Reputation matters: Why the rift between pharma and patients is ballooning
What’s in a reputation?
A lot, according to PatientView. The group, headed up by Dr. Alex Wyke in the U.K., published a report, "The Corporate Reputation of Pharma—from a Patient Perspective," in which 76 patient groups assessed corporate reputation based on six key indicators, including: patient-centered strategy; high-quality information; ensuring patient safety; making useful, high-quality products; transparency; and integrity.
This survey is based on feedback collected between November 2014 and January 2015, and stands out for another reason: Although PatientView has been conducting biopharma corporate reputation surveys for four years, this was the first year that U.S. patient groups were surveyed.
The results were somewhat surprising to Wyke for one very specific reason. "I think the level of antagonism toward pharma in the U.S. is a surprise, especially considering how deep it goes," she said.
A little background
The eleven companies included in the survey include AbbVie, AstraZeneca, Bayer, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Merck, Novartis, Pfizer, Roche, and Sanofi.
Initially, the companies in the survey were chosen based on revenues, but according to Wyke, some companies asked to be included on the list and were added later. Regardless, in order to be on the list, a company needed to be recognized by a large number of patient groups.
What’s wrong with drug prices?
Overall, the corporate reputation of the entire biopharma industry was low, verging on abysmal. None of the 76 patient groups surveyed ranked the industry "excellent" in terms of overall industry, though many companies were highly ranked in specific areas.
In fact, out of eight healthcare areas, pharmaceutical companies came in seventh place. The only industry that was ranked lower was the for-profit insurance industry. Despite the fact that 34% of patient groups ranked the overall biopharma industry reputation as “good,” that relatively positive ranking was overshadowed by the current bête noire of the industry—drug prices.
In 2014, overall drug prices rose 13.1%, compared with 2013, with total spending hitting $374 million. The costs of drugs, especially cancer drugs (which tend to come with high co-pays), devastated the household budgets of many individuals and families, leading to the perception that drug prices are precipitously high.
"Everything seems to come down to pricing," explained Wyke. "There is no doubt in my mind, as has already been frequently reported in the U.S., that the pricing of oncology drugs is driving a rift between pharma and patients."
And how about the fact, by some estimates, it costs roughly $2.6 billion to develop a prescription drug that gains regulatory approval and makes it to market (according to the Tufts Center for the Study of Drug Development)?
"Patient groups don’t care how much companies spend on R&D," said Wyke bluntly. "They only want results. So the argument of high redundancy in R&D as a driver of price increases falls on deaf ears among consumers and patients. I suspect their view is, Why should failure be rewarded?"
Taking a closer look
Despite the anguish over rising drug prices, there are bright spots in the report, especially in terms of patients’ perceptions of the ability of pharma companies to make high-quality and useful products—63% of the surveyed groups rated the industry as either “good” or “excellent” in this category. In addition, 57% of respondents rated pharma as either “good” or “excellent” with respect to being innovative, while 54% gave high marks to the industry (ranking them “good” or “excellent”) for their focus on patient safety.
Among the 11 companies included in the survey, there were winners—and then there were losers. Sitting in the winner’s circle with a number-one ranking, Eli Lilly was especially well-ranked among diabetes- and neurology-focused patient groups in terms of providing good information to patients, integrity, transparency, and providing high-quality products to patients.
One major factor driving Lilly’s good corporate reputation is its patient-assistance program, which supplied medications last year to 300,000 patients in the U.S. who otherwise could not have afforded it, many of whom are mental health patients.
In addition, Trulicity (duglatide), a diabetes treatment that was approved by the FDA in September 2014, was viewed as a major breakthrough for patients who use GLP-1 agonists to control blood glucose. The true breakthrough when it comes to the medication is a function of convenience, as patients only require once-weekly subcutaneous injections with a pen, versus daily injections with other GLP-1 agonists.
But once again, the only downside for patients when ranking Lilly was the cost of its oncology products, notably Cyramza (ramucirumab), which was approved in April 2014 for treatment of advanced stomach cancer—and costs more than $13,000 per month.
At the bottom, the lowest ranked company among U.S. patient groups for 2014 was Bayer, mainly because of the perception that its management feels that high prices, particularly for cancer drugs, are justified.
For instance, in January 2014, Bayer CEO Marijn Dekkers made some statements which were interpreted by some as him saying that Bayer does not make medicine for poor people who can’t afford them. Although there were numerous revisions to the quote, which may have been bungled from the start, the takeaway for patients was that Bayer doesn’t care about high drug prices. In addition, there have been numerous complaints from women who have used Bayer’s contraceptive implant, Essure. All told, not a good year for Bayer in the U.S.
Two other noteworthy rankings include Pfizer, which was ranked number one in the category of making useful, high-quality products and AstraZeneca, which was ranked number one in the category of being patient-centric.
At the other end of the healthcare reputation spectrum
Although patient groups were not especially friendly towards pharma in 2014, they ranked retail pharmacies at the very top of the group of eight healthcare industries included in the survey. Overall, 75% of those surveyed believed that retail pharmacists have an “excellent” or “good” corporate reputation. Patients responded positively to the community-based, patient-oriented focus of retail pharmacists, heavily differentiating their approach to patients’ needs from that of corporate pharmaceutical companies.
So what could improve the perception of the pharmaceutical industry among U.S. patients? Number one on the list would be adopting fair pricing policies, according to 30% of surveyed patients, while number two, according to 20% of respondents, would be having a more patient-centered strategy.
In the final analysis, patients conceded that the biopharmaceutical industry is developing good products. However, as Wyke said, "Patient groups do acknowledge the ability of drug companies to produce high-quality drugs, but with no reimbursement, patients can’t pay for them. So their response has been, ‘What’s the point?’"