Pharma’s uncritical use of the word ‘stakeholder’ has increased to the point where it can refer to almost anyone connected to the industry. But this can have serious consequences, warns Reflector.
Like it or not (and frankly, I don’t), stakeholders are here to stay in European pharmaceutical affairs. Don’t get me wrong. I’ve no objection to democratic engagement, or to giving people with a legitimate interest a legitimate voice. It’s the word I object to. Partly on aesthetic grounds, because it is an ugly coining. But much more because it is one of these words that has now been appropriated by everyone to mean exactly what they want it to mean, irrespective of what it means to anyone else. Consequently, despite its almost mandatory inclusion in every discussion of contemporary pharmaceutical affairs, it has largely lost its meaning.
The upcoming symposium of The Organization for Professionals in Regulatory Affairs (TOPRA) offers a fine example. One of the sessions, entitled ‘Better access to medicines in a changing regulatory environment,’ will look, says the programme, at “the important contribution of all stakeholders” in achieving better health outcomes and improved access. The session will doubtless provide a valuable investigation of some of the genuine challenges identified in the title. But why ‘stakeholders’?
In fact the programme goes on to spell out who TOPRA consider
s as the constituents of this group: “specifically patients, healthcare professionals, academia, pharmaceutical industry, EU institutions and regulatory agencies.” That seems a perfectly reasonable list of interested parties to debate the subject. But when it then indicates that the discussion will cover “the experiences of interaction between stakeholders and working parties at national and EU level,” the question immediately arises as to who sits on these working parties. Not stakeholders, since stakeholders are interacting with them. That — according to TOPRA’s own definition — would rule out patients, healthcare professionals, academia, pharmaceutical industry, EU institutions and regulatory agencies. So what looked like a useful exchange on an important subject is suddenly revealed as an exploration of what can only be phantom working parties consisting of people who have nothing at all to do with pharmaceuticals.
To offer only the most obvious example of the risks to the pharma industry from lazy use of words like ‘stakeholder,’ look at how the term is used by the European Public Health Alliance (EPHA) — an admirable, influential and respectable civil society organization, but no automatic supporter of the pharmaceutical industry. Its mission statement includes the pursuit of “European insti
tutions that are accountable and accessible, policy-making that is transparent and with real opportunities for stakeholder input.”
The stakeholders that EPHA are thinking of certainly do not include the pharmaceutical industry or EU institutions. For EPHA, and many of the other organizations that maintain cautious vigilance over the operations of the pharmaceutical industry, stakeholders are the public, or patients, or consumers, or organizations representing them — not, in other words, the uncritical allies of pharmaceutical companies.
So if the European pharmaceutical industry continues to use the term uncritically, it is at best muddling its message, and at worst playing into the hands of some of its most vociferous opponents. The point is not a simple question of semantics. If the pharmaceutical industry wants to win the battles for hearts and minds that it inevitably and constantly must fight across so many fronts, it is going to increase its chances by being more rigorous in its approach to debate — and it is going to decrease them by sloppy talk. One stakeholder’s heaven may prove to be another stakeholder’s hell.