The lion's share of pharma's effort has been directed at the arcane world of FDA regulations, patents, and intellectual-property issues. But the public's upset emerges from a far deeper issue: the belief that companies are not doing what's best for the public. True, the industry has begun to respond to the outcry over soaring drug prices, safety fears, and other issues. PhRMA has launched PR efforts aimed at the public, the press, and politicians, touting industry's long list of costly, socially responsible, and effective programs helping patients. But to many consumers, it's just window dressing.
2. Campaign to prevent mistakes in drug administration. Medical errors are the nation's third leading cause of death and are often related to drug misuse, overuse, or underuse. Manufacturers have a responsibility to ensure that their drugs are being used properly. New strategies, from patient-friendly labels to innovative Internet outreach, could be initiated to promote appropriate usage.
3. Address the epidemic of noncompliance. Relinquishing this responsibility to physicians clearly has not worked. Conference after conference has been held on how to improve adherence, to little avail. New approaches are needed, like bringing nurses and consumers together to learn about certain chronic diseases and providing compliance strategies as a constant companion to prescriptions.
4. Make friends with public interest groups. CEOs glad-handing on Capitol Hill should regularly include business and consumer leaders—especially as globalization means a growing intolerance of high healthcare costs in corporate America. Brand-name companies are an easy mark for anger by those who have to pay the bills: private insurers, self-insuring companies or government programs. Forging closer ties and greater education will go a long way.
5. Admit the pharma business goes beyond just providing pills. Pharma needs to realize that, like it or not, it is in the business of providing healthcare rather than pills. Funding new models to address the pressing issue of the uninsured is a good place to start. Like Wal-Mart, which is using nurse practitioners to make affordable care accessible, pharma could also court nurses as an important group of prescribers. Rather than spending in a shotgun approach to establish brand identity, companies should invest resources in sustained experiments, such as Bayer's efforts to teach physicians communication skills or Pfizer's study of disease management in Florida.
6. Establish new doctor-industry partnership. Relationships have soured in recent years under a barrage of attacks from prominent physicians, starting with Marcia Angell, former editor of The New England Journal of Medicine. Again and again, pharma responds belatedly and weakly to ethical challenges, such as calls for the posting of all study data. Only by leading the dialogue on ethics—in research, education, marketing, and sales—can its credibility be reestablished.