How Corruption Infected Greece’s Healthcare | Novartis

Imagine sitting in a doctor’s office in Athens. The lights are sterile. The air smells of antiseptic. You’re there because your vision is blurring, and you’re scared. The doctor, a professional you trust with your sight, recommends a drug called Lucentis. It’s for a serious condition, age-related macular degeneration. You trust this person. You trust their expertise. You trust the prescription they write.

But what if that trust was built on a lie? What if that piece of paper in your hand had less to do with your health and more to do with your doctor’s recent trip to New Orleans, all expenses paid?.

That was the rotten core of a scheme run by Novartis Hellas, the Greek branch of the global pharmaceutical giant Novartis. For years, they didn’t just sell medicine like what one might imagine. They also bought prescriptions. And in doing so, they treated the sacred trust between doctor and patient as just another line item on a budget sheet.

A Strategy of Seduction

So, how did they pull it off? It wasn’t complicated. It was just brazen. Between 2012 and 2015, Novartis Hellas dangled a very shiny carrot in front of doctors at Greece’s state-run hospitals. That carrot was all-expenses-paid travel to glamorous “medical congresses” in cities across Europe and the United States.

Let’s be clear. This wasn’t about education. The company’s own policies might have claimed the trips were for “scientific or educational information”. But reality had a different story to tell. This was a straightforward transaction. A bribe. Novartis Hellas shelled out for airfare, fancy hotels, and registration fees. We’re talking more than $6,000 per doctor for a single trip.

The company’s own documents, now public record, spell out the quid pro quo with chilling clarity. In one internal meeting in September 2012, the team discussed their strategy. The minutes from that meeting are a gut punch. Doctors “must understand that their participation in [congresses] will be cancelled if sales performance is not improved significantly”.

Read that again. If you don’t sell more of our drug, your free trip is off.

It gets worse. They created “Action Plans” for specific doctors. One plan for a doctor at a state-owned clinic had a simple, thuggish message to be delivered: “to get you must write. No presents anymore”. The goal? To capture 100% of that doctor’s prescriptions. They weren’t just influencing doctors; they were trying to own them.

They even created a basketball-themed presentation to train their sales team. It was designed to help them overcome doctors’ “defenses”—like, say, preferring a competitor’s drug that was less expensive. The solution to this pesky problem of medical judgment? More inducements. The presentation budgeted 67,000 euros (about $89,000 back then) to send ten doctors to a single conference in the U.S.. This wasn’t healthcare. It was a marketing campaign where patients were the pawns.

The Ripple of Betrayal

So what? A few doctors got a nice vacation. Who cares?

You do. Or you should, anyway. I do at least…. Because! Every time a doctor’s pen hits a prescription pad because of a bribe, the entire system of medicine is poisoned. The real victim isn’t a government or a competing drug company. It’s the person sitting in the waiting room, vulnerable and trusting.

Were these patients in Greece getting the best possible drug? Or were they getting the one attached to the best perks? Some doctors apparently felt a competitor’s product was the “preferred choice” and cheaper, too. Thanks to this scheme, that choice may have been taken away, replaced by a decision made in a corporate boardroom.

And to hide their tracks, Novartis Hellas cooked the books. They labeled these bribes—these payments for trips and dodgy “studies”—as simple “advertising and promotion expenses”. It was a lie designed to make corruption look like business as usual. And because the Greek company’s finances rolled up to its parent, Novartis AG, a company traded on the New York Stock Exchange, these false records propped up the financial reports seen by American investors. The deception had gone global.

A System Built for This

It’s tempting to look at this and see one bad apple. A rogue subsidiary in Greece. But that’s letting the real culprit off the hook. This wasn’t an accident. It was a strategy. This is what happens in a system that relentlessly prioritizes profit above all else. When the pressure to grow sales is absolute, corners will be cut, ethics will be bent, and eventually, people will get hurt.

The U.S. government charged Novartis Hellas under the Foreign Corrupt Practices Act (FCPA) , a law designed to stop this exact kind of international bribery when it involves companies tied to U.S. markets. It’s a powerful tool. But the story often ends the same way.

The Cost of Doing Business

The document lays out the crime in meticulous detail. What it doesn’t lay out is justice. Typically, in cases like these, the corporation pays a massive fine. Lawyers release statements. The stock price might dip for a day or two. But the individuals who drew up the “Action Plans” and wrote the meeting minutes often remain anonymous, shielded by the corporate veil. “Novartis Hellas Employee 1” gets to keep their identity secret.

The company itself made at least $71.48 million in profits from these schemes. So when a fine is eventually levied, we have to ask a hard question: Is it a punishment, or is it just the cost of doing business? Did the company learn its lesson, or did it just learn what it can get away with and how much it costs when it gets caught?

The Real Cure

This here be a story about what we value. If we want a healthcare system we can trust, we need more than just laws that punish corporations after the fact. We need a culture of real accountability. We need to see the individuals responsible for these schemes face consequences.

We need stronger internal governance at these companies, where ethical policies aren’t just paper tigers. Most of all, we need to remember the person in the waiting room. Their health is not a commodity. Their trust is not for sale. And their prescription should never, ever be a lie.

All factual claims in this article are sourced from the United States District Court, District of New Jersey, criminal information document Case 2:20-cr-00538-SDW, filed on June 25, 2020.

You can visit this link for a press release on the DOJ’s website about this settlement: https://www.justice.gov/usao-nj/pr/novartis-ag-and-subsidiaries-pay-345-million-resolve-foreign-corrupt-practices-act-cases