As he prepares to step down as chief executive of GlaxoSmithKline, Jean-Pierre Garnier has been speaking about the legacy that is being left by fundamental changes that the pharmaceutical industry has gone through in the last year and urged sections of the media to be more sophisticated when reporting scientific news and avoid scaremongering.

At the firm’s annual press conference in London, Dr Garnier spoke about the environment in which drugmakers are facing with regards to increasingly cautious regulatory authorities and getting drugs approved. The pendulum has swung from risk/benefit to simply risk, he argued, and the fact that there is now more data transparency means that there are more questions raised about treatments.

However these questions often lack scientific rigour, Dr Garnier believes, and this leads to “amplification and distortion” in the media, alluding to the firm’s diabetes drug Avandia (rosiglitazone). This is followed by more “patient angst” which then damages a product, often irreversibly. When asked by PharmaTimes World Newsabout how this process can be changed for the better, CEO-designate Andrew Witty said that there needs to be a shift in sentiment and an acknowledgment that all drugs come with risks.

If that was not the case, not even paracetamol would have made it to pharmacy shelves, he noted and “we need better and more balance about risk, full stop”. He went on to say that greater dialogue is needed between the pharmaceutical firms and the regulators and noted that the US Food and Drug Administration “has led the way” in pushing for a better relationship.

Mr Witty added that the dialogue with payers, be they private or governments also need work but the relationship is not necessarily an antagonistic one. He said that in the several years he has spent talking to heads of state and corporate bosses, “not once has anyone said they don’t want innovative medicines”. There is a shared goal that is achievable and he acknowledged that GSK needs to show that its products offer value for money.

Dawn of the ‘progressive blockbuster’
Still there is no doubt that a slowdown is taking place at the FDA and healthcare payers are tightening their belts so what to do? Dr Garnier said that changing efficacy measures means that a rethink is needed on the part of firms is needed when it comes to their R&D focus.

This will lead to the rise of the “progressive blockbuster”, he said, ie aiming at approvals for subsets of patients which can then be followed by other indications. Dr Garnier gave the example of trials of an extended-release form of Avandia looking at Alzheimer’s disease which initially proved unsuccessful, but GSK scientists then identified a sizeable sub-group of patients with a specific genetic profile on whom benefits of rosiglitazone were seen.

Dr Garnier also noted that GSK’s effective cost management has helped prop up the financials at a time of generic competition and lowers sales of Avandia and that “R&D is not immune to improvement.” Measures such as switching clinical trials to lower-cost countries have proved beneficial and “we now have a footprint of research in most parts of the world”.

Staying with operations outside western Europe and the USA, Mr Witty said that further expansion into the emerging markets is key to GSK’s future success. China is a priority as is India, and the soon-to-be chief noted that “20% of everything we manufacture, we sell in India”.