Here is a copy of a talk I recently gave via Zoom to my European colleagues.

Those of you who know me know that I am a frequent contributor to Hedley Rees books as well as the author of a blog that gets close to 100,000 reads a month.

I have been and continue to be critical of the pharma industry but it’s not out of spite or hate. I am critical because I love this industry. I have seen first hand how the drugs we market can save lives and lead to a better quality of life for millions.

When I first started in the industry DTC was fairly new as we launched a number of groundbreaking drugs such as statins. Slowly I saw a change within companies. It suddenly wasn’t about patients as much as it was about ROI and sales. I observed people who were able to launch groundbreaking initiatives leave the industry.

The CEO of Lilly who took a dollar as salary when we lost patent protection on our top drug was replaced by an atmosphere of weeding out older employees and scrapping new ideas that could be a real benefit to patients while at the same time raising pricing on insulin.

Today, pharma CEOs make tens of millions of dollars because of one goal: sales. The CEO of AbbVie is actually compensated for his ability to fight off patent challenges on their top drug Humira.

Now, as they all race towards a vaccine for COVID-19 with government help we are hearing of their desire “to make a profit”.

As Matt Taibbi recently wrote ” Gilead, a company with a market capitalization of more than $90 billion, making it bigger than Goldman Sachs, develops an antiviral drug with the help of $99 million in American government grant money. Though the drug may cost as little as $10 per dose to make, and is being produced generically in Bangladesh at about a fifth of the list price, and costs about a third less in Europe than it does in the U.S., Gilead ended up selling hundreds of thousands of doses at the maximum conceivable level, i.e., the American private-insurance price — which, incidentally, might be about 10 times what it’s worth, given its actual medical impact”.

The pharma industry., worldwide, employs thousands and pays very well. However the pay becomes “golden handcuffs” as people become addicted to their paychecks and do anything to stay in their current positions. In doing so they sacrifice a part of who they were.

I also know that there are a lot of very good, caring, people within the industry. I know because I have worked with them and seen them in action trying to fight for patients. The issue seems to be the overhead managerial structure that is meant to protect the status quo along with trade magazines that too often recognize people as part of THEIR business cycle.

It would take so little for every pharma CEO to sit before an audience and plainly say “no patient will ever go without our medication because they can’t afford it”. Instead we here the same blurb about helping patients who may not be able to afford their medicine at the end of DTC TV spots.

Then there are DTC ads themselves. Today we know that more people are turning to the internet to research medications but where is pharma on this online journey? Sure they are a stop but they are not a stop that leads to a decision.

Pharma will spend hundreds of thousands of dollars on Google keywords but they won’t do usability testing as part of their website development. They will use programmatic advertising that leads to fraud and poor metrics rather than working with an agency to develop targeted ads that deliver better results.

Why does this happen? Part of it is that the organization is not meant to take risks. The other is that emarketing people run into roadblocks when trying to get decent budgets versus TV ads which only have a 7% effectiveness according to past research.

The industry needs people who understand the balance between trying to help people and ROI. We need people who are willing to risk their jobs to fight for patients who don’t have a voice. We need CEOs who understand that Wall Street isn’t a customer but, rather, nothing but people whose desire to make money is too powerful.

If you want to stay within pharma you’re eventually going to come to a crossroads at which you’ll have to decide which is better; doing something that’s better for patients or doing something that is better for making money.

The choice is yours but no industry can continue to take the heat from patients and the media for long. Eventually, decision making on drug prices will be taken out of the hands of pharma and put into the hands of the government which could really screw things up as we have seen with the pandemic.

The decision and choice is yours.