Reporter’s Notebook

Dear CEO Michael Goettler,

“There was no mention of Ibrance in the question and answer session at the Pfizer media event for rare diseases.”

I got a phone call from Pfizer Korea Monday. We talked about a media event organized by Pfizer Korea in which you took part. A reporter working for the Korea Biomedical Review, the sister paper of the Korean Doctors Weekly, also participated in the event. The phone call was to take issue with the article written by the English-language reporter based on your comments.

You got questions from reporters after explaining a global trend of rare diseases, and our reporter wrote an article based on it. The reporter wrote you expressed your views about the controversy over the breast cancer therapy “Ibrance.” It was a wrong story if we talk about only facts.

You did not mention even “I” of Ibrance. You just talked about corporate social responsibility (CSR). I remember it well because I was there.

I asked why the reporter wrote that way. “In Korea, there has been a controversy about the expensive anticancer drug Ibrance,” the reporter said. “When CEO Goettler talked about the CSR and costly drugs, I thought these were the same issues.”

I don’t know if you remember, but there were a lot of questions related to expensive medicines. Of course, reporters didn’t mention the word Ibrance, either. (I now wish I had said it straight.)

But questions about expensive drugs referred to the Ibrance controversy. I think you must have sensed that much.

Currently, many Koreans patients are experiencing economic difficulty because of the high price of Ibrance worth more than 5 million won ($4,300) a month. Since Pfizer Korea proposed too high a price to Health Insurance Review & Assessment Service (HIRA), and HIRA turned down its insurance coverage, the voices of complaint have only grown louder.

An increasing number of patients are wandering around to get cheaper Ibrance so that we are hearing the phrase “Ibrance refugees.” And the patients criticize Pfizer because they heard patients in England where Ibrance also failed to cover medical insurance could get the drug free of charge for five months. Voices criticizing discrimination against Korean patients are mounting, I think you have already known about these situations here.

It was impressive in more than a few ways that Pfizer said it was developing new products under a motto of “every patient counts” during the media event.

In the news release distributed in the event, your company was predicting Korea would expand “special calculation system for insurance coverage.” Some speakers also stressed the need to publicize the system more actively.

The special calculation system is a scheme to support up to 90-95 percent of treatment costs for patients with four major severe diseases. Finding this kind of system in foreign countries is difficult.

But the system resulted in significant burden on healthcare budget. The payments for four serious diseases covered by the system have already exceeded 20 percent of the total healthcare expenses by amounting to 46.5 trillion won ($40.7 billion) in 2015. And rare diseases accounted for 34 percent (3 trillion won) of the total.

And most of the spending caused by the system goes to multinational companies that have many therapies related to rare diseases such as Pfizer. This is why we are interested in whether the companies fulfill their social responsibilities.

You said Pfizer, in particular, has more than 20 therapies for rare diseases. You know why reporters concentrate their questions on the CSR issue, don’t you?

But I was disappointed with your answer. Your reply can be summed up to: the reason to take the risk to develop new drugs is because of the corresponding rewards (drug prices); drug price is but one of the costs of treating patients so that we need to see it from broader aspects; high drug prices are highly likely to fall because of various innovations; if there are alternative treatments to maintain their effects for more than five, 10, and 15 years, these can make enormous contribution eventually.

It sounded as if your company had fulfilled the CSR with just the development of new drugs. Do you think so?

China releases CSR indexes of companies operating in the country. Sometimes, these indexes led to a boycott campaign to change the market trend because China thinks multinational businesses that make money in its land shouldn’t turn their backs on the Chinese people who need help. It 's hard to stage a boycott drive in the case of pharmaceutical products because doing so can risk lives.

Because the U.S. has started activities and discussions concerning CSR long time ago, I think you are well aware of its value and necessity. Korea has just begun to discuss the issue in earnest. This is why Koreans criticize Pfizer for not fulfilling CSR appropriately.

I only hope Pfizer will not avoid taking social responsibility but take the lead on this issue.

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