The Pharmaceutical Research and Manufacturers of America, known as PhRMA, said its new campaign will cost in the high tens of millions of dollars each year. It will highlight areas of true scientific excitement: immunotherapies for cancer and the power of personalized medicine and genomics to target medicines to patients. PhRMA President Steve Ubl said at a press event Monday that the industry hasn't told its scientific story well enough. The print, online and TV campaign would fill in that gap, explaining to consumers that we're in a “new era of medicine,” he said.
But the emphasis on innovation instead of pricing is a familiar strategy, according to historians of medicine. Today's “new era of medicine” is yesterday's antibiotics, antituberculosis drugs, psychotropic drugs or antidiabetic medicines.
That strategy has worked many times in the past, but it may be a risky time to rehash this message. The campaign launches as the affordability of health care has become a pressing issue for millions of Americans, as it remains uncertain what will replace the Affordable Care Act.
“What does it matter to the average American that there are new and exciting treatments for cancer if there’s no confidence they’ll be able to afford them or access them?” said Jeremy Greene, a historian of medicine at Johns Hopkins University who also practices medicine in a community health center in Baltimore. “When people don’t have insurance, you begin to realize just how much drugs cost at the pharmacy with no insurance.”
Ubl said that it was the right time for the industry to go on the offense. He argued that the negative image of drug companies stems from a handful of outlier companies that raised prices on old drugs. Specifically, he noted Martin Shkreli, the hoodie-wearing former chief executive of Turing Pharmaceuticals who hiked the price of an old drug to $750 a pill overnight.
“We want to replace the image of the industry that some have,” Ubl said. “In short, less hoodie and more lab coats,” he added, referring to Shkreli. In response, Shkreli put up his own website, arguing that other companies had hiked drug prices.
Industry observers said that a campaign focused on science and future therapeutic revolutions don't address a core issue that has emerged over the past year and a half: the public perception that the industry is not holding up its part of the social contract to not only develop drugs but also make them accessible.
“Just because you have a new breakthrough medicine doesn’t mean I’m going to get access to it,” said Kenneth Kaitin, director of the Tufts Center for the Study of Drug Development. “I think this is the exact wrong time to play around with that issue, because more and more people are going to get concerned — or already are concerned — about the state of their health-care coverage.”
Ubl said the campaign will also focus on demonstrating the value of drugs. That, too, isn't new, said Dominique Tobbell, a historian of medicine at the University of Minnesota. Tobbell said in an email that since the late 1950s the pharmaceutical industry has made arguments about its drugs' values, from the reductions in mortality to saving health-care costs through reduced hospitalizations or getting workers back on the job faster.
“Consistently, the industry has cast pharmaceuticals as the major reasons for these health-care gains — the role of public-health measures, preventive medicine, and lifestyle changes have been routinely missing or downplayed in its campaigns,” Tobbell said.
Greene argues that there are essentially two conversations Americans have about drugs. One is about the frontiers of science and the need for medicines to treat rare and overlooked diseases. Another is about access to medicine and health. These two discussions rarely overlap, he says.
For example, in a rare wave of bipartisan support late last year, Congress passed the 21st Century Cures Act aimed at speeding up the development of new drugs. What wasn't part of that legislation was an acknowledgment that patients were frustrated with the price and access to older drugs, an issue that came up at multiple congressional hearings over the past year.
Tobbell said that although the strategy of focusing on innovation has been successfully used for decades, consumers have more information about how pricing works that may keep them skeptical about the industry. But if history is a guide, the strategy may simply put off the issue until the next time a pricing controversy flares.
“Each time, it seems like prescription drug prices have reached some new high that’s just impossible to bear. The level of prices that we’re talking about when we talk about the unaffordability of prescription drugs — if you were to show them to people having arguments over prescription drug prices in the '80s, it would be incredible,” Greene said. “How many cycles of normalization of high drug prices and reinflation of drug prices can we stand as a society?”