It all began with a raid by Chinese officials on a small travel agency in Shanghai. What the investigators found were fake contracts and travel invoices that were used to cover payments to doctors, hospitals, foundations, government officials, and anyone else who had connections to China's health care industry. \({ }^{76}\) The investigation and raid resulted from Chinese government concerns about a widespread market for fake receipts. The fake receipts are used as a front by pharmaceutical companies to funnel money and perks to individuals in the health care system. The purpose of these types of gifts, cash and otherwise, is to influence decision makers in the system to recommend the use of a particular pharmaceutical company's drugs.

Travel agencies were an ideal source for the receipts because pharmaceutical companies do indeed arrange for travel for physicians to medical conferences, a type of perk that is permitted under both the FCPA and U.S. laws and regulations. However, providing escorts, shopping sprees, and cash go well beyond permitted conference benefits. The travel agency was, however, a way to accomplish those secondary and illegal perks under the guise of the protected perks. For example, the Wall Street Journal obtained an itinerary from a threeday trip that GSK arranged for 30 doctors in order to get them to begin using Botox. The trip was to Guilin, a city where you can take in Elephant Trunk Hill and Seven Stars Park. \({ }^{77}\) One doctor said she learned a great deal on the trip even though there was no space on the itinerary for Botox training. The doctors also received a lecture fee for attending....................

Discussion Questions
1. Why do you think GSK found nothing based on its whistleblower complaint?
2. What factors would have influenced these behaviors by the GSK staff and executives?
3. What is the impact of bribery on the pharmaceutical market in China?
4. How would you respond if GSK said that it was doing what everyone does in China?