PM Society Annual Lecture 2009

The PM Society Annual Lecture took place on the evening of 13th May 2009 at Le Meridien Piccadilly in London's West End. The speaker was ABPI President Chris Brinsmead whose talk was entitled 'Key issues affecting the pharmaceutical industry: can we succeed?'

Chris gave his address after a drinks reception and dinner, which facilitated a great networking opportunity.

Chris began on a high note saying he believed that it's an exciting time in the evolution of the industry. Even though the current economic climate is challenging, it has also highlighted just how valuable businesses are to the UK and that we now have a great opportunity to shape the environment to ensure the industry's success.

There were three core themes Chris wanted to cover in his lecture:

• To review what's happened over the last year in the UK industry
• To share the ABPI's vision for the future and the priorities that it is focussing on
• To look at how these priorities relate to marketing professionals because the world is changing fast and there are tremendous opportunities ahead

The year in review

One of the high profile highlights of the year was the agreement reached with the government on a new PPRS. This proved a turning point as for the first time the agreement went way beyond the economics. Part of the settlement was the agreement on flexible pricing announced by Alan Johnson in November – flexible pricing which recognised that innovation actually had a value. The agreement also contained commitments to improve access, uptake and innovation.

2008 also saw the Darzi review published, setting the tone for the way the NHS needs to move forward and also setting out some important rights for patients – rights which should improve their ability to access new, innovative medicines.

Related to this, Alan Johnson accepted all 14 of the recommendations made to him by Professor Mike Richards in his 'top up' review. This was another turning point. For the first time there was recognition that some patient groups and some new medicines might need to be assessed in a way that involves more flexibility and judgment. Although only affecting a small proportion of patients and medicines, this was truly a change of direction.

Another significant 'first' for the industry was the publication in March 2008 of a set of guidelines on joint working between NHS providers and pharmaceutical companies.

The ABPI Code of Practice also celebrated 50 years with a revised code published in the summer, demonstrating that it is continually evolving and that self regulation is taken very seriously.

In January this year a summit meeting was held between representatives of the industry and the prime minister, together with several other ministers including Alan Johnson, Lord Mandelson and Lord Drayson. This meeting included global Chief Executive Officers and discussed the key issues for the industry, in particular, it was agreed that the Office for Life Sciences (OLS) would be initiated under the leadership of Lord Drayson. As far as Chris was concerned he knew of no other industry with such an office, which showed the importance of the industry and the influence it can have.

Since its creation, four strategic work-streams have been put in place, populated by all relevant government departments and by many in the industry. This group is now having weekly meetings and, as Chris pointed out, it's the first time he's heard complaints from the industry that the government are moving too quickly!

In order to take advantage of the opportunity the OLS has created, the industry needs to be in good shape, clear about where it needs to grow and to make even more of a contribution to the UK's economy and society. The ABPI has decided to focus on just a few priorities, while aiming to make real progress on each of them. It's ambition is to be the World Class Trade Association and Chris took a moment to recognise the tremendous energy shown by Richard Barker and the ABPI team, as well as many people in the industry who have worked extremely hard and contributed a lot of time and effort.
 

The ABPI's imperatives

The four campaigning imperatives, based on the feedback from a survey in 2007, are: Value, Innovation, Trust and Access. Focussing on them in a practical way, the ABPI has set up a work-stream for each imperative with its own leader and each of them engaging member companies and people from beyond the industry.

Value
The three key points for this imperative include:
 

• Those in industry have to do a better job in describing the value that medicines provide. One of the work-stream activities is to gather and present evidence on the benefits of medicines and the value for money they provide.
• The NHS need to take a wider view of the value such as when we meet unmet patient need, when we provide savings for the NHS and health providers, when we help carers and when we provide benefits to wider society.
• We need to be clearer with government about the value of our industry to the UK.

Innovation

• Innovation is the life blood of our industry. The UK has been a great place for our industry with a record second only to the US in terms of developing innovative medicines.
• We need to work with the NHS and with the appropriate government departments such as the Department of Health, the Department of Innovation and Skills, the Treasury and BERR to make sure that we continue to be a strong base for R&D.

Access

• Or as the ABPI puts it – 'The right medicine for the right patient at the right time.' Chris's intention is that we don't stray from this pertinent point because it is what we are all about. The data from many studies shows that the UK lags behind most other European countries in our use of new innovative medicines. So the ABPI was delighted with the Darzi review and its announcement of faster review by NICE and by the commitments in the new PPRS.
• It's essential that the ABPI plays its part in helping to develop better metrics for uptake, working with the NHS and DH to make sure that access is possible across the UK.
• Working closely with David Nicholson, his leadership team and with more people in the SHAs and Trusts through the joint working projects, has shown that by working together they are more likely to be successful in achieving the same goals.

Trust

• Trust underpins all the other imperatives. Although progress has been made in areas such as transparency in clinical trials and relationships with patient groups, a new updated code and a joint working agreement with the DH, we cannot afford to stand still.
• As an industry we need to act in a collective manner and take steps to build on this strong base by working with our partners.
• We need to be more transparent and to stop being seen as a cheque book and start being a true partner.
• We need to stop activities which add little value and undermine the good work we do in bringing innovative medicines to help treat patients.

From left to right: Steve Clark, PM Society Chairman, Ivor Eisenstadt, Chair - Education Events Sub-Committee, Chris Brinsmead, President - ABPI, David Southern, Education Events Sub-Committee

Priorities for marketing professionals

Pulling everything that has happened over the last year together, Chris suggested that trust was clearly a marketing issue and that the way we behave as we market products is critical to building or losing that trust.

Behind these ideas is the fact that the industry is developing a deeper and more mature relationship with its customers. Industry culture has changed over the years and today purchasing decisions are taken on a more strategic basis and are made by a whole variety of different professionals within the buying organisation.

This means we need to know all these people and be able to build relationships with them. We have to understand their needs really well because only by solving their problems can we truly succeed. So today we are solution providers, partners and account managers.

These deeper relationships cannot be sustained by exchanges and contacts which are superficial or unbalanced and that is why, for example, the ABPI will be consulting on a co-funding approach in relation to education.

However, the ideas on reform are a small part of the bigger picture which is generally about positive developments. For example, most people are now involved in new ways of reaching customers electronically, but it's important to maintain a relationship with the industry that is personal as well as digital.

The changes are about closer engagement and greater understanding, about being a respected partner in the healthcare community – being an insider rather than an outsider. And that is just one reason why Chris believes that joint working is so important, as it brings us into the health provider's world and creates benefits for both sides.

Chris went on to give relevant examples, including the Inforce programme, designed to halve unplanned admissions for COPD exacerbations in Nottingham where there are about 900 such admissions a year, costing around £2.5million.

This is a partnership between Nottingham City PCT, Nottingham University NHS Trust and companies. The industry contribution includes a senior manager's part time secondment. The strategy is to identify gaps in care, provide early diagnosis and help patients to manage their conditions.

The companies have brought to the project their skills in project management, data gathering and stakeholder engagement – in fact since the project began the British Lung Foundation has come on board as a patient group partner. The project has attracted much publicity and many enquiries from other providers interested in replicating it.
 

New type of partnership

2009 has seen the launch of a new type of partnership in the South West covering a whole SHA area and focusing very specifically on medicines. The South West Medicines Safety Partnership has three work-streams:
 

• One aimed at improving reporting and recording of drug allergies
• Another aimed at improving medicines reconciliation when patients are admitted to hospital
• And one aimed at creating a new system to prevent and manage drug shortages

Chris pointed out that the importance of these projects were significant because:

• They give a deeper insight into the customers' problems and priorities, with first-hand experience of how the NHS and PCTs work
• They help to build relationships with individual trust and providers
• They give the NHS and Trusts access to business people and resources
• They build trust generally between NHS and industry

From society's point of view, these projects are the frontline in the battle against chronic disease, costing the government billions of pounds a year, so if that cost can be cut through medicines, then the industry becomes even more valuable to the country and society. If these projects help to create a more preventative culture in the NHS, then patients win by being treated earlier, the NHS and government win by reducing costs and the industry wins by providing more treatments to more people and having a better understanding of the needs of its customers.
 

In conclusion

Chris recalled being interviewed by a reporter who said “You seem very positive” and he replied “what's the alternative?” He believes it is a great time for the industry as we're seeing unprecedented engagement with government and recognition of our strategic importance to the UK. He thinks we have a great opportunity to work more closely with those who influence healthcare and that they are ready to collaborate as never before.

However, Chris suggested that there was still a lot more work to do with people still seeing the industry as the creators of life-saving medicine but also as a profit making business – so it's paramount to prove that these two points are inseparable.

Chris concluded by returning to the ABPIs core imperatives which will allow the industry to play a powerful role in UK society, make a major contribution to its economy and bring new benefits to the lives of patients. He urged the industry to remember

• Access to medicines enables people to live longer and better lives.
• Value for medicines enables the industry to make a fair return.
• The return enables investment in innovation and the creation of more medicines.
• Trust is the driver of all these stages– it's what makes the cycle turn.

Held on: 13/05/2009