Leadership, obviously, is a huge issue in the industry right now. What do you think of the pharma industry's performance in
It's not been a strength. One of the things the industry has lacked is visible leaders who can express the reasons why pharma
should be appreciated. Part of the issue is that people in our industry tend to be very fact-based. Industry messages have
been primarily aimed at the head. But for many people, healthcare is a heart issue. We have facts and figures and arguments
about the contribution of drugs, the value of drugs, the responsible way most companies have behaved, but we are unable to
respond to attacks, which tend to be very anecdotal and emotionally driven.
One of the reasons Billy Tauzin is the head of PhRMA right now is that I watched him answer some questions in a TV interview.
He was asked by a reporter about drug importation from Canada. Billy said something like, "Well, I'm no expert on drug importation,
but my mother went into a drugstore in her hometown in Louisiana last Thursday, and let me tell you what happened..." I don't
remember exactly what he said, but I remember that at the end of the story, people looked at him and they said, "Okay, I kind
of get it."
How about leadership at FDA?
Phew! That's a tough one. I've known the last few FDA commissioners, not really well, but I've certainly come in contact with
them a lot. They're in a very difficult position, not unlike pharma leaders. When something goes wrong, they come under such
a hostile attack that it consumes a lot of their time and energy, especially the commissioner. It has put FDA in a position
where they deal more with the political reality of things than they do with the science. And that's never good.
It seems we're at a point when fairly large policy decisions are being made in reaction to prodding from Congress, such as
ratcheting up the standards on drug approval.
Ratcheting up is one thing, but I think the issue today is unpredictability of the standards. It's not just that they're evolving,
they're changing based on the sense of what the politicians want, and that's a shame. FDA has very good people committed to
what they're doing. But I watched some of the Congressional hearings on C-SPAN, and the treatment FDA officials get is really
brutal. Congress has got to realize that they are best off when the FDA deals with science and medicine, instead of trying
to respond to political pressures.
One of the big issues in the industry is the switch to the specialty market. Does this mean we're on the verge of a huge improvement
in the way we treat specialty conditions, or does it mean we're on the verge of seeing a collapse of the current favorable
economics of specialty drugs?
I think some of the talk is a little exaggerated. The big factor driving the pharmaceutical industry today is the availability
of good new products with new product technology—there's a real scarcity of that right now. If you start with the assumption
that the biggest issue in the pharmaceutical industry today is new product to fuel growth, I'm not sure that what you want
to do is say, "We only what to be in specialty markets," or, "We only want to be in mass markets."
The wiser course of action is to take advantage of all the good new product opportunities, whether they're in mass markets
or specialty markets. Over the last few years the industry's productivity has been in fields that were not fully developed.
But given the relatively poor state of treatment in a number of the specialty conditions, companies have been successful in
developing drugs that add something useful in, for instance, oncology. In our case, it's rheumatoid arthritis or hemophilia
or in other areas that we're heavily involved in today. That's not because Wyeth said, "We want to be a specialty company."
That's just where our research took us, and I think that's true for many other organizations.