Expert insight

Cultivating Trust in Healthcare System

6 December 2018
  • Thomas Cueni Director General

This oped was first published in The Pharma Letter on 6 December 2018.

Business performance is mostly about the tangible: robust pipeline, successful launches, development of sales, financial results, profit margins, and the like. One less tangible but absolutely crucial measure of success relates to “how” we go about our business. Ethics and building trust matter just as much as the number of medicines that get approved and the number of products sold.

It’s easy to prove the impact of bad commercial decision-making. In recent years, it’s become evident that ethics has an impact on the bottom line too – an analysis by Ethisphere showed that there could be a 6.4% “ethics premium” at the stock-market.

Another reality of business is how long it takes to build a company reputation, and how it can be lost overnight and tarnish the perception of an entire industry.

Ethical business conduct remains a constant challenge in an ever-interconnected business environment. If the expression “innovate or die” fuels businesses, then “be ethical or fail” should be equally engrained into our sector’s business DNA.

Our industry is unlike any other – our products can prolong and save lives. We do not sell consumer goods or luxury cars. We therefore hold ourselves to higher standards than other industries – we owe it to the patients and doctors who rely on our live-saving medicines. Trust is the life-blood of our industry, and we must take every opportunity to earn, sustain and grow that trust – from lab to bedside.

Creating the framework for ethical business conduct

In today’s fast-changing world, what might have been considered normal practice a few years ago may no longer be acceptable. For instance, while offering doctors tickets to sports games was a common practice in the past, it is completely frowned upon, indeed banned today. This means we must constantly look to improve how we can live up to the trust that so many – patients, healthcare professionals, regulators, policy makers from all over the world – place in our products.

This spirit of constantly checking we are living up to society’s expectations is nothing new. The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) first code of Practice was first drawn up in 1981. It was the first one of its kind for any business sector. Back then, correct information on the effects and side effects of medicines were at the core of the Code. This was necessary to build trust among patients, healthcare professionals, and other stakeholders for the innovations brought to the market. Today, more than one generation on, through periodic updates of the Code, expectations from all parts of the world regarding compliance are much more comprehensive.

Setting the bar higher and upholding trust

With the sixth edition of the Code that will come into effect on 1 January 2019, the bar is set even higher and it takes a deeper and broader appreciation of business integrity. We understand there might be some shortcomings and there are challenges to set common expectations of business integrity that apply around the world, but we owe it to ourselves to go beyond our comfort zone.

The newly introduced “Ethos” that provides the foundation to the new Code will show our commitment to apply values such as care, fairness, respect and honesty in everything that we do, in order to achieve patient trust.

The new Code has also a fiercely practical side and goes further than previous codes in setting standards and clearly bans certain business practices. The fast pace of medical innovation is reliant on proper communication throughout the entire medical community – from researchers to physicians, from nurses to patients. But sometimes, for a patient, seeing something as small as a branded pencil or calendar in their doctor’s practice may cause them to question whether the prescription has been made with their best interest at heart.

So-called “goodies” or “promotional aids”, even if they are of minimal value, send the wrong message as they trivialize the important relationship between medical representatives and healthcare professionals. IFPMA’s 2019 Code of Practice bans gifts and promotional aids worldwide, wherever IFPMA member companies and associations operate. Custom of gifts to mark significant national, cultural or religious events (for example, mooncakes or condolence payments) will no longer be allowed as of 1st January 2019.

Do we and will we get it right 100 percent of the time? No, organizations are comprised of fallible human beings who make mistakes. The information is there for anybody to check if they are in doubt. The better our stakeholders understand our standards and hold us to account, the easier it will be for us to live-up to our commitments and act when mistakes occur.


IFPMA represents the research-based pharmaceutical companies and associations across the globe. The research-based pharmaceutical industry’s 2 million employees discover, develop, and deliver medicines and vaccines that improve the life of patients worldwide. Based in Geneva, IFPMA has official relations with the United Nations and contributes industry expertise to help the global health community find solutions that improve global health.