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Tackling the Trust Issue


Pharma's challenge is to break the cycle of mistrust so that its pioneering work can fully reach patients in need, writes GSK's Murray Stewart.

An uncomfortable irony for those of us working in pharmaceutical companies today is that we are dedicated to helping people, and yet increasingly are unable to defend ourselves against accusations that our industry does the opposite. The toughest questions we face are not over why we are not curing cancer faster or whether one approach to treating diabetes might be more effective than another – but about trust.

Without trust, everything you do is looked at in a suspicious and negative manner. The pharmaceutical sector is the poster child of this dynamic, with the timeliest illustration found in the debate over the cost of medicines, but it permeates even our altruistic attempts to provide charity or disaster relief. The suspicion is so high that people look for ulterior motives rather than accept that we are trying to make a difference to patients’ lives.

Great advances in science and drug development are leading us to medicines of true value, with the potential to cure some diseases and give patients full and healthy lives again. Our challenge is to break the cycle of mistrust so that our pioneering work can fully reach patients in need and we can once again be recognized as credible health partners. The pharmaceutical industry did not get into this situation by accident and I believe that we not only must take accountability, but must take extra steps to demonstrate how our rhetoric translates into action. This shift starts with being clear and transparent about why and what we are doing.  

GSK is not without its past indiscretions, but one trait the company models is a willingness to plunge into new waters for the sake of our credibility. In recent years, we have overhauled two historically-rooted key industry practices – the first pharmaceutical company in the world to make these changes. First, over the last few years, we changed the traditional structure of our commercial relationships. For the last five years in the US, and the last year and a half globally, we no longer provide our sales representatives incentives based on the number of prescriptions generated.

Second, as of this year, we stopped paying external healthcare providers to speak on behalf of the company about our prescription medicines. While it is a legal practice, the ethical concerns that it raised were not in the best interests of the company or our relationships with customers and patients.  

Changing practices which have been long embedded across an organization, and, indeed, across an industry, is a challenging proposition and growing pains were inevitable. Many commentators have questioned our approach, and much has been written about whether it will be workable when faced with traditional commercial realities. In fact, we are seeing evidence of positive commercial impact. For example, last year ViiV Healthcare launched two innovative HIV therapies with great success in the US, surpassing launches of other recent HIV treatments and allowing these two regimens to reach #1 position in dynamic patient market share. 

We have not lost sight of our goal: to ensure we are making the right decision for patients -- which we believe is inseparable from the right decision for our business. This is driving intelligent, tough conversations with our employees about what value really means to customers, what customers really need in a world where they are under pressure, and how to help a customer or a doctor make a better, more appropriate decision. We have confidence in our medicines, but we only want them used when they are the right drug for the right patient. 

Other parts have been easier. Everyone is stretched for time, most especially our healthcare providers, and convenience is the name of the game. Now, when healthcare professionals need information on our medicines, they can go online and have a direct interaction with a highly qualified GSK physician who can give them the information they need 100 percent within the framework of the regulation. 

We have about 1,000 physicians globally at GSK and employ an increasing number of specialist medical experts in the US and other countries who work directly with healthcare providers  across therapeutic areas to provide detailed information and support the appropriate use of our medicines.

More than 16,000 providers across 20 countries recently logged into a webinar as part of this program, providing evidence that our approach is working.

That is being clear and transparent. It works when we think about how to be there for those who look to us for information, whether it is when a doctor needs us or transforming how our sales representatives work.

I believe that being clear about what we are doing and why leads to and supports trust. Being nimble and embracing progress is also the universal key to survival and, I believe, at the heart of a prosperous business. So, we must continue to dare ourselves to change for the better. 

Murray Stewart is Chief Medical Officer, GlaxoSmithKline.

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