News Analysis: Judgement day for Big Pharma

PR practices in the pharma sector are being probed by a House of Commons Select Committee. Ian Hall reports from Westminster on the issues raised. An hour into the sixth session of parliament's inquiry on 'The Influence of the Pharmaceutical Industry', there was a moment of light relief during an exchange concerning media relations and journalistic ethics.

Daily Mail medical correspondent Jenny Hope, one of five witnesses at the 16 December meeting (see box), was responding to a question on the extent to which she engaged with PR consultants. Part-joking, she said she 'doesn't regard going out for dinner as an inducement (to write a story)', to which the committee's chair David Hinchliffe, Labour MP for Wakefield, fired back with a knowing grin: 'Well it depends who the dinner is with!'

But the quip was an isolated instance of jocularity in 90 minutes of quick-fire but heavyweight questioning in the Boothroyd Room at Portcullis House.

PROs from pharma firms and agencies listened intently as one of their own - Ogilvy Healthworld European president Margot James - was questioned by MPs, alongside Hope, Sunday Times medical editor Lois Rogers, Lancet editor Dr Richard Horton and Mike Paling, MD of healthcare advertising firm Paling Walters.

The ongoing select committee inquiry comes, of course, as Big Pharma faces increasing scrutiny and challenges to its reputation of which the alleged 'burying' of negative clinical trial data is probably the most damaging to have surfaced in recent months.

Whereas the big picture is Big Pharma's ultimate integrity, micro issues raised at the sixth session included the peer review process, direct-to-consumer advertising and 'disease-mongering'.

The ethics of hospitality

Given the presence of journalists and PROs, the ethics of hospitality became a hot topic - and one that saw James in strident mood to tackle the stereotype, pointing to strict codes of practice on 'freebies' - the Association of the British Pharmaceutical Industry (ABPI) is currently in the midst of a consultation process on its own code of practice.

The two national journalists were asked whether they felt they were 'being used' by drugs firms as promotional conduits and how often they made use of 'opinion leaders' suggested by PROs.

Rogers insisted that a PRO suggesting an individual as an 'opinion leader' would deter her from quoting that person as she would 'think they were in the pocket of a drug company'.

Hope concurred, adding: 'The PR industry sets great store by opinion leaders, which mystifies me.'

When Hope and Rogers were asked whether they had been 'obstructed' by pharma firms in attempts to 'obtain the truth', both cited standard complaints that aggrieve all journalists; they flagged up a failure of PROs to return calls, the transferring of messages to answer machines with dated messages and the fielding of spokespeople 'too junior' to answer authoritatively.

The MPs, in turn, criticised the media in general for being 'unhelpful' in continually using the description 'controversial' to describe the MMR vaccine.

In respect of specific medical journals, Horton described less prestigious titles than The Lancet as being 'places to drop articles that are clearly promotional on behalf of a particular company'.

He said authenticity is often given to 'completely spurious' views by their publication in 'third and fourth-rate promotional journals' and that follow-up promotional campaigns are massively problematic.

Horton criticised the fact that much regulation of the pharma sector is voluntary and thus 'lacks teeth' - but Paling and James insisted that contraventions of such codes are rare.

Nonetheless, the fear is that regulations to encourage transparency that restrict communications could be on the cards.

The health select committee expects to publish a final report in March.

But any repercussions will not become concrete for many months, if not years.

Some of those PROs present at the hearing were clearly unimpressed by what one described as a 'biased' (anti-industry) tone of questioning from the MPs; similarly, it seemed to others that some MPs were unable to draw a distinction between different marketing disciplines.

For those PROs concerned by the motives of the committee, however, one MP struck a tone of reassurance, saying: 'We are keen to make this report fair. (As yet) we haven't had much evidence from the industry.'

Pharmas take the stand

This will change on 13 January, when the committee reconvenes for its seventh session. Industry representatives from trade bodies such as the ABPI and the British Generic Manufacturers Association will then take the stand, plus pharma firms themselves.

Twenty-four hours after the sixth session, James told PRWeek: 'I feel more positive about the review than I did before the session. I thought the questioning was critical but fair. I did sense they were listening and I wish I could have said more.'

But how could the day-to-day lives of PROs be affected by the review?

'I think there's more likely to be change on the medical education side, more rigorous procedures to follow,' says one PRO, who prefers to remain anonymous, citing issues such as publication planning, the peer-review process and data presentation and promotion.

But the PRO adds: 'This would have to be voluntary and would be a long way off.'

Meanwhile, Edelman joint chief executive Nigel Breakwell, one of the PROs in the audience at the 16 December session, says one outcome could be greater focus on codes of practice in medical education in respect of working with authors, their data and liaison with publications.

But he adds: 'I don't see the day-to-day of what PR people do as changing as a result of this review. Having said that, the committee has put so much effort in, something will certainly come out of it - most likely moves towards greater transparency.'

PROs have been left to speculate as to the potential ramifications of the select committee investigation. But 13 January will see Big Pharma's corporate communicators and public affairs specialists return to Westminster for the next instalment.

WITNESS LIST FOR 13 JANUARY

- Eddie Gray, GlaxoSmithKline Pharma (UK) senior V-P and general manager

- Dr Stuart Dollow, GlaxoSmithKline (UK) V-P, medical division

- Chris Brinsmead, AstraZeneca (UK) marketing co-president

- Dr John Patterson, AstraZeneca (UK) executive V-P, product strategy,

licensing and business development

- Dr Richard Barker, ABPI director-general

- Vincent Lawton, ABPI president

- Dr David Chiswell, BioIndustry Association chairman

- Simon Clark, British Generic Manufacturers Association chair

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