AUTH/2922/12/16: Assistant Director Medicines Management v Meda — rep criticised for omitting local ‘grey list’ status when detailing Dymista | PMCPA Case

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Key facts

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Case number	AUTH/2922/12/16
Complainant	Assistant Director, Medicines Management
Company	Meda Pharmaceuticals Limited
Product(s)	Dymista (fluticasone/azelastine); also referenced: Elleste (oestradiol), Treclin (clindamycin/tretinoin)
Setting	GP meeting (December 2016); rep provided sandwiches; ~10-minute slot
Main issue	Rep did not proactively disclose local ‘grey list’ status before detailing; impression about local prescribing/endorsement
Complaint received	19 December 2016
Case completed	24 March 2017
Applicable Code year	2016
Breach clauses	7.2, 7.4, 15.2
No breach clauses	2, 15.2
Sanctions	Undertaking received; additional sanctions not stated
Appeal	No appeal

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

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An assistant director (medicines management) complained about a Meda representative’s conduct at a GP meeting (December 2016) where the rep provided sandwiches and had ~10 minutes to speak about products.
The rep distributed/left promotional leaflets/leavepieces including for Dymista (fluticasone/azelastine) and stated local consultants recommended it.
The complainant said the local area prescribing committee had ‘grey listed’ Dymista (not recommended for use locally) and challenged the rep for promoting against local NHS guidance.
The complainant alleged the rep became combative/arrogant, told the room guidance could be ignored, and referenced the local formulary pharmacist (allegedly saying they would ‘set you right’).
Meda investigated, interviewed the rep, and argued it was legitimate to discuss evidence and local/national clinical consensus; it said there was a misunderstanding and that materials were compliant.
The rep accepted they did not actively raise the local grey-listing status before detailing Dymista.
Because accounts differed and few attendees would provide statements, the Panel decided on the balance of probabilities using available evidence.

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Breach of Clause 7.2 (detailing without proactively referencing local formulary status was considered unhelpful and misleading).
Breach of Clause 7.4 (the rep created an impression about local prescribing that could not be substantiated).
Breach of Clause 15.2 (misleading the local audience meant the rep did not maintain a high standard of ethical conduct).
No breach of Clause 2 (Panel did not consider the case warranted this level of censure).
No breach of Clause 15.2 in relation to the allegation that the rep was combative (complainant did not prove this on the balance of probabilities).
Clause 9.1: the Panel considered the Clause 15.2 ruling covered any consideration of Clause 9.1 and made no additional ruling.
No appeal.

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