Jennifer Wilson, TogoRun Europe: The transparency problem

Healthcare stakeholders have diverse agendas that make transparency a complex issue.

No-one would argue that transparency, such as that cited by GSK's Phil Thomson, is a bad thing. Countless government regulators, patient advocates, journalists and industry leaders want to see sensible schemes to address the growing clamour to tell all.

Beyond the obvious - more transparency is better - this is a complex issue that involves multiple stakeholders, diverse agendas, even life and death.

For example, the drug development and approval process is laborious and long. Phase III clinical results may not bear up when hundreds of thousands, if not millions, of people take the drug. The larger usage pool can reveal new findings that were not apparent in the testing process. No-one lied or tried to cover up information. There was total transparency, but the facts changed.

It may take a company some time to work out why the discrepancy occurred and how best to communicate the new information.

Pharma companies are highly regulated and highly cautious. They abide by a complicated set of standards that govern what they can and cannot say. Information, prematurely released or containing inaccuracies, can find its way around the world in a matter of minutes, so companies must try to control what they say and to whom they say it if they want to preserve their reputations and the public's trust.

Then there is the role of the media. Are they merely gatekeepers, or influencers whose opinions are framed by their relationship with the industry? I have worked with dozens of healthcare reporters over the years and none of them has ever said: 'Give me dramatic headlines that will sell news.' Just the opposite. Most journalists toil tirelessly, doing research and conducting interviews with independent third parties so they get it right.

Doctors and other healthcare professionals are also maligned, accused of succumbing to external influences when they prescribe certain medications. To imply that a skilled medical professional shouldn't be paid fairly for his or her expertise is absurd.

Patient advocacy organisations are important stakeholders whose voices must be considered when talking about transparency. Most are adept at distilling complex information and communicating the pros and cons to patients. In fact, there is often an outcry from patients who want to be included in clinical trials. People can be desperate. This is why many countries allow patients access to unlicensed drugs in compassionate-use programmes.

Finally, public relations professionals are also often held up to the transparency magnifying glass. We are accused of dramatising data results to grab headlines. That, too, is patently absurd. We spend hours researching and talking to clinical investigators and independent doctors to understand a drug - its benefits, side effects and mode of action. We must cite everything we write. We must include fair balance information. And then our materials go through an excruciating, time-consuming legal and regulatory review. It would be almost impossible to communicate misleading or false information in these press materials.

The call for transparency has received a great deal of attention in recent years and many stakeholders have chosen to engage with the issue. However, any call for increased transparency has to take into account these many complicating factors and the dynamics of these multiple stakeholders. Ultimately, we all have one goal: to give patients better treatment options and better outcomes.

Views in brief

- How will proposed changes to the NHS affect pharma marketing?

The Health and Social Care Bill offers real opportunities for pharma marketers. The replacement of PCTs by business-friendly consortia will let the industry work with like-minded people to offer cost-effective medicines.

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

I would ask him whether this enormous administrative upheaval in the NHS should be accompanied by the replacement of PPRS with value-based pricing. With drug prices in the UK among the lowest in Europe, this is unnecessary, and potentially very damaging to the industry and to inward investment.

Jennifer Wilson is senior vice-president and managing director at TogoRun Europe

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