Leaders in the biopharma and healthcare industries came together in Washington, D.C. in May for Flipping the Script, an intimate roundtable event produced by MM&M with our sponsor AbelsonTaylor. Continuing the conversation that took place at the Coalition for Healthcare Communication’s Rising Leaders conference earlier that same day, attendees addressed some of the key issues the pharma industry is facing today, notably rising drug prices and the opioid crisis.
Jon Bigelow, executive director of the Coalition for Healthcare Communication said rising drug prices have negatively impacted people’s perception of pharma, and have overshadowed the good that the industry is doing.
“The only information the average citizen keeps hearing is the price tag for these drugs,” he said. “For example, the first product for spinal muscular dystrophy was just approved, but it costs $1 million, so that’s the headline, not that it’s a life-altering drug that will help so many people.”
Steve Madden, MM&M’s editor in chief, who moderated the discussion, addressed Bigelow’s point on how these “astronomical numbers” could be misrepresented to the public, especially in the rare disease realm.
“When you’re developing a drug that has a huge user population, the cost gets spread out,” Madden observed. “But when you’re going after a rare disease, the population is small, so the demand is going to be less and the development costs higher.”
Jay Carter, Abelson Taylor’s EVP of business development agreed, noting that the smaller the population footing the bill, the higher the price tag.
“You look at a drug like Lipitor, which millions of people take, and it’s a $10 billion drug,” he explained. “But managed care was happy to pay for it, because A, Pfizer gave them the rebate they needed, and B, it has enormously good outcomes. Genetic therapies are so custom, prices have to be high to cover research and development.”
Spurred by a mention of the first trial against an opioid drug manufacturer, Madden pivoted the conversation to another major point of contention for the pharma industry—the opioid crisis—asking the group how they felt the coverage, and crisis overall, has contributed to pharma’s negative public image.
“I think it’s doing a lot of damage,” said Bigelow. “I truly believe what we’re hearing about in the opioid situation can be attributed to outlier behavior, but that doesn’t stop people from associating it with all pharma companies.”
“It’s just the latest in a long string of bad behavior on the part of pharma,” added Wendy Blackburn, EVP of InTouch Solutions. “But while there are plenty of physicians who have exhibited bad behavior and distributors that have messed things up, pharma is the easiest target. I think we need to get to the root of why that is and how we can show more of the life-saving and life-improving drugs pharma has brought to market.”
Bigelow agreed, noting that “the addiction crisis has become so powerful that the public is seeing only the addicts, not the cancer patients who are being saved or some of the other amazing and innovative drugs, because it all comes back to the opioid issue.”
Another factor in the debate over opioid use is the lack of available alternatives for chronic pain management, Carter said.
“While there are certainly behavioral therapies that can treat chronic pain, most insurance companies won’t pay for them simply because they cost too much,” he said. “On the other hand, you have Hydrocodone, which is made by 32 different manufacturers and is dirt cheap.”
When asked whether or not the responsibility of finding and providing these alternatives rests with pharma, the group said it was complicated.
“Big pharma doesn’t think it’s their problem to fix,” Carter said. John Kamp, Washington counsel of the Coalition for Healthcare Communication, added that many non-opioid pharmaceutical companies “won’t touch that with the proverbial 10-foot pole.”
“They already feel, in some respects, like they are saddled with the Sackler (Purdue Pharma) history,” Kamp said. “So they’re just not going to do anything that smacks of opioids because they don’t want to be associated with it any more than they already are.”
Blackburn compared the bind pharma companies find themselves in to a hypothetical situation in which the editors of MM&M felt as though they had to apologize for all the fake news out there.
“You know it’s happening, and that you’re not personally responsible, but it’s a matter of industry reputation overall, so it’s a slippery slope,” Blackburn said.
Given the current environment, Madden asked the group how each thought pharma could “flip the script” to be seen in a more positive light.
The answer to addressing the opioid crisis, is “investing more time and money into education,” said Jeff Horwitz, Director of Operations for SafeProject.org.
“A lot of companies just throw money into prevention, and think that’s going to solve the problem,” he stated. “But what they don’t realize is that people with a certain genetic disposition can become addicted to opioids in as few as five doses, which is why educating people on the risks of opioids is so vital. Patients need to know how to have a conversation with their doctor where they’re asking the right questions.”
Bigelow agreed that education is key in relaying the right message to patients. “There was a period of time several years ago where people were touting a new paradigm of pain management, where you manage pain more aggressively early on in order to decrease the total burden of pain, which drove a lot of people to use various drugs (opioids and others), early and often.” Clearly that was the wrong message, he continued, “but it takes a long time to undo that message, and reeducate people. Pharma obviously needs to be a big part of that education, but it also needs to be made up of medical education programs, CME programs, practical journals, etc.”
The path toward a solution needs to be a “two-pronged approach,” Horwitz said, one that all players in the healthcare realm have a hand in.
“You have to deal with those that are addicted today and invest in recovery services and treatments for them,” he said. “And at the same time you need to be doing everything humanly possible to prevent addiction in the future; whether that’s trying to find alternatives to opioids, creating a test that determines if a person is susceptible to addiction, or simply better preparing doctors to deal with potential issues from the very beginning, when they’re still in medical school.”
“The opioid crisis isn’t going anywhere,” Horwitz continued, “and right now, the statistics are headed in the wrong direction. This is an extremely unique situation, and we need to be willing to work together in order to fix it. If we try to do it on our own, it’s just not going to get done.”