Interview: Deepak Khanna, ABPI

The UK's Association of the British Pharmaceutical Industry (ABPI) has undergone a great deal of change over the past year – from new branding, a new website, new offices in central London, a new chief executive in the form of Stephen Whitehead, and seemingly a new attitude that emphasises the need for collaboration if the industry is to innovate.

Continuing this trend is the appointment as president of Deepak Khanna – a UK-born pharma veteran who's spent the majority of his industry career in the US with Merck & Co/MSD.

Despite this recent revamp, Khanna still links to the ABPI of a previous administration, having served for two-and-half-years on the board of management during his time as managing director of MSD UK.

His reasons for wanting to take on his new role, however, appear to be entirely in line with the direction the ABPI is moving.

“We're going through unprecedented changes when you take a look at the Health and Social Care Bill, the NHS reforms and what that would mean,” he says.

“And now more than ever, the need to partner with the government – when you've got multiple stakeholders and significant changes going on – is very important.”

“I firmly believe in the value of this industry, so I really do think that we need to do a better job communicating the value that the industry brings to the NHS, to the economy, to supporting patient care.”

Dialogue with stakeholders
This desire for a more “proactive dialogue with multiple stakeholders” is one of three priorities Khanna is keen to focus on during his tenure – the remaining two being improved engagement with ABPI members and effective leadership of the organisation through the upcoming drug pricing negotiations in the UK.

The first two are linked, however, with Khanna keen to engage with ABPI member organisations to “allow them to better work with the NHS, better work with NICE” with the ultimate aim of improving patient care.

His plans go beyond the NHS too, with a wider audience targeted: “I don't think we have been as proactive as we should have been around educating the broader public about the value of the industry; everything from the value to the economy, the value to the NHS, the benefit that we actually provide to improving patient care, the benefit of working in partnership, joint workings and how that can actually allow the NHS to achieve our mutual goals.”

In terms of overcoming some of the concerns the broader public has about the industry, Khanna concedes: “This is not something you can change overnight. It's going to require continued examples to show where we actually do add this value.”

Referencing a 'real-world' study into GlaxoSmithKline's (GSK) Relovair in Salford, he says: “We have a good example where the NHS partnered with three companies to focus on COPD. It covered everything from identifying high-risk patients in order to be able to stratify them, to educating healthcare providers on appropriate NICE guidelines and and then providing the right level of disease management to focus on improving care.”

Bringing cultures together
Khanna should know a thing or two about getting different organisations working together towards the same goal having been instrumental in the merger of Merck and Schering-Plough.

Two major elements underpin the success of any collaboration: ensuring cultural change is managed effectively and understanding and recognising that the potential of any joint effort has to be viewed holistically.

“With Merck and Schering-Plough, they were two different cultures, two different approaches, and how you blend that into creating a unique culture is very important,” he recalls.

“I think with the NHS reforms, there is an opportunity to do that, to have its unique culture and start working in collaboration. The industry just as much wants to be viewed as part of the solution and is willing to partner with the NHS to really get there.“

To implement such a cultural change takes an understanding and communication of the legacies of both organisations to create a culture that reflects the coming together of two parties.

“I think that's the type of mindset we need moving forward, which in this new NHS needs to be this joint collaboration with the industry if mutual goals are to be achieved.”

Merck and Schering Plough were never seen in isolation once plans to merge were made, says Khanna, with his focus always on the synergy savings of a new company and how to handle the final outcome.

Fair drug pricing for all
This holistic attitude in healthcare is crucial to Khanna's previously mentioned third priority for the ABPI – ensuring a fair drug pricing scheme for both the industry and NHS.

Echoing the sentiments of ABPI chief executive Whitehead and other industry figures, Khanna praised the heritage of UK research, but bemoaned the speed of access to new medicines.

“Despite the fact that innovation is created here, we still have challenges when it comes to adoption of that innovation,” he says.

“When you take a look at uptake, it's significantly lower. So what we need in the future is a pricing environment that provides fair prices and rewards innovation, so we can invest in further R&D.”

This isn't something that value-based pricing addresses in its current form, with Khanna stressing that innovation is a step-by-step process – a scheme to reward this incremental nature is a necessary topic of discussion during upcoming negotiations estimated to take place in September, 2012.

“The priority for us around the negotiations is to keep a balance of what we have today. The PPRS has a significant number of benefits for the industry and for government and the NHS, such as predictability, stability, the ability to reinvest in the development of innovation.

“These elements need to be kept together with elements of value-based pricing that will help broaden access to innovation in this country – such as broadening the definition of value from cost effectiveness to include other facets, for example innovation and burden of illness.”

“I think this is a system that would be of benefit to the patients ultimately. It is a system that would be of benefit to the NHS and a benefit to the industry, now that they will be collective partners in improving quality of patient care and making it more efficient.”

Lessons can be learnt from what has happened in Europe regarding drug regulation and the launch of new medicines on to the market as the continent battles ongoing economic issues, says Khanna, “Whether it's the example of Greece or of other countries, if you are too drastic on the short-term savings, you can really impact patient care in the longer-term, and you can also affect future innovation.”

This awareness of today's decisions on the future environment is of particular relevance considering the predicted rise in conditions such as Alzheimer's disease across Europe, “You need to have an environment that can support innovation to help be part of the solution,” he says. “So I think with the learnings from many of the European markets is to have a balance between short-term austerity needs and long-term innovation.”

The ABPI is working with its European counterparts to spread that message to make sure this doesn't happen, with Khanna citing Whitehead's position on the board of the European Federation of Pharmaceutical Industries and Associations (EFPIA) as a key means to promote long-term innovation across the continent.

Learnings from across the atlantic
Beyond Europe, Khanna's 20 years' experience in the US has enabled him to understand the different challenges each region faces, and what they can learn from each other.

He caveats his comments by saying he hasn't worked in the US since the implementation healthcare reforms of Barack Obama's administration, but his general outlook is one of a nation with a more informed patient.

“In the US you can do a lot more, such as direct-to-consumer advertising – although I'm not sure this would be suitable for the UK,” he says. “And there is probably greater patient awareness because of private insurance. I think you may have a more aware patient because of what they have to pay for their healthcare. I think that's the difference.”

This is something the UK can improve by learning from its cousins across the Atlantic, especially in an age when information is increasingly easy and quick to acquire.

“The importance of [patients] taking greater ownership in the improvement of their own health is something that we need to continue to do better,” he asserts.

“Informed patients want to understand what choices they have. That then creates broader responsibilities for us as an industry, such as making sure that they have the right information to make some of these decisions and how we go about doing that.“

Khanna's US involvement has continued during his time in the UK, having chaired the American Pharmaceutical Group (APG) – an organisation representing US pharma companies in the UK – during his time at MSD UK.

He is still involved with the Group, however, and has confidence in its value to US companies, such as Pfizer, Eli Lilly, MSD and Amgen, in the UK.

“They put an American company slant on some of the needs within the UK and why they're important. So, for example, if you're an American company, why would you invest in the UK versus other markets in Europe? Why would you invest here versus emerging markets? What are the two or three critical things that are important here to allow us to continue to invest?”

And that involvement should continue, as long as the UK remains a country that supports the life sciences and rewards innovation.

“Because of the great clinical science, because of the good clinical trials environment, because of free price, because of many other factors, the UK has a disproportionate share of investment second only to the US.”

Future success of UK healthcare
As for the future of the ABPI, it's this linking of effective collaboration, improved communications and influencing a robust and appropriate drug pricing scheme that are key to its own success and the success of not just UK industry, but UK healthcare.

“If we can be viewed as partners to facilitate that, I think there is a very great opportunity within the UK to achieve what I believe is a mutual goal of all stakeholders, which is to improve patient outcomes and make it more efficient – and deliver it in a more efficient way.”

The Interviewer
Tom Meek is web editor of PMLive.com