The Pharmaceutical Journal
Vol 274 No 7332 p42
15 January 2005

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Trinity discredits industry by changing prescriptions

Trinity Pharmaceuticals brought discredit upon the pharmaceutical industry and reduced confidence in it through a programme to change patients’ treatment to its Pulvinal brand of salbutamol dry powder inhalation, according to the Association of the British Pharmaceutical Industry’s Prescription Medicines Code of Practice Authority.

The ruling followed a complaint from a primary care trust clinical governance lead that the company had employed a sessional pharmacist to visit a GP practice, review prescriptions and make the changes. Trinity admitted that a company representative had not followed proper procedures, but denied that his actions brought discredit upon the industry.

An investigating panel ruled that prescriptions had been changed without the written agreement of a GP because they had been altered two days before a general switch agreement had been signed and no detailed list of proposed changes had been submitted to the practice for prior authorisation.

The panel also ruled that the prescription review service was inextricably linked to the promotion of Trinity products and amounted to an unacceptable inducement to prescribe.

Overall, the panel was so concerned by the case that it decided to report it to a PMCPA appeal board.

The appeal board ruled that Trinity should undergo an audit of its procedures, which revealed that patients with stable asthma were being switched to Trinity products without their knowledge or consent. After a follow-up audit three months later, which revealed a lack of progress with corrective action, the case was referred to the ABPI management board.

The board decided to take no further action because Trinity was taking corrective steps but reserved the right to require a further audit.

Trinity is the third company that has been found to have brought discredit upon the
industry by changing prescriptions without explicit consent. Previous cases involved GlaxoSmithKline (PJ, 20 March 2004, p344) and Novartis (PJ, 29 September 2001, p418).