Perception Vs. Communication: Pharma's Executive Leadership Role in Public Health
By Sudheer Reddy
Since the average consumer doesn’t fully understand the role that Big Pharma has on the delivery of healthcare, it’s not surprising that the overall perception is not very positive. In fact, pharmaceutical companies are relentlessly accused of being driven more by money than by the public’s well-being. During the 2020 coronavirus (COVID-19) pandemic, the fears, uncertainties and doubts have become even more pronounced. For example, consider the dynamics that surround the COVID-19 vaccine development. Trust issues abound among those who believe that a medication introduced “too soon” would be widely unsafe and that one brought to market “too late” would be the result of a hold up due primarily to political gains. To mitigate the negativity, today’s pharma professionals can make a difference by educating the public and becoming better advocates for the profession that takes front and center stage.
Public misperceptions
Crucial to improving the relationship between big pharma and the public is being cognizant of the concerns consumers harbor about the industry, regardless of how inaccurate they may be. Chief among the public’s misgivings are that drug prices are inflated in order to generate more profits for manufacturers, and that the motive to bring new medications to market rests solely on the profit potential. Similarly, consumers believe pharma executives could easily afford to lower drug price costs, but ultimately choose not to. Recent executive orders signed by President Trump that could lower prices on some medications in the future by allowing certain drugs to be imported from Canada and changing the way pharmacy benefit managers (PBMs) negotiate prices for Medicare,1,2 highlight misinformation that exists between consumers and drug manufacturers. In this context, many people don’t understand the complex mix of payers and negotiators across the continuum that often impact drug purchasing prices all around. The result is that the prices patients see at the point-of-sale do not reflect the prices pharma pays to actually produce these drugs. More often than not, the burden of blame and responsibility for the prices falls on this industry.
How these negatively charged beliefs evolved and became so prevalent is open to a theoretically endless debate. Inaccurate or uneven media coverage could play a factor just as easily as could an overall lack of education on how drugs are brought to market and at what cost. Any lack of public education that exists, however, implicates the industry’s constituents and stakeholders just as much as it does mass media. The misconceptions and bad impressions are primed to remain and gain traction the less that those within industry don’t communicate all the good that exists, such as the donation of nifurtimox and other drugs to neglected regions through collaborations forged by manufacturers and the World Health Organization (WHO).3
Counterbalancing media coverage
For better or worse, mass media remain a major contributing factor in how people generally view the world around them. Generally speaking, prescription-based drugs seem to be portrayed as not easily accessible to everyone, whether due to insurance restrictions, pricing, or needing to obtain a provider’s signature. While this latter point is not as easily misconstrued, assuming that the process of legitimate medical practice is being adhered to, the former examples represent concepts devoid of grey areas. Information shared on these matters will be influenced by the depths of reporting and the knowledge base of those doing the reporting, which will always be a sliding scale. This places emphasis on those in industry to proactively engage in frequent and comprehensive public relations (as opposed to only being reactive to media coverage that’s perceived to be negative).
It’s important to note that not all media coverage is “poor,” even if that may seem to be the case sometimes. Case in point: On Sept. 8, 2020, the Washington Post, reported on a pledge made in a joint effort by chief executives overseeing many major drug companies. Through the agreement, officials have assured that they will not seek regulatory approval of experimental coronavirus vaccines that have been established in Phase 3 clinical trials before safety and efficacy have been established.4 As the report states, this is “an extraordinary effort to bolster public faith in a vaccine …” but not all representatives of these companies took the initiative to voluntarily release their own press statements online for public consumption as of press time for this article. This is a missed opportunity for more positive media exposure, as well as better brand imaging, especially considering the pandemic and the heightened awareness that healthcare has in mass media and the likelihood of more people conducting related online searches currently.
Call to action for health leaders
In a landmark report published in 2016, Stefan Oschmann, president of the International Federation of Pharmaceutical Manufacturers and Associations and chief executive officer of Merck, Darmstadt, Germany, claimed: “Improving public health is everyone’s business and everyone’s responsibility, including the pharmaceutical industry.”5 The pharma industry benefits from a variety of well-educated healthcare leaders from multiple disciplines. This is a great asset for purposes of research and development; however, those in the C-suite possess more finance and business backgrounds, which may be admirable and valuable, but does not put them in close connection with patients.
Company-wide courses on public health and other related topics can be helpful to drive a cultural change that seeks to help all constituents be more acclimated to the people served by the industry and informed about the issues they face as well as the beliefs they hold.
A “patient-first” perspective should be the vision among all pharma companies from the standpoint of research and financial decisions. With a commitment to innovative approaches to health care delivery, pharma leaders can enhance public opinion and lower costs without jeopardizing profits or the public well-being. Some of these initiatives could include:
- direct-to-consumer sales and pharmacies that eliminate the “middlemen” or minimize their influence
- flat-rate pricing or a subscription-based model for pharma products
- coupons/discount offers available directly through the pharmacy
- education of consumers about the breakdown of money received by party after a sale, including the manufacturer, pharmacist, distributor, and PBMs
- application of strategies employed by other countries, especially related to insulin and epinephrine
- utilization of artificial intelligence in clinical trials and research to reduce population heterogeneity and to provide prognostic and predictive enrichment6
Promotion during pandemic
The current pandemic is a unique opportunity to help the pharmaceutical industry build its reputation and to share how it directly contributes to public health. Consider that as of September 2020, more than 3,300 COVID-19 trials have been found in Clinical Trials.gov7 and that as of August 31, nearly 600 COVID-19 drug-development programs were in the planning stages and more than 310 trials had been reviewed by the U.S. FDA.8 On another note, there are some 7,000 new medicines currently in development around the world, there has been an 88% decline in HIV/AIDS death rates since the 1990s, a 73% survival gains of cancer attributed to new medicines and, 550 new medicines have been approved by the FDA since 2000, according to PhRMA.
This time of pandemic is also an opportunity to promote public awareness of biopharma’s past successes, for instance, advocacy during the HIV crisis for anti-coagulant factor 8 deficiency that was funded by pharma.
Acknowledging challenges and overcoming barriers
There is some dissension among industry experts regarding the level of fault on the pharma industry for drug prices, particularly the patent system.5 What’s more, a broken system in Washington, DC, remains one of the main barriers that pharma executives face. As the Trump administration realizes there are many other players involved in driving the costs of drugs higher, it would be beneficial to implicate everyone involved rather than focus solely on the bigger pharmaceutical companies. There’s no question that dealing with COVID-19 is causing significant stress on this industry. Yet, the United States government would like to resolve drug pricing issues and curb innovation. This ultimately will lead to delays in COVID-19 vaccines and treatments and, likely, increase public scrutiny and mistrust. The existing negative reputation will be difficult to change and will take a great deal of time and effort on the part of industry representatives. Lowered drug prices are expected to be the main ask, but this will require the collaboration of the government and other healthcare sectors if the desired answer is to be given.
In 2016, Dr. Oschmann predicted three of the biggest challenges shared by the pharmaceutical industry and global health today would be access to essential medicines, neglected tropical diseases, antimicrobial resistance, and non-communicable diseases,5 and these sentiments appear to be validated. According to the WHO, other major concerns include healthcare delivery in areas of conflict and crisis, healthcare equity, infectious disease prevention, and, to bring the issues full circle for the pharma industry, improving public trust of healthcare workers.
Despite these issues, the fact remains that profit drives further product innovation in the pharma industry. A curb in innovation would hinder research and development of other drugs that might yield greater results for the greater good. Driving the point further, drug companies contribute to overall health by the sheer measure of manufacturing much-needed treatments and cures, discounting drug prices for lower-income populations, fast-tracking much-needed medications, and educating the public on important health-related issues. But does the general public and, in particular, vulnerable patient populations, know enough about the work being done? Industry leaders can capitalize on the overall awareness of health that exists today due to the pandemic as a teaching moment for the public and vulnerable patient populations if the right steps are taken.
About the Author:
Sudheer Reddy has been working in the pharmaceutical industry for more than 10 years and is currently a research and development leader at a major pharmaceutical company. He is a pharmacist, a public health professional, a Six Sigma Black Belt (ASQ), and an innovation coach.
Note: The content of this article represents the author’s independent opinions and is based on research and expertise but not to be attributed to the author’s company.
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References
1. American Patients First. HHS. 2018. Accessed online: www.hhs.gov/sites/default/files/AmericanPatientsFirst.pdf
2. Lupkin S. Trump Signs Executive Orders On Drug Prices. NPR. 2020. Accessed online: www.npr.org/2020/07/24/895290378/trump-signs-executive-orders-on-drug-prices
3. Essential Medicines Donated to Control, Eliminate and Eradicate Neglected Tropical Diseases. WHO. 2016. Accessed online: www.who.int/neglected_diseases/Medicine_Donation_June_2016.pdf
4. Rowland C. Vaccine CEOs Issue Safety Pledge Amid Trump’s Quest for Pre-election Approval. Washington Post. 2020. Accessed online: www.washingtonpost.com/business/2020/09/08/vaccine-safety-pledge-ceos
5. The Role of Pharmaceuticals in Public Health. Boston University School of Public Health. 2016. Accessed online: www.bu.edu/sph/files/2015/12/Role-of-Pharmaceuticals-in-Public-Health-Summary.pdf
6. Taylor K, Joao Cruz M, Properzi F. Intelligent clinical Trials: Transforming Through AI-enabled Engagement. Deloitte. 2020. Accessed online: www2.deloitte.com/us/en/insights/industry/life-sciences/artificial-intelligence-in-clinical-trials.html#endnote-sup-4
7. COVID-19 Clinical Trials. ClinicalTrials.gov. 2020. Accessed online: https://clinicaltrials.gov/ct2/results?cond=COVID-19
8. Coronavirus Treatment Acceleration Program. FDA. 2020. Accessed online: www.fda.gov/drugs/coronavirus-covid-19-drugs/coronavirus-treatment-acceleration-program-ctap