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PMCPA Case

AUTH/3283/11/19 and AUTH/3284/11/19: CCG senior pharmacist v Bristol-Myers Squibb and Pfizer (Eliquis promotion and litigation comments)

📅 8 March 2026 | 🖉 Anzal Qurbain
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Key facts

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Case numberAUTH/3283/11/19 and AUTH/3284/11/19
Case referenceCCG senior pharmacist v Bristol-Myers Squibb and Pfizer
ComplainantSenior pharmacist at a clinical commissioning group (CCG)
Respondent/companyBristol-Myers Squibb Pharmaceuticals Ltd and Pfizer Ltd (the Alliance)
Product(s)Eliquis (apixaban); Lixiana (edoxaban) referenced
Material/channelPromotional discussion at a GP practice meeting; leavepiece referenced by the Alliance (no litigation content); complainant stated no show material was provided
Key issueRepresentatives raised litigation/medico-legal consequences in context of switching stable patients (interpreted as Eliquis to Lixiana), considered scaremongering and disparaging/unbalanced
Dates (received/completed if stated)Complaint received 13 November 2019; case completed 9 March 2020
AppealNot stated
Code yearNot stated
Breaches/clausesBreaches of Clauses 2, 7.2, 8.1, 15.2; no breach of Clauses 7.3 and 9.1
SanctionsNo explicit additional sanctions stated beyond the required undertaking/corrective actions described in the report

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

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What happened

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  • A senior pharmacist at a clinical commissioning group (CCG) complained about the conduct of representatives at a GP practice meeting to promote Eliquis (apixaban), co-promoted by Bristol-Myers Squibb Pharmaceuticals Ltd and Pfizer Ltd (the Alliance).
  • Eliquis was on the CCG formulary, but practices were being asked to switch suitable patients to Lixiana (edoxaban) as first-line NOAC in the absence of specific clinical considerations; switching was being driven by cost savings including a manufacturer discount scheme (MDS) for Lixiana.
  • The meeting was with a dispensary finance consultant who appeared not to be a prescriber or a health professional.
  • During the discussion, the Pfizer representative raised the issue of litigation/medico-legal responsibility in the context of switching stable patients from one medicine to another based on cost; the complainant’s account included references to bleeds and possible hospital admission/death, while the Alliance said the representative used the general term “events”.
  • The Panel considered it inconceivable, in context, that the litigation question would be interpreted as anything other than relating to switching patients from Eliquis to Lixiana, with “events” interpreted as bleeding etc.
  • The Panel noted that if the representatives were concerned switching might be based on cost alone and not aligned with SPCs, they should have followed up with a relevant health professional (given switches were done by a pharmacist or GP, not the dispensary finance consultant).
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Outcome

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  • Breach of Clause 15.2 was ruled: the representatives had not maintained a high standard of ethical conduct.
  • Breach of Clause 7.2 was ruled: raising medico-legal consequences implied patients stabilised on Eliquis would become unstable if switched, which the Panel considered not fair, balanced or objective.
  • Breach of Clause 8.1 was ruled: the suggestion that patients would experience “events” if switched from Eliquis to Lixiana was considered disparaging.
  • No breach of Clause 7.3 was ruled: the complaint related to what was said in discussion, not comparisons in promotional material.
  • No breach of Clause 9.1 was ruled: there was nothing to suggest the Alliance encouraged or sanctioned such discussions by representatives.
  • Breach of Clause 2 was ruled: the Panel was extremely concerned litigation was used in promotion; the conversation (particularly with someone who appeared not to be a prescriber/health professional) was tantamount to scaremongering and reduced confidence in/brought discredit upon the industry.
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