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Transparency and the ABPI Code

Trust is key in ensuring the successful shift for pharma from NHS supplier to joint working partner 
A combination lock on a briefcaseIn early November, Association of the British Pharmaceutical Industry (ABPI) members will be voting on proposed changes to the ABPI Code of Practice, including proposals on ceasing the provision of branded promotional aids and adopting greater transparency in payments made to health professionals and organisations. Both of these proposals have resonated strongly with external stakeholders.
 
Change is always a feature of the health landscape but over recent years we have seen a seismic shift in customers' and society's expectations of our industry. Future success will not be measured on our ability to hang on to past practices, but on how we meet stakeholders' expectations going forward. 
 
Our industry faces a great number of challenges and opportunities. These come through the emergence of value-based reimbursement, the Cancer Drugs Fund, QIPP and an NHS in England that is going through significant re-structuring. If the industry is to evolve from a position of supplier to the NHS to a genuine partner in the healthcare system, then trust has to be part of this changing relationship. Trust is the basis for joint working and new approaches to the introduction and use of new medicines in the NHS. We have to earn our stakeholders' trust and then work hard to keep it, which places an increased emphasis on our behaviours and actions not only being appropriate, but also being recognised as such. 
 
How do we know the proposed changes to the Code of Practice meet stakeholder expectations? In responding to the Prescription Medicines Code of Practice Authority (PMCPA) consultation, Kevin Woods, chief executive of NHS Scotland, said: "I fully support companies declaring payments to health professionals and organisations annually. Ceasing the provision of promotional aids is a very sensible proposal, which I support." 
The Royal College of General Practitioners agreed, saying: "We thoroughly support these proposals." The General Medical Council, The Royal Pharmaceutical Society of Great Britain and the Royal College of Physicians Edinburgh all gave a similar view. In fact, every external organisation that represents the NHS or health professionals and responded to the PMCPA consultation supported the proposals. 
 
From the patients' perspective, Dame Helena Shovelton, chief executive of the British Lung Foundation, which represents over 220 patient groups from across the UK, said: "It is important for patients to know that doctors and nurses prescribing medication do so from a position of trust and without being influenced in any way by the healthcare professional's connection with a pharmaceutical company. Seeing your doctor writing with a pen branded with a company name and using a pad similarly branded gives the impression that the doctor is employed by the company, not the NHS. This is unhelpful in building trust between doctor and patient."
 
The proposals aimed at building trust received substantial majority support from the ABPI member companies that responded to the PMCPA consultation. On each proposal – one around promotional aids and the other around transparency of payment to healthcare professionals - only two members opposed them. Of non-member companies that comply with the Code of Practice and that responded to the consultation, one objected to the proposals on transparency and six opposed the proposals on promotional aids. 
 
We recognise that the implementation of the proposed changes will present some challenges to individual companies. However, the combination of majority support from companies and the very supportive feedback from external organisations, where the proposals clearly resonate with health professionals' expectations of the future, has led the ABPI board of management to recommend the proposals to the membership for the vote at the ABPI's conference in November.

These proposals will not in themselves fully address our industry's challenge to build trust, but they are strong symbolic indicators of change and will address common criticisms made of our relationship with health professionals. Our hope is that in making these changes, we will open the eyes of some cynics to other more positive developments we are making through working in partnership with the profession and the wider NHS.
 
 
The Author
Andrew Powrie-Smith is director of trust at the Association of the British Pharmaceutical Industry

29th October 2010

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