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Cracking the code

The new ABPI Code of Practice has left some PR and medical educational professionals puzzled. What's the issue?

The new ABPI Code of Practice landed on our desks with a bang in January and came into full force on 1 May. The reverberations it caused throughout the industry are matched only by the great puzzlement of the PR and medical education communities, which seem to be collectively flummoxed by the whole thing.

So what's the issue with the new Code? Well, much of it is down to the (probably) well-intentioned, but sadly misinformed chattering classes who huddle in corners at industry events to dissect it. Unfortunately, as all too often happens, much of this chatter is based on rumour and innuendo instead of fact. There appears to be a burgeoning perception out there in the shadowed world of PR and med ed that the new Code could ruin people's lives and livelihoods. There is genuine panic around some aspects of the Code, with concern that well-established practices are suddenly being questioned or put under the spotlight for the first time. The two closely-aligned industries become white with fear when their under-the-radar activities start to be questioned by the approver's pens. It is certainly a hot topic.

The new Code
Quite a few aspects of the traditional work of PR and med ed teams has either been changed or newly embraced by the Code. Media activities; advisory boards; hospitality at meetings; meeting reports; pre-approval of materials by the MHRA (the Code extends beyond UK law, so be aware); the humiliation of having to invite a world-renowned journalist to attend an international congress, but only fly them coach; and the well intentioned hornets nest of better transparency in relationships with patient organisations - which is welcomed by the industry, but has met with mixed views by those groups.

It is no great surprise that this is causing some commotion in the hallowed offices of PR and med ed agencies and departments. Indeed, quite a few other aspects are getting our colleagues rather hot under the collar. First, there are some new and very scary sounding sections.

Secondly, everyone and his grandfather have a view on what's acceptable and what isn't - some sections invite interpretations and so no two are the same.

Thirdly, the Code doesn't really cover many of the media aspects on which the PR industry is based.

Fourthly, it is not black and white, but shades of grey, and we don't like grey. Both PR and med ed are full of creative, inspirational and innovative folk and we all want to know what's hot or not, we don't want the 'perhaps' brigade talking to us. And yet, the Code is not really so grey as people believe.

Reading the Code
The problem lies with interpretation and no two signatories seem to agree on what is or is not acceptable. The fault here lies not with the Code, but with how aware those individuals are with breaches that relate to PR and med ed. The best ammunition in Code-conquering is to read the Code, read the supplementary information and also read the case reviews - most relate to the process and most are glaringly obvious. See how few people appeal - in many cases, the facts speak for themselves. Most are common sense.

Your corporate headquarters cannot simply ignore local legislation and randomly issue a press release to your UK media. Advisory boards need to be that, not disguised promotional meetings (that's nothing new by the way). The Code does not ban you from releasing new medical and scientific data pre-launch/outside of licence. Graphs and tables taken from clinical studies need to be true representations of the original - that's not a `what colour can I use?' issue, it's about fair and balanced reproduction of the facts.

How would you feel if you were buying a car for the nanny to ferry your kids around, and the car company showed you a graph with all the safety comparisons of the SUV you were looking at versus their main competitors? Then, you discover that four of the 10 comparator cars had not been included by the company because their competitors did a tad better than them and they weren't that keen to admit itÖ same issue? There is a need for honesty in our approach.

We too are dealing with dangerous tools in the wrong hands. Medicines are miracles for the millions of those who benefit, but each year, thousands more suffer the ill-effects of mis-prescribing or poorly recognised side-effects. With your SUV, if it doesn't quite work out for you, you can change it, but if your precious 14-year-old daughter is prescribed an unsuitable medicine for her asthma, there may be no turning back. The consequences of our economies with the truth, or boasts of miracle cures, could live with our victims or their families forever.

How the Code might affect our industry
Let me dispel another myth - the Code does not stunt our creativity, it simply forces us to be honest. Our industry is ultimately there to benefit patients, and PR and med ed play an enormously important role.

As a part of that, our teams work with product teams to identify the USP for their product and capitalise upon it. If you are the sixth atypical anti-psychotic onto the market, you would need some pretty compelling evidence to be able to describe its appearance onto the UK stage as a `major breakthrough'. And, yet, that is often what product managers are striving for and we, PR and med ed folk, are at fault for humouring them.

Every product has a niche, every product has its own benefits and downsides, but be damn sure you have one hell of a case if you are going to call it a breakthrough. Few of us seek to actively mislead and, thank goodness, few Code breaches are front-page news. Most of the breaches that impact on us PR and med ed types relate to the way in which data has been presented, how much a company, or the PR or med ed agency has influenced or dictated the content and whether or not we have been fair and balanced. The principle of the Code is pretty simple - make sure what you do is appropriate, factual, fair, balanced and able to be substantiated. Don't fool yourself, the brand manager or anyone else on what that means - sailing close to the wind will only cause trouble. We are PR and med ed people in a brave new world.

A changing world
So what advice can I impart upon the puzzled masses? It really is not doom and gloom! Our worlds are not closing in on us, they are simply changing and so must we. Use the very thing that your clients have hired you for - your heads. I can see the challenges for us all.

Whilst CEOs and managing directors across the industry have been forthright in their endorsement of the Code, many product teams would like to behave in the same way they have always done, which makes our lives very difficult. I do see this changing, but we all have a role to play here. We are all going to have to spend a little more time in the beginning to get things right in the end.

If the industry really is as serious as I think it is about this new Code, there are some pretty significant implications for everyone. We are all going to have to pay a bit more attention to the detail of what we do - this means more senior level support, more time spent exploring options, more time getting our facts right and, ultimately, a recognition that there is a price to pay for that.

The benefit for us PR and med ed gurus, if we get to grips with the Code, is that we will become full members of their extended product teams and, indeed, our responsibilities will also increase. That's going to make it more rewarding all round - both professionally and fiscally. Clients will have to accept that this level of professionalism does not come cheap and that our expertise will inevitably have to cost them more. It also means that the risks of trusting inexperienced agencies or poorly trained staff to run your programmes for you will be too high.

Finally, this is the industry's Code! If you question some aspects of it, there is no reason why you cannot lobby to change that aspect. The Code is constantly reviewed, so do not be afraid to comment to the ABPI.

The Author
Liz Shanahan is the managing director of SantÈ Communications and chair of GLOBALHealthPR. She can be at lshanahan@sante.co.uk

2nd September 2008

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