We all know that pharma is facing hard times: cut-throat competition, regulatory constraints, patent expirations, rusty pipelines,
rising generics, falling revenues—and, perhaps most important, a firestorm of consumer anger over drug prices and safety now
being restoked by the new Democratic Congress. Nevertheless, industry persists in "staying the course"—sound familiar?—rather
than charting a bold new strategy. Its two top priorities remain opposing government price controls and thwarting patent laws
favorable to generics. These defensive tactics are hardly the hallmark of leadership.
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.
What pharma badly needs is an offensive strategy that will position it very differently. Consider this seven-point proposal
for new leadership a first pass.
Eric Lister, MD
1. Envision a health-literate public. Compared to the strides that have been made in medical treatment in recent years, the use of technology to get important
health information to consumers is sorely lagging. Pharma should take DTC advertising to the next level, and begin to make
technology an enabler. Consider structural designs that bring pharma closer to consumers' daily lives, like dispensing prescriptions
through ATM machines. Consumers could get safety, dosing, and related drug information as easily as they can access bank balances.
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.