A Crisis of Trust: Pharma’s Battle to Win Back Public Confidence

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Kim Ribbink

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A Gallup poll ranks the pharmaceutical industry at rock bottom in terms of trust. So what can pharma do to overcome its image problem?

Public trust in the pharmaceutical industry is at an all-time low. Data from Gallup’s latest Work and Education poll, carried out in the first two weeks of August each year, ranks the industry last on a list of 25 industries, below the oil and gas industry and the federal government. Healthcare also languishes near the bottom, in 23rd place, just above the government.

Wendy Blackburn, executive VP of Intouch Group, says pharma is the industry that Americans love to hate, and turning that around won’t be easy or quick, especially in an election year.

“A good first step is to take an honest look in the mirror to understand what’s driving anti-pharma sentiment,” Ms. Blackburn says. “Heightened media focus on issues such as the opioid crisis, drug pricing, the size of C-suite executives’ paychecks, and recurring class action lawsuits have not endeared pharma to the masses.”

“What has jaded many about pharma, particularly in the United States, is the perception that aggressive commercial objectives come before what is best for patients,” says Nareda Mills, president of Ashfield Patient Solutions.

Exacerbating the problem is the high level of attention on the industry.

“From political candidates to the daily onslaught of news, the topic of healthcare, and in particular pharmaceutical companies, is driving negative conversation and a tone of mistrust about the industry,” says Peter Sandford, executive VP, NXLevel Solutions. “The bond with the public has been shattered.”

There’s also a perception problem due to lack of knowledge about what the industry does, Mr. Sandford says. “The perception that costs are out of control and companies charge excessively for their products is rampant,” he says. “This leads to a belief that the industry is driven by profit and does whatever it can to operate outside of the lines.”

Karen Young, US pharmaceutical and life sciences leader, PwC, says trust is an issue that is important for all stakeholders in the healthcare ecosystem, and every organization has a role to play in addressing consumer concerns with issues such as privacy, cybersecurity, affordability, experience, and quality.

Changing Perceptions

To win back public trust, pharma must clean up its bad corporate behavior from the top down, Ms. Blackburn says.

“The industry needs to clean out the bad apples and put ethics and integrity back into the corporate conversations,” she says. “We must also walk the walk when it comes to putting patients first. This means putting patients over profit and ensuring medications are affordable. If pharma doesn’t figure out pricing quickly, the government will figure it out for us — not a desirable outcome.”

While the industry has moved its focus toward a more patient-centric approach, due in part to a rigorous regulatory environment as well as a genuine mindset shift toward putting the patient first, Ms. Mills says it takes time for this cultural change to translate to a different way of doing business and for better engagement with patients across all functions. “Pharma will win back public trust when it demonstrates that it consistently puts patient-centric decision-making into practice,” she says.

Mr. Sandford says winning back public trust won’t be easy and will require companies to take internal and external steps to foster a stronger foundation of trust.

“Internal company efforts must include enhanced training and reinforcement, at all levels and roles, on the topics of compliance, conduct and policy,” he says. “Employees need to understand the what and why of compliance and appreciate how operating in a compliant and ethical manner benefits them, the company, and the public. Continuous implementation of creative and engaging training will create a greater culture of compliance in each company and enhance the reputation of the industry.”

Drug development is a mystery to most of the public so the industry needs to be more transparent and visible, and share specific metrics on the advances being made to cure disease and prolong life, says Brenda Reese, founder and president of phaseUP.

Companies must also educate the public, Mr. Sandford says, creating awareness programs to educate the public on the cost of creating products, why the industry does what it does, and the results and benefits of those efforts.

Trust is built over time by consistently demonstrating three key attributes: credibility, care and congruence, says Lauren Lawhon, chief operating officer at Health Union.

“For pharma companies, credibility is established with the product itself — delivering on the promise of an effective and tolerable therapy — and with marketing communications that use people-focused language that is clear and easy to understand,” Ms. Lawhon says.

“Companies must also demonstrate empathy and care for the people who may need or use their product by listening to them and seeking to understand their experiences, wants, and needs,” she says.

“This approach should start in preclinical development and continue to guide commercial operations, like packaging, financial support, and pharmacy experiences,” Ms. Lawhon adds. “The ultimate dimension of trust is congruent values. By conveying a set of clear values through every interaction people have with a brand, companies can strengthen loyalty with their customers through shared ideals and goals.”

Ms. Young says the pharmaceutical industry needs to continue to focus on keeping people healthy, managing chronic diseases, and advancing the life-saving specialty treatments, and consumers need to feel confident that the healthcare system is developing the right treatments, supported by the right evidence, and for the right reasons. There is also a cost element that can’t be overlooked.
“Patients need to feel that the medications they take are affordable and accessible,” she says. “And the public at large needs to see the industry engage in the current debate over drug pricing and the opioid epidemic to increase trust.”

Indeed, the issue of opioid addiction has weighed heavily on the industry. Overprescribing of opioids fueled the epidemic, and pharma companies were at the center of these issues, with court cases involving Johnson & Johnson and Purdue showing manufacturers misled the public about their products, playing down the risk of addiction.

Since the lawsuits, Johnson & Johnson’s reputation has dropped to second-to-last position out of 58 companies in alva’s 2019 Pharmaceutical Reputation Index.

Guy Chamberland, CEO of Tetra Bio-Pharma, believes the cannabinoid industry can play a key role in winning back public trust by addressing their role in the opioid crisis.

“Drug distributors and pharmaceutical manufacturers worked in concert to influence doctors on how to prescribe generic opioids with little regard to the increase in opioid-related deaths,” he says. “Now that chronic pain is an emerging health issue globally, the pharmaceutical industry can help to develop less addictive and less harmful alternatives to opioids. The more research the industry does with cannabinoids, the more efficiently companies will be able to characterize medicines that could prove useful in convincing doctors to prescribe opioid alternatives for patients with chronic pain.”

Jason Coloma, CEO of Maze Therapeutics, points out that in the biotech industry, companies struggle with poor public understanding, and to correct this, more industry leaders need to engage the public and share the vision of biotech and its benefits. “This would include using all channels and not just traditional media and the press, but also social media with a consistent and coherent message,” he says.

Providing Patient Support Beyond the Pill

The industry needs to make the experience with its support services for new products as positive and patient-led as possible, Ms. Mills says.

“Support programs should be designed, not around what patients need to know about their medication, but around the whole patient and what he or she needs to do to live a healthy life,” she says. “This transforms the relationship between pharma and patients from an old-fashioned, one-way push of information to an active, engaging experience where patients are empowered and supported with building skills to make healthy choices.”

Ramona Sequeira, president of Takeda Pharmaceuticals, describes trust as integral to the company’s ability to develop and deliver life-saving treatments.

“We are committed to improving patient outcomes by finding ways to support patients, providers, and caregivers in ways that matter most to them,” Ms. Sequeira says. “We are curious about the lives of patients. We dig deep to understand how to best support them.”

Partnering is also key, and Ms. Sequeira says Takeda partners with patient groups, providers, payers, regulators, and legislators to solve problems.

“And we’re not afraid to advocate for change,” she says. “We speak up with new ideas, we take smart risks, we are willing to have difficult conversations and answer the tough questions often unaddressed in our industry.”

Ms. Reese lays out key steps to engage and educate the public, starting with showing people the industry is serious about giving patients a stronger voice in how trials are designed and run.

“Let’s do more with patient advocacy groups and non-profit organizations, and continue the trend of having real patients tell their stories about how trials are extending and improving their quality of life,” she says. “Also, there are millions of people working to develop new drugs. Let’s shine a light on some of these people who can speak from their hearts about what they’ve seen, and why they’re so committed to developing new treatments that can give patients more time with their loved ones.”

Pharma must also commit to protecting patients’ privacy and keeping their data secure, while also producing innovative products that evolve human health for the better, Ms. Blackburn notes.

“The industry must also leverage the press and social media to tell positive stories of countless patients helped, lives improved, diseases cured,” she says. “That advice is not just good for re-building trust; studies show a link between reputation and the bottom line.”

According to Nina Kirshenbaum, VP, analytics services, at Crossix, the industry has always been an advocate in protecting patient privacy.

“These efforts should be reinforced to the public, along with clear and honest information about how they are using data in their R&D and marketing efforts,” she says.

How the industry engages with patients is key, too, and in the digital age pharma must make sure their offerings align with their patients’ lives and expectations.

“Patients need to be able to access the information and support what they need, when they need it,” Ms. Mills says. “The message, the channel and the frequency should all be tailored to individual preferences.”

The public would trust a pharmaceutical, drug, or biotech company more if it also provided information, tools, and support to help patients and caregivers manage their disease, Mr. Coloma says.

“And of course, companies need to make sure they take specific actions demonstrating that they will not put profit before patients and their families,” he says.(PV)

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In Pharma We Trust…

Wendy Blackburn
Intouch Group
The pharmaceutical industry has done so much good and saved so many lives, it is disheartening to see its reputation sink to new lows.

Guy Chamberland
Tetra Bio-Pharma
The cannabinoid industry may help big pharma win back public trust by addressing their role in the opioid crisis.

Dr. Jason Coloma
Maze Therapeutics
A company can take specific actions that both increase profits and improve the economic and social conditions in the communities where it operates.

Nina Kirshenbaum
Crossix
At the end of the day, patients must feel like their data is being protected.

Lauren Lawhon
Health Union
Pharma companies often espouse the values of transparency, integrity, and respect, but they need to be able to ask themselves: how are our customers experiencing these values?

Nareda Mills
Ashfield Patient Solutions
By implementing patient-centric changes, pharma will consistently prove it has an important role in a patient-focused model of healthcare and it will win back public trust.

Brenda Reese
phaseUP
We need to make a great effort to educate people about the drug development process.

Peter Sandford
NXLevel Solutions
The check-the-box approach to compliance training has failed to effectively change behavior, and has resulted in well-publicized legal cases and a barrage of negative news.

Ramona Sequeira
Takeda Pharmaceuticals
We see the world through the lens of patient, trust, reputation, and business — always in that order. It’s how we make decisions and bring our values to life.

Karen Young
PwC
Patients need to feel that the medications they take are affordable and accessible, and the public needs to see the industry engage in the current debate over drug pricing and the opioid epidemic to increase trust.

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PhRMA Goes Boldly

In February of this year, the Pharmaceutical Research and Manufacturers of America (PhRMA) released Breakthrough, the latest chapter of its GOBOLDLY advertising showcasing the extraordinary medical breakthroughs being discovered and the need to protect America’s leadership in medical innovation. PhRMA worked with WPP Health & Wellness and Young & Rubicam on creative for the ads.

According to AdAge, the campaign is costing PhRMA tens of millions of dollars each year and is expected to last at least three years.

“With more than 7,000 medicines in development, we are in one of the greatest eras of scientific innovation with the potential to save and improve millions of lives,” says Holly Campbell, deputy VP of public affairs at PhRMA. “ We must ensure the policy and regulatory environment in the United States encourages continued medical progress, rather than stand in its way. That’s why we’re committed to advocating for the latest innovations and protecting future innovations. We continue to go boldly, together.”

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