Could EFPIA's new code boost pharma's reputation?

The “eyes of the world will be upon the industry” from next year as disclosure of payments to doctors in Europe becomes mandatory – and pharma must embrace this change to help improve the poor public perception of this relationship.

This is according to David Morrow, head of medical excellence at AstraZeneca UK, who was speaking at a conference earlier this year organised in London by CompliMed Compliance.

He and other pharma compliance leaders were speaking before new Europe-wide rules come into force requiring, from July 2016, all members of EU pharma trade group EFPIA to disclose the name of every doctor and healthcare organisation with which they have worked, listing the amounts paid to each in consultancy, travel, training and other fees.

It is also an attempt to head off any legislation that could be passed in Europe that would force pharma and HCPs to show their payment details – the industry would rather do this on its own terms, than be mandated into action.

But this is still a major new era for pharma that requires a lot of change. Morrow explained: “The eyes of the world will be upon us in 2016, and we must be aware of the negative perception from the media over these types of payments.”

He pointed to a number of recent anti-pharma headlines from UK newspapers, which came after the ABPI published aggregate payments from the industry to healthcare professionals (HCPs) in 2013, as examples of what will likely occur next year.

Many national news writers and medical journals have for many years questioned the need for a financial relationship between the pharma industry and HCPs and up until very recently, neither doctor groups nor pharma wanted to make these payments transparent.

But during the past five years, pharma firms and their trade groups have pushed for greater transparency to help improve its reputation – although many doctors’ groups, especially those in the UK, have been reluctant to publicly back these plans.

Morrow acknowledged: “As an industry, we face a problem: we do a lot of good as we bring new medicines to the fore, we create jobs and value to the economy – but all of this can be tainted by a suspicion over our payments to HCPs.

“So as an industry, we need to redefine this relationship, and disclosure is a positive step. We must keep going, however, and communicate the need for a symbiotic relationship with HCPs to counteract the suspicions of the public and the media that are so evident from recent headlines.”

This also comes as the so-called Sunshine Act in the US came into force last year revealing around $3.5bn worth of money was paid by the industry to around 60% of doctors in the country for a variety of services, including research, medical education and speeches at conferences.

In contrast, around £40m ($61m) was spent by the UK pharma industry on similar payments in 2013 – although the number of doctors in the US is far greater than in the UK.

Interacting with HCPs is very important: prescribers need to know about our drugs – GSK’s Stephen McDonough

Alternative ways of working
Stephen McDonough, GlaxoSmithKline UK’s medical director, echoed Morrow, saying he was soon to be at a university reunion and was braced for the inevitable question: ‘Is the industry ethical?’

He explained: “I know over the years there has been much suspicion over the actions of the industry as a whole – it’s something I came across all the time.

“We can see from the headlines what the perceived problem is – but in practical terms, how can we start to deal with it? As a company, obviously we have all the EFPIA details to disclose but we at GSK are looking to go one step further.

“Interacting with HCPs is very important: prescribers need to know about our drugs, and how to use them effectively, and we have a duty to provide that information. But here is where the perceived conflicts of interest lay.

“Now, for several years we’ve been looking at creating a sustainable business model to address these perceived conflicts of interest, and proactively do something about them.”

He admitted that GSK has “had its fair share of bad news headlines in the last few years”, but that this should not detract from its desire to increase its reputation. 
“We’ve already done a lot in the transparency space,” McDonough said, adding: “In 2013, we were the first [and currently, the only] pharma firm to sign up to the AllTrials register, meaning we will be publishing all the clinical study reports from our research for public consumption.

“Now we’re looking at payments to HCPs and from this year – globally – we are fundamentally changing the way in which we interact with prescribers: after 2015, we will no longer pay HCPs to speak or present on our behalf – rather, we’ll be using GSK speakers instead.”

McDonough said that this was “quite a change” in GSK’s business model and will impact a lot of teams across its global divisions.

But after they announced their decision to do this last year – just as with its AllTrials announcement – McDonough said a lot of those people who were once criticising them were now praising them for their decision.

“We have to find an alternative way of working [with HCPs] – and this is very much the shape of things to come.”

Key elements of the EFPIA Disclosure Code