More of the Same
Nonetheless, obscured though they may be behind clouds of incense, or muffled by the outbreak of harmonious chorusing, some
stubborn vestiges of the old industry dogma still lurk. At its most innocent, the pre-reformation doctrine emerges in messages
such as the mild cautionary observation about the risks of excessive government cost-cutting: "The key is to avoid actions
that have unintended consequences—too strong a focus on cost, rather than value, will undermine valuable innovation and therefore
reduce patient benefit," EFPIA points out.
EFPIA claims that its members "have shown their commitment to work with governments to bridge funding gaps," and it invites
any government "to talk to us about their needs"—because, it goes on, "EFPIA is committed to finding solutions that work short-term
without having international knock-on effects and without hurting valuable innovation."
The tone sharpened perceptibly with warnings from Bergström that while major innovations are within the reach of industry,
"there are significant challenges in delivering these to patients in an equitable way." And Witty upped the ante by pointing
an accusing finger directly at politicians who are "not geared up" to thinking about effective ways of tackling healthcare
problems, because they have "too short-term a horizon." Healthcare authorities lack the information systems that would allow
them to understand what drives their overall costs and to identify accurately how to make real savings, he alleged, and the
industry suffers from the "schizophrenia" that affects Europe's governments. Depicting his own industry in a way that conjured
up images of a choirboy punished for stepping out of line, Witty remarked: "We have been taken behind the woodshed and given
our treatment by the governments and everybody else."
Like a disappointed missionary who finds his message rejected by unsympathetic pagans, Witty inveighed against widespread
resistance to arguments linked to overall healthcare expenditure: "People only care about what is in their silo. Nobody really
believes they will have to worry about the consequences," he says. On top of that, he even attacked the very foundation of
the institution he claimed to be seeking an understanding with: any progress in Europe is impeded, he suggested, by "the division
of the member state and European competencies for this agenda." As a result, "we have duplication at several levels and an
increase in bureaucratic barriers."
The overwhelming impression left by the EFPIA meeting is that although the industry says it has embraced a new vision, and
claims to be a born-again believer in cooperation, little has changed in its inner soul. The same old determination appears
to persist, to be devout only in a clear quid pro quo bargain where virtue is to be rewarded by guaranteed salvation. "We
will make our medicines better, and it is up to member states to make provision for paying for them," says Witty. And he warned
that "governments must not drive the pendulum too far in one direction—balance is their responsibility too." It is hard to
resist the conclusion that the industry's odor of sanctity is tainted with a more earthy scent of the pursuit of wordly goods—that
business model is still in place.
Reflector is Pharm Exec Europe's anonymous columnist, a commentator so close to the action in Europe that his identity must remain a secret