Have you ever wondered how your doctor chooses which medicine to prescribe? For some diseases they might have two, three or even 10 medicines to choose from, each of which has been approved as safe and effective by regulators.
Doctors might consider treatment guidelines and cost, or their experience of using a particular medicine. They might take into account a wealth of information sources, including publications of clinical trials, presentations at scientific conferences, expert opinions and medical education they have received. Clearly, doctors need access to high quality, up-to-date information to help make the best choice for their patients.
So what role do companies that discover, develop and market medicines have? Traditionally, companies provide information about their medicines in a range of ways.
Sales professionals visit doctors to talk about their company's medicines, including clinical data and safety information. They areusually rewarded and incentivised based on the volume of sales they generate.
Companies support medical education that provides doctors with the latest information on disease, diagnosis and treatment, supplementing the education provided by governments and doctors' employers. For example, by providing financial support to enable doctors to attend international medical conferences or sponsoring continuous medical education programmes.
Recognising that doctors want to hear from their peers, companies also invite doctors to speak on their behalf about their medicines or a particular disease. Doctors are busy people with valuable expertise to share, so they will typically receive an appropriate fee in return.
Sharing information about medicines with doctors is, and will remain, a hugely valuable role that healthcare companies like GSK can play. After all, they are the experts on the benefits and risks of the medicines they discover develop and market. But, this needs to be done in the right way so as not to, or be perceived to, inappropriately influence prescribing decisions.
This is not to say that we think healthcare professionals do not make good, independent decisions - we know that they do. But even a perception of conflict of interest can undermine the trust that patients have in the information being provided to them by their doctors about medicines and we must work to safeguard against that.
So, at GSK, we're doing something radical. We are making three big changes to reform and modernise the way we provide information to doctors.
1.Incentivising the right behaviours: By the end of this year, we will have changed the role of our sales professionals across the globe. No longer will they be assessed and rewarded based on sales targets. Instead they will take a more consultative role and they will be rewarded on their scientific and product knowledge and feedback from doctors on the value they bring.
2.Renewing our commitment to truly independent education: We are changing how we support education for doctors. Our commitment to education is unchanged but we'll be funding it at arm's length, for example via third party independent medical organisations. This leaves it to the third party medical organisations to decide the what, how and who for education programmes.
3.Being clear on who's speaking: We're stopping the practice of paying doctors to speak on our behalf to other doctors. Instead we'll make sure the expert medical doctors we have within GSK have more time to talk with and answer questions about our medicines with their peers. They will be responsible for, and measured on, providing the right information to support the safe and effective use of our medicines.
In practice, these changes will mean that if a doctor wants specialist information or to ask a question about our medicines, we can link them with a GSK expert quickly and in a way that suits them. Clinical trial investigators responsible for running trials on our medicines will still present trial results in scientific meetings but other presentations and debates on our medicines will be led through our own experts.
These new approaches will improve both how we provide information to doctors and will make us more transparent. In this way, we hope to start addressing the perception that exists of a conflict of interest results in how companies interact with doctors.
These are significant changes and will not happen overnight. They won't always be easy to make. But our previous steps on clinical trial transparency and open innovation have taught us that the hard thing to do is often the right thing to do.
The common thread with these changes is ensuring we put patients' interests at the heart of every decision. That has to be a good thing for doctors, for us and for the patients we all want to help.