel decision	No breach (including Clauses 2, 8.2, 9.1, 15.2)
Appeal	Appeal by complainant; successful in part
Final breach findings	Breach Clauses 9.1 and 15.2; No breach Clauses 2 and 8.2
Sanctions	Undertaking received; additional sanctions not stated

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

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What happened

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A consultant rheumatologist agreed to a short (“ten minute catch up”) meeting with a Pfizer representative; the representative arrived with a line manager, which the complainant said was not pre-notified (the complainant did not object when asked on arrival).
The representative opened by asking about the consultant’s prior serious health issue; the complainant found this uncomfortable and inappropriate, especially in front of the manager.
The discussion moved to Enbrel (etanercept) in psoriatic arthritis and ankylosing spondylitis; the representative questioned the consultant’s first-line choice (the consultant preferred a monoclonal antibody, citing better data for extra-articular manifestations).
The complainant said the representative repeatedly pressed for justification of prescribing decisions, which the complainant felt was not the representative’s role.
The representative referred to an alleged prior discussion about a patient admitted to ITU over Christmas who had taken golimumab (Simponi, a competitor medicine). The complainant said this was inappropriate and that no such patient existed in their practice/hospital.
After the meeting, the complainant contacted the representative’s manager and later wrote to Pfizer, stating the responses were inadequate and that there was no proper apology.
Pfizer relied on CRM entries suggesting prior interactions and asserted the ITU patient anecdote had been disclosed by the complainant at an earlier meeting; CRM entries largely lacked notes.

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Outcome

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Panel (initial): No breach ruled (including no breach of Clauses 2, 8.2, 9.1 and 15.2) due to conflicting accounts and insufficient evidence on the balance of probabilities.
Appeal Board: The complainant provided evidence that the alleged ITU patient on golimumab did not exist; the reference to such a discussion was deemed unacceptable.
Appeal Board findings: Breach of Clause 15.2 (representative failed to maintain a high standard of ethical conduct) and breach of Clause 9.1 (company failed to maintain high standards).
No breach upheld: Clause 8.2 (no disparagement of the health professional’s clinical/scientific opinion) and Clause 2 (not warranted on the facts).

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AUTH/2714/5/14: Hospital consultant v Pfizer — representative conduct, disputed patient anecdote and CRM gaps

Key facts

What happened

Outcome

Clauses

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