Long before ‘Liver Doc’, this doctor fought defamation by a pharma company – and won

On September 28, the social media platform X, formerly called Twitter, withheld the account of Dr Cyriac Abby Philips, popularly known as ‘The Liver Doc’.

The blocking order, from a Bengaluru civil court, was in response to a defamation suit filed by Himalaya Wellness against Philips in end-September for social media posts against one of the wellness company’s top selling herbal products, Liv.52.

This is not the first time that a pharmaceutical or wellness company has taken the defamation route to quell criticism of its products.

Twelve years ago, when social media platforms were not the indispensable medium of communication they are now, a Danish pharma company Lundbeck had filed a civil defamation suit against the Bengaluru-based editor of a medical journal.

In a 2009 article, Dr Chandra Gulhati, who was then the editor of Monthly Index of Medical Specialities, had pointed out that an anti-depressant drug made by Lundbeck was being sold in India – even though Denmark had prohibited its sale in its home market.

This was a clear violation of India’s Drugs and Cosmetics Act, 1940, which mandates that a drug can only be imported in India if it has been approved for sale in the home country.

Only 23 countries had approved the anti-depressant, Deanxit. “These were low-income countries with poor drug regulation,” Gulhati, who is a physician like Philips, told Scroll. Developed countries like Canada, USA, Australia, European Union or Japan had not approved Deanxit. “That raised serious concerns over its efficacy,” he said.

His article was followed up by multiple news outlets. It forced the government to form a committee to look into the approval process of the drug.

The company filed a criminal defamation case against Gulhati in a Bengaluru magistrate court, which he had to fight for 10 years. “Such action on individuals highlights pharma companies’ attempts to quash negative publicity,” Gulhati told Scroll.

Gulhati said in most cases, pharma or wellness companies succeed in silencing critics. “Not everyone can afford a legal case,” he said.

Last Friday, Philips moved the Karnataka High Court against X and Himalaya Wellness Corporation, seeking restoration of his handle @theliverdr.

The case against ‘The Liver Doc’

In 2019, Phillip first posted tweets questioning the efficacy of the herbal medicine Liv.52, a herbal medicine that Himalaya markets for treatment of viral hepatitis, alcoholic liver disease, fatty liver disease, symptomatic care in liver injury due to chemotherapy and radiation, and to increase appetite.

Philips told Scroll that representatives from Himalaya came to meet him soon after to explain that the product was safe and efficacious but could not provide scientifically validated studies to support that.

In 2021, he posted a series of tweets questioning the claim that Liv.52 was safe for humans.

In his tweets, Phillip said that while the company claims to have 300 research papers on Liv.52 to its credit, there are 86 available online with only seven that cover clinical trials on humans.

While some studies find that the use of Liv.52 affords an overall hepatoprotective quality, or ability to limit liver injury, Philip’s concern is mirrored by at least three research papers that specifically name Liv.52 and discuss the lack of its efficacious data. One study in Sri Lanka finds that the product is not useful in alcohol-induced liver disease as Himalaya claims on its website. Another important randomised controlled trial on 188 liver patients in the USA found that Liv.52 actually led to increased mortality in patients with severe cirrhosis. A third study in Chandigarh’s Postgraduate Institute of Medical Education and Research found that Liv.52 “is not useful in the management of alcohol-induced liver disease” and raised the need to evaluate the impact of such herbal products scientifically including double-blind placebo controlled trials.

Himalaya did not respond to Scroll’s queries on the research papers or its defamation case against Philips.

In its petition, Himalaya Wellness claimed that Philips has maligned the company in order to promote products of pharma company Cipla and Alchem.

In response, the Bengaluru court ordered that his Twitter account will remain suspended until the next scheduled hearing in January. The court has directed Kerala-based Dr Cyriac Abby Philips to refrain from posting or publishing any content on Himalaya. “I came to know of the court order after Twitter notified me. They suspended the account within hours of the court order,” Philips said. “My priority is to get my handle back up,” he told Scroll.

The Deanxit case

In its criminal defamation case against Gulhati in Bengaluru magistrate court, the Danish firm Lundbeck had alleged that the article “deteriorated the reputation of the petitioner Company and also affected the medical community as a whole as well as the general public”.

Gulhati told Scroll that before filing the defamation suit, Lundbeck’s officials had met him to dissuade him from further reporting. In the Liv.52 case as well, Philips said he was approached by Himalaya officials.

Gulhati had to travel from Delhi, where he now resides, to Bengaluru for every hearing in the criminal defamation case. “I made 15 trips in total. Since it was criminal defamation, I had to be present for every hearing. But officials from Lundbeck hardly turned up.”

The idea was to tie Gulhati down with the court case. “Eventually my lawyer brought it to the court’s notice that the company officials were not attending the hearing,” he said.

Gulhati said he continued to fight the case as his report “had facts and no opinion” about the drug. “But it costs a lot of money,” he said.

In 2013, the Union health ministry banned the sale of Deanxit. Gulhati said the drug accounted for 50% of the company’s sales in India. Lundbeck approached the Karnataka High Court to quash the health ministry’s notification and continued the case against Gulhati.

But in 2021, Lundbeck closed its operations in India. With it the defamation case also came to an end. “It took ten years,” Gulhati said.

‘Allopathic doctors cannot prescribe Liv.52’

Before the Lundbeck case, Gulhati too had written about Himalaya’s Liv.52. The Monthly Index of Medical Specialities flagged the contentious issue of medical representatives from Himalaya promoting Liv.52 to allopathic doctors, despite a 1996 Supreme Court order that homeopathic doctors cannot prescribe allopathic drugs and vice versa.

“In our report we showed that medical representatives of Himalaya were actually visiting allopathic doctors to encourage them to prescribe Liv.52,” Gulhati said. He added that since Liv.52 was a herbal and ayurvedic formulation, it could only be prescribed by ayurvedic or homeopathic specialists.

Himalaya stopped the practice of promotion to allopathic doctors after the article.

This reporting was supported by a grant from the Thakur Family Foundation. Thakur Family Foundation has not exercised any editorial control over the contents of this article.