GSK ignored staff warnings over marketing Senior GlaxoSmithKline executives failed to act on repeated warnings from employees over illegal marketing of its drugs, according to testimony from a whistleblower whose alerts triggered the company's record $3bn settlement with US regulators this week. Complaints raised from 2001 by Greg Thorpe, a sales representative worried about the lavish promotion to doctors of drugs beyond their authorised use, sparked investigations within the pharmaceuticals group. But the investigations triggered his dismissal rather than any internal reforms. Documents included in the Department of Justice probe eventually launched with Mr Thorpe's support highlight a corporate culture that appeared to focus more on commercial returns than ethics or patient safety. His examples formed part of a larger case that ranged across a series of GSK's drugs, and which US prosecutors argued both risked patient harm - including increased risk of suicidal feelings among adolescents taking the company's antidepressants - and unjustifiable costs for the healthcare system. In October 2001, Mr Thorpe was initially issued a warning by his manager, ostensibly for criticising the company's incentive compensation programmes and making "negative comments" towards managers and team members. He pursued his concerns internally, inspired by an initiative launched by David Stout, then US head of the company, called "Taking the high road" to make the company a leader in ethics and compliance in sales and marketing. In a January 2002 report, he described the "indifference and pompous attitude" of senior managers. He cited the illegal promotion of the antidepressant Wellbutrin for ADHD; paying nurses for promoting a GSK migraine treatment; and a ski trip for doctors to Colorado that, he believed, was "buying the business through bribery." He described a call from a doctor's assistant requesting a deep tissue massage, cleansing facial, foot reflexology and pedicure, following a lunch and presentation from a doctor promoting Wellbutrin, illegally, for weight loss. "Can you imagine if the Wall Street Journal got a copy of this invitation," he wrote. After querying entertainment for doctors that would cost $350 per person, beyond GSK's limit of $75-$125, he was apparently told by his manager that it had been approved because it would be paid nominally by an outside vendor, so "it should not be noticed on our expenses." An email in February 2002 from Arjun Rajaratnam, then GSK's global head of compliance, to a colleague referred to Mr Thorpe's concerns over doctors selling books on the "off label" use of Wellbutrin at company-sponsored events. "Can you help me find a way to show GSK's due diligence," he asks. In November 2002, Mr Thorpe raised his concerns in a letter copied to Mr Stout, Bob Ingram, GSK's chief operating officer, and Mr Rajaratnam. Mr Thorpe was forced out of GSK, and says in DoJ filings that he was never given the full benefits negotiated in his departure package - a matter that remains subject to litigation between him and the company. He says that he was unable to find fresh employment, unable to speak about his case and left more than $700,000 in debt. Regulators probed his claims over a decade. They alleged falsification of documents by a lawyer over internal presentations provided to doctors for use in promotion of the company's medicines. But the case was dropped on the grounds that seizure of the documents involved breaching attorney-client privilege. GSK has since changed most of its top US management, and installed a range of new procedures including tight limits on entertainment and a ban on bonuses linked to prescription volumes for sales reps. Mr Stout is now a non-executive director of Shire. Mr Ingram is chairman of Elan. Mr Rajaratnam is chief compliance officer at Smith & Nephew. None responded to requests for comment on Tuesday. If past practice is followed, Mr Thorpe himself and three other whistleblowers will now be eligible to share between 15-30 per cent of $1bn, part of the final settlement. But as he said in a statement: "To those who would want to be whistleblowers and try and better society to "right a wrong," you need to be forewarned it can be a long and difficult road ... I cannot be certain, if I knew beforehand what was coming after filing this case, that I could do it again."