Wednesday, November 28, 2012

Big Pharma doing well, but clinical trials still lacking transparency

Pharmaceutical companies are a constant target for conspiracy theorists who say that "Big Pharma" controls disease for profit. Some think that since these companies make money from people that are ill they must have some evil plot to keep people ill. In some cases this means that Big Pharma is responsible for creating diseases. In others it means they lie about the efficacy of things like homeopathy.

There are, of course,  flaws in the way we develop, test, and market prescription drugs,1 but the real issues have nothing to do with the conspiracy theories. A recently released report - The Access to Medicine Index (2012) - brings us some good news about the pharmaceutical industry.

Cover 2012 Access to Medicine Index The Access to Medicine Index is an independent review that ranks 20 pharmaceutical countries on how they help developing countries. Each company is ranked by their performance in:

  • General Access to Medicine Management
  • Public Policy and Marketing Influence
  • Research and Development
  • Pricing, Manufacturing, and Distribution
  • Patents and Licencing
  • Capability Advancement
  • Donations and Philanthropy

The highest ranked company in 2010 and 2012 was GlaxoSmithKline. Johnson & Johnson and the French company Sanofi, who ranked 9th and 5th in 2010, now rank at a very close second and third. Of course, these results are just comparative - they don't say anything about how "Big Pharma" as a whole is doing. What else can this report tell us?

Access to medicine in developing countries has improved and this is largely attributed to better organization. GlaxoSmithKline, for example, established a Developing Countries and Market Access department. Five other companies in the index have similar departments.

Pricing Tiers and Product Needs
Twelve of the twenty companies have a tier pricing program. These programs are designed to bring low cost drugs to developing countries. One problem with these programs is that while drug companies may provide a low cost, third party companies often sell the drugs at the standard retail price. This means that companies, not patients, benefit from these tier programs.

Contract Research Organisations
Pharmaceutical companies have come under fire recently for their transparency (or lack thereof) in clinical trials. This report is no different. Contract Research Organisations (CROs) are third party companies used to oversee clinical trials, drug recalls, and research. The Access to Medicine Index points out that Big Pharma needs to improve transparency regarding their collaborations and obligations to CROs.

Overall I think the Access to Medicine Index is good news. Out of the 20 drug companies, 17 companies scored higher in 2012 than in 2010. Although clinical trial practices remains an area that needs improvement, it's promising that the index brings the issue to the forefront once again.

[1] For a more in-depth analysis of what Big Pharma actually does wrong (instead of wild conspiracy theories) I suggest this book by Ben Goldacre.