No Jerks, we’re British

Most of the debate about the proposed merger between Pfizer and Astra Zeneca focused on whether Pfizer would asset strip and make thousands of UK employees redundant. But what’s it like working for Pfizer? An employee has sent MD details of an ‘excruciating’ No Jerks staff development program where everyone was given a ‘No Jerks’ self refection survey, ‘Straight Talk Tools’ and the ‘Let’s Discuss Behaviours’ coin.

Pfizer is a global company and presumably aware that jerking has a number of off-message meanings. ‘Often jerk like behaviour is subtle and nuanced but equally as destructive as the more overt bullying and belittling behaviours we often think of.’ Pfizer asks its employees to identify such behaviours in themselves. ‘Is your focus always on your own goals, rather than Pfizer’s? Do you think nothing of belittling others for affect or sport? Do you indulge in whisper campaigns, trade on position power and threats, over-react emotionally and take credit for the work of others while being negative and subversive in the face of change?’ If you were foolish enough to answer ‘yes’ to any of these, you may no longer be working for Pfizer.

The No Jerks Survey was apparently adapted from ‘The No Arsehole Rule’ by Robert Sutton PhD. The idea behind ‘Let’s Discuss Behaviour’ coin is to ‘facilitate a challenging conversation’ by placing the coin on the table to discuss errant behaviour or give ‘targeted one-on-one feedback’ Does such a controlling approach to staff behaviour suppress those trying to express legitimate concerns about product safety or mis-selling? In 2009, Pfizer paid $2.3 billion (including a criminal fine of $1.2 billion) to settle fraud claims about four drugs (Bextra, Geodon, Zyvox and Lyrica.) Not enough to sink a company that turns over $67 billion, but a shocking embarrassment none the less and a reminder of the importance of whistle blowers on the staff. Would staff who expose such practices be considered as jerks and non-team players who follow their own or the patients’ agenda rather than that of Pfizer?

Pfizer has at least started down the route of more openness and transparency about what it does. GlaxoSmithKline, which has also been fined heavily for mis-selling and is currently under investigation in China, was first to sign up to the All Trials campaign, which commits a drug company to publicly sharing all results, on all trials, of all uses, of all their medicines currently being prescribed. At present, the best evidence suggests that between a third and a half of all clinical trials conducted have not been published. And trials with positive results are twice as likely to be published as those with negative results. So researchers are being kept in the dark and doctors and patients are lulled into believing drugs work better than they actually do, and with fewer side effects.

Pfizer has yet to sign up but it has launched a portal through which ‘qualified researchers can request access to anonymised patient data from completed trials of approved (or discontinued) medicines and indications. And it’s pledged to publish synopses of clinical study reports CSRs) on its website for trials dating back to September 2007’. However, this will exclude “off-label” studies, even though such uses are commonplace and very profitable, and it was the unethical promotion of off-label usage that lead to Pfizer’s extremely large fines. It’s imperative that this trial data is not kept secret.

Pfizer must also publish results of older trials, which relate to many of the drugs that are most commonly used now, and publish its CSRs in full, not just as summaries. Important information on results and methodological flaws are only available in full CSRs. The corporate rap sheet for Pfizer does not make pretty reading, and its biggest wrongdoings have only come to light thanks to whistle blowers who have exposed the company for making claims about its products that can’t be substantiated by the evidence. The safest way forward is not to rely solely on whistle blowers but for all companies to sign up to All Trials and to put all the evidence on all their drugs in the public domain. Pfizer and AstraZeneca should be obliged to do this prior to any merger. www.alltrials.net