Time for Ethics and Honor

In many ways, the pharma industry deserves its bad press. But treating the industry as a single, unified entity is unfair to the many ethical companies that wouldn’t dream of price gouging. However, I think that lobby groups (for example, the Association of the British Pharmaceutical Industry, the European Federation of Pharmaceutical Industries and Associations, and the Pharmaceutical Research and Manufacturers of America) are doing the industry a disservice by defending unethical behavior. Of course, the industry does a lot of good, but we must acknowledge and take action against the bad. It is for this reason that I have set out to develop an ethical code for the pharma industry.

In our industry, drawing the line between what is acceptable and what is unacceptable can be difficult – and is often blurred. My aim is to draw that line and ask companies to put themselves on one side or the other. We need to ask ourselves, what’s the difference between 9 percent, 400 percent and 4000 percent? Who decided that Brent Saunders’ 9 percent rise per year is okay and Martin Shkreli’s 4000 percent isn’t? Shkreli may be hard to like, but he’s not all wrong: he makes the point that when a large pharma company realized what he was planning to do with the drug he wanted to buy, they stopped the sale. And then immediately increased the price themselves by 400 percent. If we are no more ethical than he is, we have a problem. We should be having these conversations transparently with payers, physicians and patients. We should be comfortable that we have an ethical core to what we do.

When I first started developing my code, I was curious to find out whether I would get a positive response. And the good news is that there are a number of major pharma companies who are happy to get on board.

Developing an ethical code won’t be easy. Am I the right person for the job? I’m sure I’m not. I have no training in ethics. But someone has to be the instigator – and we’re surrounded by medical ethicists, ethical review board members, and other experts. By announcing that we’re developing an ethical code for the industry, we are calling out for other experts to get involved – and we’ve had a number of great people come out of the woodwork with ideas on how to do it.

What will it cover? To start with, there’s pricing, trial inclusion/exclusion, trial designs, data transparency, promotion, developing world access, intellectual property and generic competition – and over a hundred other areas. The first step is to figure out what questions we’re going to answer. I don’t feel that lobby groups and industry organizations should be part of creating the code. They can – and I hope they will – endorse the code, but I do not want them to coopt it. By November 2017, we’ve committed to have a 1.0 version of the code.

We all want to feel proud to work for pharma. And I bet each and every one of you is sick of being concerned about mentioning that you work for pharma in polite dinner party conversation. We have no defence. Yet, I have never met anyone (on the R&D side, particularly) who didn’t come to work to make great medicines and a reasonable profit. We need the world to know that we have debated and discussed what we do, and that we believe we have an ethical position.

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