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Youthful optimism

Pharma needs to regain a humanitarian vision to restore its declining reputation

missing image fileFor several decades after the discovery of the first antibiotics in the 1940s the pharmaceutical industry was highly regarded for its humanitarian vision of developing medicines and vaccines that improved and extended the lives of many people worldwide.

However, in more recent years, a much more commercial and profit driven industry has emerged. This once excellent reputation has been in decline - tarnished as a result of highly publicised instances of failure to comply with the rules that govern the promotion of pharmaceuticals.

Criticism has been received from various stakeholders, politicians, consumer organisations and both mainstream and medical media. This criticism has been levelled at a number of key industry practices, such as suppression of information from clinical trials - leading to concerns over the safety of marketed medicines - and the lavishness of hospitality and other inducements for doctors - seen as inducements to prescribe certain products.

Improving image

To try to improve its image pharma has adopted numerous initiatives, such as:

  • In an effort to improve transparency, the International Federation of Pharmaceutical Manufacturers Associations (IFPMA) in 2005 produced a clinical trial register portal, to provide a single search platform to allow healthcare professionals to search for comprehensive information about on-going clinical trials.
  • The industry associations that self-regulate their members' promotion of prescription medicines have been, or are revising their codes of conduct. The European Federation of Pharmaceutical Industry Associations (EFPIA) revised their code at the end of 2004 and one of the areas addressed was what are 'acceptable' levels of hospitality. It was recommended by EFPIA that this code should be adopted as a minimum standard at the national level by the relevant industry associations. This has now been put into practice by most of these national associations such as the Association of British Pharmaceutical Industry (ABPI) in the UK.
  • Many companies have responded on an individual basis by producing internal guidance on promotional activities, appointing additional compliance officers, more internal audits and generally a tightening of procedures for approval of promotion.

On the other hand pharma does have other stakeholders, such as shareholders, to please and appears to be turning to more and more innovative ways to commercialise their products. Examples of this innovative approach to commercialisation quoted in reports on the industry are working with patient groups and funding disease awareness campaigns. There are even claims in the press that the industry has gone one step further and is inventing cures for previously unrecognised ailments.

This has not gone unnoticed by campaigners against the pharma companies. Earlier this year an article in the British Medical Journal described how satire is becoming the latest weapon of campaigners against the influence of the drug companies. In videos posted on Youtube, the campaigners created spoof adverts for products that they claim mimic the way that drug companies are convincing well people that they are ill and need the advertised drug.

Articles such as this one, reports from consumer organisations and other media seem to indicate that, to date, the pharma industry's efforts to improve its image are not working.

Consequences

If trust is not restored or, worse still, deteriorates then the public may demand that the government further regulates the industry. The consumer organisation, Consumers International, has already recommended in their report Corporate social responsibility, drug promotion and the pharmaceutical industry across Europe that alternatives to pure self-regulation for drug promotion should be considered.

Government regulation may result in a situation where research, development, sales and marketing are heavily monitored or even controlled by government. If the concerns about the safety of marketed medicines are not adequately addressed then more control over the clinical trial process or even a lengthening of it may result. Any of these scenarios would result in reduced profit and the already high-risk investments in research and development would intensify.

Recapturing youth

Self-regulation must be allowed to work effectively by the industry - it is in its own interest that it should continue to be self-regulated. Rather than seeking to continually extend the boundaries of the codes of conduct, by employing ever more innovative marketing tactics, it must recapture the ideals of its 'youth' - those based on benefiting mankind. I doubt if anyone would argue that pharma does not have a role in providing both education and funding aimed at improving healthcare, but this must be achieved without commercial exploitation.

The way forward

It is accepted that pharma companies are commercial organisations and must make profit, and yet they must not lose sight of the fact that the commodity they are selling differs from that of other industries. Business reports such as the one from PricewaterhouseCoopers Recapturing the vision have reinforced that it makes sound business sense for pharma companies to improve their public image. This report assesses that to renew public trust and start to reverse the damage to their image, pharma must recapture its humanitarian vision.

In order to be successful the industry must implement a balanced strategy that allows profitability and sustained growth while maintaining an ethical approach to the commercialisation of its products. It must have a culture that embraces self-regulation together with processes, structures, people and other resources that enable effective compliance across the organisation.

Companies must act immediately to put ethics at the top of their agenda; to delay or take a half-hearted approach to this could put the future of pharma in jeopardy.

The author:

Judith Grice is managing director of PharmaCodes Medical Communications Ltd, providing consultancy services to the industry on compliance issues in addition to other medical communication services (www.pharmacodes.com). She is author of Global Pharmaceutical Marketing: A Practical Guide to Codes and Compliance published by the Pharmaceutical Press.

5th November 2007

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