Jo Bullen, APCO: Pinpoint the power brokers

Healthcare companies must identify the stakeholders that can affect their business interests.

Phil Thomson of GSK acknowledges that the way in which a company interacts with its stakeholders is integral to its reputation. But that is only part of the jigsaw. A company's ability to align what it is saying to those who determine its business outcomes, its approach to those relationships and the way it interacts with the political and policy world are all part of its success.

Last year was, and 2011 promises to be, a year of upheaval and reform to health services and markets across Europe as the ramifications of political change play out. In the UK, the publication of the Health and Social Care Bill; in France, the review of the medicine authorisation procedure and pharmacovigilance; and in Germany, health insurance reform and the new law on drug pricing create a new context for interaction. All point to the need for an integrated approach to stakeholders that recognises the new societal and political context.

The upheaval has a common theme: a focus on efficiency, health outcomes and transparency. In the UK, the coalition Government may be experiencing an occasionally bumpy ride but it is determined to overhaul the health service in the face of vocal opposition from some entrenched interests. Significant changes in the way funds are allocated, a new pricing system for pharmaceutical products and proposed changes to NICE have created a radically different environment from only a year ago. This is an opportunity, but only if handled properly, recognising where the power lies.

In other EU markets, the upheaval is playing out in different ways. In France, the pharmaceutical industry is under the spotlight, with the legitimacy of the French medicine agency in question and the relationship between industry and government under scrutiny. An official investigation related to swine flu vaccines, the ongoing Mediator scandal and questions about the risks associated with some medicines are the driving forces. Companies operating in Germany have had their ability to set prices for their products curbed under a pricing scheme for prescription products.

Across Europe, new benchmarks for openness are being set - the UK Government's transparency agenda is one example. Companies have to respond, particularly if they have only one or a handful of purchasers of their products. Companies such as GSK must negotiate this new environment, demonstrating to their stakeholders - from parliamentarians to civil servants, from the media to patients - that they can engage in a positive, trustworthy and transparent way.

Although transparency is not something that is new to healthcare companies, some have significant reputational challenges to overcome when embarking on this approach.

Addressing these reputational challenges means going beyond the typical healthcare regulator/government relationships to make the case more broadly for the value healthcare companies and their products bring, to the patient, the economy and society. Thomson is right when he says GSK must engage with the right stakeholder, but this should not be at the expense of those others who can affect its interests.

This means having an in-depth view of the landscape, and using that knowledge to deliver integrated comms activities that do not compartmentalise comms and marketing disciplines. Evidence-based arguments can be delivered in a way that, in times of upheaval, recognise where decisions are being made. This approach may just make the reputational and transparency issues that companies face a little less challenging.

Views in brief

- What is the most innovative public health campaign in the past year?

MEND, a free healthy living programme for sevento 13-year-olds and their families developed by Great Ormond Street Hospital and the Institute of Child Health. A great example of ensuring that kids understand at an early age the importance of taking healthy decisions.

- How would you fill a five-minute meeting with Andrew Lansley?

I would take my own GP with me and ask Andrew Lansley to put the case for GP commissioning to her, so I can hear how it is supposed to work on the ground.

Jo Bullen is a director at APCO

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