Restoring Public Trust in Pharma

We all know the challenges facing our industry—patent expirations, declining R&D productivity, and ever-increasing pressure to hold down costs and deliver value—to name a few. But the biggest challenge we face, and one that permeates every aspect of our business, is the public's lack of trust in our industry.

Patients are looking for Big Pharma to give it a lift, and it's industry's job, through improving perceptions, to get its customers on board with the notion that it has their best interests at heart. (Getty Images/Compassionate Eye Foundation/Sam Diephuis)

For those of us who have made their careers in pharmaceuticals and know the contributions our industry has made to society, this lack of trust is both puzzling and frustrating. Why is this happening? After all, our industry has discovered and developed hundreds of medicines and vaccines that have made important contributions to improve the health and well-being of people around the world. Yet, instead of being held in high regard as one of the greatest contributors to health in our society, our industry ranks among the lowest in public trust. In a recent Harris poll, only 11 percent of people said the pharmaceutical industry is generally honest and trustworthy.

So what went wrong? The answer, I believe, is that in some ways our industry lost its way, and failed to fully appreciate the evolving expectations of our stakeholders.

Practices Change, Perceptions Remain

Before the first PhRMA Code was adopted in 2002, the industry engaged with its customers in ways that are common in many industries in which business-to-business selling takes place. That business model may still be OK for some industries, but we do not sell chocolate or cars. We bring life-altering and life-saving medicines to patients. Society holds our interactions with our customers—healthcare providers and payers—to a higher standard. And it should. Society expects our business to be conducted openly and transparently and in a way that does not create even a perception of inappropriate influence.

To be fair, our industry has made significant changes in how we operate over the past decade with the adoption and strengthening of the PhRMA Code. This may be something our critics either are unaware of, or choose to ignore.

So, negative perceptions remain. Some of this has to do with long-running government investigations, litigation over past practices, and the resulting news coverage. Some of it is because we haven't done enough to communicate what we do and don't do. Some of it is because industry bashing is good politics. Some of it is because we still make mistakes. No matter the reasons, at the end of the day, we must regain the public's trust in our industry.

So, What Should We Do?

We need to ensure our customers understand—that beyond compliance laws and regulations, which is a given—we operate from a core set of values that underpins every decision we make and every action we take. We must inculcate those values into our corporate cultures to create a framework and a mind-set in which compliance with rules and regulations is not the ceiling, but the floor from which our organizations operate.

At GlaxoSmithKline, the four values we strive to live by are:

» Focus on the best interests of the patient;

» Be transparent about our working relationships;

» Operate with integrity; and

» Respect those we work with and serve.

These values are not new to GSK, and we don't always get it right. But, one of my goals in joining GSK two years ago was to ensure that if you stopped any GSK employee and asked them what the values of the company are, they could tell you without hesitation. Most importantly, my goal is to ensure our customers see those values in each of our employees.

It is my view that, as long as we continue to demonstrate these values into our daily conduct and decision-making, we will meet the expectations society has for us, and we will be able to deliver value to our stakeholders in a values-based way.

So how do we put these values to work in our business?

Let me give you an example: When our representatives talk with doctors, we require that they share the extensive knowledge they have about our drugs—including both who should and, quite importantly, who should not take our medicines. To reinforce this requirement, we're changing the way we provide bonuses to our sales professionals. In the past, like other companies, we based the variable portion of their compensation on the volume of prescriptions they obtained in their sales territory. Now, we're rewarding them for providing the information and support our customers need and that is in the best interest of the patient.

Integrity is doing the right thing; transparency is being open about what we do. Some of the financial relationships and industry practices from previous years are no longer viewed as appropriate, and so we've changed them. Other practices that the public sometimes views as inappropriate are actually important to good healthcare. For instance, we believe properly engaging doctors to share their knowledge with other physicians in peer-to-peer education programs helps them keep up with advances in medicine.

We also believe that physicians should be fairly compensated for their time and expertise. Yet some patients, government officials, policymakers, and even some in the medical community have questioned the integrity of these relationships. So to provide assurance on the integrity of these relationships and to be transparent, we began voluntarily posting our payments to US healthcare professionals for speaking and consulting services on our website.

Our fourth value is respect. We all know the golden rule: Treat others as you would like to be treated. We market a drug that treats erectile dysfunction (ED), a legitimate medical condition that affects the lives of many men. It is also a condition that many people are not comfortable speaking about. And it certainly is not a condition parents, aunts, uncles, and grandparents want to explain to children while watching a football game on Thanksgiving.

This is where respect comes in. While a practice may be perfectly legal and even acceptable according to industry codes, we have to respect the wishes of the society we serve. At GSK, we are very thoughtful about where we advertise our ED medicine so we can reach the patient where they are, rather than blanketing the airwaves, in order to avoid advertising in places that are easily accessible to children.

For our industry to regain public trust, we must constantly examine how we interact with our customers, how we communicate with patients and providers, how we fund activities, and how we share information. We also need to do a better job of informing those we serve about how we operate now. We also need others in healthcare to stand with us and embrace a values-based approach to our interactions and recognize and respond to how we've changed.

By doing these things, we can assure the public that our industry—an industry that has brought so much benefit to so many—is conducting its business with focus on the patient, with transparency, with integrity, and with respect. In this way we will be worthy of trust.

Deirdre Connelly is President, North America Pharmaceuticals at GlaxoSmithKline. She can be reached at Deirdre.p.connelly@gsk.com