The European industry is making saintly noises about collaboration, but vestiges of the old dogma remain, says Reflector.
If you want to know what the Vatican is thinking, a pontifical high mass is a good place to start. If you want to know what the European pharmaceutical industry is thinking, you can do worse than attend its equivalent – the annual meeting of Europe’s main drug industry association, the EFPIA.
This year’s ceremony, in mid-June, offered some fashionable displays of ecumenism – a desire to bridge divisions, to collaborate, to work together. The federation’s president, GSK CEO Andrew Witty, pledged to “continue listening to patients, customers and other stakeholders and work in partnership with them to find solutions to the challenges facing Europe.”
Other virtues that the industry paraded included joint actions with European regulatory authorities on everything from new pricing methodologies to seeking innovative responses to the challenges of an ageing society. It is important now, says EFPIA, that the industry works closely with the authorities in Brussels and across the member states. “New thinking, new mindsets and new partnerships will be essential,” added its new director-general, Richard Bergström.
The pharma industry’s Damascene conversion to cooperation may in part be pure altruism, but there are some strong practical incentives for the European drug industry to start singing from a different hymn-book too. Over recent months the debate on healthcare among European governments has become increasingly focused on keeping a tight rein on expenditure; the drug industry is recognizing that it can no longer rely on what it has for years regarded as a clinching argument in its dealings with governments: that industry imperatives absolutely require decent prices for drugs.
The June council of European Union health ministers ended with a tirade against overpriced drugs, unleashed by the current council president. Miklós Réthelyi, Hungarian minister for national resources, who chaired the meeting, highlighted the importance of “cost-efficient use of medicines”. It will be necessary, he said, “to impose controls on expenditure on medicines”. This angle of attack is becoming the norm in the EU, as a follow-up to extensive council debates last year on healthcare that produced highly critical reports on the cost of medicines.
As a consequence, industry is shifting its arguments away from the need for drug sales to fund the research cycle, and is putting its faith in a more comprehensive view of the overall healthcare scene. Success in this revised strategy depends on winning friends not just among the authorities that handle drug budgets, but among the authorities that handle the entire healthcare budget. Hence the surge of enthusiasm for new partnerships.
Nonetheless, some stubborn vestiges of the old industry dogma still lurk. 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”.
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 said. On top of that, he even attacked the very foundations 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. It is hard to resist the conclusion that the industry’s odour of new-found sanctity is tainted with a more earthy scent of the pursuit of wordly goods.
Reflector is Pharm Exec’s European correspondent.