Pete Butterfield's speech from the ABPI Annual Conference and Dinner 2011

Pete ButterfieldGood afternoon everyone and thanks to Tim, Andy and John for their insights. For those of you I’ve not met, I’m an executive director of Alliance Pharmaceuticals, a small, but rapidly growing UK based pharmaceutical company. I chair the ABPI’s small company’s forum and have been on the ABPI Board of Management for the last three years.

I’m also a member of the ABPIs Reputation and Ethical Practices Group and I’ve been asked to speak to you today to give you my view of the world in 2020 and what the relationships between industry and our customer base will look like.

As with all these matters, this is only my personal view, but hopefully it will provide some food for thought.

Now, some of you in this room may be sat there thinking that your individual company does not have a reputation problem, in fact far from it. 

Value 

That may play to the hypothesis out there that companies who deliver demonstrable value do not seem to have an inherent trust problem.

The problem I see is this – as an industry, we add enormous value, but we’re not very good at communicating this collectively. There are reasons for this - sometimes our outcomes, can be difficult to quantify and also only evident sometimes over the long term.

Whatever the reasons for these difficulties, we need to get better demonstrating and communicating the value we provide. We are judged as an industry and as such need to take collective action to change the perceptions that Andy has already highlighted.

So what about 2020?

In order to have some understanding of how the world will change in the next 10 years or so, I thought it might be useful to cast out minds back for a minute to May 2001 to see what we have learnt.

2001

Have we revolutionized the way we work over the last 10 years? I think that you’ll get a different answer depending on who you ask. If you were to ask the medical profession and the man in the street, they may say that there have been subtle changes but broadly things have remained similar.

However, from an insider’s perspective there have been some significant changes in the way we work. 10 years ago, the industry was at the tail end of the culture of big brand and battalions of sales representatives. This in turn had escalated into mega trials, mega conferences and mega meetings. At the time, this was perfectly acceptable, but what is acceptable changes over time.

NICE is now 12 years old. 12 years on, it is accepted that Health Technology Assessment in some form is here to stay, albeit things undoubtedly need to change away from a narrow health economic analysis to take into account the broader societal benefits that medicines bring

In terms of the environment in which we operate, the received wisdom 10 years ago was that the UK was a good priced market with low uptake, whereas today we have the lowest branded prices in Europe and uptake remains questionable.

However, no-one can questions the explosion of technology which has occurred over that last 10 years. This coupled with society’s leaning towards increased transparency has meant that corporate reputation has been brought sharply into focus and is now a critical issue for industry.

So, has trust and our working relationship improved since 2001? I’m not sure. The current data show we still have significant areas to work on with key members of the medical profession and the NHS

We have however learnt some positive lessons from last year – the code changes around increased transparency and removal of promotional items in themselves are not fundamental to building trust, but by making a first, symbolic, move this has led to a new dialogue and genuine goodwill between ourselves and our customers.

A good example of this is the joint response from both the RCP and the ABPI around the negative press relating to the relationship between industry and the medical profession in the Financial Times earlier this year. I don’t think this would have happened 12 months ago.

These changes are not yet fully understood by the grass roots and will take time to settle in but by making these symbolic moves, I certainly hope that we have opened the way for a virtuous circle to exist and a new dialogue which will be welcomed by the medical profession.

So what about the future?

2020

There are some fundamental and well received opinions out there about what the landscape will look like 10 years from now. The UK will have a population of around 66 million in 2020 according to the office of statistics

There’s a 1 in 2 chance that my children will live to over 100 years old and by then at least 20% of our population will be over the age of 80.

And what about this population?

Well as the population ages, the demographic will become much more active both physically and also on the lobbying and campaigning front. Expectations of quality of this longer life will also rise dramatically.

It would therefore seem reasonable to assume that outcomes based around quality of life will become more and more important and HTA will be more to the fore than ever.

It’s also safe to say that the intensely competitive environment within the industry will continue, as industry moves into an era of unprecedented change, as a result of many factors which are well documented and too numerous to mention here.

Where does trust and reputation fit in with all this?

Well, If we return to the hypothesis that companies who add value don’t seem to have a trust problem and value will be defined by quality of life, not quantity, in 2020, it would be reasonable to assume that a partnership model will probably prevail. This means that companies will have to move from a supplier/procurer relationship to a trusted partner in healthcare. This means joint working. True, value delivering, relationships can only work on trust.

So how should our relationship look in 2020?

I would like to see collaborations which derive mutual value championed by the industry and more importantly, the medical profession and replicated where appropriate. I would also like us to work towards transparent financial relations, a two way flow of information, mutual trust and respect and an interchange of staff. 

There is no single solution to how this might be achieved, but I thought might be useful to offer up some practical ideas to help the way forward.

I would like to see more collaboration with our medical and scientific graduate talent in order to be seen as part of the solution rather than the problem – trainee health professionals do not receive training on how to engage with industry and often get negative messages rather than positive reasons for doing so.

Companies displaying good practice should be publically praised rather than consistently holding up examples of those who break the code. Sometimes we can be perceived as our own worst enemy. Self regulation is vital in a healthy thriving industry, but if we don’t improve trust, then surely the logical endpoint is that this gets removed or eroded in some way.

We must continually ensure that the Code reflects changing stakeholder expectations and includes shared ownership of the issues between health professionals and the industry. The document Andy refers to (10 Myths etc.) could well be the first seeds of a joint code of conduct which could be agreed with our customers to help to facilitate relationships. This may be another small but significant step to removing barriers. 

Overall, we need to much better at communicating a good and honest account of ourselves as an industry and I wonder if we put all our collective energies behind this, what things might look like in the future.

So where are we now?

Over the last 12 months, we’ve just made some small, but fundamentally important shifts in the way we interact which I hope is the start of a virtuous circle between the medical profession and the industry. However, we must work harder, and be much bolder and faster in both the industry and the medical profession in order to build on the momentum we have created.

It’s vital that industry and the medical profession work to develop a relationship where honesty and transparency thrive and where innovative solutions which above all deliver demonstrable value to our customers can be created together.

In summary, by 2020 the considerations of trust and reputation cannot be seen as optional add-ons to our relationship; they need to be its bedrock.

Thank you

Peter Butterfield, Executive Director, Alliance Pharmaceuticals

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