Ferring voluntary admission: sales manager drafted hospital letter to GPs promoting DesmoMelt over Desmospray (disguised promotion)

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Key facts

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Case number	AUTH/2848/5/16
Company	Ferring Pharmaceuticals Ltd
Case type	Voluntary admission (treated as a complaint under Paragraph 5.6)
Issue	Representative-facilitated hospital letter to GPs recommending DesmoMelt over Desmospray; disguised promotion
Products	DesmoMelt (sublingual desmopressin); Desmospray (desmopressin nasal spray)
Therapy area	Enuresis/urology (primary nocturnal enuresis referenced)
What was drafted	Handwritten draft letter text for hospital consultants to send to GP practices; did not mention Ferring’s initiation
Reach	15 GP practices identified as potential recipients; no letters sent
Complaint received	26 May 2016
Case completed	22 July 2016
Applicable Code year	2016
Breach clauses	9.1, 12.1, 15.2
No breach clauses	2
Sanctions	Undertaking received; additional sanctions not stated
Appeal	No appeal

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

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Ferring voluntarily admitted that an area sales manager encouraged representatives to facilitate a local hospital sending a letter to GP practices promoting DesmoMelt (sublingual desmopressin) instead of Desmospray (desmopressin nasal spray).
The sales manager drafted the letter text by hand (on notepaper) for hospital consultants to place on hospital letterhead and send to selected GP practices with high Desmospray usage.
The draft letter discouraged use of desmopressin spray for primary nocturnal enuresis and recommended DesmoMelt; it did not disclose Ferring’s initiation of the content.
Ferring said the initiative mixed a genuine safety concern (hyponatremia risk in children; Desmospray’s enuresis indication had been removed by MHRA in September 2007) with a commercial objective (boosting DesmoMelt sales).
One hospital generated a letter signed by one consultant but it was withdrawn and not sent; a second hospital was approached but no letter was sent.
Across two hospitals, 15 GP practices were identified as potential recipients; no letters were sent to any practice.
Under Paragraph 5.6 of the Constitution and Procedure, the Director treated the voluntary admission as a complaint.

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Breach of Clause 12.1 (disguised promotion): the draft text was promotional material and providing it to hospital consultants constituted disguised promotion, even though no letters were ultimately sent to GPs.
Breach of Clause 15.2: representatives did not maintain a high standard of ethical conduct.
Breach of Clause 9.1: high standards were not maintained.
No breach of Clause 2: given the very limited reach (no letters sent), the conduct was not ruled to bring discredit upon or reduce confidence in the industry.
No appeal.

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