Amending Pharmaceutical Industry Practices Can Build Trust, Panellists Say

At a side event to this week’s World Health Assembly, GlaxoSmithKline detailed measures taken by the company to dispel the perception of conflict of interest, and build trust, including amending the ways its sales forces operate, and no longer paying speakers at scientific congresses, and said it wants to provide leadership on the issue. Patients and physicians associations call for mainstreaming those practices.

GlaxoSmithKline (GSK) co-organised a side event to the WHA with the International Alliance of Patients’ Organisations (IAPO) yesterday on the topic of putting the patient first by addressing industry practices.

The panel moderator said close collaboration with all health actors is key for the benefit of patients, but it is easier said than done. The relationship between health actors is not always serene, he said. There are a lot of concerns about conflict of interest, a lot a suspicion, he said.

However practices can be changed to best server patients, he said.

GSK Trying to Build Trust, Leadership Role

Danie Du Plessis, head of Worldwide Medical Affairs at GSK, said transparency and trust are very often linked. GSK started its journey of transparency many years ago, he said, when in 2004 GSK launched the first online clinical trial register, making sure the data in research is available. Over time this concept has evolved, he said, and now that is applied to patient level, and people can apply to see the data.

In 2011, GSK amended the way its sales forces operated in the United States, he said. They eliminated incentives for sales forces which were at the time based on volume of medicines prescribed. This initiative was expanded to the rest of the globe last year, he added.

“So we do not have any sales forces any more who is incentivised [by prescriptions] but rather on value that they bring to the healthcare professionals as determined by the healthcare professionals,” he said.

Also, Du Plessis said GSK no longer pays external speakers to speak on GSK’s behalf during events because that is perceived as a conflict of interest. “Of course it is not illegal but there is the perception and there is the ethics around this,” he said.

GSK has always had medical experts in the company, but it has recently increased the number of those experts and appointed a number of academic experts to work for the company. So that is very clear, open and transparent what their credentials are, and that they now work for GSK, he added.

“This is part of a very long journey on the leadership role that we want to play as a company listening also to society, and what people are saying on the topic of conflict of interest…”

GSK will continue to support medical education, but in different ways maybe than in the past, through independent third parties, ideally, he said. “We have also said that we would not directly sponsor physicians and health professionals to attend scientific congresses that may have been taken out of context somewhat,” he added.

In March, GSK announced steps to further help bring innovative medicines to poor countries, by evolving its graduated approach to filing and enforcing patents “so that IP protection reflects a country’s economic maturity.” GSK further said that it intends to commit its future portfolio of cancer treatments to patent pooling (IPW, Public Health, 31 March 2016).

Patients Echo Concerns on Conflict of Interest

Matthias Wienold, treasurer of IAPO, said the organisation has four main principles: putting patients first, supporting ethical research and innovation, ensuring independence and ethical conduct, and promoting transparency and accountability.

Wienold said IAPO support moves to ensure that medical representatives are no longer rewarded for the number of individual prescriptions written. IAPO also promotes the fact that health care professionals speak without being paid and are invited to talk about therapeutics without mentioning companies and brand names.

Physicians: Policy Guidelines, Call for Influence-Free Publication Results

Julia Tainijoki-Seyers, medical advisor at the World Medical Association (WMA), said the main activities of WMA are ethical guidance on policy-making and advocacy and representation.

For example, the WMA policy guidelines indicates that for medical conferences, the conference topic should not be influenced, and no direct payment should be made. On gifts for physicians, the guidelines recommend that no payment or cash, or gifts for personal benefits should be accepted by health professionals.

However, she said, in many parts of the world, physicians cannot get by on their physician’s salary and this situation makes it difficult to apply the guidelines.

On research, the WMA calls for transparency and the absence of influence on content or on publication results. All results should be published, she said, including negative results, as they can provide insights for further research.

The 69th World Health Assembly is taking place from 23-28 May.

 

Image Credits: Catherine Saez