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Page 10 of the document asked: "As a result of the program, what changes, if any, will you make in your practice?"
Healy testified that after talks at this type of program, the audience will be asked to rate the points that are made. Tracey read some of the comments made by doctors attending the seminar, which included: "Possibly less fearful of treating pregnant women," "Increased comfort in treating pregnant women," "Increase use of Paxil - Will reassess the use or nonuse of SSRIs in pregnant/lactating clients," and "More aggressive in treatment of special population, children and pregnant women."
Healy testified that this document supported his opinion that Glaxo did influence doctors' prescribing practices with respect to Paxil and pregnancy and "they were quite successful at this."
"I don't think you can find a single comment which says, I will be more cautious about treating pregnant women with Paxil," he pointed out.
The jury was also shown a "Protocol" where Stowe had applied to Glaxo for funds to do research on the issue of Paxil in breast milk. Under the objectives for performing the study, there were five possible boxes to check, and Glaxo checked the box for "image enhancement."
Healy knew of no article that ever appeared in peer-reviewed literature or was published in a reputable journal where the author said the purpose of the study was image enhancement. The odds of getting a paper published in a leading journal "would be remote to nonexistent," if you told the journal that the reason for the study was to enhance the image of the drug, he said.
Tracey then introduced a January 10, 2000 email from Jillian, at the Cohn and Wolfe PR firm, to Scott Sproull and others at Glaxo, that showed Stowe was going on a publicity tour and would issue a press release for the Paxil breast milk study on Emory letterhead to lend credibility to the study in the media.
The email stated: "Scott, please review the attached press release and forward me any comments or edits."
"As you may know," Jillian said, "Dr. Stowe is on board for publicity efforts and Sherrie and I are coordinating time to meet with him next week to arm him with key messages for this announcement, which is slated for February."
"We are sending the release for his review at the same time in efforts to secure distribution on Emory letterhead," the email said, "as you know would provide further credibility to data for media."
Healy had never hired PR firms to disseminate his published literature or lent his name to go on publicity tours for drug companies, he told the jury.
Tracy presented another protocol for a Paxil study, with Stowe as the investigator, where the objective checked was again "image enhancement." As a scientist looking at the design of this protocol, Healy said, "this appears to be part of the positioning of Paxil as a drug that will be favorable to women of childbearing years."
The budget for the study showed that Glaxo would pay $600 for each patient enrolled and the cost would be about $9,000.
Prior to 2005, Healy testified, he was not aware that Glaxo "spent any money to actually determine if the drug could be causing birth defects in human children."
Tracey produced another document from a September seminar held in Philadelphia, at which Kimberly Yonkers was speaking to a Women's Health Advisory Board. Healy said Yonkers was a professor of psychiatry from Yale University and she was on Glaxo's Women's Health Advisory Board.
He told the jury that Yonkers was particularly influential "from the point of view of issues to do with women's mental health."
