Pharma and Governments – in need of a new narrative, a new circle of trust

*Disclaimer – My social media writings always suffer from typos or grammatical errors. I apologies for this but I’m too impatient now to start proofreading what I write for 5 times??

There is an inherit paradox that is now emerging from the huge efforts by the pharmaceutical industry to develop new treatments to battle with Covid19. On the one hand Governments, the media and public applaud these efforts. On the other hand, the criticism against drug prices, intellectual property protection etc. is ever growing (even more than usual).

How come? I’m not sure I can come up with a persuasive or rational explanation. My view (not yet grounded in empirical evidence) is that Covid19 has somehow deepen the gap between our appreciation of scientific efforts and results, and our willingness to pay for such efforts as individuals and as a society. 

This is not an ethical think piece, so I am not going to dwell on the why. But I do want to focus on some principles that in my view Governments and research-based biopharma companies should adopt. In my view they will constitute the NEW NARRATIVE of our social contract.

From the Governments perspective, I believe the following should be remembered

It is the private sector that delivers results. Governments efforts to develop new solutions, vaccines for example, are unsuccessful, despite of all the hype. It is either pharma companies alone, or in collaboration with research institutes (be it Oxford or NIH via so called tech-transfer frameworks), that deliver results. Only big pharma has the capacity to carry thought a technology from the test tube to and make it a product.

Governments are currently spending currently huge sums of money on a wide range of solutions, products, devices and processes, etc. some of which are ineffective, others are completely useless. If governments were to adopt “HTA” analysis on their own spending, pharmaceutical products would be ranked extremely high, compared to all the rest unknown spending (think about the fiasco or respiratory machines, in which sometimes a huge share of these machines are substandard or even lethal).

The additional cumulative death toll and health damage resulted by neglect in treating other healthcare areas due to Covid19 is HUGE. Leading researchers recently reported in the Lancet report on an alarming level of excess deaths registered in the UK due to COVID19 indirect impact on our health, or more accurately on the neglect in detecting or treating other medical issues for the public ( VOLUME 395, ISSUE 10238, P1715-1725, MAY 30, 2020)

From the Industry’s perspective the following should be recalled:

Governments and the public are utterly struggling with deflated budgets, sharp decrease in GDP and rising unemployment – things are not what they were used to be. Poverty and economic gaps are becoming a tragedy. Fiscal and monetary conditions are changing dramatically. Some foresee, and I don’t disagree, that 2021 is going to be an economic disaster. There is a dire need to take these equations into account in any commercial negotiations or pricing decisions.

The biopharma business model is going to take a hit as and must change as well. Some practices will be lost forever or will require a complete remodeling, for example the manner in which medical reps interact with healthcare professionals.

Product development must be part of a broader umbrella of healthcare or medical solutions. This is part of the transition from a vertical structure to a horizontal one in the Industry (something I have written about extensively in previous blogs and seems to be now more valid than ever). As a society we want and should pay for an encompassing solution, not just for products by products.

All this calls for a new Industry-Government narrative, a new circle of trust if you will. Here are my suggested principles.

1.      The private sector, not least the pharmaceutical industry, is part of the solution and should be perceived as such. Enough with this nonsense of evil big bad pharma, who wishes to exploit the situation, etc.

2.      The commitment to develop and deliver COVID19 solutions, including vaccines, as well as any other medical technologies, is first and foremost for all people, for all the human race. It should not be done for the benefit of one or a group of countries. Looking at what is going on as an arm race between governments, protectionism, self-sustainability at the expense of others is destructive and should be utterly abandoned.

3.      Now more than ever the economic-principles of differential pricing should apply, but only if governments are willing to ensure there is no free-riding or rent seeking. Different economies will have growing gaps in their ability to finance healthcare technologies. This time the richer governments should be willing to pay more and not frown upon the fact some countries are getting it cheaper. Otherwise, no one will get anything, or worse only some will get something.

4.      Stop proposing to demolish the global intellectual property system, certainly not now. Yes, the system is not perfect, yes it should be adapted and evolve (not least given 4IR), something that will occur naturally. But the IP system is almost 700 years old. It has managed to sustain industrial revolutions and pandemics and still work for our benefit. Lets’ not ruin what is already working rather successfully. Modify yes, destroy no!

5.      Convergence, integration and harmonization are the name of the game. Industry and governments must work together to better streamline their technological and informational capabilities. We are in dire need to better databases, higher level or data transparency, more efficient cross-functional systems. Only by working together these can be achieved.

I believe these principles can be used to create a “new deal” between industry and governments; a new chapter or a new story. What do you think?