Drug pricing. The opioid crisis. Patent thickets. Scientific misinformation. Around every corner is an issue that has chipped away at the biopharma industry's reputation even after public perception reached a zenith during the COVID-19 pandemic.
The consensus among biopharma leaders that PharmaVoice spoke to at the Biotechnology Innovation Organization’s (BIO) conference this week was that, yes, the industry still has a reputation problem. But they also said there is a good deal of miscommunication around drugmakers' intentions and education about the drug development process would go a long way to rebuilding trust.
Still, business reputation research firm RepTrak saw pharma's reputation fade away in the minds of the public just as the pandemic did.
"The unpredictable culture storm that boosted pharma's reputation at the beginning of the pandemic has fizzled out in the first half of 2022 — their scores are down across the board," RepTrak's 2022 report said. "We've warned that high scores aren't a permanent stamp of approval, but a call to action. And pharma's actions going into the 'post-pandemic' phase haven't earned them those lasting highs."
While there are many factors to consider when calculating the industry's reputation, patient access to medicines has become a major sticking point. In 2022, only 32% of patient groups surveyed by the research firm PatientView thought pharma was "excellent" or "good" at improving patient access to medicines. As many as 52% of respondents felt pharma was only "fair" or "poor" at improving access. In 2020, PatientView's survey showed that 76% of groups thought the pharma industry was "very effective" or "effective" at supporting patients.
Ultimately, reputation plays a big role in the future success of the biopharma complex, leaders agreed, and setting the industry on the right track is not just a one-and-done fix. Here's what biotech leaders had to say about the industry's reputation and potential solutions for digging out of that hole.
Policy action on price
With Merck & Co.'s lawsuit this week against the federal government over a provision in the Inflation Reduction Act (IRA) allowing Medicare to negotiate drug prices, the industry's pricing fight is back in the spotlight.
"The biggest reputational problem is price, and I think we have a lot of work to do," said Meredith Manning, president of the Americas at PharmaEssentia, a Taiwanese hematologic disease company. "The IRA possibly had really positive intent around pricing, but I think there are a lot of detrimental aspects of it that we need to work through — I think we missed the boat on educating and actually being in there negotiating the policy."
At the same time, the biotech industry faces a truly existential problem of being able to sell products at a price point that allows innovation to continue, said Erin Mistry, chief commercial officer at CorMedix, a biotech focused on fighting infection.
"The responsibility we all bear is continuing innovation and continuing to be rewarded for the innovation at the end of the day," Mistry said. "Incentives have to be aligned and based on patient population and setting of care, and all of those play a big role in how price is set — unfortunately it comes down to federal and payer policies."
"I don’t think we should shy away from opportunities to educate — advancing the conversation of innovation in a more digestible way is our opportunity.”
Katherine Vega Stultz
CEO, Ocelot Bio
Often, the reputation of the biopharma industry is heavily dependent on the overarching healthcare system. And it will be up to not just individual pharma companies or industry groups like BIO to set the pace, but rather a larger set of puzzle pieces, said Michelle Werner, a partner at Flagship Pioneering, and CEO of the biotech Alltrna.
"When we look around the world, I don't think there's a perfect healthcare system anywhere — I've spent half of my career living and working in other countries with very different payer models and healthcare systems," Werner said. "We spend a lot of time talking about the cost associated with therapeutic interventions within a system, but the reality is, it's only a small component of the entirety of the system, and if you're trying to solve one small piece but not the whole, it's a very shortsighted way of approaching a very complex but much needed challenge."
Companies like GSK's ViiV Healthcare are very familiar with this issue. As a specialist in HIV — a therapeutic area where pricing has historically been very closely watched due to needs in diverse U.S. and global communities — the company’s learned that reputation is a matter of trust, said Lynn Baxter, head of North America at Viiv.
"Building trust with policymakers, shapers, communities and governments around the world is something that increasingly we have to focus on," Baxter said, noting that ViiV's strategy depends on pricing for a successful business in developed markets so that they can negotiate with less developed countries to access medicines in an affordable way. "It's a virtuous cycle if you get it right — and I'm not suggesting that every company can go that route from the start, but if you're able to play your part in the whole ecosystem and walk the talk of partnering with communities, you can be part of the solution."
Solve pressing challenges
When it comes to pain management and the discussion around irresponsible marketing practices in the opioid market, pharmaceutical companies have paid large settlements to state governments looking to address the issue. The reputational damage to the industry has been monumental.
But when it comes to biotechs looking to solve that particular problem, they have gone to the drawing board to do what they do best: Innovate. Tris Pharma has several candidates for pain management in the pipeline and is looking to get over the hill of reckless prescribing that led to the health crisis ravaging the U.S., said James Hackworth, president of the brand division at Tris.
"In pain management, there's obviously a long history of companies doing things that were unethical, making claims they couldn't back up and creating the problem we have today — we want to be part of the solution," Hackworth said. "Where the science is clear is pointing to what we have as a much safer, less abusable, less addictive drug, but we're looking to generate data in every possible way to back that up or refute it."
Part of gathering that data for Tris is going above and beyond FDA requirements in clinical trials by pitting their non-opioid pain drug against the opioids Tramadol and Oxycodone. Tris's drug cebranopadol showed to be significantly less risky for abuse and physical dependence.
"There's a growing number of people in really severe pain where nothing will work except an opioid, so doctors have risked causing further harm by prescribing an addictive and dangerous drug or by not treating the pain, which is a terrible choice," Hackworth said. "We desperately need safer therapies."
Bringing innovation to light
Biotech leaders agreed that the best action they can take to bolster the industry's reputation is to bring new therapies to the table for people who need them. Visibility is an important aspect of the trust that people have in science and innovation, said Katherine Vega Stultz, CEO of Ocelot Bio, which is developing treatments for end-stage liver disease.
"The reputation of biopharma has ebbed and flowed — right now, we came off the high of COVID with a sense that magic can happen, but that's what needs to continue," Stultz said. "It's about innovation and bringing meaningful changes to patients that are visible. I don't think we should shy away from opportunities to educate — advancing the conversation of innovation in a more digestible way is our opportunity."
At the end of the day, the people who enter the biotech field do so to do good science and keep the wheels of innovation turning, said Ankit Mahadevia, CEO of infectious disease company Spero Therapeutics.
"In our sphere of the world in biotech, nobody joins for nefarious reasons — many of these people are very hardworking, intelligent, thoughtful and often very, very well-trained people who make the choice to get into the complexity and the risk of our business to help people feel better," Mahadevia said. "And I think as you translate that all the way to how society invests in what these folks build every day, there is a series of misunderstandings that we have some responsibility to better communicate, and that the world has a responsibility to understand.
