Out in front

For the past two years, pharmaceutical industry veteran Dr. Freda Lewis-Hall has served as Executive Vice President and Chief Medical Officer of Pfizer Inc, spearheading an initiative to reshape the company's regulatory and medical policies during a time of fast-changing expectations. She heads up Pfizer's Medical Division, providing leadership to many of the world's foremost experts on regulatory and safety strategy, clinical trial design, post-marketing surveillance, medical communications and information technology.

Lewis-Hall joined Pfizer after an earlier career that included leadership positions in medical affairs and biomedical product development with Vertex, Pharmacia, Bristol-Myers Squibb and Eli Lilly, as well as leadership, medical and research positions at The National Institute of Mental Health and at The Howard University Hospital and College of Medicine. She is a scientist by training, having received her undergraduate degree from The Johns Hopkins University and her medical doctorate from The Howard University Hospital and College of Medicine.

However, when the Healthcare Businesswomen's Association recently named Lewis-Hall its 2011 Woman of the Year, it wasn't only her scientific accomplishments that were being lauded. Lewis-Hall has been a business leader and a tireless mentor, and through it all, she has had a keen interest in issues such as promoting health literacy and eliminating health disparities, influencing the industry profoundly when it comes to transparency and effective communications with patients and doctors.
In this Q&A, healthcare journalist Kate Fodor talks to Lewis-Hall about her efforts in those arenas and beyond.

KF: There is a lot of concern these days about the pharmaceutical industry's reputation. How do you think the public perceives the industry, and what do you think can be done to continue to improve that perception?

FLH: Obviously, the view of the industry is troubling. Although we want to be – and believe we can be and should be – a trusted source of information and service, clearly that is not a position that is always shared by the public. It's interesting: people I meet will hear that I'm a physician and will have a delighted smile and a twinkle in their eye. They'll say, "Oh, that's wonderful! What do you do?" and when I say I work for a pharmaceutical company, their eyes narrow and suddenly I'm not so trusted anymore.

I believe that the way we change that is first of all to understand what people want and need and then to deliver that in an ethical manner, and secondly, to educate about the value that we bring. I am very proud to be part of the industry. When I think about what we've delivered in term of health outcomes through scientific advancement and innovation, it's staggering, and I'm not sure that there's a full appreciation of that. I think a part of our responsibility as people in the industry is to help that be better understood.

Transparency is also important – lifting the veil and allowing people to see what we do, how the work gets done, who's involved, and how much money is involved. At Pfizer, we've certainly been a pioneer in the area of transparency. We've said: here are the clinical trials that are going on; here's the data that came out of the trials;
here's the information about the healthcare practitioner payments. We've opened ourselves up and posted this information for the public to see, and I think this transparency is an important part of regaining trust.

Last but not least, I don't think the public realizes how much the pharmaceutical industry is in partnership with them. Hundreds of thousands of people actively participate in clinical trials every year, and they are helping us develop lifesaving, life-changing medicines, so we really work together, far beyond what the general public necessarily knows and understands. If you ever talk to someone who has been in a clinical trial, they have such an amazing and different perspective of the work that we do. They know how hard we work to ensure the safety of patients in clinical trials. They know how complicated this work is. They understand the importance of their partnership with us.

KF: As an industry leader, you are known in part for your focus on effective communication. How is Pfizer evolving the ways that it communicates with the people who use its medicines?

FLH: Part of that work has been to really evolve the way we look at the risk-benefit platform and help communicate that actively. I think that we've been taking into greater consideration the need for people who are decision makers – patients, their family care-givers and professional healthcare givers – to have the full range of information that they need to make their decisions. We’ve really started to reach out to decision makers so that our information is more readily available to them and we are more readily available to answer questions. We’re reaching out in a greater variety of ways to allow patients and caregivers to touch us, and us to touch them

KF: Pfizer recently formed an alliance with the digital solutions provider Epocrates that puts information about some of the company's key medicines into a 'super app' and on to a system used by hundreds of thousands of doctors carrying iPhones. Can you talk a little bit about how that works, and the rationale behind it?

FLH: One of the questions that we had was whether there was a way to provide a contact to our medical information organization, which has all the power of our data and our publications, organized with our access to it, for healthcare providers. We wanted to put that information into their hands and make it available to them when they need it to make decisions. So we did a pilot with Epocrates, which has literally put Pfizer's medical information organization into the hands of healthcare providers. And if what they need isn't there, just one touch puts them in touch with us. That to me is an exciting use of both the power of information and the power of technology to get good information into the hands of the people who need it when they need it.

The Epocrates program has been ongoing for a little over a year now. We started with about seven products and have ramped up to 40. We want to do things that are responsive to the needs of the people we serve, and so when we saw that the pilot was quite successful and we got good feedback, we expanded it to more products and a broader swath of service. We're really excited to try new things to leverage science, information, knowledge and technology to improve health outcomes.

KF: So you are positioning Pfizer as a place where doctors can come with their questions?

FLH: We answer questions on the Internet. We answer them via phone. We have experts in the therapeutic areas who are trained health professionals themselves, and they have data and information available that they can pull up and use to articulate a scientifically accurate answer in a timely manner.

I always laugh and say, when there's something wrong with my computer, I call the company that made my computer. When there's something wrong with my dishwasher, I call the company that made my dishwasher, or if I have a question about the dishwasher, I call the company that made it. We want professional healthcare providers, if they have a question about our products, to call us. And then we will seek out medically accurate timely balanced information to provide the answer to their question. We want them to be able to reach out to us and ask their scientific and medical questions, and we want to be able to provide them with the data to give them the opportunity to evaluate it and make their own decisions about things.

KF: Is there a danger of crossing regulatory lines when you have so much direct contact with physicians?

FLH: We consider the regulatory agencies as truly our partners. We want the same things they want: we want our treatments to be safe, effective and used appropriately. I think we would all agree that having the right information in the hands of people when they need to make decisions is the right way to go, and so that's why we've really been proactive around making ourselves accessible to people to ask us questions.

KF: Pfizer has also been out in front when it comes to using social media to reach out to patients. How is the company managing to make the most of social media given the still-murky regulatory climate in that arena?

FLH: We do think we have been somewhat pioneers in social media and are excited about its possibilities for sharing plain talk in a timely manner with patients. However, we also understand its challenges, so we're carefully advancing to make sure that we're providing the right information at the right time to the right people in the right way.

From a social media standpoint right now, we are much broader on the corporate level than on the product level, given the current lack of guidance from the FDA on the product-specific sites. I do think it is very important for physicians and other healthcare providers to be able to access product information, but I think that there's broader information that's very important for patients and other health-information seekers to have, and those are both great opportunities to leverage social media.

KF: Recently, you were appointed by the head of the U.S. Government Accountability Office to a four-year term on the inaugural Board of Governors for the Patient-Centered Outcomes Research Institute (PCORI), which was established through the Patient Protection and Affordable Health Care Act of 2010. PCORI will carry out research projects to provide evidence on how diseases can be prevented or managed. What has your role been so far, and what do you hope to accomplish?

FLH: We just finished a board meeting here in New York yesterday afternoon (May 17, 2011) and it was really wonderful. We've just named our executive director
(Dr. Joe V. Selby, formerly director of the Division of Research at Kaiser Permanente) and we're very excited about having him on board.

The board is 21 people with highly diverse backgrounds. What I'll do from the pharmaceutical industry perspective is to essentially bring the power of our collective scientific, therapeutic and methodical expertise, our data and capabilities, to try and advance this research pursuit. I'll also bring some of the perspectives that we have as an industry, our longstanding, global experience across a number of therapeutic areas. I guess I'm intended to act as a funnel for the vast knowledge and information that we have in the industry, to bring it to the table on behalf of advancing our research agenda.

We on the board are thrilled to be able to really focus on patients having the information that they need to make their healthcare decisions through the value of rigorous science to compare the things that collectively impact health outcomes. We have spent a lot of time listening to our stakeholders. Our meetings are open. People can listen in on the web or physically come into the room, so we've really enjoyed a benefit from that transparency.

We've also done active outreach and invited people to come and sit with us in evening programs where we actually are asking them: What do you need from us? What kind of data needs to come to you to help support your decision making? What's the right way to bring it to you? What kind of research do you think needs to be done? We're asking stakeholders, everyone from patients to caregivers to healthcare providers to systems experts to methodologic experts.

It's been really striking, the impact of that openness on people, and it's just plain old beneficial to listen to what people have to say about their needs and expectations.

The author
Kate Fodor is former editor of Communiqué.
The editorial team can be contacted at communique@pmlive.com