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Drug companies seem to be under fire from all sides these days, whether it be for not revealing research data on side effects, or for neglecting the diseases of the developing world. Daniel Vasella, the medical doctor who runs Swiss pharmaceutical group Novartis, has come up with some novel solutions to how his industry can work to regain
the world's trust, without losing sight of its core mission. NEWSWEEK's Karen Lowry Miller spoke to him recently. Excerpts:
LOWRY MILLER: Do drug companies focus only on rich-country diseases?
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VASELLA: If that is true, and I'm not saying it is true, the fact is that genius also needs incentive. It is clear that you have to offer financial incentives for organizations to do work where they can make a profit. Otherwise nothing will change. If you think that you can take away the incentives without having the same effect you have currently on the developing world, you're wrong.
So how does society create incentives?
If governments say it is a priority, they need to create financial incentives for companies to engage. You cannot count on a company to engage out of personal commitment and acceptance of a role within society that goes beyond making a profit. Profit is absolutely essential. You could say it's like the air we breathe. More vital, maybe, is intellectual property. If you destroy it, you destroy the basis for rewarding innovation.
To what extent is that system at risk?
It is a trading of the future for the present. Yes, you could get cheaper drugs immediately. But you sacrifice the future by cutting into research spending. Can anyone assume this responsibility?
So companies should pursue profit and charity separately?
Absolutely. We alone had programs worth $570 million last year. I'm just waiting to get criticized by shareholders because in 2003 it was $350 million. If you add it up for the industry, you get several billion dollars. It's a huge amount of money, but not communicated.
Do you get credit for communicating?
We have the most effective malaria treatment. In 2003, we provided 100,000 treatments at rock-bottom, sustainable prices, and in 2004 it was 200,000. This year the World Health Organization wanted 60 million. We can't do it, because one of the ingredients is a plant that needs a year to grow. Then we hear from Medecins sans Frontieres that Novartis doesn't produce it because there is no financial incentive. Please, take all the facts. We bought all the plants available worldwide and we made a contract with plantations in Kenya. It's sobering to see what kind of credit you get or don't get.
The drug industry is also under fire for not publicizing data on side effects.
Trust is the overriding theme. When does trust get lost? When there is a lack of reliability, and disappointment. In my view, consumers have lost sight of the fact that drugs are serious stuff. Innovation is great, but it is in its nature not to know everything from day one on.
What about the regulators?
Industry always gave full transparency to the regulatory authorities. So I think that indirectly, the public said that we don't trust the regulators anymore as much as we did because we are not sure they are making the right judgment call.
What is your duty as an industry?
To give the information. And the duty of physicians is to make recommendations and judgments. I don't think people should be left alone with the data, because it can be very confusing.
Are negative facts hidden?
No. Is there systematic promotion of positive facts? Yes. We as an industry have to demonstrate that we are unequivocal about transparency. People don't trust that we disclose everything.
How do you regain trust?
The big companies have committed to putting clinical data on the Internet, as well as all the studies we start, so nothing gets lost. Also, we must pursue in a more optimal way our fundamental mission, and not care about adapting to any kind of fashion. I think we are being paid by society to give better drugs. That's what we ought to concentrate on.
Transparency is a fashion?
No, transparency is fundamental. It's an absolute ethical foundation for being in the arena of disease and death and life. You have to have complete confidence that what you are being told is true.
What do you think of open-source drug research?
Why not? In the end, society has to find the most effective ways to treat people. If there are better models, we'll just be obsolete. So be it.
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