Devalued and Distrusted: How Can Pharma Rebuild its Image?
What issues are driving the negative perceptions plaguing the pharma industry and what can be done to restore trust and integrity?
“Because the industry has been kept away from its customers, the media has come in between. As a result you get a distortion. The media wants to sell papers - and bad stories sell better than good.” Mary Baker, President of the European Brain Council– extracted from “Building Bridges, Building Trust, Conversations on the Pharmaceutical Industry.
As you will no doubt have seen, the recent Tamiflu media storm has hit the industry hard and the BBC’s Panorama exposé of illegal payments to Polish doctors has left pharma’s reputation in a sodden mess. Unbalanced media coverage and ineffective communication by pharmaceutical companies and the industry as a whole have both played a part in slanting the public’s perception. But what are the key issues that are driving the negative perceptions and what role has the industry to play in proactively addressing these issues and building a bridge between the industry and those it serves?
Knowledge is the Antidote of Fear
According to John LaMattina, former Senior Vice President of Pfizer and President, Pfizer Research and Development:
“I believe that the single biggest issue facing the pharma industry today is overcoming its poor image; more important than R&D productivity because at the end of the day, if the general public doesn’t value the new and innovative drugs that are being brought to market and question their value and efficacy then what is the point? If the industry as a whole isn’t valued and trusted and has no credibility then what is the point? I think the reason that pharmascolds have gotten such credence in the media is because of the low esteem in which the industry as a whole is held; people aren’t willing to give you the benefit of the doubt. It’s time for pharma to act and act quickly to address the issues that lead to pharma’s demise: the backlash against DTC advertising, lawsuits as a result of illegal detailing of drugs and the perception that clinical trial data is being withheld. Until we tackle these issues, any other efforts will fail as we lack credibility as an industry”.
I believe that the single biggest issue facing the pharma industry today is overcoming its poor image; more important than R&D productivity because at the end of the day, if the general public doesn’t value the new and innovative drugs that are being brought to market and question their value and efficacy then what is the point?
LaMattina also contends that the general public needs to be educated on how the process of researching and developing drugs works: “The industry has not done a good job in educating the public on the contributions it has made in the battles against heart disease, AIDS, cancer and so on. Attempts to belittle it or skew people’s opinion towards it do a grave disservice to healthcare in general if people lose faith in the medication they are taking and desist from taking it. This impacts on healthcare costs and we all end up paying for it. Many people in the general public aren’t aware of what the drug industry does in bringing innovative new drugs to market – often mistakenly thinking that drug discovery takes place in academia. This gap in knowledge is dangerous as it causes people to be unquestioning of misrepresentation in the media. Many aren’t aware of the industry’s efforts in increasing drug access in developing countries. When your reputation is tarnished, even the good you do gets denigrated”.
Prescription for Rebuilding Pharma’s Image
There was a time when the pharmaceutical industry was the world’s most admired. LaMattina recalls that Merck was deemed by Fortune magazine to be the “World’s Most Admired Company” for seven straight years starting in 1987. So what actions need to be taken to restore pharma to a position of reverence?
La Mattina’s prescription for restoring pharma’s image is fourfold:
1) Stop the DTC Advertising
“Many consumers deem them offensive, specifically ads relating to erectile dysfunction. There’s a mistaken belief that the industry spends more on TV ad spend than on R&D. If the members of PhRMA agreed to halt TV ads, my guess is that the public’s response would be overwhelmingly positive”.
2) Illegal Detailing of Drugs
“Many of the fines that have been levied against pharma companies recently for such illegal marketing practices have created a lot of cynicism about the motives of the pharma industry. Dr. Jerome Avorn, a Harvard Professor of Medicine and critic of the industry, explained it this way: ‘It’s about the money. When you’re selling $1 billion a year or more of a drug, it’s very tempting to just ignore the traffic ticket and keep speeding’. When the public reads stories like these, they are certainly not going to believe industry's claims about the cost of developing new drugs or about the importance of pharma R&D to solve health issues. If we are to regain trust, there needs to be zero tolerance for illegal marketing practives".
3) Greater Transparency Around Clinical Trials
If we have nothing to hide then demonstrate that loud and clear. It will involve investing resources in this area but it will have a significant impact on the public’s perception and it will deflate the pharmascold’s argument that bad pharma are surreptitiously burying negative trial data”.
“The industry is often accused of hiding negative trial results. The industry now posts all clinical trials it is conducting on a government website, ClinicalTrials.gov. The problem is that it has been slow to enter the final results from these studies in a timely matter. The industry needs to conform to the expectation that all results be entered within 30 months of the last patient completing the study. To show how transparent a company CAN be on data disclosure, GSK last October announced a policy that it would allow access to outside scientists to probe all the data it holds on clinical trials. Other companies need to follow suit and adopt a rigorous transparency policy. If we have nothing to hide then demonstrate that loud and clear. It will involve investing resources in this area but it will have a significant impact on the public’s perception and it will deflate the pharmascold’s argument that bad pharma are surreptitiously burying negative trial data”.
4) Transparency of payments to health professionals
“Physicians are invaluable to companies in terms of offering advice on clinical trials, leading these trials, publishing and discussing the results, etc. Doctors are justifiably paid for these services. But patients have a right to know just how much doctors are being paid. As we move towards full disclosure, there is no reason why all companies can’t publish payments to doctors on their websites and demontrate complete transparency in this area".
Changing the Dialogue: Focus on Value
They need to set restoring their tarnished image as a strategic goal both at individual company level and as an industry".
According to Christopher de Wolff, senior consultant, Numerof & Associates, Inc., there are a series of steps the industry should take to proactively improve their reputation.
"Firstly, they need to set restoring their tarnished image as a strategic goal both at individual company level and as an industry. It's widely acknowledged that their image is getting in the way of the message they want to get across to their stakeholders. That strategic goal needs to be set at the level of the CEO, where acting with integrity is as important as reaching their business goals. Changing the culture so that integrity becomes ingrained in everything they do is a vital first step to rebuilding their credibility. The behavious that requires should not need to be incentivized but rather "doing the right thing" should be an expected part of everyone's role - GSK have made initial steps in this regard.
Secondly, there needs to be total transparency in everything they do. Prove to the public they have nothing to hide.
Thirdly, I would recommend that they reallocate DTC funds to disease awareness and publicizing the positive work that they do. That could be using patient testimonials to demonstrate the value they bring to peoples’ lives or the philanthropic initiatives they engage in. People don’t want to be “sold to”, they want credible transparent health information to help them make decisions. Given the low trust of the pharma industry, why would anyone continue with the same old DTC marketing model?
Next, they need to shift the dialogue away from cost, and focus on the value that they deliver. Stop talking about the exorbitant costs of R&D – price is reflective of the value it delivers. What outcome does it deliver and what value does it bring?
Lastly, the industry needs to be strategic as to when to challenge and correct misrepresentations. They can’t tackle every pharmascold on every blog post, but where people are maliciously telling lies, that needs to be addressed with evidence to support their argument and counteract the lies. When it’s a matter of interpretation of scientific data they should argue their side forcefully, backed up with evidence”.
Pharma is a very important and powerful industry that has delivered globally important discoveries that have changed the lives of millions of people. In order to have a sustainable future, it needs to address the misdeeds of the past, take corrective action where needed to rout out damaging behaviour and take a proactive stance to rehabilitating its image through engagement and consultation. These preliminary steps are vital in order to bridge the communication gap between the industry and the general public. A revered industry is in everyone’s best interest – particularly the sick and the vulnerable who depend on the industry for access to innovative, lifesaving medication.
In a follow-up article on the topic of Pharma's Reputation, we will be interviewing Kaspar Ulf Nielsen of the Reputation Institute to discuss the specific steps pharma needs to take to rehabilitate its image.