At a recent PMGroup event, a Q&A session following a presentation on communications quickly veered off into a meaty discussion about healthcare collaboration.
The group comprised of a mixture of delegates from pharma, agency, charity and recruitment sectors, and while some agreed that there are examples of successful partnerships and joint working schemes, others questioned the practical value of such efforts, believing shared outcomes will remain an unrealistic target.
Business ecosystem
Anyone who has spent time at pharma or healthcare conferences over the past year or more will almost certainly have heard at least one speaker, if not all, extolling the virtues of forming partnerships or collaborations, or engaging in joint working.
A good example of private enterprise collaboration can be seen in the global HIV specialist ViiV Healthcare
Of course, the concept of a business partnership to further mutual interests is not a new one; in fact it’s as old as the process of commerce itself. But the shape it is now taking within the pharmaceutical industry is one that owes much to a shifting payer landscape, which is moving increasingly to a patient-focused business model, against a backdrop of cost-containment.
Shared investment
Setting aside the issue of communications and PR agencies for the time being, this new age of partnerships has begun to take several forms, but can loosely be defined as those collaborations between companies within industry and the collaborations between industry and health services, namely the NHS in the UK.
Examples of the former are becoming more and more frequent. As Stephen Whitehead said in 2012 during his first Association of the British Pharmaceutical Industry (ABPI) Annual Conference speech as CEO: “The various challenges and financial difficulties industry has faced over the past few years has led us to a period of modernisation. We are seeing greater externalisation, translational relationships, shared investment.”
A good example of private enterprise collaboration can be seen in the global HIV specialist company ViiV Healthcare, the project that was initially set up in 2009 between GlaxoSmithKline (GSK) and Pfizer and more recently has involved Japanese drug company Shionogi.
Whitehead went on to explain that this process of externalisation was beginning to permeate the broader life science sector, stating that “we are now seeing industry partner with academia, with research charities, and with the NHS”.
Making savings
With a funding gap of up £20bn by 2015, it is the NHS that would particularly benefit from an increase in joint working.
Mike Farrar CBE, chief executive of the NHS Confederation, identified some of the drivers for NHS–industry partnerships in an article in Partnership in Practice: A guide to joint working between NHS and industry.
‘The waste of ineffective prescribing, which leads to poorer outcomes and greater use of resources for patients; the waste in terms of pain or additional suffering that people endure as a consequence; the wasted resources spent by the life sciences sector in developing innovative technologies that simply don’t get applied; and the waste of development costs that are so [unnecessarily] high that companies have to try to recoup them through their pricing – which only exacerbates the problem.’
If these negatives can be reversed, waste and costs can be reduced on both sides and the NHS will be able to offer better patient care, while the life science sector would have more resources to channel back into its development phases.
So if both parties recognise the benefits of forging partnerships, it begs the question, why have we not seen more successful joint working schemes already?
Bridge building
One answer is simply necessity: the poor economy and the current fiscal pressure on the government has meant the NHS is only now being forced to making tough savings.
But it also stems from the issue of lack of trust. Chris Ross, editor at Health Publishing, wrote in the forward to Partnership in Practice: ‘… a recent online poll of medical representatives showed that lack of trust in the industry was the biggest perceived barrier to facilitating NHS–industry partnerships.’
This concern was echoed by the Ethical Standards in Health and Life Science Group, in its Guidance on Collaboration between Healthcare Professionals and the Pharmaceutical Industry. The guidance acknowledged that pharma was critical to delivering innovation in medicine and that bringing medicines to patients is a collaborative process, but it also identified transparency as key to overcoming concerns and misconceptions about the industry.
Developing relationships, which can then lead to the forging of up-front, transparent working practices, is essential. And these relationships will only work if the right people are engaged at the right level, working to understand the needs of the other.
In April 2012, the ABPI set up a team that aims to facilitate collaborations between industry and the NHS at a regional level, in order to build trust and encourage further joint working schemes.
Announcing the launch of the initiative at the 2012 ABPI Annual Conference, Whitehead said: “This team will aim to establish strong sustainable relationships between the industry and key regional NHS figures within England to address a range of healthcare challenges for more rapid access and uptake of medicines”.
The organisation’s initiatives have led to a number of successful partnerships in various disease areas, including the ABPI/DH Diabetes group, which involves a number of pharma companies with an interest in diabetes and led to the development of an e-learning module to help up-skill clinicians regarding the safe use of insulin.
Common purpose
In order to create such partnerships, both sectors need to agree on a common core purpose, which Farrar insists, “must be patient care”. This purpose can then be underpinned by a joint, compatible architecture that is supported by aligned incentives.
Such architecture can become problematic, however, if separate parties are focused on opposing outcomes.
Annabel Lee, senior external communications manager at Bayer UK, took up the discussion during the Q&A session, saying: “When working in partnerships, it can sometimes be problematic when parties become solely focused on their own outcomes, which are not necessarily the outcomes of the partnership.
“It is therefore crucial to maintain communication throughout the collaboration and remain focused on the joint win, which needs to be established transparently from the outset.”
The NHS and pharma will undoubtedly have differing objectives; one is a publicly funded health service, the other comprises of commercial enterprises. But as the NHS moves towards a more outcomes-focused model, similarities can be more easily identified and the ‘joint win’ can be achieved.
By ensuring the right patient receives the right medicine at the right time, for instance, pharma can provide the necessary medicines, while the NHS reaches its targets.
What remains, in that case, is ensuring each party’s position is made clear. Jennifer Wilson, managing director of TogoRun, said: “One of the key elements to a working partnership is being open and honest about your own objectives,” and the bedrock to this is good communication.
