The Price of Life: Shifting Perceptions of Pharmaceuticals

This episode explores the complex relationship between the public perception of pharmaceutical companies and the actual value and cost of medications.

1. Public Distrust Predominates: Despite life-saving innovations, pharmaceutical companies struggle with a negative reputation primarily due to high drug prices and perceived greed.
2. Impact of COVID-19: The pandemic initially boosted the industry's image due to rapid vaccine development but later reinforced skepticism about motives and profits.
3. Need for Narrative Change: Shifting the focus from profit to patient care and innovation can help improve public perception.
4. Strategic Storytelling: Effective communication should emphasize the tangible benefits of pharmaceuticals, focusing on their role in enhancing health and quality of life.
5. Action Over Words: Suggests that pharmaceutical companies need bold actions, like transparency in pricing or involving the public in research decisions, to rebuild trust.

1. Introduction

Overview of the episode's theme about the complex perception of pharmaceuticals. Briefly introduces hosts and guests.

• Michael Maslansky: "It's not what you say, it's what they hear."

2. The Industry’s Reputation

Discusses the longstanding challenges faced by the pharmaceutical industry, especially in light of the COVID-19 pandemic.

• Lee Carter: "We were cheering for them during COVID."

3. Pricing and Public Perception

Explores how pricing strategies and the rapid development of COVID-19 vaccines affected public perception.

• Katie Cronin: "The industry faced a reputation crisis post-2016."

4. Strategies for Change

Discusses potential strategies for pharmaceutical companies to shift public perception and regain trust.

• Michael Maslansky: "Shifting the blame does not work in the long term."

1. Understand the Full Cost: Learn about the research and development behind medications to appreciate their pricing better.
2. Stay Informed: Follow updates on pharmaceutical innovations to understand their impact on health care.
3. Support Transparency: Advocate for clear communication and transparency from pharmaceutical companies.
4. Educate Others: Share accurate information about the benefits and challenges within the pharmaceutical industry.
5. Engage Critically: Question narratives that solely focus on profit without considering patient care and innovation.

In this episode, CEO Michael Maslansky, and Partners Lee Carter and Katie Cronen delve into the pharmaceutical industry's enduring reputation struggles, tracing their origins back to pre-pandemic times and exploring the transformative impact of COVID-19. Through insightful discussions and case studies, they’ll propose strategies for reshaping the industry's narrative, emphasizing the importance of recasting pharma as more than profit-driven entities and fostering consumer trust.

People

Michael Maslansky, Lee Carter, Katie Cronin

Companies

maslansky + partners

Books

None

Guest Name(s):

None

Content Warnings:

None

Michael Maslansky

They said what? Welcome to Hearsay, a podcast from the language strategists at Meslanskane Partners, where we give our take on the strategy behind the smartest, savviest, and stupidest messages in the market today and what you can learn from them. Our philosophy is, it's not what you say, it's what they hear. And that's why we call this hearsay. I'm Michael Maslansky, CEO of Mislansky and Partners, and author of the Language of Trust.

And today I've got Lee Carter, our president and partner, and Katie Cronin, our partner as well, here to talk about a topic that I think can teach us lessons in a lot of different areas, which we work. And we're going to talk about. I don't know. I'm going to call this the price of life, because we're going to talk about pharmaceuticals, the pharmaceutical industry, the cost of medication, and the way that people react to those costs. What do you think?

Did I make up a good name? Is that pretty good? I love it. And you know what? It's pretty hard to put a cost on life, Michael.

Lee Carter

So that was clever, what you did there. I try. I try. All right, so it will be no surprise to anyone listening to this podcast that pharmaceuticals and the pharmaceutical industry has had its ups and downs over the last couple of years. There have been moments of great success.

Michael Maslansky

There have been moments of challenge, and a lot of them have been around the cost of medications. And certainly, I think over the last couple of years, we've been living in the shadow of what happened during COVID And so we're going to delve into a little bit about what has happened with the industry's reputation as a result of COVID and what the industry can do about it. And so we've been doing research on pharmaceutical pricing for, I would say, 20 years now. And I can remember being in a focus group where we were talking about a new breakthrough innovation, a life saving medication. And a woman stood up and said, this drug is literally keeping me alive, and I hate the company that makes it.

That's what she said. And so as we think about the challenges that the industry faces today, I think that a lot of these challenges are longstanding. If we look at data, we can see that the industry's had a negative reputation for a long time. But I do think that there was, like, an inflection point where it got really bad. And that was around 2015, where we started looking at what the real drivers were of negative reputation.

And so, Katie, I know, you've looked a lot at what was going on then, and kind of like, as we boiled up all the challenges that the industry faced pre pandemic, that it came down to a couple things. What were those things? Yeah, in 2015, we were gearing up for presidential election cycle, and the out of pocket costs that Americans were paying for medicine was ranking really highly on the things that people were concerned about and cared about. Bernie Sanders, as a presidential candidate, gave it a lot of attention. We saw this trend evolve of talking about health care is a right, and therefore it feels unfair to profit off of it.

Katie Cronin

And we also saw bad actors like pharmabro and other companies being hauled in front of Congress and getting a lot of attention and having to explain where pricing comes from in medicines, especially when you have some companies who are seemingly jacking up prices for necessary medicines in a very, very short amount of time. And so it seemed like there was a tremendous amount of pressure on the industry. And yet, if we look kind of backwards, that may have been the last golden age of pharmaceutical reputation, with the exception of maybe the moment of the pandemic. Right. So, Lee, what happened, that pandemic moment, which seemed like such a promising moment, why didn't it turn out to be a real opportunity for the industry?

Lee Carter

Well, it's fascinating, because one of the answers to the reputational challenge was, how do you broaden the view of what happens in pharmaceutical companies? Because people think about the profit of the pill, but not the research that goes on the lab. So during COVID we were all brought into the lab with the pharmaceutical companies, and we were cheering for them. We were all saying, which one of you is going to get the vaccine to us faster so that we can get back to our lives? And we saw whether it was Moderna, Pfizer, J.

And J. AstraZeneca, all of the companies that had these promising vaccines with scientists in the labs, and we were really rooting for them. And it was an exciting moment, and people who were excited about the vaccine lined up to get it. It was like, thank you, Lord, for pharmaceutical companies for once. And it lasted a very short amount of time.

And I think that the reason for that is it didn't take very long for people to make the connection that, wait a minute. This vaccine doesn't necessarily work that well in some people's minds, because there were a lot of people who, as soon as they got the vaccine, still got COVID, so they couldn't understand how well it worked. They saw how much the companies that did make this vaccine profited. And there was at the same time, a forcing of people to take this vaccine. So there were some people who got fired who wouldn't take the vaccine.

There were mandates. And we know that a lot of people really push back when you're forced to do anything. And so instead of being happy and thankful to pharmaceutical companies, people felt even more beholden to pharmaceutical companies. And they took this moment. And so the idea that they put profits before people was amplified even more than it was before, and things that got worse than they even were before.

Katie Cronin

You know, what's interesting, too, is I think that's a really good encapsulation, too, of the general consumer sentiment. But even if you look at how physicians, how nurses and nurse practitioners felt, how industry insiders started to feel toward pharmaceutical companies, they were very aware that prior to the pandemic, one of the most prominent defenses the pharmaceutical industry has been using about why medicines cost, what they do is that R and D takes ten years and a billion dollars, and we fail more often than we succeed. That's why this is so expensive, is because this industry is so challenging. And they basically had a double edged sword with the advent of the vaccines in a year. Because all of a sudden, while it's amazing and very necessary, you're seeing, oh, pharmaceutical companies, you can do it faster than ten years, you can be more successful when you really need to be.

You can focus on prevention, not just turning things into chronic conditions. So is it just that you don't want to the rest of the time? It brings together so many different strands of things that we see all the time, but you've got the desire to innovate. And really, this should have been a celebration of our incredible ability to innovate. But, as you said, kind of countered some of the beliefs or arguments that were being made by the industry.

Michael Maslansky

So it seemed like it kind of defeated other arguments for innovation. It was definitely politicized in a way that made it tribal to support or oppose, and made the whole industry tribal in ways that I think I've seen some data on how reputation crises in a really a post 2016, post pandemic world, if they are politicized, they are much harder to recover from than if they are not. And this was definitely a situation that was politicized, and that the focus of so many things was on the deficit mentality, what the vaccine wasn't doing as opposed to what the vaccine was doing. But all of these really turned a situation that should have been really, as we talked about, a new golden age for pharma into one that has almost amplified all the criticisms of the industry that existed beforehand. And so now, as we look at data, the reputation of the industry is really in bad shape.

And so our job is not to talk about how bad things are for an industry, but to figure out what they can do about them. And so what do we do? What does Pharma do to overcome the challenges that they've been facing for the last couple of years? One of the things that we've noticed in terms of how companies are currently responding, there is an instinct to be reactive and to go back into defensive mode, where you're explaining how much you invest in R and D, the effort involved, the idea being, let's prove how hard it is so that you have a deeper appreciation for why you should support us. But there's been another avenue of messaging in a way that I think is more prominent than it was ten years ago is to shift the blame to the middlemen, to the pharmacy benefit managers who work on behalf of insurance companies, who the industry says they work to negotiate really large discounts on medicine, but then they don't really pass those statements along to patients.

Katie Cronin

They just are a middleman who is just taking their cut and driving up your out of pocket costs. And while I think it's very tempting to try and shift the blame and point to a new villain, hey, we're not the bad guys. Be mad at these middlemen. They're the ones who are responsible for your pain. I think we see over and over again that it won't work long term, because while it may give your audience a new vocabulary for somebody else to be mad at, they're still gonna be mad at you.

Michael Maslansky

And even does it work in the short term? Cause I think we often see that blame shifting does not work. But, in fact, there could be another villain to create that doesn't look like you're shifting blame. Right, Lee? Yeah.

Lee Carter

And I think one of the things that we see when we're working on issues like this, there's often principles of good storytelling that help shift the narrative, and that's really what we're trying to do. So what we have to do here is, right now, we're in this dynamic where it's patients versus pharmaceutical companies. It's the people versus pharmaceutical companies, us versus them. They're the bad guys. We're all struggling.

So how do you recast that villain so that instead of the pharmaceutical company being the villain, it's actually the disease that's the villain. It's actually something else? That's a villain, that we're all on the same team, and you actually bring all of us into the same team so that we're rooting for the pharmaceutical companies just as much as we're rooting for everybody else. And I think that's one of the exercises that we need to go through. So what does that look like?

Well, trying to think of some examples from companies have done this. Well, there's an advertising campaign by Roe over the summer. Roe is this online medical service, and they are treating obesity with a lot of these new injectable weight loss drugs. And there's a lot of stigma around those drugs, and they did something really clever in their advertising, and they changed the frame, they changed the way you looked at it, so that the frame that they said or that the line that they use is taking medicine for weight loss isn't lazy, it's health care. So what does it do?

It goes right on the face. It goes right to the problem, which is the stigma around taking medicine, is that it's a problem with a person, and it changes that instead of it's not a problem with a person, it's actually a problem with their health, and that's something that there's medically that they can do about it. So by shifting that, you can shift the conversation. So really, how does a pharmaceutical company then shift who they're looking at? And I think it's such a good parallel example of how pharmaceutical companies really need to shift that question, too, so that they're looking at things differently.

Michael Maslansky

Yeah, I mean, in arguably, if you're in a debate about who the villain is on pricing, whether it's the pharma company or the middleman, then you're talking about pricing. And if you're talking about pricing, you're probably losing. And so the more that the focus becomes on something else, in this case, the benefits of the medication, the more successful you are likely to be. It reminds me of, do you remember the ad campaigns from years ago from Mucinex? And they personified this, like, mucus monster who was so gross, like this mucus monster who camped out in your nasal cavity and was disgusting.

Katie Cronin

That's the mental image that I want to apply to a challenge like this is stop personifying the middleman. Personify the disease that you have to go up against, because I'd throw all my weight behind getting rid of that ugly, disgusting mucus monster any day of the week. All right. Okay. So that's one thing that they need to do, is they need to condition the villain and talk about their ability to defeat the villain.

Michael Maslansky

But they also don't necessarily have a lot of credibility as an industry right now. And they need to get people to overcome their own skepticism that anything that the industry says is going to be kind of biased or self serving. So how are they going to do that? Yeah, I think, number one, when we're talking to our clients that are in these kinds of situations, first you have to know that the skepticism is not going to go away overnight and not going to go away easily. You can't just simply say, trust me, things are going to be different today.

Lee Carter

And so in these situations, we find that you have to disrupt thinking. You have to do something that's powerful, some kind of a moment or symbolic gesture that allows people to see that you're actually truly different in this moment. And one of the examples I love to think of when I think about how do you do a reset really well when you're trying to really disrupt the way people are thinking? I think back to when Howard Schultz came back to Starbucks the first time he had left and Starbucks had lost their way. There are a lot of criticism about the coffee flavor.

Said that it wasn't always consistently good, and they didn't have that same consistent Starbucks experience it used to have. The stores themselves weren't all consistent. And Howard Schultz could have done what lots of people do is come back and say, I'm back, and we have a commitment to making great coffee again, and that's what we're going to do. That's not what he did. He closed the doors of every single Starbucks for an afternoon and said, I'm going to train every barista how to make the perfect cup of coffee again.

We're going back to our roots, what we're all about just making perfect coffee now. That moment was a huge reset for Starbucks, and one we all remember 15 years later because it was such a powerful reset. So then the question becomes, how can pharma do something that's a symbolic gesture, whether it's making sure that they have a transparent formula? We've talked to some pharmaceutical companies about saying, what are the four elements that go into pricing so that everybody can know what to expect each and every time? Is there some kind of a bill of rights that you could release that says, patients have a bill of rights around pricing?

And this is what we're going to do, is there's some other kind of symbol, and this might be something that we want to debate, what it could be, but how do they do something that goes beyond saying, this is what we have to do. It's so hard for us. We're bringing life saving medicines. We're all on the same team. You've got to do something to disrupt that thinking.

Michael Maslansky

Some ways, what they did around COVID was an attempt at kind of resetting reputation. Right. It was like, look at all that we can do when we put our minds to it, that didn't work, and that might discourage them from doing something else. Transparency, I think, is an interesting idea. Is that going to help them or is that going to hurt them?

And do they have the appetite often when you're going to do something very different, as was the case, I think with Starbucks closing its doors, is there is risk involved in doing it and taking a strong position and acknowledging, as he did, that the quality was not where it needed to be. If you're going to do something that is symbolic, it often has to be kind of counter to your interest in some way in order to get to that other place. And the question is, what is the industry willing to do if you go down the transparency route? There's a lot that, from what I understand, is baked into pharma pricing that, some of which makes the drugs more expensive in a way that doesn't help the pharma companies, some of which that might. And in simplifying it, do you risk creating a problem that's worse?

And so it's a big challenge, I think, for the companies to think about, although I agree it's the right direction to be thinking about. I wonder what it would look like if a company said they were going to open up a portion of their pipeline dedicated to research that was driven by what the public says they want them to research. If the narrative is that pharma chases whatever they can make money off of, if you could own being the company that said, we give the public a say in what we try to bring to market next. I think that could be interesting and powerful. I think about if Starbucks closed their doors, is there some kind of advertising black out that a company could do for a period of time to show that they'll put that spend elsewhere?

Katie Cronin

Along the lines of what you were saying, Michael, it has to be something that feels very out of character in order to be successful. And Michael, I think you're right. There's a huge risk, but there's also a huge reward if you get it right. And I think the thing that companies need to be really careful of is if you think about some of the things that are happening right now with government and the Biden administration taking credit for putting price caps on certain things like insulin will never be more than $35 a vial now, because they have now done this, and companies are finding a way to profit. So if you suddenly go out there and say, you know what?

Lee Carter

We're going to put a price cap on something, you're running the risk that people are going to say, hey, wait a second, what were you doing before? Right. So you got to be really careful and thoughtful about any unintended consequence of what you're doing. But I think a couple of those suggestions that Katie had there are really smart ones, because they get at not just the problem, but the root of the problem that could have some kind of a symbolic moment reset that allows people to, at least for a minute, listen to what pharmaceutical companies are saying rather than push back on that same narrative. So while we're trying to figure out the great reset, what else can the industry do if they're not going to stop advertising?

Michael Maslansky

Although I think that that's a great idea, to shift the focus of DTC advertising, at least for a minute, and put it someplace else. What else could they do? One of the things that we've been talking a lot about is to focus on highlighting the tangible benefits of the work that they've done. I think there's so much of an instinct to focus on the goal, hey, we are looking to save and improve lives. We are tackling these kinds of disease states.

Katie Cronin

And often, I think, companies forget to show the progress that they've made or to translate what those outcomes look like in a real, personal, tangible way for people, even in terms of small things. And one of the examples of an organization that I think has done a pretty good job with this is actually NASA. They have a lot of storytelling that they've done dedicated to the benefits of space exploration. And it is not just about, you know, having a moonshot, because going to the moon is cool. They are in a habit of talking about all of the things that the work of their engineers and scientists translates into for everyday people.

They talk about what they did with food turned into dippin dots. They talk about how their standards for making sure that food was safe for astronauts on Apollo, and thank God we. Have dippin dots, by the way. I know, I know. A trip to Six Flags is not complete without dippin dots.

But NASA's work on making sure the Apollo astronauts didn't get food poisoning translates into the food safety standards that general mills uses today. The work that they did in communication led to the first modernized conference call they recently took their speed of engineering to create a patent that anybody could access for a new ventilator that doesn't use any of the same materials that traditional ventilators use. So that when we were running out of supplies, we could manufacture new ventilators really fast. So the idea that they are translating everything they do routinely into everyday benefits for people makes a much stronger case about why you should spend a gazillion dollars. And yes, that's a technical term on space exploration.

Michael Maslansky

I think there's something really interesting there in terms of things that have come out of the work that the pharmaceutical industry has done that were not direct benefits. But I also wonder, has the industry done a good enough job of creating a narrative about the impact that the industry has had on health? Id say human health, but I think its probably really about health in the US, because I think in many ways, the narrative about health and healthcare in the US is that we are getting less healthy than we used to be. And I'm not sure that that's accurate. And I think that there are a lot of medications out there that really have changed the trajectory of health in America in really positive ways.

And I'm not sure that that story is being told. We are often talking about how hard is it to make a new drug instead of look around and see how lucky we are to be alive right now, to quote a certain Broadway show. Lee, what do you think about that? I think it's such a good point. And that's a really good reframe.

Lee Carter

How do we reframe it around those things that are really practical, tangible benefits that we feel every day, rather than it just being about the moonshot of going after cancer or Alzheimer's? And it's interesting because we've done so much work for different therapeutic areas over time, having nothing to do with pricing. Just how do you talk about a new medication or a therapy that has gone from twice a day dosing to single day dosing, or something that was once an injection to something that is now a pill? And I remember we worked on a cancer therapy that was non injectable, and that suddenly became a huge benefit to patients, not just that you were saving their lives, but also that they didn't have to go through the agony of injections and the iv process. And so I think sometimes we take for granted the smaller things, but it's those smaller things that makes our lives better each and every day.

And when you start to appreciate all of those different things, you start to appreciate the companies that are behind it and the people who have thought of them. And it doesn't always have to be those big, huge things. It can be the smaller things too, that just make our lives better. Yeah, I think all of this kind of reveals the fact that it does seem like the industry spends a lot of time talking about the individual kind of breakthroughs and cures, like for an individual medication, and then the challenges of creating that next one. And that, at least from my experience, you used to talk about cancer being a death sentence, and now it's like, well, what kind of cancer is it?

Michael Maslansky

What stage is it, what treatments have already been offered and leave cost aside for a second. As important as that is, like, the number of people who are able to benefit from some breakthrough innovation in oncology or immunotherapy, or one of the great innovations that has happened at writ large. There is nobody telling that story in a way that I think is breaking through, where people just look at cancer in a totally different way, they look at HIV in a totally different way, they look at Hep C in a totally different way. They look at all of these things that were life ending, and now they are life changing, but not necessarily life ending. And yet, we also know that a lot of research we have to support innovation.

I'm just not sure how much that argument really helps build reputation, and it may, in fact, be contributing to the negative. So we can talk about how far we've come. We can talk about progress and momentum. We can make it tangible. If you're advising one of our clients or others in the industry, what else?

Is there anything else that we can talk to them about to help them strengthen their reputation? The other thing that we talk about a lot is this challenge of how often we associate the medicine with just a pill, a pill that you pay hundreds or thousands of dollars for, that you need monthly at your pharmacy. And the limitations behind that is that it just looks like something that doesn't necessarily seem to have a lot of value in it when it's viewed as just one simple product. And I think the question for the industry is how can we credibly and meaningfully expand what it is that the industry does in people's minds to shift away from just being a product to actually offering services or a service that improves the quality of your life? And how would we do that?

Lee Carter

If you think for a minute about the financial services industry, in 2008, after the financial collapse, there were a lot of financial services companies that were trying to do all the things that we've talked about. They were trying to distance themselves to the problem, say we weren't the ones that took bailout funds, we weren't the irresponsible actors. Not our fault. It wasn't us. It was these other guys.

But I can remember very, very vividly we were working with one financial services company in particular, and we had to convince them, stop all of that. The answer isn't in helping them appreciate that you're not part of the problem. The answer is making them appreciate that you are the solution. What do I mean by that? The language that we tested that worked was there are a lot of things that led us to this moment, and we're not here to debate them.

What we are here to do is talk about how we are going to set the financial services industry right going forward, so that you know that your money is always going to be safe. They're always going to know exactly what you're getting into when you get a loan from us, that you're always going to do these kinds of things. Now here's why I think that example is so powerful, doesn't go backwards, it goes forwards. And it starts to say, wait a minute, when you start listing out the different things the financial services company is doing, it is actually important part of my life. I actually need financial institutions to do well.

I want them to do well because they're part of the solution, the future. They can keep my money secure. They can help give me loans and help me buy homes. They can help me do all of these things. They can be a supporting actor in my life.

That's really, really important. But I start to appreciate all those things by listing it rather than going after and debating them. And so suddenly start to view in this one statement the company not as just trying to push product or trying to push, you know, savings accounts, credit cards and loans into something that actually is providing invaluable service to you. And so pharmaceutical companies, instead of trying to debate this issue, how do we talk about all of the things that they're doing for us? They're actually inventing life enhancing services.

It's a total surround that's important every part of our day and every part of our life. Yeah, I think that's a great reframe and one that not only applies to pharma, it applies to many other reputation challenge situations. But I think all this comes back to this idea of where is the industry kind of focusing its attention and its messaging. And all the answers seem to be separate and different from defending, explaining, blame, shifting on pricing. It's all about telling a different, broader, more emotional, more effective story about what it is that the industry delivers, and that there is a tremendous amount of, I think, fighting that goes on inside the healthcare industry overall.

Michael Maslansky

Between the government and doctors and payers and pharmaceutical companies, you may not be serving any of them well. When you think about the fact that I am a believer that all of this innovation, it certainly is costly. And we're leaving aside the international element of things about how they price things. But I do think that I don't want to be sick, but if I had to be sick, I'd rather be sick today than I would yesterday. And that every day we are better able to address these just incredibly complex medical conditions in ways that were never possible before.

And I know the industry talks about this stuff, but it seems like there are opportunities to look at it in a different way because it doesn't seem like that message is getting through. Well said. Well, thank you. Call us to help. Exactly.

There definitely are opportunities, and that's what we're here for. One final point that I'd like to make is it's interesting that pharmaceutical companies can be so demonized when we all have personal stories on how powerful and important they have been to our lives. And I think for all of us that have worked on these kinds of issues, we all have our reasons and our stories on why this could be so important to us. I think one of the things that is going to be really important to all of this is making big corporate America seem relevant and personal to me. And it's possible to do that.

Lee Carter

And one of the ways we thought that the right way to do that was to bring the scientists into our living room. So we started to see scientists instead of executives, but that happened during COVID And so now I think there's the next generation of how do we make these big, impersonal, corporate, greedy giants relevant and personal to us in the ways that they are in all of our lives when you start thinking about it. So I think it's a really important challenge and one that can be done even though it seems impossible at times. I think that's a great point. It also reminds us that pharma has become kind of tribal, that there are people who are for it and who are against it.

Michael Maslansky

And that's why some of the things that maybe used to work are not working as much. And that maybe if we all can find the things that we agree on, like health, like advancing the health of people we love in ways that are personal and different from what's been done before, that maybe we can overcome the politicization of the pharmaceutical industry. Certainly something that we can hope for. And it's been super interesting. Thank you, Lee and Katie, for educating me on all this work that you've been doing in the pharma industry.

And thanks to our listeners for sticking around with us for this. For more language, insights, and to be in the loop on all the other fun stuff we're doing. Follow us on LinkedIn as Lansky and partners. That's all for now. Stay tuned for more episodes of hearsay.

Because when it comes to truly effective communications, it's not what you say, it's what they hear.