Out in the open

Eli Lilly's decision to post educational grant funding online solidifies the company's commitment to transparency.

Eli Lilly's decision to post educational grant funding online solidifies the company's commitment to transparency.

On May 1, executives from Eli Lilly and Co., one of the largest pharmaceutical companies in the world, made an announcement that had been in the works for more than a year. Beginning that day, the company would post online all educational grant funding it provided to US-based organizations, becoming the first pharmaceutical company to do so.

The company unveiled a detailed list of the organizations requesting grant money, the program or project description it was to be used for, and the individual payment amount. An industrywide process that had for years been subjected to criticism for perceived conflicts and influence was suddenly revealed for all to see.

It was not a decision that was made overnight. In March 2006, Eli Lilly received a letter from the Senate Finance Committee, detailing its interest in the grant process and requesting additional information from the company.

The next month, the seeds were planted for eventual action on the issue during a conference call with a number of high-level executives across the disciplines.

"We started talking about it, and it really evolved from a discussion that was very defensive, and thinking about how we were going to prepare in a defensive posture, to one that moved into a very proactive discussion, saying we believe in the positive nature of these grants," says Ed Sagebiel, manager of corporate communications.

Eventually the communications team proposed its plan of action. If it was possible to collect the massive amounts of data from organizations across the country, the company could compile it into an easy-to-use registry at www.lillygrantoffice.com. Of course, nothing in this industry is an easy sell.

"I think it's fair to say that not everyone was comfortable with this level of transparency," Sagebiel says. "It certainly invites the opportunity for scrutiny and to look in greater detail [at] what it is we're funding." But he was also supremely confident that the grants were not only beneficial, but also essential to the industry. If greater transparency could help critics see this, then it was worth it.

It wasn't Eli Lilly's first foray into uncharted territory in regard to the transparency issue. In late 2004, the company made a comprehensive commitment to disclose its clinical trial results, again becoming the first major pharma company to do so. That move quickly began to aid its reputation efforts.

In an editorial from June 2005, The New York Times took Merck and Pfizer to task for their respective records on disclosing clinical trial results. It said of their track record: "That meager contribution appears to satisfy the weak guidelines set by the industry, but it offers a sorry contrast with the record of Eli Lilly. Lilly appears to have been quite scrupulous in listing its current trials with the government site and has posted the results of hundreds of completed clinical trials on the industry site. Surely, if one big company can make its trials transparent, other drug makers can do the same."

Groundwork pays off

Phil Belt, director of corporate communications at Lilly, says the clinical trial registry was a huge reason there wasn't much resistance to his team's pitch for a grant registry. "If we go back to the clinical trial registry, one of the things we gleaned from it was that it clearly gave us a tangible message - with actions behind it - that we could deliver about the company being serious about being transparent," he said. "That fact certainly helped people see how much sense it made to be so open and clear."

There were other moves that helped, too. In 2004, the company formed the Lilly Grants Office, creating a wall between its sales and marketing and the grant decision-making process. Also, in 2005, the company began disclosing the contributions its Political Action Committee makes. Both moves, Belt says, helped pave the way for the grant registry.

But, of course, critics remain. Dr. Sidney Wolfe, director of watchdog Public Citizen, says that while both the clinical trial registry and grant registry are better than nothing, they still can't replace government regulation in those areas. "I think all these industry efforts are efforts to try to fend off something mandatory that would surely be much better than what any of them are doing," he says.

But Sagebiel argues that the company's efforts are genuine and that by keeping the public informed, it can better articulate programs it believes are in the public's interest. "We shouldn't be doing this for PR purposes," he says. "We should be doing this for broader reputation purposes and because it's the right thing to do. If we do that, then good PR should follow."

Less than a month after the grant registry announcement, Alex Azar, former deputy secretary of the Department of Health and Human Services, came on board as SVP of corporate affairs and communications, reporting directly to CEO Sidney Taurel.

Azar believes the transparency issue is paramount to the industry reversing its reputation slide in the public opinion polls. The lesson, he says, is not that the company or industry has anything to hide, but that the public needs to be kept in the loop.

"I don't like that word 'disclosure,'" Azar says. "I think it's more announcing. Disclosure suggests there's something that's wrong, but you're letting people know about it. I think that these are things we do, we're not ashamed we do them, and we're taking some of the cloak off them by being transparent about them."

Both Belt and Sagebiel agree, adding that should other big pharma companies follow Lilly's lead, it could only help.

"We've heard positive feedback from our pharma colleagues," notes Sagebiel. "I think that the momentum this has created will probably continue. Any way you can help break down a negative perception by doing something positive is always helpful."

Eli Lilly's top grant recipients for Q2 2007

Requestor Program/project description Payment amount

Pri-Med Institute Meetings and newsletter on depression and pain $750,000

Pri-Med Institute Meetings and newsletter on depression and pain $536,400

Postgraduate Institute
Weighing the Evidence: Weight Management Insights $532,039 Medicine for Treating Serious Persistent Mental Illness

Collaboration for Advancement of Urologic, Sexual, $500,000 and Endocrine Education

Massachusetts General 2007 Psychiatry Academy $412.500 Hospital Dept. of Psychiatry

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