Is image everything?

A poor image

Given the contribution of drugs to advances in healthcare it often comes as a surprise to those in the pharmaceutical sector that the industry’s public image is so poor. There is a growing demand for advanced healthcare and without the development of new and effective medicines further progress will not be made. The pharmaceutical industry is the major source of new drugs and its commercial focus has driven innovation. Unfortunately, because companies generate profit and as healthcare is an emotive subject the industry’s activities are often portrayed by the media in a negative light. The media and public often forget the role of the industry in developing new drugs - as the attention shifts to the high prices of its products.

Furthermore, the narrow focus on pricing of pharmaceuticals detracts from the long-term benefits of using such products and also ignores the contribution of non-pharmaceutical components to rising healthcare expenditure. For example, a US study found that pharmaceuticals accounted for only 9.4% of the total US$1.3 trillion spent on healthcare in 2000 (1). Many new treatments aim to modify the diseases being targeted rather than treating only the symptoms and thus they can remove the need for expensive, lengthy stays in hospital. The pharmaceutical industry has suggested that the recent increases in pharmaceutical spending observed in many countries are due to the accumulated need for innovative therapies (2).

If society is to tackle unmet medical need there is an argument that more needs to spent on pharmaceuticals, not less. The pharmaceutical industry has urged governments to create an environment in which innovation is encouraged so that future treatments can be developed. A number of governments have launched initiatives with the pharmaceutical industry that enable both parties to achieve their objectives (2).

Despite these cooperative efforts, that demonstrate the possibility of industry and governments working together, it is still important to better communicate with the public and the media so that a one-sided view of the industry does not continue. As well as a source of new medicines that will drive improvements in healthcare, the pharmaceutical industry is an important contributor to national economies and is a major employer. Therefore, its decline is in no one’s interest.

The pharmaceutical industry is not the only industry to have concerns about its public image, but as examples show any campaign to improve the image of a company must be well handled.

The oil industry has received considerable adverse publicity with respect to the impact of its activities on the environment and its work in troubled regions of the world. Shell was one company that was heavily criticized and its management attempted to promote a more ethical image. For example, it stated that it would not explore or develop oil and gas resources in natural areas that had been designated by UNESCO as World Heritage sites (3). It also contributed US$140 million for social programs (3). In September 2003 a group of scientists at the Smithsonian Institution actually praised the company for minimizing the environmental impact of its drilling at a site in Africa (4). In addition, Shell and the Smithsonian worked with other energy companies to develop an international code of practice for sensitive areas (4). However, even these steps have not convinced all activists and the company continues to be criticized by certain pressure groups. There has also been criticism by others that Shell’s preoccupation with its environmental image has led to an imbalance in the way the company is managed (5). In January 2004, it was forced to reveal that it had overestimated its proven oil reserves (5). Shell’s management were criticized for failing to act over initial warnings from its senior exploration and production personnel. In particular, it was felt that the excessive concern over the company’s image had led to a culture of not discussing negative issues (5).

Therefore, as important as public image is, a company’s shareholders and employees will be expecting the organization to maintain productivity and remain a strong commercial force in the market. As it tries to improve its public image, the pharmaceutical market is keenly aware of these factors. In November 2004, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), which represents the industry at a global level, decided to bring in a range of reforms to improve its lobbying position (6). In particular, it highlighted the importance of better communicating its views and news of its activities to the public. The IFPMA highlights the importance of partnerships with important world bodies such as the World Health Organization (WHO), the World Trade Organization (WTO), the World Bank and the United Nations in order to make long-term improvements in healthcare (6, 7). Equally, it has sought constructive dialogue with non-governmental organization (NGOs) on important issues such as access to medicines in the developing world (7).

Although media coverage can be poor, there are several ongoing collaborations between the industry and external parties (7). In particular, a number of schemes have been launched to decrease the health disparities between poor and affluent populations and to improve drug access across the world. Public-Private Partnerships (PPP) have been set up involving governments, pharmaceutical companies and NGOs to address such issues (7). Even in the absence of widespread public knowledge these cooperative efforts are increasing. As the different parties gain a better understanding of the issues involved and how they can each achieve their objectives, more common ground will be found. The pharmaceutical industry has a history of successful drug development and so its experience is vital if these initiatives are to result in generating effective treatments.

There is also an urgent need for medicines in certain disease areas and without incentives it may not be in a company’s commercial interest to invest. For example, bacterial resistance to current antibiotics is a growing healthcare problem. In the USA, the FDA is providing incentives for pharmaceutical companies to engage in R&D for novel antibacterials (8). Since 2000, the agency’s Task Force on Antimicrobial Resistance has been developing a regulatory framework to encourage companies to develop novel antibiotics, whilst exploring options that will maintain the effectiveness of such drugs before bacteria gain resistance (8).