“I was certainly intimidated by them… It makes me embarrassed to have caved in several years ago.”

That’s what Dr. John Buse, a diabetes expert and professor at the University of North Carolina, had to say about the treatment he received at the hands of GSK after he criticized Avandia, a drug GSK manufactures to control glucose levels in diabetics.
The details of Buse’s knuckling under GSK’s thumb were revealed in a report by the United States Senate Committee on Finance (see “The Intimidation of Dr. John Buse and the Diabetes Drug Avandia“).

At one point, Dr. Buse wrote to a GSK executive “Please call off the dogs. I cannot remain civilized much longer under this kind of heat.”

Implications for Independent CME
The “heat” he was referring to was repeated calls to Fred Sparling, Dr. Buse’s department chairman. This is significant because there were threats to cut off funding for CME programs and a national survey of department chairs at medical schools and teaching hospitals found that more than half have relationships with industry, including receiving financial support, research equipment and consulting fees (see “Industry Influence Over Academia Should Be Studied“).

In June 1999, GSK executives discussed Dr. Buse in a series of emails they titled, “Avandia Renegade.” One email reads:

[M]ention was made of John Buse from UNC who apparently has repeatedly and intentionally misrepresented Avandia data from the speaker’s dais in various fora, most recent among which was the ADA.

The sentiment of the SB group was to write him a firm letter that would warn him about doing this again..with the punishment being that we will complain up his academic line and to the CME granting bodies that accredit his activities….The question comes up as to whether you think this is a sensible strategy in the future (we don’t really do too much work at UNC to make any threats).

In other words, GSK threatened to cut off Dr. Buse’s CME funding and would have also threatened UNC funding if only they did “much work at UNC.”

Afterward, Buse caved in and signed “some legal document in which I agreed not to discuss this issue further in public.”

Later in 2000, Dr. Buse reached out to GSK officials, asking them to sponsor a continuing medical education (CME) program about TZD use. Dr. Buse wrote an intriguing request to get $ from GSK for CME, which he said would put an end of the “glitazone wars”:

I spoke to Rich Daly, the head of marketing (and sales?) for Takeda. He was going to run the idea of joint support for the CME program by the Takeda lawyers to make sure there are no FTC issues in what I proposed. I highlighted to him that the benefit to Takeda and [SmithKline Beecham] would be the potential to grow interest in the class as a whole and as a very public display of the end of the “glitazone wars.”

By late 2000, GSK officials appeared to believe that they had the former “Avandia Renegade” under control.

At that point, I’d say GSK executives were singing the classic Stones song “Under My Thumb” whenever they thought about Buse: