Pf Magazine, along with E4H, set out to survey healthcare professionals about the level of trust they have in the pharmaceutical industry. This is a snapshot in time survey which Pf will use as an annual benchmark.
It could be said that the pharmaceutical industry has a bad reputation amongst society. Known collectively as ‘Big Pharma’, recent mainstream media headlines don’t do anything to change that view.
Big pharma can only see the benefit of R&D for wealthy markets – The Guardian May 2019; Patients’ charity took cash from Big Pharma – The Times May 2019; Antibiotics aren’t profitable enough for Big Pharma to make more – Bloomberg May 2019.
However, what about healthcare professionals, those who interact with industry regularly? Do they have a different impression through their professional interactions? We set out to survey healthcare professionals to gauge their level of trust in the industry.
“Is it important that industry is trusted by its key partner? We at Pf think it is”
The majority of respondents work in the NHS (84%) with fewer than one in 10 working in private healthcare. Of those who declared their field of work, nearly seven out of 10 work in primary care, just over one in 10 work in secondary care, a similar number work in community services, and the remaining respondents work in public health, tertiary care and voluntary sector. More than 90% of respondents are aged between 40 and 69.
Interaction with industry
It’s clear that industry still believes in promoting products directly to healthcare professionals, with half of those surveyed saying that this is their primary interaction.
Whilst there is a proliferation of medical education opportunities open to the profession, four out of 10 surveyed are still accessing medical education with some support from industry, as this was the second most common primary interaction. This continues to be a key function for industry in supporting healthcare professionals to be at the forefront of treating patients effectively.
It is interesting to note that there was very little interaction with industry through R&D, which raises a number of questions, such as is industry-supported R&D in UK on the decline? Or is it that our survey did not reach out to those who are engaging in this activity with industry? Either way, this is a key point of leverage for the pharmaceutical industry that may not be being utilised to full effect.
We commonly hear of the decline of the sales representative in the UK, yet our survey says that four out of 10 medics interact with them to gain their information. A third engage with industry via digital methods such as websites, webinars, podcasts or online learning. The remainder of the interaction with industry is split between a variety of additional roles that industry now offers, including market access, customer services and medical scientific liaison.
“the pharmaceutical industry and medical profession have a crucial partnership”
Trust in industry
Getting to the heart of the matter, when asked ‘Overall, I trust the pharmaceutical industry’, opinion is polarised. Approximately a third agree, with very few who strongly agree, and a third disagree or strongly disagree with the statement. The remaining third are neutral.
There is no doubt that the pharmaceutical industry and medical profession have a crucial partnership, so why is opinion polarised on the issue of trust in the industry? Does any other sector polarise opinion with its key partners that rely on each other so heavily? This has to be a real worry for industry and its trade organisations. Regaining that level of trust must be a key priority. We know the ABPI has undertaken a number of activities to improve this.
Digging deeper into our analysis, approximately half of respondents think that some pharmaceutical companies are more trustworthy than others. Is it fair to assume that this is based on historical relationships?
When asked about personal experience of industry, 25% of respondents say personal history makes them trust industry more. So, although digital is a growing channel to engage the medical profession, personal interaction and relationships are critical
to building trust. This begs the question, what is the role of the sales representative? Is it promotional or relationship building? Or can both be achieved?
Pierre Van Weperen, Managing Director of Ashfield Healthcare UK, says pharma must change the way it communicates: “Building trust is about creating valuable interactions and real dialogue rather than just talking about a new drug and its applications. The pharmaceutical industry has to change the way it talks about drugs, healthcare professionals and the NHS, including medicines management. Clinical commissioning groups need to offer information in return about what they want and expect from treatments and how they define positive outcomes.”
Returning to the polarised opinion of industry, this is also reflected in responses to the statement ‘I trust the pharmaceutical industry to do the right thing for patients’. Only 27% agree or strongly agree, and 30% disagree or strongly disagree.
Stephen Jowett, Country Lead, Health System Engagement at IQVIA, believes that the patient’s journey is key to building trust. He says: “With the patient’s full journey at the centre, that pathway becomes the common denominator on which to build such trust and engagement to appreciate the mutual benefits of a deeper working relationship.”
When it comes to research and development (R&D) and clinical research, healthcare professionals have slightly better views of industry, with just under half trusting the industry’s R&D and one in five not trusting it. There’s no doubt that industry’s investment in R&D and clinical research is valued and trusted by the health profession.
However, there is some concern that over 50% of respondents believe industry only publishes favourable clinical trial results, with just 4% believing this not to be the case. This is despite the ABPI’s commitment to transparency through its clinical trial disclosure toolkit.
When looking at the sales and marketing activities of industry, there is still work to do. A third of respondents say that these activities make them trust industry less, and only 15% say it makes them trust industry more. So how can sales and marketing activities be aligned to improve trust? One area that is continuing to improve is regulation, as 40% say that industry regulation improves their trust.
Van Weperen added to this, saying: “Representatives are what they are – their role is to ensure that healthcare professionals understand a product so they can use it effectively. With all the regulations and compliance requirements however, there is very little that representatives can do to avoid presenting data in an objective and balanced way. The ABPI Code of Practice has clear guidelines on what is allowed, guaranteeing that data is presented in the right way.”
Is it important that industry is trusted by its key partner? We at Pf think it is. And we know the industry is one of the most regulated sectors with regard to sales and marketing (although self-regulated), so surely trust between industry and its key partners is critical to ensuring patients receive the best possible health outcomes. What can industry do to improve this?
Jowett shares his thoughts: “For trust to grow further between healthcare professionals and the life sciences industry, both need to work in a collaborative, transparent and sustainable way reflecting and providing insight to what the healthcare professional sees every day, in their hospital, clinic or surgery and in the geography where they work.”
Van Weperen adds: “In my opinion, the most important role that industry can play is adding value to how healthcare professionals can optimise patient care and outcomes, and that goes broader than talking about drugs and data. What are the key challenges for a practice, clinic or a clinical commissioning group and where can there be meaningful support? What else can be done to improve care and patient outcomes and how could other services, such as patient support programmes, objective patient audits, improving diagnosis and patient identification help? This is where the value lies and how trust will be built.
“Pharmaceutical innovations have saved millions of lives in the hands of healthcare professionals. Surely, we should be able to work together to continue that in the years to come.”
It’s clear from this survey that industry must try harder to build trust with healthcare professionals. We will run the survey again in 2020 to see if trust improves over the next 12 months.
ABPI: The regulator’s view
Given the ABPI’s ongoing work on trust and reputation, we asked Jill Pearcy, Director of Code Engagement, for her thoughts on the survey results. She said:
“People in industry and healthcare professionals both talk about the same goal equally passionately – to improve the lives of patients. It makes sense for industry and health professionals to work together to do that – so building our reputation is a top priority.
“93% of industry trials are published within 12 months – 96% overall. A BMJ study also highlighted that commercially sponsored trials are more likely to be published. We obviously have more work to do to make sure people know this.
“We are working on building trust in industry in a number of ways. Medicines pricing is a key element behind many people’s views of industry, so we have produced educational materials to help people understand the process of creating new medicines and the need to reinvest in new research.
“We are also constantly working on updating and raising awareness of our Code of Practice. If we can build trust in that, we can go a long way to improving our reputation with healthcare professionals overall.”
Pharmafield is the media partner to E4H. E4H specialises in delivering bespoke communications, medical education and event programmes for the pharmaceutical and healthcare industries. Visit www.e4h.co.uk