Still Reaching for Hearts and Minds on Drug Development Challenges

The European drug industry is multiplying its attempts to fight back against what it sees as a climate of misunderstanding as the European Union begins to put some shape into its priorities for the next five years. With everything up for grabs in policy terms, from drug pricing to patent protection, and from research funding to the use of real world evidence, the industry is keenly aware that it has a brief window this year to influence the new European Parliament - which holds its constituent assembly next month – and the new European Commission, due to take office in November. If it can get its message across, it may induce a more industry-friendly choice of health policies, it reasons. And it is also conscious that if it does not spell out its merits, there are plenty of opponents whose loud calls for tighter controls on the industry may spur legislation or regulation that could tie its hands.

The latest bid to win hearts and minds is a public opinion survey sponsored by Lilly in major European countries, which suggests in particular that the industry's research efforts are under-valued and even largely unperceived. "There are notable knowledge gaps in public understanding of R&D in the biopharmaceutical industry", says the report. "A large majority" of citizens surveyed in Belgium, France, Germany, Ireland, Italy and Spain do not know how much it costs to develop a medicine (Lilly cites an average of €1.9 billion) or guess at a relatively low figure. Nearly a quarter believe it costs less than €10 million (in Ireland and Germany nearly a third of respondents take this view), and fewer than a tenth guess at anything over €1billion.

"On average, there is a tendency to believe that more molecules tested make it into a final medicine than actually do," the report continues. On average, Europeans surveyed believe that 35% make it into a final medicine, and again fewer than a tenth say they know the odds are less than 1%. On average, European respondents say that 40% of medicines that enter the clinical trial stage are successfully made available for patients, with fewer than a tenth guessing at less than 10%.

More than a third of Europeans surveyed do not know how long it takes to develop a medicine, and nearly a half believe it takes less time than it does in reality, says the report. The average estimate among respondents was 9.6 years.

A survey of this sort among the general public may serve as a starting point, but on its own is not going to change much. Europe's political leaders are not going to be hugely swayed by some selective findings that people in a few countries don't really grasp the realities of the drug development. They are more likely to respond to alarming rises in drug budgets, or to be inspired to provide support out of fears of disinvestment and high-quality job losses, or of front-page coverage of drug shortages. Only over the longer term are they going to take much account of public opinion – and it will be a long time before public opinion becomes so well-informed about the mechanics of drug development that it starts to demand better conditions for drug firms.

If the Lilly survey has any immediate value, it is to jolt the industry itself into recognizing what a poor job it has done of profiling itself with the general public. And remedying that could be the start of a very long journey.