How Covid is building trust in Big Pharma

Big Phar­ma is hav­ing a moment. News of a coro­n­avirus vac­cine is cast­ing the phar­ma­ceu­ti­cal indus­try in a new light, as col­lab­o­ra­tive and work­ing in the pub­lic inter­est. It’s a world away from pre­vi­ous per­cep­tions of putting prof­its before peo­ple, keep­ing secrets and tak­ing time to inno­vate.

Indeed, the 2019 Edel­man Trust Barom­e­ter found only 57 per cent of the UK pub­lic had faith and trust in the sec­tor. More recent­ly, a sur­vey of UK con­sumers by med­ica­tion review site Drugs Dis­closed revealed 93 per cent of patients are mis­trust­ful of infor­ma­tion about their med­ica­tion, with 84 per cent believ­ing the phar­ma indus­try influ­ences pre­scrip­tion deci­sions.

What poten­tial, then, does the vac­cine have to redeem the phar­ma­ceu­ti­cal industry’s rep­u­ta­tion and how can this rein­vig­o­rat­ed trust unleash its true poten­tial? More impor­tant­ly, how can Big Phar­ma main­tain this trust post-Covid?

Continuing momentum to maintain positive perception

Con­sen­sus is that the col­lab­o­ra­tion, open­ness and pub­lic ben­e­fit demon­strat­ed in cre­at­ing a vac­cine are what stands to reha­bil­i­tate the industry’s rep­u­ta­tion, with more of this need­ed beyond its roll­out.

“The events of 2020 have giv­en the pub­lic a win­dow into the world of phar­ma research and devel­op­ment and, for many, have enhanced their view of the sec­tor,” says Dr Steve Arling­ton, pres­i­dent of phar­ma­ceu­ti­cal col­lab­o­ra­tion net­work the Pis­toia Alliance.

“The impor­tance of set­ting up col­lab­o­ra­tive pro­grammes between com­pa­nies that would nor­mal­ly com­pete was quick­ly recog­nised by the indus­try. The recent announce­ment by Pfiz­er is one of, we hope, many that will be made over the next few months and this suc­cess proves col­lab­o­ra­tion is huge­ly impor­tant in our quest to cure, treat and pre­vent dis­ease.”

The sec­tor must car­ry this momen­tum and col­lab­o­ra­tive instinct for­ward to con­tin­ue build­ing trust, he adds.

This atti­tude needs to extend to the gen­er­al pub­lic, notes Pro­fes­sor Sam Shah, chief med­ical strat­e­gy offi­cer of men’s health spe­cial­ists Numan, with deep­er trans­paren­cy required on a range of lev­els.

“Advances in health­care are like­ly to come from real-world evi­dence and cit­i­zen data. How­ev­er, for cit­i­zens to share their data they need to know how it’s going to be used, for what ben­e­fit and what out­come. Increased trans­paren­cy with­in the sec­tor would build this trust, but requires col­lab­o­ra­tion between reg­u­la­tors, indus­try and the pub­lic,” says Shah.

“Mech­a­nisms could include plat­forms where cit­i­zens con­trol their own data, with vis­i­bil­i­ty of who access­es it. These sorts of plat­forms don’t yet exist in the UK or most parts of the world.”

The incen­tive mod­el for phar­ma­ceu­ti­cal com­pa­nies must also move towards bet­ter patient out­comes and com­mu­ni­ty invest­ment, ver­sus the cur­rent trans­ac­tion­al mod­el, allow­ing for bet­ter align­ment with the pub­lic sys­tem, he adds.

“There needs to be a bet­ter way of match­ing needs to the pipeline. How­ev­er, this requires a new rela­tion­ship of co-pro­duc­tion, one many pub­lic health­care sys­tems strug­gle with. They gen­er­al­ly have a poor record of man­ag­ing com­mer­cial rela­tion­ships or work­ing with indus­try,” says Shah. It boils down to bet­ter engage­ment with cit­i­zens and the health­care com­mu­ni­ty over­all.

Kari­na Mal­ho­tra, founder and man­ag­ing direc­tor of patient expe­ri­ence con­sul­tan­cy Acu­men­tice, believes this is eas­i­er said than done.

“Renew­ing an image that doesn’t put prof­its against the greater good is key. It’s the com­mu­ni­ca­tion of that social-val­ue piece, with­out com­ing across as oppor­tunis­tic, that remains elu­sive,” she warns.

Breaking the mould to transform the industry’s reputation

A hand­ful of phar­ma­ceu­ti­cal cor­po­ra­tions are break­ing the mould. Chiesi, for exam­ple, has become the largest phar­ma com­pa­ny to obtain B Corp accred­i­ta­tion. And, as Sana Ala­j­movic, founder and chief exec­u­tive at pre­ven­ta­tive health­care start­up Sigrid Ther­a­peu­tics, points out, they are already gain­ing ground in boost­ing the phar­ma­ceu­ti­cal industry’s rep­u­ta­tion.

“Merck’s CEO [Ken Fra­zier] was part of a busi­ness advi­so­ry coun­cil in the Trump admin­is­tra­tion and when the Pres­i­dent refused to crack down on white suprema­cist vio­lence that was hap­pen­ing in 2017, he sim­ply stepped away from that coun­cil,” Ala­j­movic recalls.

“And Novar­tis’ CEO [Vas­ant Narasimhan] is a great exam­ple of a mod­ern leader. He has his own Insta­gram account, where he com­mu­ni­cates with staff, shares books he has read; it’s like he’s talk­ing to you. “So a shift in the indus­try has to start with lead­er­ship at the top; they have to become more human. They have to take a stand because you don’t oper­ate in a vac­u­um. There are a lot of forces at play, like sus­tain­abil­i­ty and lead­er­ship, through which phar­ma will have to change the way it works, to be bet­ter per­ceived.”

B Corps and Big Pharma

Becom­ing a B Corp is no easy feat, yet those who do can claim the high­est stan­dards of social and envi­ron­men­tal per­for­mance, pub­lic trans­paren­cy and legal account­abil­i­ty to bal­ance prof­it and pur­pose.

With more than 3,500 com­pa­nies world­wide now cer­ti­fied as B Corps, just 20 are in phar­ma­ceu­ti­cals. The largest is Ital­ian con­glom­er­ate Chiesi. Group pres­i­dent Alber­to Chiesi believes coro­n­avirus has accel­er­at­ed a cul­tur­al shift from “share­hold­er cap­i­tal­ism” to “stake­hold­er cap­i­tal­ism”, and Chiesi has a role to play to attract more com­pa­nies to “embrace this way of doing and mea­sur­ing busi­ness per­for­mance”.

“The trig­ger point is when it will be clear­ly acknowl­edged that striv­ing to gen­er­ate shared val­ue does not mean busi­ness­es should focus on pos­i­tive impact at the expense of finan­cial per­for­mance. Act­ing as a sus­tain­able busi­ness is a key com­po­nent of a long-term suc­cess strat­e­gy. That deserves also a con­crete reflec­tion on how for­ward-look­ing poli­cies could sup­port and reward sus­tain­able busi­ness mod­els,” he says.

Yet Dr Steve Arling­ton, pres­i­dent of the Pis­toia Alliance, caveats that becom­ing a B Corp is just one ele­ment of repair­ing the phar­ma­ceu­ti­cal industry’s rep­u­ta­tion. Co-ordi­nat­ed efforts both across and out­side the sec­tor are cru­cial for last­ing change.

“Com­pa­nies need to be able to work close­ly and non-com­pet­i­tive­ly with groups includ­ing oth­er phar­mas, reg­u­la­tors, patient advo­ca­cy groups, health pay­ers and providers, and logis­tics and sup­ply,” he says.

“It’s impor­tant to look out­side of the sec­tor, too. The crossover between tech­nol­o­gy and research and devel­op­ment, in areas like arti­fi­cial intel­li­gence and machine-learn­ing, telemed­i­cine and quan­tum com­put­ing, is grow­ing all the time. We can only make sure every­one ben­e­fits from these inno­va­tions if we work togeth­er to put in place frame­works to guide adop­tion and pool resources.”