But what really is needed to turn things around is interplay of pharmaceutical companies, doctors, and government. The general objective is to change how these 3 influential factors functions in delivering value healthcare to the vast majority. To change how drug companies affect doctor’s prescription, to tighten and step up reaction time of US FDA in controlling, recalling and monitoring drugs in the market, to educate and empower the patients on the real value of their drugs -– its benefits and its side effects, and to offer reasonable pricing and promotions from drug companies.

Large pharmaceutical companies do not act morally better then automotive or beverage companies, but they ought to. We might take a page from Schumacher and break up these giants, depending instead on smaller firms, which are not driven by shareholders, to research new treatments for a wider group of ailments.

Small changes will not be adequate. Big pharmaceuticals have the financial and political clout to run their enterprises the way they see fit, which is more aligned with shareholders expectations than with the public good.

The incident of Vioxx is an accident, which can happen with any industry. Take for example Chernobyl, Bhopal Gas Tragedy and so on. I mean any industry is vulnerable to such stray accidents.

Why do we forget that it is the input of doctors backed by quality medicines by pharma companies, which actually saves lives of millions of people daily. No one gives credit to pharma company for their effort in R&D, which results in novel drugs thus potentially saving lives of people.

Does anybody know the amount of effort required to be put in to discover one marketable medicine. It's roughly about 12 years of hardwork and millions of dollars.

I am not defending Vioxx incident but only supporting the fact that such incidents should not leave a mark on an entire industry. It is because of efforts of this industry that we can be assured of good medical treatment even in cases of many dreadful diseases like cancer.

Also, Pharma companies are into a business of creating value for their shareholders and profit is one of their motives. But the same can be achieved by these companies by restructuring their present promotional activities, which presntly is supposed to have clout of doctors and politicians. Shareholders value can be increased even by not coaxing influencers for a particular brand.

The Vioxx issue was not a unique one or 'an accident.' It is just now getting press and public attention. The products [drug companies] develop are never cures, rather they are treatments or symptom suppressors so that we continue to need their product. Few believe today they are in the market to truly cure anything and likely never will.

The drug development life-cycle involves a high gestation period & subsequent protection of intellectual property rights. Ignoring medial ethics & yielding to marketing pressures results in short-circuiting the new development cycle of innovation, research, clinical trials, product evaluation & regulation standards. Consumer trust is all that counts for a sustainable growth.

Most patients don't care about a pharma brand name -- they want an efficacious treatment. Cost to the patient and the health services is a major consideration these days of aging populations, and companies must be aware of it.

The industry might also help itself if it demonstrated a greater interest in, and sensitivity to, peoples concerns about safety, pricing etc.

But these changes open up real opportunities for pharma companies to build much closer relationships with patients and consumers. Individual companies can start to do this by getting closer and closer to their consumers, and by demonstrating their understanding of consumer needs, fears and wishes in the way they communicate.

They can talk in simple, clear and friendly language, uncluttered by legal, medical or technical jargon and have clearer, more helpful packaging and leaflets. They can demonstrate an understanding that health is a two way process in which the consumer is an equal partner, and by ensuring that new products own a strong benefit-oriented idea that is understood by consumers and communicated.

Getting closer to consumers doesn’t mean to the exclusion of the doctor or pharmacist. In fact the insights gained may provide sales tools for use with healthcare professionals.

During the seventies Glaxo sent a mailer to all doctors on its lists in India informing them of one isolated case of anaphylactic reaction with its B1B6B12 injection although it was not required by law at that time.

The mailer virtually killed an otherwise excellent product but earned the company the medical community’s immense trust in its probity. Glaxo could not have worked for stronger brand equity than what the mailer did although the company suffered a temporary setback.

Safety first…

Always remembering the raison d' être of the pharmaceutical industry as healthcare may be a sobering thought for pharma marketers even when commercial considerations are a compelling reason to cut corners to add a blockbuster.

Some pharmacology textbooks like the primer on the subject by Lawrence used to mention the Thalidomide Disaster as a warning. An alert FDA Commissioner, who felt that the drug was not adequately tested, halted thalidomide’s entry into the US. By then however, the damage was done in several European countries, which rushed to approve the drug as a safe tranquilizer for pregnant women. The appalling sequelae surfaced for nearly ten years after its first introduction.

Good Marketing Conduct (GMC)!

Pharma companies are often blamed for dumping hazardous drugs not marketed in their own countries (e.g. Analgin, Oxyphenbutazone and Phenylbutazone), in third world countries. Similarly they do not publicize warnings about side effects especially when they are prescribed for children. An example of this is diphenoxylate and atropine sulphate combination prescribed extensively as an anti-dirrhoeal in India. A question often raised is when GMP/GCP procedures are a must for procurement of drugs from third world countries why are not similar practices rigidly followed for marketing drugs.

The recent setback companies marketing COX2 inhibitors suffered and earlier withdrawal of terfenadine analogues are totally avoidable as the drugs (like thalidomide) are not in a class where they can be termed as necessary evil like immunosuppressive drugs or cytostatic agents.