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Built on trust

The dynamic between the industry and the medical community must be addressed as the foundation for a strong partnership

A pile of rocks with 'trust' written on the uppermost oneIn 2008, the Science, Technology, Engineering and Manufacturing (STEM) survey of ABPI members identified that being a trusted partner in the healthcare system is key; key to creating the environment in which patients have access to the right medicine at the right time, where medicines are appropriately valued and where the healthcare economy supports life science innovation.

Trust provides our social licence to operate and builds the platform for real transformational change in our relationships with the NHS at all levels.

Public confidence
Recent research suggests that, in the eyes of the public, pharma has above average levels of trust when compared with other industries. However, trust in business as a whole is a falling currency. The MPs' expenses scandal, the global banking crisis, even BP's recent troubles in the Gulf, have hit public confidence in formerly trusted institutions. So, are the trust issues that the industry is facing just symptomatic of global trends?

Despite being untainted by an expenses scandal, contributing billions to the economy, having never had to be bailed out by the taxpayer, being heavily regulated and having a long-standing code of practice that is the envy of those operated by other standards agencies, the pharma industry has never enjoyed a golden image in the media. The reasons for this are complex.

Though we might argue that medicines are 24 per cent cheaper than they were ten years ago and that life-saving medication has a higher social worth than a hedge fund, we have to acknowledge that the pharmaceutical industry has always had an image problem. This image problem is probably fundamentally connected to a deep discomfort felt by certain sectors of society about the commercialisation of life-enhancing and life-saving products. Furthermore, even when trust levels are comparatively high across major groups — the general public, key stakeholders in the NHS, the medical professions and the media — we all recognise that there are issues that have an impact on the way we are able to do business.

The Royal College of Physicians (RCP) report, Innovation for Health, published in 2008, concludes: "Pharmaceutical companies distort medicine and politics, drive up the costs of drugs unnecessarily; exaggerate the investments needed to discover and develop new medicines, overstate their contributions to innovation, commercialise clinical trials and healthcare to the disadvantage of patients and the public, use marketing to manipulate science and lobby governments for their own private interests."

Whether or not you view the criticism as credible, the fact remains that views akin to these are nevertheless held by certain sectors of influential bodies such as the RCP. We are seeing an increasing trend among NHS organisations of changing the way their staff relate to the industry, particularly in areas such as support for education, training and meetings and the promotion of non-formulary medicines. Organisations such as the British Medical Association (BMA) have produced guidelines for medical students on interaction with industry and called for the cessation of "gifts and free lunches".

In facing up to these challenges we need to acknowledge that there remains a legacy from some of our past conduct and that some of our current practices do not help our case.

Key elements
The ABPI Trust Imperative is a major piece of work being undertaken across the industry to develop a new contract between industry and society based on integrity, honesty, knowledge, appropriate behaviours, transparency and trust. The Imperative has two key elements: breaking down barriers to trust and then building trust.

Over the next few months, the ABPI will be consulting with members and stakeholders on proposals to tackle some of the barriers to trust head-on. This is not simply about industry behaviour, but about addressing the dynamic between the industry and the medical community. Building an understanding of the reputational risk to both industry and the medical professions of getting the relationship wrong will help us create the right relationship in the future. Partnership will be central to success.

Transparency may just hold the key to facilitating behavioural and perception change on both sides of the industry/NHS equation. The Global Pulse Report 2010 by the Reputation Institute identified governance and the need for greater transparency as the second most important driver of reputation for the global pharmaceutical industry after its "products and services". If we are truly comfortable with the way in which we do business, we should be comfortable holding our behaviours up to scrutiny: greater transparency should encourage best practice and sideline practices we no longer want to see.

With greater transparency come the complex issues of reporting, stakeholder management and communications. The prize is to go some way towards shaking off the label of being a guarded, secretive industry, prone to inappropriate influence, and to get back to the business of meeting unmet medical needs through innovative medicines, as a trusted partner in the healthcare system.

Andy Powrie-Smith
The Author

Andy Powrie-Smith is director of the Association of the British Pharmaceutical Industry (ABPI) Scotland

To comment on this article, email

14th July 2010


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