AUTH/3530/7/21 - Complainant v AbbVie

Concerns about instructions to representatives

  • Received
    07 July 2021
  • Case number
    AUTH/3530/7/21
  • Applicable Code year
    2019
  • Completed
    26 May 2022
  • No breach Clause(s)
  • Breach Clause(s)
  • Sanctions applied
    Undertaking received
  • Additional sanctions
  • Appeal
    No appeal

Case Summary

The complainant, a current employee of AbbVie UK, was very concerned about the conduct of the senior management, in encouraging the salesforce to act in conduct which would clearly bring the industry into disrepute. Especially during the Covid-19 pandemic.

The complainant provided screenshots of email correspondence between a representative and a senior manager (the response from the manager which was sent to the entire salesforce) and alleged that these described how the representative circumvented a hospital security system.

In addition, the complainant alleged that representatives had been told to meet in coffee shops, car parks, picnics and to text health professionals to offer ice creams/sandwiches.

The complainant alleged that sales teams across AbbVie were alleged to be currently targeted and incentivised to achieve 5 face to face calls with health professionals per week during a time when hospitals were not seeing many patients face to face.

The complainant subsequently provided further information that since the original complaint the sales team had received sales targets which were dependent on seeing 35 health professionals face to face during Q3. If the sales target was met but 35 health professionals were not seen, no bonus would be paid. Virtual calls no longer counted towards this target. This placed pressure on the sales team to circumvent trust policies still in place to restrict non-essential visitors within the acute setting.

The detailed response from AbbVie is given below.

The Panel noted the representative’s email and was concerned at some of the language used in the email. Whilst the representative’s reasoning to enter the hospital, when challenged, was to ‘follow up a recent educational event with the nurses’, it appeared to the Panel that this reasoning might have been inaccurate and only prepared by the representative to gain entry if challenged. The representative’s reason for visiting the hospital, according to AbbVie, was the hope of securing an appointment with a health professional. The Panel was further concerned about the representative’s reference to ‘strategic loitering’. The Panel considered that the representative had failed to maintain a high standard of ethical conduct in this regard and a breach of the Code was ruled.

The Panel noted that the response from the representative’s manager referred to the representative ‘gaining promotional opportunities…which will help address the performance gap we are working to fix, deliver our … messaging and win back dynamic opportunities from our competitor’. The manager also stated that ‘Naturally we’d never deliberately go against any local policies but staying within the Code of Practice and AbbVie’s Code of Business Conduct we will be able to find ways to reconnect, just as you have done here.’. The response ended with ‘Thanks again for sharing and keep up the great work’.

With regard to AbbVie’s submission that the manager’s response email did not refer to the representative’s description of the engagement as an example of best practice, nor did it encourage other members of the team to follow suit, the Panel considered that the circulation of the manager’s response to his/her team would likely be seen as an endorsement that the representative’s actions were acceptable to the company and were to be encouraged. In the Panel’s view, it could thus be considered to be briefing material. The Panel did not consider that the manager’s reference to AbbVie’s Code of Business Conduct was sufficient to discourage representatives to act in a similar manner; it would not be unreasonable for readers of the emails to assume that the actions were within the bounds of the Code and AbbVie’s internal Code of Business Conduct. There was no reminder in the correspondence of the requirement in Clause 15.4 of the Code.

The Panel considered that the manager’s email to his/her entire team, in response to the representative’s email, endorsed a course of action which would likely lead to a breach of the Code. High standards had not been maintained in this regard and the Panel ruled a breach of the Code.

With regard to the allegation that management had told representatives to meet in coffee shops, car parks, picnics and to text health professionals to offer ice creams and sandwiches, there was an implication that representatives were using the provision of hospitality as the reason for the meeting rather than the hospitality being secondary to the main purpose of the meeting and were holding meetings in venues where members of the public might be able to overhear them. The Panel noted that the complainant had provided no evidence in this regard or that ice cream had been offered or provided as hospitality.

The Panel noted that in a Compliance Matters newsletter dated 21 May 2021, sent to staff, guidance was given around meeting venues and appropriate hospitality with the return of face to face engagements. This advice was consistent with information sent to staff in July 2021 and the company’s training.

The Panel was concerned that it appeared that AbbVie was encouraging the provision of coffee, meals etc as a business courtesy. There was an impression that hospitality could be provided at every meeting with a health professional and that this was a way of encouraging health professionals to see representatives. In addition to the requirement in the Code that hospitality should be strictly limited to the main purpose of the meeting, the level of subsistence must be appropriate and not out of proportion to the occasion.

Whilst the Panel was concerned about AbbVie’s instructions, on balance, it did not consider that the instructions would encourage representatives to breach the requirements in the Code relating to the provision of hospitality. The Panel considered that the complainant had not established that high standards had not been maintained in relation to his/her allegation regarding the offering of hospitality or meeting venues and ruled no breach of the Code.
The Panel noted that it was unknown if local trust policies would have permitted access for all representatives in Q2 and Q3 when the face to face targets and incentive schemes had been set by AbbVie. The Panel, however, noted AbbVie’s submission that it remained respectful to individual challenges and local constraints in this regard.

The Panel did not consider that the complainant had established that the targets set by AbbVie encouraged a course of action which would likely lead to a breach of the Code as alleged. The Panel did not consider that high standards had not been maintained in this regard and therefore ruled no breach of the Code.

The Panel did not know the specific arrangements and policies in place at the hospital visited by the representative, as referred to within the email in question. It appeared that access to the rheumatology department required a security pass, and the representative had been let in by a member of staff as they were exiting the building after showing his/her business card as proof of ID; the reasoning given was following up a recent educational event with nurses. Whilst the Panel queried the validity of that reason, it noted that a consultant had queried how the representative had got into the “locked” department and appeared satisfied with the representative’s explanation.

Whilst the Panel was concerned with the representative’s methods of entering the hospital department, it did not consider that the complainant had shown, on the balance of probabilities, that the representatives had called on the hospital in a way that caused inconvenience or did not observe the wishes of individuals and the arrangements in force at the hospital. The Panel, therefore, based on the complainant’s allegation, ruled no breach of the Code.

The Panel did not consider that the particular circumstances of this case warranted a ruling of a breach of Clause 2 which was a sign of particular censure and was reserved for such use. No breach of Clause 2 was ruled.

AbbVie provided the requisite undertaking and assurance and as the case completed at Panel level the Appeal Board received the case report as set out in Paragraph 13.4 of the Constitution and Procedure.

The Appeal Board was very concerned about circulation of the manager’s response email to his/her team which in effect endorsed ‘strategic loitering’ by sales representatives to contact health professionals.

The Appeal Board was of the view that consideration should be given to the imposition of additional sanctions under Paragraph 11.1 of the Constitution and Procedure.

The detailed response from AbbVie to the possibility of further sanctions being imposed is given below.

The Appeal Board was particularly concerned that none of the recipients of the email raised any concerns about its content within the company nor had the complaint been addressed through any company whistleblowing procedure. It was only after AbbVie was notified of the complaint to the PMCPA that the company took action.

The Appeal Board noted the submission of the company representatives that the email was sent when the field force was transitioning from virtual to face-to-face meetings and AbbVie’s acknowledgement that in retrospect the company should have highlighted the importance of Code compliance to the field force during this time.

The Appeal Board welcomed the actions taken by AbbVie. The Appeal Board did not consider that there was evidence to suggest that the emails at issue were symptomatic of wider problems within the company. The Appeal Board noted the apparent contrition and the extent of the remedial action undertaken. The Appeal Board remained concerned that the recipients of the email in question had not spoken up internally. The Appeal Board gave consideration to the use of additional sanctions but decided that none were required.