Moving the pharmaceutical industry forward

The pharmaceutical industry continues to be the focus of attention of the public, albeit it for the wrong reasons, at least from the industry’s perspective, presumably. That many perceive the increasing healthcare spending at the individual and other levels as due significantly to machinations in the industry is more than conjectural given the media blitz it has attracted over the years. The validity of many of the charges levied against the industry is suspect, its need for an image-makeover, and to tread a different, more user-friendly path as it sojourns nonetheless, equally obvious.

This is more so, given the very nature of its core business, which is to make drugs and related products, for, of course, the public. It is arguable which of the public or the industry needs the other more, but not quite that they both do. This puts the onus on the public to collaborate with the industry in essentially the latter’s ‘cleanup’ process, and on the industry to make this process transparent and laden with fervor. At the survivability level, what is at stake is in fact more generic, the potential economic consequences of the collapse of the pharmaceutical industry likely to be pervasive at all levels, including the probable yet at once, real threat that this could pose to national economies.

The stakes become even higher in a progressively hyper-competitive global economic milieu. The question arises therefore, in whose ultimate interest it is the pharmaceutical industry becoming moribund, and whether moving the industry forward is its task solely. Without much ado, the industry not being passive in addressing the many issues that have dented its public image would serve it right before a receptive public. This is so considering that the goal of the public, which in essence is the achievement of the dual healthcare delivery objectives (DHDO), in other words, the availability and receipt of qualitative and affordable healthcare, is primary, and causal in its reaction to the industry, and indeed, to other players in the healthcare delivery enterprise.

The industry thus needs to present a friendly face to the public, that of an ally, not a foe, in the realization of these objectives, without compromising its bottom line, a crucial survival lubricant, literally, whose significance for not just the industry but for all healthcare stakeholders, the public would likely be increasingly willing to accept. In other words, both the public and the industry would gradually more need to ferret from their crypts some of the fundamentals without either acquiescent to which, no amount of ‘surgical’ intervention, would yield a convincing makeover.

Here then is where emergent from one such fundamental, the need to rectify the pervasive information asymmetry that distorts perception comes to the fore, its roots, atavistic, relic of the seemingly enduring paternalism in the patient-doctor dyadic that belies the veneer of centrality of the patient in the healthcare delivery universe. Hence starting from the position of the need for information to enable the full realization of the fundamental ideals of liberty inherent in free market operations, backed by solid democratic institutions, the onus on the pharmaceutical industry to embrace transparency in the conduct of its affairs, including being forthcoming with information that would reassure the public, becomes self-evident.

That this has nothing to do with the health system-financing mode in the jurisdiction in which it operates is instructive. To buttress this latter point, consider one study that compared the link of income and education with breast and cervical cancer screening in Ontario, Canada, and the United States1. It found that Papanicolaou test and clinical breast examination rates were identical in both countries, but mammography rates were twice to thrice higher in the U.S across all age groups, and that college graduates were likelier, versus women with lower than a high school degree, to receive screening, the country, regardless.

The authors concluded that in spite of Ontario having universal insurance coverage for long, the disparities in the use of cancer screening procedures by the poor were identical to the U.S. hence universal coverage is not enough to surmount the large disparities in screenings across socioeconomic status that the study showed for both countries. Indeed, the public needs information not only for reassurance, but also with particular regard to its perception of the pharmaceutical industry, and the latter’s goal of improving this perception, information that would facilitate its ability to make rational decisions, regarding for example, the use of generic medications, issues related to whose availability or otherwise, many would contend mystery currently cloaks.

 

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