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					ATTRACTING
DEBATE
Pfizer UK
Stakeholder Report 2009




MOVING IN THE RIGHT DIRECTION
LET’S KEEP TALKING…
ABOUT                                                       ABOUT PFIZER
ATTRACTING                                                  Pfizer is the world’s largest research-based
                                                            pharmaceutical company. We discover, develop,
DEBATE                                                      manufacture and market prescription medicines
Since the first edition of Attracting Debate                 in 11 therapeutic areas. These include oncology,
we have asked over 2,000 people to talk to us               cardiovascular, pain, neuroscience and
very honestly about what they think of Pfizer.               infectious diseases, including HIV/AIDS and
We asked them to say what they like about what              malaria. Pfizer is also the world’s largest animal
we do and what they don’t like. If you were one             health company.
of those people, thank you for taking the time
to help us do this. We have listened, and we are            40 MILLION
                                                            40 million people around the world are treated with a Pfizer
changing the way we do things as a result of                medicine every day.
what we’ve heard. Read about it here.
                                                            3 MILLION
                                                            Every month, three million patients in the UK are prescribed one
                                                            of our medicines.
                                                            85,000
                                                            Pfizer employs 85,000 people worldwide and 5,000 of these are
                                                            in the UK.
                                                            13,000
                                                            Pfizer conducts more biomedical research than any other organisation.
                                                            This work is led by more than 13,000 scientists worldwide.
                                                            $7.6 BILLION
                                                            We invested $7.6 billion in research during 2007. £550 million of
                                                            this was in the UK.
                                                            2,700
                                                            The European headquarters of Pfizer Global Research and
                                                            Development is in Sandwich, Kent. There, 2,700 of our scientists
                                                            are involved in the search for compounds that may provide the
 THE PROCESS                                                basis for the effective treatment of diseases.
                                    2008   2009     2010…   TEN
k




                                                            Our scientists in Sandwich have invented ten medicines in recent
 We will meet you face-to-face                              years that have had a significant impact on the lives of millions
                                    w      We are
                                           here!    w       of patients, both in the UK and worldwide.
                                                            £4 MILLION
 We will respond to everyone                                Since 2005 the Pfizer UK Foundation has made grants of nearly
 who gets back to us
                                    w w w                   £4 million to community groups working across the UK to support
                                                            people with health inequalities.
 We will tell the UK Board what
 you’ve told us
                                    w w w
 For issues of global importance,
 we will report what you’ve said
 to our global office
                                    w w w
 Action!
                                    w w w
 Publish next report
                                    w w w
  Thank you very much for your feedback last year.
  We received feedback from over 2,000 stakeholders, which was invaluable when writing this year’s report.
  We would be very grateful if you could take the time to fill in the questions below and return the form to us.
  If you prefer, the questionnaire can be completed online at: www.pfizer.co.uk

Overall, do you think:                                                           Please list in order of priority the issues most important to you:
                                        Yes           No            Unsure       Issue number:
We’ve covered the issues
you care about
                                                                                 Are there any other issues, not included above, you think
We’ve provided balanced                                                          Pfizer should address in future reports?
and honest feedback
We are prepared to listen
We are prepared to change
We are making progress                                                           Do you have any additional comments you would like to make?

In general, what is your opinion of Pfizer?
Excellent           Good                Fair                 Poor



Has this report changed your opinion?
Yes                 No
                                                                                 Please select the stakeholder group which best represents you:
                                                                                     Pharmacist                                   Think Tank

If so, how?                                                                          NGO/Charitable organisation                  Government

                                                                                     Hospital Healthcare Professional             Patient Advocacy Group

                                                                                     Community Healthcare                         Pfizer life member
                                                                                     Professional
Please indicate, by ticking the relevant box, how well you think                     Pfizer Business partner                       Journalist
Pfizer is performing in relation to the issues listed below:
                                                                                 Other (please state):

                                   Excellent   Good        Fair      Poor
1. Access to medicines                                                           Would you like to receive future copies of Attracting Debate?
   in developing countries
                                                                                         Yes, please send me a hard copy.
2. How we conduct                                                                        (Please leave your contact details so we can send you a copy next year)
   clinical trials
                                                                                         Yes, I will view your website.
3. Reducing our
   environmental impact                                                                  No, I do not want to receive future copies.
4. Supporting local                                                                      (Please leave your contact details so we can ensure you do not
                                                                                         receive a copy next year)
   communities
5. How we address
   counterfeit medicine                                                          Please leave your contact details below:
   concerns                                                                      Name
6. Helping to reduce                                                             Job Title
   health inequalities
   in the UK                                                                     Organisation

7. Developing new and                                                            Address
   innovative medicines
8. Safe use of our
   medicines
                                                                                 Telephone
9. How we market
   our medicines                                                                 Email
10. How we price                                                                 Your information will only be used for the purpose of
    our medicines                                                                responding to your queries/comments.
11. Openness about                                                               To return your comments: Please tear off this page, fold and
    what we do                                                                   secure using the glue.

 Thank you very much for completing the feedback form. The comments we receive during
 2009, will be presented in our 2010 Attracting Debate report.
 By returning this form, you give consent to Pfizer for the processing of your personal information for the purposes set out above. As Pfizer is a global
 organisation, your information may be held on a database and transferred within or outside of the European Economic Area, but we will always employ
 appropriate technical security measures to protect your information. You will at any time have the right to access your information, or to request that your
 information on the Pfizer database is amended or deleted, by writing to us at: Pfizer Limited, Walton Oaks, Surrey KT20 7NS.
                                                                                  01   Attracting Debate
                                                                                       Pfizer UK Stakeholder Report 2009




WELCOME                                            CONTENTS

Welcome to Attracting Debate 2009.                 02   Our values
Attracting Debate is an ongoing commitment
we’ve made to understanding people’s               03   Thank you!
perspectives better. If you haven’t talked to           Message from John Young
us already, we’d still like to hear your point
of view. Maybe you’re reading this because
we’ve already asked if we can come and talk
to you. If you don’t have the time to talk to
us face to face, please fill in the feedback form
at the back of this document. We really do         04   What you told us
want to hear from you.
                                                   06   How we do business




                                                   10   Patients
                                                   16   Patient Advocacy Groups
                                                   20   Community Healthcare Professionals
                                                   24   Hospital Healthcare Professionals
                                                   28   Pharmacists
                                                   32   NGOs
                                                   38   Our People
                                                   43   Government
                                                   43   HTA Bodies
                                                   44   Think Tanks




                                                   KEEP US ON TRACK.
                                                   WE WANT TO
                                                   HEAR FROM YOU!
02   Attracting Debate
     Pfizer UK Stakeholder Report 2009




OUR VALUES
We are changing the way we do business but
our values remain the same. They are enduring
principles that go to the heart of who we are
and how we conduct ourselves every day.

CUSTOMER FOCUS                                                              TEAMWORK
We are deeply committed to meeting the needs of our customers,              We know that to be a successful company we must work together,
and we constantly focus on customer satisfaction.                           frequently transcending organisational and geographic boundaries
                                                                            to meet the changing needs of our customers.
INNOVATION
Innovation is the key to improving health and sustaining Pfizer’s growth
                                                                            COMMUNITY
and profitability.                                                           We play an active role in making every community in which we operate
                                                                            a better place to live and work, knowing that its ongoing vitality has
INTEGRITY                                                                   a direct impact on the long-term health of our business.
We demand of ourselves and others the highest ethical standards,
and our products and processes will be of the highest quality.
                                                                            LEADERSHIP
                                                                            We believe that leaders empower those around them by sharing
PERFORMANCE                                                                 knowledge and rewarding outstanding individual effort.
We strive for continuous improvement in our performance, measuring
results carefully, and ensuring that integrity and respect for people are
                                                                            QUALITY
never compromised.                                                          Quality is ingrained in the work of our colleagues and all our values.
                                                                            We are dedicated to the delivery of quality healthcare around the world.
RESPECT FOR PEOPLE                                                          Our business practices and processes are designed to achieve quality
                                                                            results that exceed the expectations of all of our stakeholders.
We recognise that people are the cornerstone of Pfizer’s success.
We value our diversity as a source of strength and are proud of
Pfizer’s history of treating employees with respect and dignity.
                                                                                                                       03      Attracting Debate
                                                                                                                               Pfizer UK Stakeholder Report 2009




THANK YOU!                                                                   KEEPING IT PERSONAL
                                                                             The decision to conduct these conversations ourselves was very important.
                                                                             We felt that it would be impossible to get closer to our stakeholders if we
From John Young                                                              didn’t keep the whole thing very direct. It’s taken a fair bit of time, and we’ve
                                                                             done a lot of travelling up and down the UK, but every meeting has been
                                                                             worthwhile. Doing it ourselves has helped us build better relationships
                                                                             and allowed us to pick up on issues that we might otherwise have missed.

                                                                             YOU AND US
                                                                             You told us you want to work with us in different ways, which is great,
                                                                             because we do too. You also told us that personal relationships matter
                                                                             enormously. It matters to you that you like and respect the people from
                                                                             Pfizer you know and work with. It matters that you have consistent points
                                                                             of contact and that you can build relationships over time based on a shared
                                                                             understanding of what is important to both parties. None of this is surprising.
                                                                             What is surprising, however, is that some of you said that the positive way
                                                                             you feel about an individual is not connected to how you feel about Pfizer
                                                                             the company. You didn’t feel that you had a strong sense of our identity as a
                                                                             company or of the values we believe in. This is a big concern for me because
                                                                             Pfizer is its people and we are all ambassadors of the company we work for.
                                                                             I firmly believe that we have a great team of people working for Pfizer here in
                                                                             the UK. They are good at their jobs and we seek to ensure that every Pfizer
                                                                             colleague lives by the values we stand for as an organisation. But we need
THE FIRST THING I WANT TO SAY IS                                             to get better at communicating as a company. Attracting Debate has made
THANK YOU                                                                    me surer than ever that we can never invest too much time in making sure
                                                                             that we all, as individual colleagues, are spending proper time with our
When we launched Attracting Debate this time last year, we                   stakeholders, working with them to meet their needs. But it’s also told me
hoped to hold around 200 conversations, with a broad mix                     that our steps to communicate more openly about what we do – and what
of people, to ask them for their honest opinion of Pfizer.                    we stand for – are the right ones. I hope what you read
To be honest, we weren’t sure whether everyone would be                      here convinces you that we mean it.
prepared to take the time to talk to us. Not long afterwards,
we realised we needed to change our target to 1,000 people,                  WHO WE’RE TALKING TO NEXT
and I’m pleased to say that in our first year we succeeded in                 Attracting Debate doesn’t stop here. We want to talk to even more people
taking Attracting Debate to more than 2,000 people. I have                   and understand their points of view. There are some groups of people with
personally been quite surprised – and pleased – by how                       whom we didn’t have Attracting Debate conversations last year, and they
willing they have been to give up their time to talk to us.                  are our priorities for 2009. They include people who work in government
                                                                             departments, health technology assessment (HTA) bodies and think tanks.
If you were one of those people, thank you. I hope that this
updated Attracting Debate shows you that we really have                      We’ve already done a lot to respond to many of the things people said
listened and that we are genuinely committed to doing                        to us, and we’ve told you about that in this report. Some of the issues
something about what we heard.                                               that were raised don’t have easy answers. We’re going to be asking people
                                                                             with strong views on these issues to talk to us again and help us work
                                                                             out better ways of dealing with them.
SO WHAT DID YOU TELL US?
                                                                             Attracting Debate is helping us change the way we do business and we
Well, quite a lot. Some of the feedback was, understandably, to do with
                                                                             are going to carry on listening. Thank you for helping us do this and thank
the business relationship we have with the people we talked to, and was
                                                                             you for your openness.
quite specific to their jobs and how they interact with us. Other feedback
was about broader issues, and often the same issues were raised by
different types of stakeholders. The conversations have given us a
much better understanding of what matters most to our stakeholders.
We’ve also had overwhelming feedback from the Pfizer employees
involved in Attracting Debate that holding these very honest conversations
with the people they work with outside Pfizer has helped them do their
jobs better and build more meaningful relationships.
                                                                             John Young
                                                                             Regional President, Pfizer
04   Attracting Debate
     Pfizer UK Stakeholder Report 2009




WHAT YOU                                LISTENING IS GOOD, BUT WILL
                                        YOU CHANGE?
TOLD US                                 You told us that holding these conversations improved your view
                                        of Pfizer as a company, but not all of you believe we are going to
                                        do anything about what we’ve heard.

                                        43% of you told us that your perception of Pfizer
                                        had improved because we were prepared to listen.
                                        “The conversation has changed my view, not the report. I now believe
                                        you are prepared to listen.” Pharmacist
                                        “No one else has come to me asking for this sort of conversation.” GP
                                        “Attracting Debate has reinforced my opinion that you are willing
                                        to open up, listen and hopefully act.” Practice Manager

                                        But 13% of you are sceptical about whether we
WHO WE’VE SPOKEN TO…                    will actually do anything differently as a result.
 Patients:                              “Very impressive but how long will this initiative last?” Pharmaceutical Adviser


 1,373
                                        “Lots of people will need to be convinced, you can’t afford to get it
                                        wrong.” Hospital Pharmacist
                                        “I am very cynical about what Attracting Debate will achieve.
 Patient Advocacy Groups:               What difference is the view of a small patient group going to make?”

 54                                     Patient Advocacy Group



 Community Healthcare Professionals:    WHAT ARE WE DOING DIFFERENTLY?
 168                                          Please read the individual stakeholder sections to find out what we are
                                              doing about the issues raised during Attracting Debate.

 Hospital Healthcare Professionals:
 99                                     WORK WITH ME IN NEW WAYS
 Pharmacists:                           You said that you would like to work more with us in the future, but in
                                        new and different ways. You said you would like to find ways to work
 93                                     together where there was a clear benefit for both parties.

                                        37% of you said you were interested in working
 NGOs:
                                        with us in a closer partnership.
 21                                     “People talk a lot about partnerships but they don’t really know what
                                        they mean. It doesn’t have to be about money. There are lots of people
 Our People:                            here buzzing with ideas – offer us a partnership that helps us get some
                                        momentum going.” Medical Director
 229                                    “Attracting Debate comes at a time when debate needs to happen at
                                        a senior level to encourage partnership with industry.” GP
 Government:
                                        “We are keen to focus on partnership working, not just cheque writing,
 6                                      in a relationship based on equality, respect and trust, rather than brand
                                        marketing opportunities.” Patient Advocacy Group
 HTA Bodies:
                                              What are we doing about this?

 7                                            Go to pages 26, 30 and 34.



 Think Tanks:
 2
                                                                                                                     05      Attracting Debate
                                                                                                                             Pfizer UK Stakeholder Report 2009




PERSONAL RELATIONSHIPS MATTER                                               BE OPEN AND HONEST
TO ME                                                                       You told us how important it is to you that we are transparent,
You want consistent points of contact so that you can build good            open and honest.
relationships over time. However, some of you said that the individual      You want to know more about the medicines we are developing,
person you know from Pfizer isn’t very connected in your mind with           and you want to know about our plans sooner.
Pfizer ‘the company’.
                                                                            You want to know what clinical trials we are conducting and where
25% of you said that good personal relationships                            they are.
are critical to working successfully with us.                               You want to know more about the work we do in partnership with patient
“My views are shaped by the people I see.” GP                               advocacy groups and clinicians. When we provide them with funding,
                                                                            you want to know how much and what the money is for.
“The company is less important than the personal relationship I have with
reps.” Practice Manager                                                     20% of the people we spoke to raised
“Personal relationships are very important to me.” Patient Advocacy Group   transparency as an issue that was important
                                                                            to them.
      What are we doing about this?
      Go to page 27.                                                        “Just be honest about what you do – don’t leave it open for
                                                                            interpretation.” Assistant Chief Executive, Primary Care Trust
      To see more about our Values                                          “Coming clean over trial data is the best thing you can do.” GP
      Go to page 2.
                                                                            “Transparency and clarity is what we need.” Chair, Professional
                                                                            Executive Committee


EXPLAIN WHY YOU’VE CHANGED THINGS                                                 What are we doing about this?
                                                                                  Go to pages 7, 13 and 19.
A lot of people commented on the way we have changed our rules
around hospitality. Some of you are pleased about the new levels
of transparency around the way we work with healthcare professionals.
Some of you feel we have made lots of changes without explaining            COMMUNICATE MORE!
them very well. Some of you said we impose too much bureaucratic
                                                                            You think we are poor at communicating some of the positive things
paperwork on the people we work with because of the regulations
                                                                            we do.
we work within.
                                                                            Lots of you said that you had never seen such a clear explanation of
22% of you raised the issue of how we have                                  how we research and develop medicines, and how that relates to the
changed the way we work with doctors and                                    prices we charge for them.
other healthcare professionals, how we have                                 18% of you said you think we should
explained this and the impact this has had in                               communicate more about how our business
terms of paperwork.                                                         works and about our community programmes.
“You need to get better at explaining the ABPI Code to us.”
                                                                            “Pfizer is too reluctant to talk about the good you do, like Health Relief.”
Patient Advocacy Group
                                                                            Pharmacist
“… glut of irrelevant paperwork.” Practice Nurse
                                                                            “I didn’t realise the length of time it takes to develop a medicine.”
“The rules are often used as an ‘excuse’ not to be able to do something,    Assistant Director of Primary Care
without giving a rationale.” Consultant
                                                                            “We need to shout loud about all the good things Pfizer does.”
                                                                            Pfizer Employee
      What are we doing about this?
      Go to page 23.
                                                                                  What are we doing about this?
                                                                                  Go to pages 6 and 18.
06   Attracting Debate
     Pfizer UK Stakeholder Report 2009




HOW WE DO                                              1
                                                       DISCOVERY
BUSINESS                                               Developing safe and effective medicines that treat or prevent diseases
This is how we discover, test, produce and             is extremely difficult. The average medicine costs Pfizer approximately
                                                       £500 million to bring to the market, and the process can take 10 to
market the medicines which are used every              12 years.
day by 2.7 million people in the UK.
                                                       Our researchers begin by identifying an unmet medical need or a
                                                       condition for which there is no treatment. They also research diseases
                                                       which could benefit from a new treatment. First, they have to identify
                                                       what causes the disease or condition and understand how it causes harm,
                                                       or change, to the body. Once this is understood they can begin to search
                                                       for a compound which can intervene and treat the condition.
                                                       A number of compounds will be identified as having potential to achieve
                                                       the desired effect on the body through a process called ‘High Throughput
                                                       Screening’ (HTS). This involves the use of robotics, data processing and
                                                       control software, liquid handling devices and sensitive detectors and
                                                       allows a researcher to conduct millions of tests in a relatively short space
                                                       of time. These tests will find compounds which can change the way a
                                                       disease acts in the body. Once some potentially useful compounds (‘hits’)
                                                       have been identified, teams of chemists and biologists create a range of
                                                       related new chemicals with specific structural changes to optimise the
                                                       impact of the medicine in terms of efficacy and safety. This process is
                                                       highly skilled, and relies on intuition, expertise and broad knowledge
                                                       of the complexity of different biochemical reactions taking place in the
                                                       human body. Sometimes as many as a thousand new molecules are
                                                       developed until we arrive at what we believe to be the best candidate
                                                       to take forward into clinical development.
                                                       At this stage, up to 10,000 compounds will be identified as a possible
                                                       treatment for the specific disease or condition. Only one of these original
                                                       10,000 compounds might go on to become a licensed medicine.




                                        CLINICAL
                                         TRIALS
                                                   LICENSING
     DISCOVERY



                                                                        MANUFACTURING




                                                                                        MARKETING
                                                                                        AND SALES
                                                                                                                         07      Attracting Debate
                                                                                                                                 Pfizer UK Stakeholder Report 2009




2
CLINICAL TRIALS
Only about 250 of the original 10,000 compounds will make it through           There are three stages of clinical trials which lead up to the approval
to pre-clinical testing. Of those 250, five will make it to first-in-human       of a new medicine, although if there are safety concerns the trial can
studies. The rest will be screened out during the pre-clinical tests –         be stopped at any time.
for example, through computer simulation (in silico), in the laboratory
in test tubes (in vitro) and through testing in other living organisms,
most of which are rodents.                                                       Phase I      Phase II      Phase III
The subject of animal welfare is very important and we take our
responsibilities in this area extremely seriously. All research involving          6–9
                                                                                  months
animals carried out by Pfizer is conducted in accordance with our
corporate policy on laboratory care and use of animals. This policy            This first study is usually carried out on a small number of healthy male
is based on the ‘3Rs’: the replacement of animals with alternatives            volunteers (between 20 and 100), who take the drug for a short period
wherever possible; the reduction of the number of animals used;                of time whilst being closely monitored. Tests are carried out to see exactly
and the refinement of procedures. At Pfizer, we have added two additional        how the drug is acting in the body.
‘Rs’ as important additional principles that apply to our work: respect for
animals, and recognition of the important contribution that animal-based
research makes to our goal of improving human and animal health                  Phase I      Phase II      Phase III
worldwide. We also meet or exceed all relevant national legislation. In the
UK, experiments involving animals are strictly regulated by the Animals
                                                                                              6 months –
(Scientific Procedures) Act 1986 and veterinary advice and care is available                     3 years
at all times. Every place, every project and every person involved in animal
                                                                               Next, the drug’s effectiveness and minimum and maximum doses must
research must get a licence from the Home Office before the experiment
                                                                               be established, so testing is usually carried out on another small group
can begin. Every application for a licence must explain why the animal
                                                                               of people who suffer from the disease or whose condition the drug is
research is vital to medical progress and why alternatives to the use of
                                                                               designed to treat. Normally several hundred patients are involved in
animals are not possible. The application must also specify that the
                                                                               this round of testing.
research has not been done before anywhere else.
                                                                               Most phase II trials are carried out on a randomised basis, meaning that
Animal use remains necessary as it is only possible to answer certain
                                                                               part of the group will receive the new medicine and the rest will receive
questions about a medicine’s safety and effectiveness by observing it in
                                                                               a placebo (a dummy medicine). In cases where there is already an
an entire body. Information from animal studies is required by regulatory
                                                                               alternative standard treatment, a third group will usually be given that
authorities for all new prescription medicines. Everyone looks forward to
                                                                               medication. Often, these trials are double-blind, which means that neither
a time when it will no longer be necessary to involve animals in research.
                                                                               the patient nor the researcher knows which medication a patient is taking
However, with present knowledge as it is, there is no alternative if cures
                                                                               in order to ensure robust results.
or improved treatments are to be found.
We are working on cures and treatments for pressing medical challenges
that include HIV/AIDS and other infectious diseases, heart disease,              Phase I      Phase II      Phase III
stroke, cancer, inflammatory diseases like rheumatoid arthritis and
nervous system disorders such as Alzheimer’s disease. Research involving
                                                                                                             1 year –
animals also makes a significant contribution to veterinary care for both                                     4 years
farm and companion animals.
                                                                               At this stage, tests are expanded to include a much larger population;
Before a new medicine can be tested in humans, Pfizer produces                  from a few hundred to thousands of volunteer patients. This is also
comprehensive documents, combining all findings from laboratory and             usually carried out on a randomised, double-blind basis.
animal studies, to demonstrate to regulators that there is no evidence
                                                                               Throughout this rigorous testing process, multiple safeguards are in
that the medicine poses a significant risk to humans. Human trials of
                                                                               place to protect the rights and safety of study participants.
Pfizer medicines don’t just take place in one country, and they are often
run in different countries at the same time. No matter where they take         Every trial we run involving our compounds is registered and made public.
place, Pfizer clinical trials are conducted in accordance with recognised       We publish information about the purpose of each trial, the eligibility of
international standards, as well as local laws and regulations. All clinical   patients to join the trial and the location of the study.
trials carried out by Pfizer are always relevant to the health needs of
that country.                                                                       You can see this online at:
Our main concern in all clinical trials is patient safety.                          www.clinicaltrials.gov
                                                                                    The results of all Pfizer initiated clinical trials are also online,
                                                                                    you can view these at:
                                                                                    www.clinicalstudyresults.org
08     Attracting Debate
       Pfizer UK Stakeholder Report 2009




3                                                                                5
LICENSING: 6 MONTHS – 2 YEARS                                                    MARKETING AND SALES
Medicines are among the most heavily regulated products in the world.            Every day, 2.7 million people in the UK take a Pfizer medicine. The way in
In the UK, they are licensed either by the Medicines and Healthcare              which we can communicate with these patients is very strictly regulated,
products Regulatory Agency (MHRA), which ensures that our medicines              especially when it comes to talking about individual medicines. The law
work and are safe, or the European Medicines Evaluation Agency                   in the UK says that it must be healthcare professionals, using their clinical
(EMEA), which coordinates medicine licence applications within the               judgement, who talk to patients about specific medicines that might be
European Union.                                                                  appropriate for them. We are not allowed to advertise our prescription
                                                                                 medicines to the public.
Companies must provide substantial evidence of safety and effectiveness
when applying for a Marketing Authorisation Application, and often               We are also governed by the Code of Practice drawn up by our trade
extra information and further tests will be asked for by the regulators.         association, the Association of the British Pharmaceutical Industry
It can take up to two years to gain a licence. Pharmaceutical companies          (ABPI), which defines what we can say to patients.
are required to meet the costs of medicine regulation.
                                                                                 We can answer specific questions about one of our medicines if asked
                                                                                 by a patient who is currently taking the medication. However, we are not

4                                                                                permitted to discuss any personal medical matters with them. We are sure
                                                                                 that patients will appreciate the very sound reasons behind this policy,
MANUFACTURING                                                                    which ensures that they consult their own doctor or other healthcare
                                                                                 professional on matters relating to their health.
Our scientists will have already worked out how to produce the
medicine in small quantities in order for it to be used in clinical trials and   We communicate with healthcare professionals, in person and through
will have started to think about ways to mass produce it, if it is licensed      the post, to update them about our medicines and ensure they have the
for use. This can be extremely difficult and can involve the design of            most recent and relevant information available so that they can make
new, custom-made equipment.                                                      the correct prescribing decisions. Items which are intended for use by the
                                                                                 healthcare professional at home or in the car – such as umbrellas, coffee
Pfizer has a worldwide network of manufacturing, logistical, technical            pots, clocks, rugs and coasters – are not acceptable as promotional aids.
and support organisations to allow us to manufacture and supply
high-quality products with speed and flexibility. We have a secure and
efficient supply chain which provides products whenever and wherever
they are needed around the world.




                                           CLINICAL
                                            TRIALS
                                                                            LICENSING
        DISCOVERY



                                                                                                   MANUFACTURING




                                                                                                                  MARKETING
                                                                                                                  AND SALES
                                                                                                                     09     Attracting Debate
                                                                                                                            Pfizer UK Stakeholder Report 2009




The Code also extends to stating how we can operate when holding or          We encourage healthcare professionals to report any ‘adverse events’
sponsoring meetings for healthcare professionals. Hospitality can only       (side effects) in their patients on a Pfizer medicine, whether it is thought
be offered in association with certain types of meetings, and it must        the event was caused by our medicine or not. We also encourage
always be for the purposes of subsistence, secondary to the main purpose     reporting if the medicine fails to work as expected. In addition to this,
of the event. We may not extend that hospitality to anyone attending who     all Pfizer employees are fully trained in how to recognise and report an
has not been invited or is not qualified to be at the meeting. We must also   adverse event. We have to report all such events to the regulatory bodies,
ensure that the amount of money we spend on hospitality is not above         whether or not we can confirm their accuracy. In 2005, our Drug Safety
the level the recipient would be likely to spend on themselves. The venues   Group processed 11,944 cases from the UK and Ireland, 2,015 of which
we use must be appropriate to the main purpose of the meeting. Lavish,       were submitted to the UK Medicines and Healthcare products Regulatory
deluxe or extravagant venues are not permitted and neither are those         Agency (UK-MHRA) and the Irish Medicines Board (IMB). An additional
which are renowned for their entertainment facilities. Additionally,         62,102 foreign cases were also reviewed.
companies must not sponsor or organise entertainment.
                                                                             If you are taking or prescribing a medicine and experience any side
As part of our commitment to being open about our dealings with              effects which are not listed on the patient information leaflet, you
healthcare professionals, we also ensure that all sponsorship details        should immediately report these to your doctor, to another healthcare
are clearly disclosed on meeting materials.                                  professional (such as a nurse or carer) or to the company which produced
                                                                             your medicine. The telephone number for the Drug Safety Group at Pfizer
Safety                                                                       is 01304 616161. The MHRA can be contacted through its Yellow Card
                                                                             reporting system at mhra.gov.uk.
At Pfizer, our unwavering commitment to medicine safety begins
in the research laboratory and continues for as long as the medicine         It is extremely rare for information to be discovered after a drug has been
is prescribed to patients anywhere in the world. This commitment             approved which will lead to a medicine being withdrawn or its use being
to safety enables healthcare professionals to prescribe Pfizer products       severely restricted. However, when this occurs, it usually receives
and patients to receive the products with confidence.                         considerable public attention. The more common – but less dramatic –
                                                                             scenario is that newly identified safety issues help the pharmaceutical
Receiving regulatory approval for a medicine is a significant judgement
                                                                             companies, working with regulatory agencies, to better understand
on the safety of a medicine, but it is not the final safety checkpoint.
                                                                             who should or should not take the medicine, or how to update dosing
Pre-registration clinical trials cannot detect every possible side effect,
                                                                             recommendations. This information is then given to healthcare
and more may become apparent because the drug is used:
                                                                             professionals who can then inform their patients.
• in much larger number groups of patients
• for longer periods of time – sometimes for months or years
• in a more diverse patient population
                                                                              About the ABPI
• under ‘real-world’ circumstances rather than the more predictable
                                                                              The Association of the British Pharmaceutical Industry (ABPI)
  and closely monitored conditions of clinical trials.
                                                                              is the trade association for more than 75 companies in the UK who
It is very important that we monitor how our medicines act in real-world      produce prescription medicines. Its members supply more than 80%
patients, who are not as closely monitored and supervised as participants     of the medicines prescribed through the National Health Service.
in clinical studies. In the real world, patients:
                                                                              In 1958, the ABPI voluntarily published the first Code of Practice for
• don’t always take their medication as recommended                           the Pharmaceutical Industry. The Code has been regularly updated
                                                                              in the last 50 years and has always gone beyond UK law, based on
• don’t always adhere to dosing recommendations
                                                                              self-regulation by pharmaceutical companies. It is administered
• may have underlying conditions that may affect the expected                 by the Prescription Medicines Code of Practice Authority (PMCPA).
  performance of a medicine
                                                                              The Code has strict clauses detailing what must happen if an employee
• may take other medication, including non-prescription medication.           of a pharmaceutical company wishes to meet with a healthcare
                                                                              professional. The Code does not permit any gifts, benefits or
In addition to these factors, healthcare professionals may prescribe a
                                                                              money to be given to healthcare professionals by pharmaceutical
drug for conditions other than those approved by the regulatory agency,
                                                                              representatives as an incentive to prescribe, supply, administer,
or for shorter or longer periods of time than those recommended.
                                                                              recommend, buy or sell prescription medicines. We can, and do,
Patient follow-up may for all sorts of reasons be less comprehensive.
                                                                              give healthcare professionals promotional aids, which must cost less
These different conditions provide the opportunity to build up knowledge
                                                                              than £6 and must be valued at this price by the recipient. These aids
and may go beyond what was known about the safety characteristics
                                                                              must all be useful and relevant to the healthcare professional when
of the medicine at the time of approval.
                                                                              at work, and can include, for example, stationery, surgical gloves,
                                                                              tongue depressors and peak flow meters.
10   Attracting Debate
     Pfizer UK Stakeholder Report 2009




PATIENTS




                                        SAFE AND SECURE
                                        EVERY STEP
                                                                                                               11      Attracting Debate
                                                                                                                       Pfizer UK Stakeholder Report 2009
                                                                                                                k      Patients
                                                                                                                       Patient Advocacy Groups
                                                                                                                       Community Healthcare Professionals
                                                                                                                       Hospital Healthcare Professionals
                                                                                                                       Pharmacists
                                                                                                                       NGOs
                                                                                                                       Our People
                                                                                                                       Government
                                                                                                                       HTA Bodies
                                                                                                                       Think Tanks



WHAT WE DO                                                              WHAT YOU
AND WHY…                                                                TOLD US…
The pharmaceutical industry is governed by very strict                  As we’ve said, the pharmaceutical industry is governed by very strict
regulations. When it comes to talking about individual                  regulations and this affects the types of conversation we can have with
medicines, the law in the UK says that it must be healthcare            patients. However, we do want to know what matters most to patients,
                                                                        and we of course wanted to involve them in Attracting Debate. After all,
professionals, using their clinical judgement, who speak                the entire purpose of our business is to develop medicines that improve
to patients about the specific medicines that might be                   their health and it is important that we understand what they want and need.
appropriate for them. We are not allowed to advertise our
                                                                        We contacted patients through the membership of Pfizer life, Pfizer’s
prescription medicines and we can only talk to a patient
                                                                        patient information programme. People can sign up to join this programme
about a Pfizer medicine if we know they have already been                through our website, www.pfizerlife.co.uk, or by joining another one
prescribed it by a healthcare professional and they are                 of the programmes we run to support patients taking our medicines.
currently taking it. We are encouraged, however, by the                 Although many Pfizer life members will have been prescribed a Pfizer
Medicines and Healthcare products Regulatory Agency                     medicine at some stage, they may not still be on this medication. We sent
(MHRA), to run responsible disease awareness programmes                 a copy of Attracting Debate to a random selection of just under 5,500
that inform patients about their health and about all the               Pfizer life members last year, asking them to get in touch with us with their
                                                                        point of view on a range of issues. We received a 30% response rate.
different treatment options open to them. We never
encourage people to ask their healthcare professional for
one particular product – to do this would be illegal.                                  life
We think we can play an important role here because
patients who understand their conditions and treatment
options are better able to have worthwhile discussions                   THE ISSUES MOST IMPORTANT TO YOU
with their doctor and are able to make informed personal
choices. They are more likely to understand the treatment
they are receiving, more likely to complete their course
                                                                        27%
                                                                        of you said the safe use of medicines was one
of medication, and more likely to manage their condition
effectively so that they can live in the best health possible.
                                                                        of the issues most important to you
We know a lot about the diseases we have medicines for
and we believe the high quality of our disease awareness
programmes makes a real difference to people’s health.
                                                                        27%
                                                                        of you said the development of new and innovative
For example, our patient information programme, Pfizer life,             medicines was one of the issues most important
covers a range of conditions and provides information about             to you
how to live healthily, and how to live with a health condition.

                                                                        22%
The information we provide is shaped by what our members
tell us what they want to know about.
                                                                        of you said that reducing health inequalities in
                                                                        the UK is one of the issues most important to you

 Although we are not permitted to start conversations with patients     17%
 about our medicines, and are not able to provide advice on personal    of you said the way in which we conduct clinical
 medical matters, we are able to respond to enquiries relating to the
 use of our prescription medicines. We have a Medical Information
                                                                        trials is one of the issues most important to you
 team providing this service, which is available to both healthcare
 professionals and members of the public. Visit www.pfizer.co.uk
 for details of our Medical Information service.
                                                                        87%
                                                                        of you said that you thought we are prepared
                                                                        to listen…
 For every patient who got in touch with us after reading Attracting
 Debate we pledged a donation of £5 to the British Red Cross.
 Thanks to your feedback we made a total contribution of £10,000.
                                                                        73%
                                                                        believe we are prepared to change
12     Attracting Debate
       Pfizer UK Stakeholder Report 2009




WE HAVE…
                                                                                   Despite the risks, people still buy unregulated medicines online.
                                                                                   Last year we conducted a survey which showed that men, in particular,
                                                                                   are using the internet to buy medicines even though they are aware of

27%
                                                                                   the risks. 68% of the men interviewed who had purchased a medicine
                                                                                   online without a prescription, said they suspected that fake medicines
                                                                                   could contain ingredients that are very different from those in authentic
of you said the safe use of medicines was one                                      medicines. Only 6% of men interviewed said they would seek advice from
of the issues most important to you                                                a doctor or pharmacist before buying medicines online. The results of our
With every medicine, safety is the primary focus, from the earliest stage          survey demonstrate that there is a real lack of awareness of the dangers
in the research laboratory, until long beyond the time it is licensed –            of using counterfeit medicines. To highlight these risks to the public
in fact, right up until the time when no patient, anywhere in the world,           we ran a series of roadshows during November 2008 in London, Cardiff,
is taking the medicine. Regulatory approval is an important stage in               Birmingham, Manchester and Edinburgh. We used actors to explain the
assessing the safety of a medicine, but our own scrutiny of its safety will        risks that people are taking with their health when buying medicines
continue for as long as it is prescribed. We watch carefully as our medicines      without a prescription.
move beyond clinical trials to much larger groups of patients who may need         We’ve also learnt that you find it confusing when different doses of our
to take the medicine for long periods of time. We encourage healthcare             medicines are in very similar packaging. This is a particular problem
professionals to report any adverse events (side effects) in their patients,       for patients who take more than one type of medicine, often at different
whether it is thought the event was caused by our medicine or not. It is           doses, because it is easier to mix up the tablets. We have done a lot
extremely rare for information to be discovered after a medicine has been          of work during the past year to make our packaging much clearer,
approved which will lead to it being withdrawn, or its use severely restricted.    both for patients, and for the pharmacists who dispense them. You can
More usually, the improved understanding of the characteristics of a               find out more about this on page 31. We’ve also had feedback from you
medicine, in different types of patient, enables pharmaceutical companies          that the Patient Information Leaflet in boxes of medicine is very difficult
to work with regulatory agencies to establish with greater clarity who             to understand.
should or should not be prescribed the medicine, and at what dose.
                                                                                        To find out what we’ve been doing about that, please go to page 19.
     Please go to page 9 for much more detail on how we ensure
     our medicines are as safe as possible.


We’ve recently been involved in some new work to help us respond more
actively on this issue. As part of the ‘a healthy partnership’TM programme,        27%
which is described in more detail on page 30, we have produced a leaflet            of you said the development of new and innovative
called Simple Facts about your Medicines. It describes the whole life cycle        medicines was one of the issues most important
of a medicine. It provides information about the dangers of counterfeit
medicines and how to avoid them. Simple Facts about your Medicines
                                                                                   to you
is available from your pharmacist.                                                 You’ve told us, like other stakeholders we have spoken to, that you want
                                                                                   to know more about the new medicines we are working on. Our pipeline
Over the past decade, the volume of counterfeit medicines and medical
                                                                                   of medicines in development is the largest in the pharmaceutical industry,
treatments, fraudulently produced and marketed as the real thing, has
                                                                                   focusing on a broad range of unmet medical needs, spanning ten
rocketed. Between 2005 and 2007, the number of counterfeit medicines
                                                                                   therapeutic areas. We invest more than $7 billion annually in the research
seized at EU Borders rose by 628%. Counterfeits are an important issue
                                                                                   and development of new medicines. The majority of our recent advances
for any patients who are concerned about the safety of their medicines,
                                                                                   have been in oncology, pain, inflammation, diabetes, Alzheimer’s disease
but particularly for those who buy medicines from unregulated websites.
                                                                                   and schizophrenia.
It is estimated that 90% of medicines sold online are fake.
                                                                                   You can get up-to-date information about our pipeline at
It is illegal for us to sell prescription medicines direct to the public online,
                                                                                   www.pfizer.com/pipeline. Here you can search our portfolio of new
and there have been many cases of disreputable websites claiming to
                                                                                   medicines and find out more about our research and development
sell our medicines legitimately. In fact, during one of our Attracting Debate
                                                                                   work around the world. You can see how many programmes we have
conversations we were criticised by an NHS Executive who had seen a
                                                                                   in our pipeline from Phase 1 right through to registration. You can also
Pfizer-branded website selling one of our medicines. It turned out that
                                                                                   read about trials that we have discontinued and compounds we have
this was an illegal site, using our company logo without our permission,
                                                                                   withdrawn from registration. This information is updated every
so we took legal action and had it closed down.
                                                                                   three months.
                                                                                                                      13     Attracting Debate
                                                                                                                             Pfizer UK Stakeholder Report 2009
                                                                                                                      k      Patients
                                                                                                                             Patient Advocacy Groups
                                                                                                                             Community Healthcare Professionals
                                                                                                                             Hospital Healthcare Professionals
                                                                                                                             Pharmacists
                                                                                                                             NGOs
                                                                                                                             Our People
                                                                                                                             Government
                                                                                                                             HTA Bodies
                                                                                                                             Think Tanks



OUR PIPELINE

1 ALLERGY AND RESPIRATORY                                                     7 INFLAMMATION
Pfizer’s Allergy and Respiratory team is developing compounds that             The body’s first natural reaction to wounds and infections is the
target two of the diseases that affect the lower airways: asthma and          inflammatory response. However, in diseases such as rheumatoid
chronic obstructive pulmonary disease (COPD). Millions of patients            arthritis, the immune system can be activated without stimulus or
across the world suffer from COPD and with the industrialisation              infection, attacking its own healthy tissues. In other situations such as
of the developing world and the rise of smoking in the same regions           transplantation, it becomes necessary to suppress the immune system
it is predicted that this disease will become the leading cause of death      to ensure that the body does not attack the new organ. Many current
in the world by 2020.                                                         therapies leave transplant patients in a vulnerable position due to their
                                                                              many side effects. Our researchers are working on medicines that
2 CARDIOVASCULAR METABOLIC                                                    will make this less of a balancing act, reducing the risk of side effects
                                                                              and making them more manageable. Another active area our scientists
  AND ENDOCRINE DISEASE                                                       are working on is osteoarthritis.
Chronic cardiovascular disease and diabetes cause one in three deaths
in the world today. Advances in understanding the risk factors behind         8 INFECTIOUS DISEASES
these diseases and in the development of new therapies have shown
that cardiovascular disease is largely preventable. Our current and           The nature of infectious diseases is that they change and develop
future portfolio of medicines in this therapeutic area is focused on the      new strains that are resistant to current therapies. There is always
control of the risk factors inherent in smoking, diet, physical inactivity,   the possibility of a new infectious disease emerging with little or no
and type 2 diabetes. We are also working on discovering and developing        warning. The most significant example of this in recent history is,
medicines to treat obesity, atherosclerosis, thrombosis, bone health          of course, HIV/AIDS. Pfizer is breaking new ground in our approaches
and muscle health.                                                            to the treatment of HIV. We are also researching vaccines to treat
                                                                              infectious diseases, with a particular focus on influenza.
3 DERMATOLOGY
                                                                              9 ONCOLOGY
Pfizer is developing new prescription medicines to help increase the
availability of effective skin treatments.                                    In many countries cancer causes more deaths than any other medical
                                                                              condition except heart disease. We are currently developing medicines
                                                                              to treat breast cancer, colorectal cancer, Ewings sarcoma, hepatocullular
4 NEUROSCIENCE                                                                cancer, glioblastoma multiforme, lung cancer, melanoma, pancreatic
Pfizer is investigating new approaches to treating Alzheimer’s disease,        cancer, prostate cancer, renal cell cancer and thyroid neoplasm.
schizophrenia and other debilitating conditions. For anxiety, sleep
disorders and neuropathic pain, we continue to expand research into           10 OPHTHALMOLOGY
alpha-2-delta binding site agents, the mechanism that has already led
to the development of two of our medicines.                                   The incidence of eye disease is growing as the world’s population
                                                                              ages and suffers increasingly from conditions such as diabetes. We are
                                                                              building on our expertise in treating diseases of the eye to expand our
5 GASTROINTESTINAL AND HEPATOLOGY                                             portfolio of ophthalmic compounds. These include glaucoma and retinal
Diseases that affect the gastrointestinal tract and the liver can cause       diseases such as age-related macular degeneration (AMD), diabetic
severe life-altering symptoms that can lead to devastating physical,          macular edema (DME) and chronic dry eye (CDE).
emotional and social effects. Some, like liver fibrosis progressing to
cirrhosis, can also be life-threatening. Pfizer is committed to discovering    11 PAIN
new treatments for these conditions.
                                                                              We are developing medicines for acute pain (the sudden onset of pain
                                                                              that lasts for a short time), chronic pain (persistent pain, whose cause
6 GENITOURINARY/SEXUAL HEALTH                                                 is often unidentified), fibromyalgia (primarily occurring in women and
Genitourinary (GU) conditions account for a major source of distress          characterised by widespread tenderness in muscles and the areas
for millions of people throughout the world. While many GU diseases           around joints), neuropathic pain (caused by nerve damage or damage
are manageable, patients often don’t seek treatment through                   to the nervous system) and osteoarthritic pain.
embarrassment, misunderstanding of their symptoms or because they
regard these as aspects of their life that they should just put up with.
Our goal is to restore dignity to those suffering from GU conditions
and to help improve their quality of life.
14     Attracting Debate
       Pfizer UK Stakeholder Report 2009




22%                                                                       17%
of you said that reducing health inequalities in                          of you said the way in which we conduct clinical
the UK is one of the issues most important to you                         trials is one of the issues most important to you
So what are we doing about health inequalities in the UK? We are          Safety has to be, and is, the most important consideration at every stage
committed to helping people who experience health inequalities and        of the clinical trial process. We know that people want to know more about
the Pfizer UK Foundation is one way in which we are working to achieve     this process than ever before and that they want us to be as open as
healthier outcomes for people, especially those in disadvantaged          we can be about how trials are progressing. We also know that for some
communities. We believe that people who work at grass roots,              patients, these trials can provide early access to innovative, life-saving
community level are the best people to understand what will really        treatments, and for that reason many people want to know about our
meet people’s needs. The Pfizer UK Foundation was established in 2005      plans as early as possible. We are providing more information about our
to address health inequalities across the UK arising because of social,   trials than ever before but it should always be a patient’s choice to join or
economic, cultural and demographic reasons. Since then it has donated     leave a trial and they should only ever make that decision with the clinical
nearly £4 million in grants to support more than 150 community based      guidance of their healthcare professional.
projects in England, Northern Ireland, Scotland and Wales, benefiting
                                                                          Only about 250 out of 10,000 compounds will make it through to be tested
an estimated 400,000 people.
                                                                          in humans (the rest having been screened out during earlier pre-clinical
     For more information about the Pfizer UK Foundation,                  tests). Even if it reaches this stage, a new medicine must still go through
     please go to page 18.                                                three stages of clinical trials before it can be approved, and if there are
                                                                          any safety concerns a trial can be stopped at any time. These three stages
                                                                          together can take anything from two to eight years.

                                                                               For a more detailed explanation of the way in which we carry out
                                                                               clinical trials, please go to page 7.


                                                                          Every clinical trial that we run is registered and made public. We publish
                                                                          information about its purpose, its location and the eligibility of patients to
                                                                          join the trial. You can view this online at www.clinicaltrials.gov. The results
                                                                          of all of our clinical trials are also online – you can view these at
                                                                          www.clinicalstudyresults.org. You can search this database by company
                                                                          (or sponsor) name, condition or generic drug name. We have also started
                                                                          working in partnership with Cancer Research UK to ensure that our
                                                                          oncology trials are also registered on www.cancerhelp.org.uk, making
                                                                          their details accessible to patients. Investigator-Initiated Research (IRR)
         “You have changed my                                             studies, which are independently conceived and developed by scientists,
                                                                          and not sponsored by Pfizer, are not necessarily published in this way.
       opinion of Pfizer. I believed                                       We encourage all investigators to disclose information on the research
        before reading this that                                          they are conducting but there is no formal requirement for them to do this.
           all pharmaceutical                                             All of the information on these registries should be used in conjunction
          companies were only                                             with advice from healthcare professionals.
         concerned with profits
       and gave out far too many
                free gifts.”
                        Pfizer Patient
                                                                                              15      Attracting Debate
                                                                                                      Pfizer UK Stakeholder Report 2009
                                                                                              k       Patients
                                                                                                      Patient Advocacy Groups
                                                                                                      Community Healthcare Professionals
                                                                                                      Hospital Healthcare Professionals
                                                                                                      Pharmacists
                                                                                                      NGOs
                                                                                                      Our People
                                                                                                      Government
                                                                                                      HTA Bodies
                                                                                                      Think Tanks




                            “I am amazed at
                         the amount of money
                        invested in developing
                          a new medicine and
                           the time it takes.”
                               Member of Pfizer life




                                                                                                   “I appreciate the
                                                                                                  opportunity to voice
                                                                                                    my opinions.”
                                                                                                         Member of Pfizer life




                                                      WE WILL...
                                                      We will continue to be much more open about the medicines we are
                                                      developing and the clinical trials that are underway. You can obtain
                                                      the most up-to-date information on our website: www.pfizer.co.uk.
                                                      Increasing patients’ awareness and sense of responsibility for
                                                      maintaining their health can prevent the onset of disease, improve
                                                      early diagnosis and ensure that medicines are taken correctly. In 2009,
                                                      we will be building on our work to provide the highest standards of
                                                      patient information. We will be developing Pfizer life, our patient
                                                      information programme, so that it provides advice and support that is
                                                      tailored to patients’ individual needs. People need information at different
                                                      times and in different ways, and everyone is different. Pfizer life focuses
                                                      on the individual rather than the condition, so we will be developing
                                                      tailored support programmes for individuals, based on what they tell
                                                      us they need. We’ll also be offering practical tools to support them when
                                                      they visit their GP or pharmacist. We have conducted extensive research
                                                      among patients with a range of conditions to develop a service that is
                                                      genuinely focused on what they have told us they want – and when.
                                                      Pfizer life is supported by a website: www.pfizerlife.co.uk. If you have
                                                      not visited the website recently, please have a look.
                                                      We will also be developing patient adherence programmes to make
                                                      it easier for our patients to learn more about the Pfizer medicines they
“Has brought to light things                          are taking, so that they are more likely to take their medicines correctly
  I did not know about the                            and safely.
 pharmaceutical industry.”                            During 2009, we will continue to focus on the dangers of counterfeit
        Pfizer Patient                                 medicines and to raise awareness of the risks. We have commissioned
                                                      a hard-hitting advertising campaign in cinemas which, we hope, will really
                                                      make people think twice about taking any medicine from an unregulated,
                                                      untrusted source. This is just the start of a programme to make people
                                                      much more aware of the risks posed by counterfeit medicines.
16   Attracting Debate
     Pfizer UK Stakeholder Report 2009




PATIENT
ADVOCACY
GROUPS




                                        ENSURING
                                        PROTECTION
                                        AND ACCESS
                                                                                                          17   Attracting Debate
                                                                                                               Pfizer UK Stakeholder Report 2009
                                                                                                               Patients
                                                                                                          k    Patient Advocacy Groups
                                                                                                               Community Healthcare Professionals
                                                                                                               Hospital Healthcare Professionals
                                                                                                               Pharmacists
                                                                                                               NGOs
                                                                                                               Our People
                                                                                                               Government
                                                                                                               HTA Bodies
                                                                                                               Think Tanks



WHAT WE DO                                                                     WHAT YOU
AND WHY…                                                                       TOLD US…
Patient organisations do huge amounts of work
to support patients and provide them with the information
                                                                                THE ISSUES MOST IMPORTANT TO YOU
they need to help them manage their conditions as well
as they can. They also campaign on behalf of patients
to make sure their needs are well represented within
                                                                               79%
                                                                               of you said that reducing health inequalities
the health service. We do a lot of work with patient                           in the UK was an important issue you wanted
organisations to develop programmes to inform patients
about their conditions and help them manage their
                                                                               us to address
treatment effectively. You can see full details of all the
work we do with patient organisations at:                                      72%
www.pfizer.co.uk/Inhealthcare/PatientGroups/Search/                             of you talked about the importance of developing
Pages/Patientgroupsearch.aspx                                                  new and innovative medicines
This website describes the work we are doing with each
organisation and details the financial and non-financial                         54%
support we have given.                                                         of you said openness about what we do is one
                                                                               of the issues most important to you

                                                                               50%
                                                                               of you said the safe use of medicines is one
                                                                               of the issues most important to you

                            “You need to be                                    88%
                           clearer about the                                   of you said that you thought we are prepared
                         restrictions you face.                                to listen…
                          You say ‘we can’t’,
                               but why?”                                       51%
                             Patient Advocacy Group
                                                                               believe we are prepared to change
    “I think the whole
   concept of Attracting
       Debate is very
  refreshing and brave.”
      Patient Advocacy
           Group




                                                                                                                     “I learnt an awful
                                                                                                                    lot about what you
                                                                                                                   are doing that I didn’t
                                                                                                                       know before.”
                                                                                                                        Patient Advocacy
                                              “We need to understand                                                         Group
                                             what can and can’t be done.
                                             We need to understand the
                                            Code and the other restrictions
                                                  you face better.”
                                                      Patient Advocacy Group
18     Attracting Debate
       Pfizer UK Stakeholder Report 2009




WE HAVE...                                                                       72%
                                                                                 of you talked about the importance of developing
79%                                                                              new and innovative medicines
of you said that reducing health inequalities                                    When you read the first edition of Attracting Debate you told us you had
                                                                                 never seen such a clear explanation of the way medicines are developed
in the UK was an important issue you wanted                                      and the time it takes. We had lots of feedback from you that we should
us to address                                                                    tell people more about this, because it’s something that seems to have
This issue is core to our business, and we’ve described in some detail           been clouded in mystery in the past. In this edition we’ve included more
the work we do support disease awareness and patient health in the               information about the medicines development process.
‘Patients’ section of this report. The aim of reducing health inequalities
                                                                                      You can see this on page 6.
in the UK is the cornerstone of Pfizer’s corporate giving in the UK.
We want to help people manage their health and stay well, and we
know that people who find it difficult to access the most basic services,
for reasons linked to geography, race, religion or socio-economic status,
are in particular need of support.
The Pfizer UK Foundation is a grant scheme that provides short-term
funding for creative and innovative projects based on local need in
deprived areas and marginalised communities. It makes donations
of £1 million each year, each of which is decided upon by a Board,
which includes members who are independent of Pfizer. These Board
                                                                                  £3,993,710
members have longstanding and considerable expertise in the fields                 155 PFIZER UK                                                2

of health and social inequalities. Since 2005, the Foundation has                 FOUNDATION
                                                                                                                                        3
donated nearly £4 million in grants to more than 150 community-based              PROJECTS*
projects in England, Northern Ireland, Scotland and Wales, benefiting an                                                                              4
estimated 400,000 people. We’ve supported community organisations,
                                                                                                                                               1
local and national charities, local authorities, primary care trusts and local
health boards – all experts in identifying and finding solutions to local
health needs.
                                                                                  Some examples of projects that have received funding
The Foundation does more than just give money; it also seeks to                   from the Pfizer UK Foundation.
understand what constitutes best practice in delivering these services,
and to share that knowledge. An annual networking event and a regular               WALES
                                                                                    1 Cambrian Village Trust
newsletter, Foundation News, encourages groups which have received
Pfizer UK Foundation funding to partner with similar organisations,                Encouraging young girls in the communities of Mid-Rhondda where
share ideas and expertise and create networks. Pfizer’s collaboration with         there are high levels of deprivation and associated health inequalities,
the Government’s Beacon Scheme enables it to work with local authorities          to become more physically active and learn about healthy eating.
which have been recognised as leaders in the provision of services
tackling health inequalities, to share best practice, promote learning              SCOTLAND
                                                                                    2 The Pakistani Society, Edinburgh
exchange and help make the connection between health and social
care closer.                                                                      Providing a bespoke, culturally sensitive diabetic education for ethnic
The Pfizer UK Foundation, together with Pfizer’s volunteering programme             minority patients which has benefited over 200 people by successfully
Health Relief, were recently recognised for their positive impact in              reducing overall blood sugar levels and blood pressures within that group.
addressing health inequalities through a Business in the Community                  NORTHERN IRELAND
Big Tick Award. Peer-assessed and independently assured, the Big Tick               3 POSITIVE Change Programme, South Belfast
is a highly respected endorsement of responsible business practice.
                                                                                  A tailored and targeted programme to reach young women living
For more information about the Pfizer UK Foundation, to request an                 with HIV/AIDS in South Belfast. This disease is currently seeing the
application form or receive regular editions of Foundation News, please           highest rate of growth in young adults.
contact us on 01737 330713 or email us at pfizerukfoundation@pfizer.com.
                                                                                    ENGLAND
                                                                                    4 Football in the Community, Notts County FC

                                                                                  Using football to engage hard-to-reach male populations with mental
                                                                                  health issues in Nottingham City. Since men do not access health
                                                                                  services as readily as women, there are obvious advantages in
                                                                                  delivering a mental health project in a non-health setting. Many of
                                                                                  those who initially took part have now moved on with better self
                                                                                  esteem, motivation and social skills, together with much improved
                                                                                  levels of fitness.
                                                                                  *Figures correct as of October 2008
                                                                                                                           19      Attracting Debate
                                                                                                                                   Pfizer UK Stakeholder Report 2009
                                                                                                                                   Patients
                                                                                                                                   Patients
                                                                                                                           k       Patient Advocacy Groups
                                                                                                                                   Patient Advocacy Groups
                                                                                                                                   Community Healthcare Professionals
                                                                                                                                   Community Healthcare Professionals
                                                                                                                                   Hospital Healthcare Professionals
                                                                                                                                   Hospital Healthcare Professionals
                                                                                                                                   Pharmacists
                                                                                                                                   Pharmacists
                                                                                                                                   NGOs
                                                                                                                                   NGOs
                                                                                                                                   Our People
                                                                                                                                   Our People
                                                                                                                                   Government
                                                                                                                                   Government
                                                                                                                                   HTA Bodies
                                                                                                                                   HTA Bodies
                                                                                                                                   Think Tanks
                                                                                                                                   Think Tanks

Like the patients we spoke to, you told us that you want to know more             We are proud to work with and support patient groups, and we are proud
about the work we are doing to discover new medicines. Since the first             to say so. We believe you fulfil an immensely important role, and also
Attracting Debate we’ve started publishing much more information about            that we have a lot of shared interests. We never make a payment to a
our pipeline and you can find out more in the Patients section on page 13.         patient advocacy group with any intention to influence the organisation
This section also explains where to get the most up-to-date information           or individuals within that organisation. The regulations we face are very
about all the trials we are conducting, where they are taking place and           strict and we are absolutely barred from ever making a payment that
how to find out about eligibility to join them.                                    could even be perceived to be intended to incentivise someone to use
                                                                                  their powers of office in our favour. This would include the approval,
You told us that it is important that the patients you represent have
                                                                                  reimbursement, prescription or recommendation of any of our products.
access to the latest clinical trials, and that you would like to see more
trials taking place in the UK. So would we. There are many difficulties we
face when trying to run clinical research in the UK. It is more expensive to
run trials here than in other countries and is it also more difficult to recruit
                                                                                  50%
patients to participate in studies. New drugs have to be tested against           of you said the safe use of medicines is one
the most widely accepted ‘gold standard’ medicine for the condition being         of the issues most important to you
studied. It can be difficult to place trials in countries where access to new
                                                                                  Safety is the most important consideration, from the moment a compound
medicines is restricted as a result of government driven cost containment
                                                                                  is first investigated in a laboratory right through the lifespan of a licensed
measures. This is becoming a challenge for us in the UK.
                                                                                  medicine, for as long as it is prescribed.
Between 2007 and 2008, funding for health research in the UK
was roughly split in this way: the pharmaceutical industry invested                    We’ve provided information abut how safety considerations govern
                                                                                       every stage of the medicine development process on page 9.
£5,000 million; the government invested £2,388 million; research
charities invested £750 million. To maintain this level of investment,
it is very important that the UK continues to be a place where industry           Once clinical trials are complete and a medicine is licensed and prescribed
is prepared to invest in research. We know that, and we are working very          to ‘real-world’ patients, it is important that we do as much as we can to
hard to overcome the current difficulties and obstacles which make the             ensure that patients take their medication as recommended. This means
UK less attractive than other countries for clinical research. We are             taking it at the right time, regularly, and at the right dose. Every medicine
supporting and contributing to government initiatives, including the              dispensed comes with a patient information leaflet, which provides
Clinical Research Collaboration and the National Institute of Health              details of any possible side effects. It’s a legislative requirement that these
Research, through our representation on government working parties                leaflets are included with medicines and it is a valuable opportunity for
which feed into the Department of Health. We are also involved with               us to provide patients with important information about their medicine.
groups like the Medicines for Children Research Network, and are working          However, one-fifth of you told us that you don’t like the way patient
in partnership with a number of trusts to support them in improving               information leaflets (PILs) are written. You told us that they are hard to
their research infrastructure. What’s more, we are working to promote             read, full of legal phrases and they focus more on the possible side effects
increased collaboration between industry, the academic community and              of medicines than they do on explaining to patients how their medicines
regulators, and researching ways to deliver pre-marketing data in a better        work and how they should take them. You also told us that you would like
way, through the use of new technologies and increasing transparency              to see more information about patient groups on the PIL so that patients
and accountability of our trials.                                                 know where to go to for support and advice.
Despite the difficult climate facing us when running trials in this country,       This feedback coincided with a legislative requirement to ‘user test’
Pfizer invested in 91 UK commercial clinical trials during the course              patient information leaflets and to make it easier for patients to
of 2008.                                                                          understand the risks and benefits of their medicines. We have reviewed
                                                                                  the PILs for all 150 of our licensed products and have rewritten them in

54%                                                                               a more straightforward style. We tested all of these leaflets with groups
                                                                                  of patients who were likely to use each medicine. In the case of complex
of you said openness about what we do is one                                      therapy areas we amended the leaflet and tested it several times in
of the issues most important to you                                               order to get it absolutely right. The rewritten leaflets were then submitted
                                                                                  to the Medicines and Healthcare products Regulatory Agency (MHRA)
As we’ve described already, we’ve become much more open about our                 for approval.
clinical trials and about the medicines we are developing. We know that
there is a particular demand for easy-to-access information about clinical
trials for cancer treatments and we are working with Cancer Research UK
to make sure that all our oncology trials are also registered on
www.cancerhelp.org.uk to make them even more accessible.
We are also very open about the work we do with you, patient groups.
Since 2007, we have published full details of all the work we do with
                                                                                  WE WILL...
you, including full disclosure of the financial support we give to patient         In 2009, we will build on the progress we have made in disclosing more
advocacy groups. You will find this at:                                            about our pipeline, clinical trials and the work we do with patient groups.
www.pfizer.co.uk/Inhealthcare/PatientGroups/Search/Pages/                          We know how important it is to be transparent about the way we manage
Patientgroupsearch.aspx                                                           our business. We hope to go a step further and publish full details of the
                                                                                  work we do with medical clinicians and institutions in the UK during 2009.
                                                                                  We will also work with the MHRA to incorporate information about patient
                                                                                  support groups in our patient information leaflets.
20   Attracting Debate
     Pfizer UK Stakeholder Report 2009




COMMUNITY
HEALTHCARE
PROFESSIONALS




GETTING IT RIGHT
FOR EVERY PATIENT
                                                                                                   21   Attracting Debate
                                                                                                        Pfizer UK Stakeholder Report 2009
                                                                                                        Patients
                                                                                                        Patient Advocacy Groups
                                                                                                   k    Community Healthcare Professionals
                                                                                                        Hospital Healthcare Professionals
                                                                                                        Pharmacists
                                                                                                        NGOs
                                                                                                        Our People
                                                                                                        Government
                                                                                                        HTA Bodies
                                                                                                        Think Tanks



WHAT WE DO                                                              WHAT YOU
AND WHY...                                                              TOLD US…
We talk to a wide range of people who are responsible for
delivering NHS services at community level. The people who                   THE ISSUES MOST IMPORTANT TO YOU
prescribe medicines need to understand how our medicines
work and that they have access to the clinical data behind
them. They need to understand which medicines are most
                                                                        40%
                                                                        of you made comments about the way our field
suited to individual patients, how those medicines might                force operates. Among that 40%, half of you
interact with other medicines or conditions, and how
individual medicines should be taken to maximise their
                                                                        made positive comments and half of you made
effectiveness. They also need to know what our medicines                negative comments
cost and how they fit into patient pathways so that they
can manage their budgets and get the best outcomes for
their investment. We also invest a considerable amount
                                                                        27%
                                                                        of you said you were interested in support services
in providing healthcare professionals with detailed clinical
education, through individual meetings and a range of
                                                                        we could offer to help you manage patient care and
educational events.                                                     meet your business objectives
In the first Attracting Debate, we reported that we have
made some significant changes to our business model.                     24%
We now have a much smaller team of representatives                      of you said the personal relationship with the
who visit prescribers and visit them less often. Moreover,              person you know from Pfizer has a big impact
under the industry’s code of practice, a representative                 on the way you work with us
can now only visit a healthcare professional three times
a year, unless the healthcare professional requests more.
                                                                        20%
                                                                        of you made negative comments about our
                                                                        marketing practices

                                                                        79%
                                                                        of you said that you thought we are prepared
                                                                        to listen…

                                                                        50%
                                                                        believed we are prepared to change


                                                                                                           “PCTs are split between
                                                                                                          those positive to industry
                       “Attracting Debate                                                                   and those that brand
                                                                                                              it as the devil.”
                      represents a cultural
                                                                                                            Director of Commissioning
                      shift for the industry.
                   I’m most impressed with
                     Pfizer for doing this.”
                           Director of Nursing     “You’ve shown a
                                                  human side of the
                                                     company, not
                                                    just products.”
                                                 Director of Public Health
22 AttractingStakeholder Report 2009
   Pfizer UK
              Debate




WE HAVE...
                                                                              We are also looking at ways to help patients be better informed about
                                                                              potential side effects and about the decisions that need to be made if they
                                                                              do experience them. This needs careful management because, in some cases,

40%
                                                                              it may be appropriate to change a patient’s treatment course but, in other
                                                                              cases, side effects may occur only in the early stages of treatment or the
                                                                              effect of discontinuing treatment may be worse than the side effects.
of you made comments about the way our field
force operates. Among that 40%, half of you                                   We are happy to develop these new types of programme on our own and with
                                                                              other companies. We have found that, in some instances, people working
made positive comments and half of you made                                   in the NHS have been reluctant to work with us if we are the only company.
negative comments                                                             They feel that there is less likely to be any bias if more than one company
We know that many of you find it useful to talk to our sales                   is involved. We have worked on a lot of multi-company partnerships with
representatives and that you want us to give you clinical information         the NHS and are very comfortable with this way of working but we really
about our medicines. However we also know that some of you don’t like         do believe that the starting point should be the desired outcome. If one
seeing sales representatives at all. The NHS has changed a lot, and so        company has unique expertise and can deliver the results needed then
have the roles of all healthcare professionals. We have been working          that should not prevent the NHS from working with them. This way of
hard to find new ways to talk to you so that we add value to your jobs         working can produce results a lot faster and, frankly, from our perspective,
and help you address the needs of your patients better. For a start,          there are situations where we are comfortable sharing our intellectual
we have made major changes to the way our field force operates.                property with NHS partners but not with competitors. The most important
Our representatives now make fewer visits and have more wide-ranging          thing, regardless of how many partners there are, is that everyone involved
conversations with healthcare professionals. We’ve also introduced new        is very clear and open about the respective benefits to all parties.
specialist roles in our field force and these colleagues are responsible       When that is the case, no-one can be accused of behaving inappropriately.
for meeting with a broader range of people who work for the NHS.
We’ve had some feedback during Attracting Debate that you have                 Pfizer Health Solutions
seen the difference and that you like it.
                                                                               Pfizer Health Solutions is a group within Pfizer that operates
                                                                               independently of our medicines business. In 2006, Pfizer Health
27%                                                                            Solutions won a commission to establish Birmingham OwnHealth®,
                                                                               a partnership with Birmingham East and North Primary Care Trust
of you said you were interested in support services                            (BEN PCT) and NHS Direct. It operates in some of the most deprived
we could offer to help you manage patient care and                             areas in Birmingham and supports people with long-term medical
meet your business objectives                                                  conditions by helping them to take a more active role in managing
                                                                               their own health. It offers personalised support over the telephone for
Although we still believe it is important to talk to prescribers and budget    people who have been diagnosed with coronary heart disease, heart
holders about how our medicines work and what they cost, we are also           failure, diabetes and chronic obstructive pulmonary disease (COPD).
looking at the broader support services we can offer to help healthcare        During 2008, we extended this programme to offer support to stroke
professionals meet the health challenges in their local patient                patients, elderly patients needing greater support and people at risk
populations. These services are very much focused on patient outcomes          of developing cardiovascular disease. A team of over 40 care
and include screening and health promotion programmes, as well as              managers, all of whom are experienced nurses employed by NHS
programmes to help patients understand how their medicines work so             Direct, work closely with patients to help them understand their
that they are more likely to take them correctly. We also provide services     conditions, develop personal action plans to stay well and to help
to help healthcare professionals develop their business skills.                them understand how to use local healthcare services more effectively.
During 2008, we started a pilot programme looking at ways to reduce            The service is offered in English, Punjabi, Urdu and Hindi in order to
medicines waste. We are working with a primary care trust to understand        reach ethnic minority communities who face barriers in accessing
the underlying reasons for it. The aim is to use that knowledge to identify    and engaging with local healthcare services.
ways to reduce waste. Medicines wastage is a major issue for the NHS –         There are now more than 3,000 people enrolled on the programme and
estimated by the Office of Fair Trading to amount to £300 million per year.     this number grows by the day. Self reporting from these patients has
It has been assumed in the past that these high levels of wastage are          shown high levels of satisfaction and improved lifestyle behaviours,
the result of patients over-ordering repeat prescriptions. The preliminary     including reduced levels of smoking, increased exercise and improved
findings of this programme have challenged this assumption and suggest          diet. They are also showing improved clinical measures and reductions
that significant wastage occurs when prescribers change treatment               in the use of unscheduled care. We recently signed a new three-year
courses for patients experiencing side effects or those experiencing           contract which will extend these services to up to 27,000 people in
insufficient response. We are working with the trust to develop solutions       Birmingham by 2011.
to help prescribers diagnose and select appropriate medicines in ways
that are likely to reduce waste. One possible way might be to reduce the       In 2008, Pfizer Health Solutions announced two new collaborations.
number of tablets given to the patient in their first prescription so that      We won a four-year contract to partner with NHS Direct and are now
the healthcare professional can identify whether side effects are occurring    one of their preferred suppliers in delivering services for long-term
early on in the course of treatment.                                           conditions. We also launched a pilot programme with Guy’s and
                                                                               St Thomas Foundation Trust and King’s College to provide support
                                                                               to up to 600 people who’ve survived breast and prostate cancer.
                                                                               The service is helping people who’ve come through acute treatment
                                                                               to manage their health in the survivorship stage of care.
                                                                                                                               23      Attracting Debate
                                                                                                                                       Pfizer UK Stakeholder Report 2009
                                                                                                                                       Patients
                                                                                                                                       Patient Advocacy Groups
                                                                                                                               k       Community Healthcare Professionals
                                                                                                                                       Hospital Healthcare Professionals
                                                                                                                                       Pharmacists
                                                                                                                                       NGOs
                                                                                                                                       Our People
                                                                                                                                       Government
                                                                                                                                       HTA Bodies
                                                                                                                                       Think Tanks



24%                                                                               THE DIFFERENT TYPES OF COMMUNITY
                                                                                  HEALTHCARE PROFESSIONALS WE
of you said the personal relationship with the
person you know from Pfizer has a big impact                                       SPOKE TO:
on the way you work with us                                                       •
                                                                                  •
                                                                                      GP
                                                                                      Professional Executive Committee (PEC) Chair
We know that the person you work with day-to-day has a big influence on how        •   Head of Medicines Management
                                                                                  •   Commissioning Manager
effectively we work together. Hospital healthcare professionals said the same.    •   Director of Strategic Commissioning
                                                                                  •   Director of Public Health
     For more information this, please see the Hospital Healthcare                •   Director of Nursing
     Professionals section on page 27.                                            •   Chief Executive
                                                                                  •   Board Member
                                                                                  •   Assistant Chief Executive


20%
                                                                                  •   Practice Manager
                                                                                  •   Practice Nurse
                                                                                  •   Business Manager
of you made negative comments about our                                           •   Pharmaceutical Adviser
                                                                                  •   Communications Director
marketing practices                                                               •   Assistant Director of Primary Care
                                                                                  •   Director of Nursing
We know that the traditional marketing model, whereby a large team                •   Service Development Manager
of representatives was responsible for visiting healthcare professionals          •   Head of Service User and Carer Involvement
to talk about our medicines, is no longer the most effective way to market        •   Nurse Practitioner
our medicines and we have changed it. We’ve also heard that a number              •   Practice Based Commissioning (PBC) Cluster Manager
of you feel we send you too many marketing materials and, as a result
of Attracting Debate, we are reviewing the amount of materials we
send. A lot of you made comments about our promotional activities.
The regulations we face under the industry Code of Practice and the law
are very strict and we are absolutely barred from making any payment
intended to incentivise someone to use their powers of office in
our favour.
We may not pass gifts, benefits or money to healthcare professionals
as an incentive to prescribe, supply, administer, recommend, buy or sell
                                                                                                                              “The NHS
prescription medicines. We can, and do, give healthcare professionals                                                      needs support
promotional aids. An aid must cost less than £6 and must be valued at
this price by the recipient. Promotional aids must be useful and relevant                                                   from pharma
to the healthcare professional when at work and can include, for example,
stationery, surgical gloves, tongue depressors and peak flow meters.                                                        but intentions
When we hold or sponsor educational meetings for healthcare
professionals, hospitality must always be for the purposes of subsistence                                                  must be clear.”
and may not be above the level recipients would likely spend on                                                                       Assistant Director
themselves. It must be secondary to the main purpose of the event.                                                                     of Primary Care
We may not extend that hospitality to anyone attending who has not
been invited or is not qualified to be at the meeting. The venues we use
must be appropriate to the main purpose of the meeting; lavish, deluxe
or extravagant venues are not permitted and neither are those renowned
for their entertainment facilities.
Some of you told us that you don’t feel we have done enough to explain
these regulatory restrictions to you. We hope this explanation of what
is and isn’t allowed has made them clearer and we will be following this
up with a guide to what the various regulations we face mean in practice
when it comes to working with you. These include the Medicines Act
and the US Foreign Corrupt Practices Act as well as the Association
of the British Pharmaceutical Industry (ABPI) Code. We know that, at
times, you find the paperwork that is involved with these rules a little
time-consuming and frustrating but we honestly believe that these new
                                                                                 WE WILL...
levels of openness about what we do are good for the industry and for            We will continue to work with a wide range of people in the NHS to
the people we work with.                                                         understand the types of support services that would be most useful
                                                                                 to them and to develop new ways to work together. We will get better
                                                                                 at explaining the regulations we have to work within and will be
                                                                                 clearer about why certain practices have changed. In 2009 we plan
                                                                                 to disclose full details of the payments we make to clinicians for their
                                                                                 time and expertise.
24 AttractingStakeholder Report 2009
   Pfizer UK
              Debate




HOSPITAL
HEALTHCARE
PROFESSIONALS




                                       KEEPING UP WITH
                                       THE MOMENTUM
                                       OF CHANGE
                                                                                                 25     Attracting Debate
                                                                                                        Pfizer UK Stakeholder Report 2009
                                                                                                        Patients
                                                                                                        Patient Advocacy Groups
                                                                                                        Community Healthcare Professionals
                                                                                                  k     Hospital Healthcare Professionals
                                                                                                        Pharmacists
                                                                                                        NGOs
                                                                                                        Our People
                                                                                                        Government
                                                                                                        HTA Bodies
                                                                                                        Think Tanks



WHAT WE DO                                                            WHAT YOU
AND WHY...                                                            TOLD US…
We have regular conversations with hospital consultants,
hospital managers, senior nurses and clinical pharmacists
                                                                       THE ISSUES MOST IMPORTANT TO YOU
in order to ensure they have up-to-date information
about our medicines, the clinical data they need and an
understanding of where our medicines best fit in patients’
                                                                      50%
                                                                      of you raised openness about what we do as
treatment courses. They also need to know what our                    an important issue to you
medicines cost so that they can plan their budgets

                                                                      38%
effectively. We work hard to understand the connections
between what happens in the hospital and what happens
in Primary Care Trusts and healthcare in the community.               of you said you want us to work with you in
We want to understand the bigger picture so that we can               a way that reflects the new roles people have
make a more meaningful, joined-up contribution across                 in the new NHS
health economies as a whole.

                                                                      33%
                                                                      of you said you would like to see greater
                                                                      transparency in the pricing of our medicines

                                                                      25%
                                                                      of you said the personal relationship with the
                                                                      person you know from Pfizer has a big impact
                                                                      on the way you work with us

                          “Attracting Debate
                             is an honest
                                                                      86%
                                                                      of you said that you thought we are prepared
                          self-assessment.”                           to listen…
                                Consultant

    “You need to offer
   doctors something
                                                                      57%
                                                                      believe we are prepared to change
   that helps them do
    their jobs better.”
      Medical Director




                                                                                                   “You hold a huge amount
                                                                                                     of information that as
                                                                                                commissioners we would find
                                                                                             extremely useful – drug expenditure
                                                                                                  trends, targeting of certain
                                                                                              diseases, the priority of spend by
                                                                                             providers. Some of this information
                                                                                                is not available anywhere else
                                                                                                          in the NHS.”
                                            “You want to ask
                                                                                                         Commissioner
                                          someone about price
                                         and they say they can’t
                                         answer the question.”
                                             Pharmaceutical Adviser
26     Attracting Debate
       Pfizer UK Stakeholder Report 2009




WE HAVE...
                                                                                We can see that the relationship between what happens in primary
                                                                                care and secondary care is changing but what hasn’t changed is the
                                                                                fundamental impact each has on the other. We’ve introduced a number

50%
                                                                                of new programmes to help make better connections between the two.
                                                                                In 2008, we organised Case Notes Reviews for the treatment of patients
                                                                                with diabetes, pain and COPD (Chronic Obstructive Pulmonary Disease).
of you raised openness about what we do as                                      Typically, this means that hospital specialists visit GP practices to review
an important issue to you                                                       challenging cases and discuss referral criteria according to local protocols.
As we’ve described already, we’ve become much more open about                   This is a non-promotional activity – we do not attend the meetings,
our clinical trials, about the medicines we are developing and about            we supply supporting documentation and organise the logistics. It’s a
our relationships with patient groups.                                          simple approach but it has proved successful at helping GPs and hospital
                                                                                doctors work more closely together. Through our Business Approaches
     You can find details of how to get all this information on                  to Clinical Improvement series of support programmes we have also assisted
     pages 7, 13 and 19.                                                        providers in primary and secondary care in evaluating and promoting their
                                                                                services to commissioners, GPs and to patients. These programmes have
                                                                                been successful and we want to run more of them.
One area you particularly wanted to know more about was our clinical
trials. We provide information about all of our trials and about our pipeline
and we update it every quarter.
                                                                                33%
     You can read more about this on page 7.                                    of you said you would like to see greater
                                                                                transparency in the pricing of our medicines
                                                                                We’ve had a lot of feedback from Attracting Debate that we aren’t good
We’ve also made some changes in the way in which we structure                   enough at explaining the research and development process and why
our agreements with you when we work with you so that the benefits               our medicines cost what they do. We’ve given much more information
to all the respective parties are much clearer. We’re not pretending            about the time it takes to develop a medicine, the money that needs to
that there is no benefit to us in working with you – quite the opposite –        be invested, the regulatory stages we have to go through and the risks
but these partnerships also have very tangible benefits for patients             we face at each stage of this process on pages 6 to 9. However, we know
and the NHS.                                                                    that, despite the heavy investment involved in developing new medicines,
                                                                                many of you still think we charge too much for them.

38%                                                                             New medicines are expensive because we have only a limited period
                                                                                of time to earn enough profit to pay back the cost of development.
of you said you want us to work with you in                                     Profit from medicines also needs to pay for the costs of developing the
a way that reflects the new roles people have                                    many compounds which – although a necessary part of the research
in the new NHS                                                                  process – do not make it to market. We are granted patents for innovative
                                                                                medicines which provide us a temporary period of exclusive rights to sell
You told us that the NHS is changing fast and that you don’t think we
                                                                                the product at a price that is acceptable to payers – usually government –
understand that people working in the NHS have new and different
                                                                                in a particular country. This does not mean that we are able to charge
responsibilities. Some of you said that we focus too much on meeting
                                                                                what we like. We are regulated in the UK by the Pharmaceutical Pricing
prescribers in primary care and not enough on talking to decision-makers
                                                                                Regulation Scheme (PPRS) which limits the amount of profit we are able
in Strategic Health Authorities and Foundation Trusts. Yet you also told
                                                                                to make. Health technology assessment (HTA) bodies such as the National
us that you didn’t want us to focus more on you if that meant a visit to
                                                                                Institute for health and Clinical Excellence (NICE) also have an increasingly
promote our medicines. You want us to work with you in a way that
                                                                                important role. Many UK patients are unable to access new medicines
supports you, helps you do your job and helps you think long term about
                                                                                unless NICE has deemed the prices we charge cost-effective.
healthcare provision. You said you want us to show that we understand
the dynamics of the healthcare market and to show that we are thinking          Once our exclusive rights to sell the medicine expire, the blueprint for the
long term too. You want us to recognise who holds budgets and who               compound formula is freely available for any company to copy and sell at
makes decisions. We absolutely do understand that the NHS is changing           a cheaper price. It is this competition between manufacturers that means
and experience this first hand every day. The changes we are making              older medicines are far cheaper than they were when patent protected.
to the way we work are continual and are in direct response to the fact         The reason we can buy, for instance, a pack of Aspirin from a UK
that our customers want and need a different relationship with us.              supermarket for around 30 pence is that the costs of development
We have made substantial changes to the way our field force is organised,        have long since been paid and many different manufacturers are able
both in terms of the number of sales representatives and the number             to compete with one another to produce the product at the lowest cost.
of visits they make. During the last four years, we have introduced new
specialist roles.
                                                                                                                         27      Attracting Debate
                                                                                                                                 Pfizer UK Stakeholder Report 2009
                                                                                                                                 Patients
                                                                                                                                 Patient Advocacy Groups
                                                                                                                                 Community Healthcare Professionals
                                                                                                                         k       Hospital Healthcare Professionals
                                                                                                                                 Pharmacists
                                                                                                                                 NGOs
                                                                                                                                 Our People
                                                                                                                                 Government
                                                                                                                                 HTA Bodies
                                                                                                                                 Think Tanks

Recent trends in science and medicine have led to a steep decline in
the number of so-called blockbuster drugs – the sort that can be used            THE DIFFERENT TYPES OF HOSPITAL
to treat diseases affecting huge numbers of patients. As our scientific           HEALTHCARE PROFESSIONALS WE
understanding improves we are increasingly able to target new medicines          SPOKE TO
to specific variants of disease and to more defined patient populations.
                                                                                 •   Specialist Consultant
This may mean we will have more effective medicines with fewer side
                                                                                 •   NHS Manager
effects – but for a smaller group of patients than would have been treated       •   Chief Executive Officer (CEO)
with the sort of medicines we developed in previous decades. Although            •   Audit Manager
some newer medicines are designed for fewer patients, the development            •   Clinical Effectiveness Adviser
costs for industry are the same – if not higher. As a result, we have to         •   Specialist Nurse
                                                                                 •   Commissioning Manager
spread the costs over fewer people which means, in some cases, individual        •   Pharmaceutical Adviser
prices seem higher than they used to be.
Observing these trends, alongside the often cited issue of demographic
change, has led a number of commentators to question society’s ability
to pay for the medicines of the future. In reality, in developed economies
such as the UK, the growth of Government spending on medicines is not
as fast as many believe. To a large degree this is due to substantial savings
that accrue to governments from therapy areas that are dominated by
older medicines where prices are falling quickly. We understand that,
particularly in the current economic climate, governments need to
be careful about how they spend their money. It is our responsibility to do                                             “Actions speak
everything we can to demonstrate what value patients will derive from
the medicines we bring to market and to give confidence that the prices                                                louder than words
we charge represent value for money.
                                                                                                                        and I’m hearing
The pharmaceutical industry in the UK has recently reached agreement
with Government on a landmark change to the way medicines are priced.                                                  the right thing.”
We have developed with the Government a system of flexible pricing                                                            Pharmaceutical Adviser
which – unlike today – will allow prices to go up or down depending
on the latest evidence on the effectiveness of the treatment. NICE and
other HTA bodies will have an important role to play in ensuring that
any changes to price offer value for money to the taxpayer. In addition,
the new deal provides a more structured way of managing patient access
schemes, such as ‘risk share’ arrangements. The new patient access
schemes are designed to achieve maximum patient access whilst
minimising administrative burden on the NHS. We hope and expect that
this new value-based approach to pricing in the UK will lead to greater
access to the latest medicines for patients and should go some way
towards addressing some of the concerns you have raised.


25%
of you said the personal relationship with the
person you know from Pfizer has a big impact
on the way you work with us
                                                                                WE WILL...
                                                                                The two big points of feedback we’ve had from you are that you want
Personal relationships are important to us too. We know it is important         us to be more transparent and that you want us to work with you in
to maintain continuity in our relationships with all our customers because      ways that show we understand what you need. Throughout this report,
it takes time to build up strong business relationships and good mutual         we’ve highlighted many areas where we’ve become much more transparent,
understanding. Keeping this level of continuity is a challenge for any          and it is something we are genuinely committed to. It’s what Attracting
large organisation but this has been particularly difficult for us to achieve    Debate is all about and we will be continuing to ask our customers to
while we have been remodelling our field force. However, we think we             talk to us very candidly during 2009. We’ll also be continuing to develop
now have a model of working which is much better suited to your needs           our understanding of how we should best work with you in the future in
and the new specialist roles will, we hope, help us develop new and better      the new NHS. Trading Workplaces is one example. It’s a new programme
ways of working with you in the future.                                         for 2009 organising job swaps between Pfizer and the NHS. The aim
                                                                                is that colleagues from both parties will gain new skills and expertise
                                                                                from working in a different organisation for a period of time. From our
                                                                                perspective, working in this way can give us a much deeper understanding
                                                                                of your strategic objectives, the pressures you face and the types
                                                                                of support service you, our customers, would really value in future.
                                                                                Six Pfizer employees are participating in job swaps with NHS colleagues
                                                                                during 2009.
28 AttractingStakeholder Report 2009
   Pfizer UK
              Debate




PHARMACISTS




INCREASINGLY
MULTI-FACETED
                                                                                        29   Attracting Debate
                                                                                             Pfizer UK Stakeholder Report 2009
                                                                                             Patients
                                                                                             Patient Advocacy Groups
                                                                                             Community Healthcare Professionals
                                                                                             Hospital Healthcare Professionals
                                                                                         k   Pharmacists
                                                                                             NGOs
                                                                                             Our People
                                                                                             Government
                                                                                             HTA Bodies
                                                                                             Think Tanks



WHAT WE DO                                                    WHAT YOU
AND WHY...                                                    TOLD US…
We supply our medicines direct to pharmacists and they
dispense them to patients. We put this system in place
                                                               THE ISSUES MOST IMPORTANT TO YOU
because we wanted more control of our supply chain and
because we felt that there were too many vulnerable points
in the old supply chain where counterfeit medicines posed
                                                              74%
                                                              of you told us you were unhappy with the changes
a real risk. We can now track our medicines from our          we have made to our supply chain
manufacturing centres right through to when they reach

                                                              68%
the pharmacist. We also manage stock shortages better,
and should it be necessary to trace and recall Pfizer
medicines, we can respond much more quickly.                  of you said you would like to work more closely
There’s a strong commercial reason for us to know what        with us in different ways in the future
pharmacists are prescribing, but pharmacists also have
a very good understanding of changes in the needs
of their local patient populations and it is important for
                                                              68%
us to understand these wider trends in patient needs.
                                                              of you also told us you would value support
                                                              to help you fulfil the new requirements of the
Pharmacists vary enormously in terms of the specific jobs      Pharmacy Contract
they do. We spoke to independent community pharmacists,
pharmacists working for regional and national chains and
pharmacists based in supermarkets. We also spoke to           32%
hospital pharmacists, pharmaceutical advisers and research    of you asked us to make changes to the packaging
pharmacists. The one consistent thing is that their role is   of our medicines
growing, and we think this evolving role is opening up new
ways for us to work together.
                                                              90%
                                                              of you said that you thought we are prepared
                                                              to listen…

                                                              60%
                                                              believe we are prepared to change




        “Attracting Debate
          has made me
        think that maybe
         you have a heart
             after all.”
                     Pharmacist
30   Attracting Debate
     Pfizer UK Stakeholder Report 2009




WE HAVE...                                                      74%
                                                                of you told us you were unhappy with the changes
                                                                we have made to our supply chain
                                                                You have told us very clearly that you don’t like our new direct-to-pharmacy
                                                                (DTP) supply arrangements; in fact, some of you refused to get involved
                                                                in Attracting Debate because you were so unhappy with the new system.
                                                                We understand that few people react well to changes that are imposed
                                                                on them. We absolutely need to take on board your feedback that we
                                                                didn’t communicate the change as effectively as you expected us to.
                                                                We didn’t communicate the benefits of the change to your patients as
                                                                effectively as our critics put across the messages about potential harm
                                                                to pharmacy. We made the change because we needed tighter control
                                                                of our supply chain to minimise stock shortages for your patients, and
                                                                to prevent counterfeits getting onto your shelves.
                                                                At a logistical level, we have to say that it is working very well; we regularly
                                                                achieve over 99% service levels in our medicines supply arrangements
                                                                with pharmacies. Despite many of you not being happy about the
                                                                changes initially, we have been encouraged by the fact that a lot of
                                                                the pharmacists we spoke to during Attracting Debate said they would
                                                                be interested in any work we could do to support them better in the new
                                                                pharmacy environment.


                                  “DTP caused a                 68%
                                 furore amongst                 of you said you would like to work more closely
                                                                with us in different ways in the future
                                  pharmacists.”
                                             LPC Co-ordinator
                                                                68%
                                                                of you also told us you would value support
                                                                to help you fulfil the new requirements of the
                                                                Pharmacy Contract
                                                                The Government’s Pharmacy Contract in England and Wales and the
                                                                modernisation of pharmacy services in Scotland and Northern Ireland
                                                                have expanded the role of pharmacists. Some pharmacists now
                                                                prescribe medicines as well as dispense them and there is more emphasis
    “You have been                                              on consultation with the patient in the pharmacy. The Pharmacy White
                                                                Paper and the Darzi Review have pointed to a growing role for community
slow at coming up with                                          pharmacists as a primary point of contact both for patients with minor
                                                                ailments and for those with long-term medical conditions. You told us
   new ways to work                                             that you see us as a partner who could help you deliver the services you
                                                                need to develop.
  with pharmacists.”                                            We have created a new integrated support initiative for pharmacists
              Pharmacy Owner and LPC Chair                      called ‘a healthy partnership’TM and, through this initiative, are offering
                                                                pharmacists a series of training courses in the skills needed to deliver
                                                                these new services to patients. For example, we are offering specially
                                                                designed courses for pharmacists in England and Wales who are now
                                                                required to conduct Medicines Use Reviews (MURs) with patients to
                                                                help them better manage their courses of treatment.
                                                                                                                      31      Attracting Debate
                                                                                                                              Pfizer UK Stakeholder Report 2009
                                                                                                                              Patients
                                                                                                                              Patient Advocacy Groups
                                                                                                                              Community Healthcare Professionals
                                                                                                                              Hospital Healthcare Professionals
                                                                                                                      k       Pharmacists
                                                                                                                              NGOs
                                                                                                                              Our People
                                                                                                                              Government
                                                                                                                              HTA Bodies
                                                                                                                              Think Tanks



32%
of you asked us to make changes to the packaging
of our medicines
The feedback we have had from you is corroborated by National Patient
Safety Agency (NPSA) data which shows that one-third of the 59,000
medication incidents reported between January 2005 and June 2007
were caused by confusion over packaging and labelling. Since Attracting
Debate, we have conducted specific research with pharmacists to find out
exactly what changes to our packaging they would like to see and, as a
result, we have started to redesign our medicine packaging in the UK. The
new designs aim to help both pharmacists and patients identify individual
medicines more easily and we have tested them with patients. The new
packaging includes various colours to differentiate between our medicines
and between different doses. The packaging was designed in line with
                                                                                                          “Your packaging
MHRA (Medicines and Healthcare products Regulatory Agency) and NPSA
(National Patient Safety Agency) best practice guidelines. Every medicine
                                                                                                           is clogging up
pack will be securely sealed. To help pharmacists and patients ensure
a medicine is not a counterfeit, we’ve used the same technology used
                                                                                                         my shelves. It’s so
to protect banknotes worldwide from counterfeiting. This security                                        big I can’t fit more
device takes the form of a two-colour Pfizer logo on the medicine pack.
The new packaging is part of our new programme, ‘a healthy
                                                                                                         than three boxes
partnership’TM, to support pharmacists in ensuring patients understand
their medicines and manage their health well. The first new packs will
                                                                                                           on the shelf.”
                                                                                                                    Independent Pharmacist
be in circulation from the beginning of 2009 and all Pfizer medicines
in the UK will have new packaging within the next two to three years.
Some of you also criticised the patient information leaflet (PIL) we put
in our packs of medicines. You told us that these leaflets fail to put side
effects in the context of benefit and that they are not an effective way
to communicate with patients because of the technical way in which
they are written.

     We have done a lot of work to improve the patient information
     leaflets in all our medicine packs and you can read more about
     that on page 19.




                                                                             WE WILL...
                                                                             We will pledge to support community pharmacists in their professional
                                                                             and commercial development through our support programme, ‘a healthy
                                                                             partnership’TM. We will be offering pharmacists a range of training courses.
                                                                             We know that the role of the pharmacist is evolving and, at the same time
                                                                             we recognise that many pharmacists run their own business so we will
                                                                             be offering training on a range of topics. We are starting with a training
                                                                             course on patient counselling skills but plan to expand this during 2009
       “Pfizer can contribute                                                 to offer training in other skills. We’ll also be rolling out a range of patient
     to patient compliance by                                                information services to help pharmacists help patients understand their
                                                                             conditions and their medicines. The Simple Facts About Your Medicine
       making blister packs                                                  booklet which we described in the patient section is just the first in a
    easier to open and making                                                programme of work we are planning. For more information about this,
   packages for different doses                                              please see page 12. We’ve carried out a lot of research amongst
      more distinguishable.”                                                 pharmacists and have made a significant investment in getting the
                                                                             ‘healthy partnership’TM programme right, and we hope it signals a
               Independent Pharmacist
                                                                             new, more collaborative way of working with pharmacists in the future.
                                                                             We’ve set up a dedicated pharmacy team within Pfizer who will be
                                                                             responsible for continuing to consult pharmacists about the support they
                                                                             need and will give them regular information about Pfizer programmes.
32   Attracting Debate
     Pfizer UK Stakeholder Report 2009




NGOs




PUTTING ISSUES
INTO FOCUS
                                                                                          33       Attracting Debate
                                                                                                   Pfizer UK Stakeholder Report 2009
                                                                                                   Patients
                                                                                                   Patient Advocacy Groups
                                                                                                   Community Healthcare Professionals
                                                                                                   Hospital Healthcare Professionals
                                                                                                   Pharmacists
                                                                                           k       NGOs
                                                                                                   Our People
                                                                                                   Government
                                                                                                   HTA Bodies
                                                                                                   Think Tanks



WHAT WE DO                                                     WHAT YOU
AND WHY...                                                     TOLD US…
A large number of non-governmental organisations
(NGOs) are headquartered in the UK and many of them
                                                                THE ISSUES MOST IMPORTANT TO YOU
are concerned about healthcare and related issues.
We support some of these organisations through the
Pfizer UK Foundation, which provides financial support to
                                                               35%
                                                               of you told us you would be interested in working
community groups working to help people who experience         with us in partnership in the future
health inequalities in this country. However, a large number

                                                               29%
of NGOs based in the UK have a global remit and, very often,
global influence. Many are concerned with issues relating
to access to medicines in the developing world which is,       of you said you cared most about access
of course, a subject central to our work.                      to medicines in the developing world
We haven’t had ongoing conversations with all of these
NGOs about these issues in the past. This has sometimes
been because these conversations have been held with
                                                               24%
                                                               of you told us you want to see a shift away from
our colleagues in our global headquarters, but sometimes
it has been because NGOs haven’t wanted to talk to us.         philanthropy to more integrated approaches to
Since Attracting Debate began last year, we have had           health in the developing world
conversations with some NGOs we hadn’t spoken regularly
to before. We’ve been really pleased about this and hope
that it marks the beginning of a new, very open way of
                                                               24%
                                                               of you told us you want to see more openness
talking to each other. 82% of the NGOs we spoke to said
that Attracting Debate has improved their perception of
                                                               and transparency
our company, but the most important thing is that so many
people said they are interested in working with us more
closely in the future.
                                                               100%
                                                               of you said that you thought we are prepared
                                                               to listen…

                            “Face-to-face
                                                               33%
                                                               believe we are prepared to change
                            consultations
                            are essential.”
                            Partnership Manager, NGO




     “I wouldn’t like
   this to be a one-off
 conversation. Let’s keep
   the debate going!”
                                                                               “We are interested
       Director, NGO                                                            in moving beyond
                                                                                  a philanthropy
                                                                              approach and looking
                                                                                 for a constructive
                                                                                   partnership.”
                                                                                         Head of Health, NGO
34     Attracting Debate
       Pfizer UK Stakeholder Report 2009




WE HAVE...
                                                                              In 2006, we announced a new collaboration with the Special Programme
                                                                              for Research and Training in Tropical Diseases of the World Health
                                                                              Organization (WHO/TDR). This is part of a new effort to link our research

35%
                                                                              resources as a major pharmaceutical company to a global network
                                                                              of discovery research. We hope it will speed up the search for new
                                                                              drugs to combat some of the world’s most deadly parasitic diseases,
of you told us you would be interested in working                             including malaria, leishmaniasis, African trypanosomiasis, onchocerciasis,
with us in partnership in the future                                          schistosomiasis and Chagas disease. As part of this collaboration,
All of the work we do with NGOs is based on the principles of partnership     we opened up our library of medicinal compounds and invited scientists
and we are always looking for new ways to work together. We have              from developing countries to our laboratories for training in drug
recently become involved in two new types of partnership with NGOs.           discovery techniques and state-of-the-art tools. Under the arrangement,
                                                                              scientists in institutes affiliated with the WHO/TDR-sponsored Compound
Mentori is a new mentoring programme that uses technology to allow            Evaluation Network are testing thousands of compounds from the Pfizer
people to use their skills to support people in the developing world          library. In a process called screening, the researchers are seeking to
countries by mentoring them from their desk. They are sponsored by            identify hits – compounds that show initial activity against a range of
their employer to volunteer their time for an average of an hour a week       tropical parasites. Following training, scientists return to their home
(which adds up to five or six days each year) for a minimum of one year.       countries to deploy their new knowledge and skills. We are exploring ways
The aim is to overcome the constraints of geography, cost and time and        in which the collaboration with WHO/TDR might be expanded to further
enable people to volunteer over a longer period of time. We have recently     aid the search for drugs with the potential to treat tropical diseases.
arranged for Pfizer colleagues to act as mentors to staff working for

                                                                              29%
Merlin – a UK charity which provides vital healthcare and medical relief
for vulnerable people caught up in natural disasters, conflict, disease and
health system collapse. To date, Merlin has worked in 39 countries
and responded to some of the most serious humanitarian emergencies
                                                                              of you said you cared most about access
of recent years. These include the Rwandan genocide, Hurricane Mitch,         to medicines in the developing world
the 2003 Iraq War, the 2004 Indian Ocean tsunami, the Darfur crisis,
and the Myanmar cyclone.
As a medical aid charity, Merlin procures pharmaceutical products from
                                                                              24%
suppliers around the world and it is very important that they can be sure
                                                                              of you told us you want to see a shift away from
of the quality of their supply chain. We are working with Merlin to provide   philanthropy to more integrated approaches to
its in-country logistical staff with tools and expertise to help them         health in the developing world
undertake difficult procurement decisions about medicines and medical
                                                                              We agree that philanthropy alone is not a sustainable solution to the
supplies. The Pfizer Mentor will work alongside Merlin’s logistics teams
                                                                              many issues faced by developing world countries. Medicines need
to develop a selection methodology to enable logisticians who don’t
                                                                              to be affordable to patients in these regions and, at the same time,
have pharmaceutical knowledge to establish whether items they are
                                                                              public health infrastructures need to be strengthened so that those
looking to procure are bona fide, high quality products. This will be used
                                                                              medicines can actually be delivered to the people who need them.
by in-country staff as a guide to purchasing medicines locally where
                                                                              These types of solutions can only be found by working with the people
international importation is difficult. The mentors will train staff on how
                                                                              who know most about local regions, local systems and local needs.
to use the methodology and, beyond that, will continue to provide advice
                                                                              Donated medicines can, of course, play an important role when they
and support to people on the ground. The new methodology will take
                                                                              are distributed by expert organisations who understand local health
into account WHO International Standards of Good Manufacturing
                                                                              and government infrastructures and when they are combined with
Practices & Good Distribution Practices, conformity to British (or other)
                                                                              wider health programmes.
Pharmacopoeia standards, and other applicable ISO standards.
                                                                              Since 2007, we have made regular donations to International Health
                                                                              Partners (IHP) who among other activities, make up Doctors’ Travel
                                                                              Packs of essential medicines which are used by medical teams working
                                                                              in regions most at need. Thanks to IHP our medicines have reached
                                                                              North Korea, The Gambia, Ethiopia, Myanmar, Nepal, Uganda, Liberia and
                                                                              the Democratic Republic of Congo to provide emergency medical supplies
                                                                              to charitable hospitals and health service providers. In addition to
                                                                              donating medicines for these packs, we have become a Foundation
                                                                              Partner of IHP which involves providing financial support for some of the
                                                                              core operating costs of the organisation. To date, we have provided more
                                                                              than 500,000 treatments to IHP, valued at approximately £8.5 million
                                                                              in UK wholesale prices.
                                                                                                                     35      Attracting Debate
                                                                                                                             Pfizer UK Stakeholder Report 2009
                                                                                                                             Patients
                                                                                                                             Patient Advocacy Groups
                                                                                                                             Community Healthcare Professionals
                                                                                                                             Hospital Healthcare Professionals
                                                                                                                             Pharmacists
                                                                                                                      k      NGOs
                                                                                                                             Our People
                                                                                                                             Government
                                                                                                                             HTA Bodies
                                                                                                                             Think Tanks

At a global level, we have established a number of public-private
partnerships which combine the donation of appropriate medicines               PFIZER INVESTMENTS
with capacity building and public health education programmes aimed            IN HEALTH
at halting the spread of preventable diseases. These include training for
                                                                               Pfizer Investments in Health is Pfizer’s coordinated approach
healthcare workers in diagnosis and treatment, alongside information
                                                                               to philanthropy. It focuses on improving and delivering quality
for patients on how to live healthier lives. These programmes all form part
                                                                               healthcare in a long term and sustainable way to people in need
of Pfizer Investments in Health, a coordinated approach to philanthropy.
                                                                               around the world. It uses four key strategies to contribute the full
Its focus is to improve and deliver quality healthcare in a long term and
                                                                               range of Pfizer’s resources (people, skills, expertise and funding)
sustainable way. It uses four key strategies to maximise the contribution
                                                                               to improving healthcare worldwide. The four strategies are Treat,
of Pfizer’s full range of resources – people, skills, expertise and funding.
                                                                               Teach, Build and Serve:
A recent Pfizer Investments in Health programme is ‘Mobilize Against            Treat: focuses on improving patient access to medicines and
Malaria’, which aims to close critical gaps in malaria treatment and           healthcare services
education in sub-Saharan Africa. The programme was set up in
partnership with international and local experts to evaluate what works        Teach: works with providers and communities to expand healthcare
most effectively on the ground and to share findings and best practice          worker training and patient education on disease prevention and
with other organisations working to alleviate the malaria epidemic.            treatment options
We are working with key international and local health experts to develop      Build: strengthens the organisational capacity of health partners
public health interventions that engage and educate treatment providers        to support prevention, diagnosis, treatment and care
and patients in high-risk areas. This three-country initiative is focused      Serve: advocates and shares best practice in the public health
on Kenya, Ghana and Senegal and is being implemented over the course           community to improve healthcare for the underserved.
of five years. In Ghana, we are working in partnership with Family Health
International and the Ghana Social Marketing Foundation to train the
informal sector of Licensed Chemical Sellers in selected districts to          Two Pfizer Investments in Health programmes:
promote effective malaria symptom recognition, proper treatment and             INFECTIOUS DISEASES INSTITUTE (IDI)
the referral of acute cases. In Senegal, Intrahealth is training community
health workers and nurses serving in the Tambacounda Region. In Kenya,         In 2001, Pfizer formed a partnership with a number of organisations,
we are working with Population Services International (PSI) to promote         including the Accordia Global Health Foundation, Makere University,
symptom recognition and treatment-seeking behaviours at the household          the Infectious Diseases Society of America and Pangaea Global AIDS
level, with an emphasis on pregnant women and children under five,              Foundation to establish the Infectious Diseases Institute (IDI) in
using antenatal clinics in western and coastal provinces as an entry point     Uganda. The IDI aims to improve health in Africa by training medical
to these target groups. To lead the overall initiative and coordinate global   professionals, providing them with skills and resources that they can
monitoring and evaluation of the different programmes, the London              use in their communities to deliver sustainable, high quality care for
School of Hygiene and Tropical Medicine is working in partnership with         HIV/AIDs and related infectious diseases. Since 2004 more than 2,900
Pfizer and with local partners to share lessons learned and best practices      healthcare workers from 27 African countries have been trained at the
with other organisations addressing the malaria epidemic.                      IDI, which currently provides care to approximately 9,000 patients
                                                                               each year.
                                                                                INTERNATIONAL TRACHOMA INITIATIVE (ITI)
                                                                               This public-private partnership, which Pfizer helped found and
                                                                               continues to support, is dedicated to eliminating trachoma, the world’s
                                                                               leading cause of preventable blindness. It involves health worker
                                                                               training, patient education and donations of an antibiotic. Since 1998
                                                                               the programme has supported the training of thousands of healthcare
                                      “Philanthropy is                         workers around the world. More than 399,000 surgeries to treat
                                   becoming ‘yesterday’s                       advanced cases of trachoma have been performed. The ITI has given
                                   news’. There is a need                      94 million treatments to trachoma patients in 16 countries as part
                                                                               of the WHO SAFE strategy (Surgery, Antibiotics, Face-Washing and
                                   for you to have a core                      Environmental Improvement). At its most successful, the programme
                                 business involvement with                     has reduced the prevalence of trachoma from over 60% to 7% in some
                                  the developing world.”                       regions of Niger. In 2006, after six years of work, Morocco became
                                               Director, NGO
                                                                               the first country to complete the campaign for trachoma control and
                                                                               is working toward WHO certification that blinding trachoma has been
                                                                               eliminated as a public health problem


     “Attracting Debate
        is certainly a
       leap forward.”
          CEO, NGO
36    Attracting Debate
      Pfizer UK Stakeholder Report 2009




                                                                         We know these sorts of programme play a crucial role but that they
                                                                         cannot, on their own, solve the problems faced by health systems
                                                                         in the developing world. There are four billion people around the
                                                                         world who survive on incomes of less than $3,000 a year and this
                                                                         number is going to grow. The challenge goes beyond philanthropy.
                                                                         It is central to the sustainability of our own business that we find ways
                                                                         to make medicines accessible in these markets. We are working on a
                                                                         Global Access Strategy that calls for the development of a new market
                                                                         category focused on those four billion people at the base of the
                                                                         socio-economic pyramid.
                                                                         The principles of this strategy are to create a commercially viable,
                                                                         socially responsible and sustainable business model for the future.
                                                                         We, of course, need to continue to invest in the research and development
                                                                         of treatments for neglected diseases but we also need to look at broader
                                                                         issues including financing for healthcare in emerging markets and new
                                                                         commercial models for managing our supply chain.
                                                                         We have made an important step forward in our Global Access Strategy
                                                                         by forming a partnership with Grameen Health, an affiliate of Grameen
                                                                         Bank. Grameen is a pioneer in micro-financing – the provision of financial
     “Medicine donations                                                 services to those whose annual income is less than $3,000 – and has
      are not sustainable,                                               already helped to alleviate the poverty cycle in Bangladesh by creating
      you must work with                                                 the infrastructure needed to help millions of people sustain and improve
                                                                         their economic livelihood. Grameen has significant experience in
       other partners to                                                 providing healthcare services and products to patients in poverty.
      make a difference.”                                                The aim of this collaboration is to identify sustainable models for
     Corporate Engagement Manager, NGO                                   healthcare delivery in the developing world. It will evaluate ways
                                                                         to improve Grameen Health’s existing healthcare delivery systems and
                                                                         primary care clinics in rural Bangladesh, identifying ways to expand
                                                                         and improve the current low-cost micro-health delivery and insurance
                                                                         programmes at Grameen Health’s 38 existing Kalyan clinics. As part
                                                                         of our commitment to the collaboration, Pfizer is dedicating key
                                                                         employees to provide technical and advisory support. At the end of
THE MILLENNIUM DEVELOPMENT                                               one year, we hope to identify appropriate business models that can
                                                                         be replicated in other countries and address the health needs of
GOALS AND THE MDG BUSINESS CALL                                          people at the base of the socio-economic pyramid.
TO ACTION DECLARATION
The United Nations’ eight Millennium Development Goals (MDGs) were
agreed in 2000 and set out targets that must be reached by 2015 to
meet the needs of the world's poorest people. In 2007, Gordon Brown
launched the Business Call to Action, a major campaign to accelerate
progress on the MDGs and he called on business to play a pivotal role
in reaching these goals.
The Business Call to Action is not about philanthropy. It challenges
companies to use their core business – whether manufacturing,
finance or telecommunications, for example – in a way that contributes
both to the MDGs and meets their core business objectives. It aims
to inspire companies to realise that reducing poverty also makes
good business sense. By building a safer and more prosperous
world, businesses are securing their own future commercial success.
Over the next five years, initiatives under the Business Call to Action
are expected to save almost half a million lives, create thousands of
                                                                                      “For Pfizer
jobs and benefit millions of poor people across Africa, Asia and Latin               and us to work
America. They are part of a concerted push to meet the MDGs that                   closely, it would
will enable poor people to access up-to-the minute information,                   be necessary to lay
money and business expertise, as well as creating new businesses
and employment opportunities.
                                                                                   down objectives
                                                                                     very clearly.”
In May 2008, Pfizer signed up to the Business Call to Action
                                                                                      Partnership Manager, NGO
Declaration. In doing so, we made a commitment to work alongside
other companies to help meet the MDGs.
                                                                                                                         37       Attracting Debate
                                                                                                                                  Pfizer UK Stakeholder Report 2009
                                                                                                                                  Patients
                                                                                                                                  Patient Advocacy Groups
                                                                                                                                  Community Healthcare Professionals
                                                                                                                                  Hospital Healthcare Professionals
                                                                                                                                  Pharmacists
                                                                                                                          k       NGOs
                                                                                                                                  Our People
                                                                                                                                  Government
                                                                                                                                  HTA Bodies
                                                                                                                                  Think Tanks



24%
of you told us you want to see more openness
and transparency
As we’ve described earlier in this report, we’ve become much more open
about the way we do business and publish information about our pipeline,
                                                                                                            “We hope this is
the clinical trials we are involved in and their results, and the work we do
with patient advocacy groups. You raised transparency about our clinical
                                                                                                           the beginning of a
trials as a particular issue but many of you did not know that we already                                long-term relationship
publish this information. We publish information about every trial we run
involving one of our compounds at www.clinicaltrials.gov. This site will tell                                 with Pfizer.”
you about the purpose of each trial, the eligibility of patients to join it and                                               Director, NGO
the location of the study. The results of all of our clinical trials are also
online at www.clinicalstudyresults.org. You can search this database by
company (sponsor) name, studied condition or generic drug name.
We only sponsor clinical research that follows accepted ethical, scientific
and clinical standards and all our clinical studies are conducted in
accordance with local laws and regulations. We also follow the principles
of the ‘Declaration of Helsinki’, the ‘WHO Guidelines on Good Clinical
Practice’ and the International Conference of Harmonization (ICH)
‘Good Clinical Practices (GCP) Guidelines’. Social and cultural
considerations and legal infrastructures vary from country to country but
our overriding concern is to ensure that participants in any trial anywhere       WE WILL...
in the world are given appropriate protection and that their rights are           The Grameen partnership is only the first of many initiatives in support
respected. We will put in place additional measures over and above                of our Global Access Strategy going forward. The focus of this strategy
local laws where we feel it necessary.                                            is to improve access to healthcare services and medicines through the
Ensuring that the objectives of clinical trials – and the rights and              development of non-conventional socially responsible and commercially
obligations of patients participating in them – are clear and easy to             viable healthcare delivery and financing models. We do not yet know
understand is one of the necessary, ethical prerequisites to obtaining            how these models will work but we know that a key element will be
informed consent from participants. In many parts of the world, however,          considering impoverished people in the developing world as viable
patients and their relatives do not read well enough to understand                customers and not solely recipients of aid and donations. We are
information provided to them to help them decide whether or not to enrol          committed to working with partners, such as Grameen, who have
in a clinical research study. We have recently introduced a new ‘Speaking         significant expertise in developing non-traditional business models in
Book’ programme for patients participating in Pfizer clinical trials in Africa.    the developing world. We are optimistic that these initiatives will have a
This audio book helps explain to people with low levels of literacy what          positive impact in the developing world and contribute to the renewed
research studies involve and what it means to take part in them. It gives         global efforts to move closer towards the fulfilment of the Millennium
a simple overview of clinical trials and explains the rights, roles and           Development Goals.
responsibilities of the patients participating in them. It uses storytelling      During 2009, we will develop our online mentoring scheme for NGOs
as a technique to explain what it means to take part in a clinical trial.         working in the developing world. A number of Pfizer employees will
The book has been translated into several African languages and can be            become mentors for a one year period. Each volunteer will receive
used by patients, social workers and community-based health workers               face-to-face training in coaching and ongoing web-based training and
involved in clinical trials.                                                      support. Mentors will be able to draft in additional support or bring
                                                                                  together project teams from the mentor network.
                                                                                  We have also recently announced the Pfizer Gambia Fund, a multi-
                                                                                  stakeholder partnership project in the Gambian health sector. Our aim
                                                                                  is to create sustainable impact on the ground and, at the same time,
                                                                                  support the development of expertise that we hope can be transferred
                                                                                  to other regions. We’ll be working with International Health Partners
                                                                                  and other partners from the NGO sector, multi-lateral organisations,
                                                                                  academia and government to develop capacity in Gambia for quality
                                                                                  control and quality assurance which will ultimately lead to the supply
                                                                                  of better quality medicines. We are applying new financing mechanisms
                                                                                  which will ensure sustainable medicine procurement in Gambia and
                                                                                  we are investigating how we can improve the medicines supply chain
                                                                                  in the country. The Fund will also provide additional training for Gambian
                                                                                  healthcare professionals in the use of maternal and child specific drugs
                                                                                  and to increase public health education in order to ensure that women
                                                                                  and children are aware of the benefits of proper medical assessment
                                                                                  and treatment.
38   Attracting Debate
     Pfizer UK Stakeholder Report 2009




OUR
PEOPLE




LIVING BY
OUR VALUES
                                                                                                  39   Attracting Debate
                                                                                                       Pfizer UK Stakeholder Report 2009
                                                                                                       Patients
                                                                                                       Patient Advocacy Groups
                                                                                                       Community Healthcare Professionals
                                                                                                       Hospital Healthcare Professionals
                                                                                                       Pharmacists
                                                                                                       NGOs
                                                                                                  k    Our People
                                                                                                       Government
                                                                                                       HTA Bodies
                                                                                                       Think Tanks



WHAT WE DO                                                      WHAT YOU
AND WHY...                                                      TOLD US…
The views of people who work for Pfizer UK are
just as important as the views of our external stakeholders.
                                                                 THE ISSUES MOST IMPORTANT TO YOU
For this reason, all of our colleagues received a copy
of Attracting Debate, with the same invitation to give
feedback as those outside our company. The opinions of
                                                                48%
                                                                of you said developing new and innovative
our colleagues are very important to the way we run our         medicines is one of the issues most important
business and, as a company, we send out surveys and
questionnaires several times each year to assess the way
                                                                to you
we work together and the services we provide our staff.
It has been through colleague feedback that we have shaped
several programmes, including some of our environmental
                                                                40%
                                                                of you placed helping to reduce health inequalities
programmes. Our colleagues have a high awareness of the         in the UK as one of the issues most important
need to protect our environment. Our well established Green
Transport Plan is one of the key ways in which we manage
                                                                to you
the carbon dioxide emissions and traffic congestion
associated with travelling to and from work. All employees
and visitors are incentivised to car-share, walk or cycle to
                                                                29%
                                                                of you said access to medicines in developing
work and we continue to offer a free shuttle-bus service from   countries is one of the issues most important
local train stations. 45% of our employees use this service.    to you
Recycling at our Surrey offices has become part of our

                                                                20%
working life. With the support of our colleagues, we are
currently recycling 70% of our overall waste. What remains
is incinerated and used to generate power, enabling us          of you listed openness about what we do as one
to achieve our target of zero waste to landfill. To align this   of the issues most important to you
with our CO2 reduction objectives, we have worked with
our waste management provider to reduce collections and
deliveries to our site. Waste is now collected on average       83%
three times a month, as compared to the previous three          of colleagues believed we are prepared to listen…
times a week.
Our global target is to reduce Pfizer’s CO2 emissions by         68%
20% by 2012.                                                    felt positive that we will be prepared to change
                                                                as a result of feedback
The issues of highest importance to our colleagues are
closely aligned to the top issues stated by many of our
stakeholders during Attracting Debate.

                                                                                                     “I am proud to
                                                                                                   work for Pfizer and
     “A bold ground-                                                                                feel we make a
    breaking initiative:
     however, the real
                                                                                                  positive contribution
        test is what                                                                                to healthcare.”
      happens next!”                                                “It is very encouraging               Pfizer Employee
       Pfizer Employee                                            to see that Pfizer is listening
                                                                and actively seeking input from
                                                                  all stakeholders and then
                                                                  making informed decisions
                                                                    and making changes.”
                                                                         Pfizer Employee
40     Attracting Debate
       Pfizer UK Stakeholder Report 2009




WE HAVE...
                                                                                Our volunteering programme, Health Relief, encourages employees to
                                                                                volunteer their time and business skills to support local organisations
                                                                                that educate people about health and wellbeing, and assist those affected

48%
                                                                                by poor health and local inequalities. Pfizer encourages its staff to take
                                                                                five paid days every year to volunteer for community-based organisations.
                                                                                Colleagues can either volunteer as an individual or organise a team of
of you said developing new and innovative                                       helpers. They may volunteer for a single day or several days running.
medicines is one of the issues most important                                   Since this targeted volunteering programme was launched, the uptake
to you                                                                          by Pfizer colleagues has increased from 14% to 40%, with 1,194 people
                                                                                volunteering their time to benefit 140 organisations.
As a research-based pharmaceutical company, discovering and developing
new medicines to benefit patients is at the core of our business. 84%            We recognise that Health Relief is not just about building relationships
of you stated that you think we do an ‘excellent’ or ‘good’ job in this area.   and supporting local projects. There is a direct and tangible benefit to our
Quite likely, it is one of the reasons you decided to join Pfizer. You are       colleagues – providing opportunities for personal and team development.
not alone in ranking this issue among the most important and, like other        Several departments have used volunteering projects as an alternative
stakeholders, you told us you want to learn more about the medicines            and challenging approach to team building.
under development in our pipeline and what you can communicate to
those customers with whom you have regular contact. We are more open
than ever before about the medicines we are developing. We have an              29%
online database where you can get up to date information about our              of you said access to medicines in developing
pipeline at www.pfizer.com/pipeline.
                                                                                countries is one of the issues most important
     Please go to page 13 for more information about our pipeline.              to you
                                                                                Along with non-governmental organisations (NGOs), you listed
                                                                                ‘access to medicines in developing countries’ as a top priority.
40%                                                                                  Please turn to page 34 to read more about our work in the
of you placed helping to reduce health inequalities                                  developing world.
in the UK as one of the issues most important
to you
                                                                                As people working in the pharmaceutical sector you know that the
Addressing health inequalities within the UK is an important objective          healthcare challenges faced by developing countries are not limited to
for us. At a practical level, we provide financial and networking support        accessing medicines alone. Other fundamental barriers exist, blocking
to local organisations and charities through the Pfizer UK Foundation.           the flow of adequate healthcare to populations in regions throughout
We also encourage all employees to volunteer with the organisations             the world. Pfizer supports a number of initiatives in the developing world.
and charities that are themselves working on the front-line to reduce           Some of these work to improve patient access to medicines in efforts to
health inequalities in the UK. The Pfizer UK Foundation is in its fourth         target and eradicate specific diseases. Others are programmes to train
year and a large part of its success must be attributed to the efforts          and support healthcare professionals. All are aimed at working with
made by our colleagues in raising awareness of the Foundation among             partners on the ground to find sustainable solutions that meet local
stakeholders and recommending suitable organisations to make                    needs. We know that philanthropic efforts can never be enough on their
an application for funding. During this time, 247 of you have helped            own and we have recently announced a new strategy for managing the
organisations submit their applications. Over half of all successful            way our business responds to the growing health needs of populations
applications have come about as a result of action by employees.                in lower income regions around the world.
     Please go to page 18 for more information about the Pfizer UK                    You can read more about our Global Access Strategy, as well
     Foundation and the projects we have funded recently.                            as our partnership programmes on pages 35 and 36.




         “The recipient charities were
      delighted with the outcomes and
       the volunteers seemed to have
      a real feeling of achievement and
          fun as a team. I think some
      of them may be going back there
          in their own time – magic!”
                  Pfizer Employee
                                                                                                                     41     Attracting Debate
                                                                                                                            Pfizer UK Stakeholder Report 2009
                                                                                                                            Patients
                                                                                                                            Patient Advocacy Groups
                                                                                                                            Community Healthcare Professionals
                                                                                                                            Hospital Healthcare Professionals
                                                                                                                            Pharmacists
                                                                                                                            NGOs
                                                                                                                     k      Our People
                                                                                                                            Government
                                                                                                                            HTA Bodies
                                                                                                                            Think Tanks

Pfizer also runs an initiative to enable employees to make a direct
contribution to improving healthcare in the developing world.
The programme is called Pfizer Global Health Fellows and was launched
in 2003. It calls on our talented, committed and trained employees to work
in Africa, Asia, Eastern Europe and Latin America for three-to-six-month
periods. These Fellows have a range of skills and include physicians,
nurses, epidemiologists, laboratory technicians, marketing managers,
financial administrators, and health educators. During their assignments,
Pfizer employees train and support their local counterparts, transferring
skills so that the important contributions they make are sustained after
they come home. Since 2003, 171 Global Health Fellows have been
selected to work with NGOs in 34 countries to deliver healthcare and
health system support to those in need around the world.
In September 2008, a Pfizer UK employee left for a six-month term in
Tanzania, working for the humanitarian organisation, CARE. She was
tasked with leading an initiative to develop and implement a new project
for community healthcare support, particularly for mothers and daughters                          “The benefits
affected by HIV/AIDS and tuberculosis.
                                                                                                  to us as Pfizer
 “The big issue here, as in many parts of Africa, is HIV/AIDS and its                         employees were huge…
 devastating consequences, alongside TB and Malaria. So, as well
 as helping CARE to understand how they can support the population                              giving something
 in the long term in the best way, I will be aiming to work with the
 government, looking at the policy and infrastructure needed to                               back to the community,
 encourage investment from private individuals and organisations.
 There’s obviously a limit to what I can do in six months, so it’s also                           team building
 about transferring my skills. I’ll be partnering with people in the
 organisation so that they can pick up where I have left off.”
                                                                                                  and bonding.”
                                                                                                                 Pfizer Employee
 Laura, Senior Sales Manager, Pfizer UK




20%
of you listed openness about what we do as one
of the issues most important to you
Openness and transparency in what we do was raised by all our
stakeholders and is an issue that we have covered extensively
throughout this report. 65% of you think we do an ‘excellent’ or
‘good’ job in countering the image of secrecy and closed doors that the
pharmaceutical industry has faced in the past. Through Attracting Debate,
we’ve discovered that many of our stakeholders are unaware of all of the
work we have done to become more open about what we do. It’s a point
that you, our colleagues, have made, that we need to be much better at
talking about what we do. As a competitive company, there is obviously
a need to keep intellectual property guarded. But we are becoming            WE WILL...
much more open about issues that are in our stakeholders’ interests.         We will listen to your views. As Pfizer colleagues, your views are as
Earlier in this report, we covered how we are communicating information      important to us as the views of our external stakeholders. It is great that
about our clinical trials, the medicines in our pipeline and our             so many of you believe that, as a company, we are listening but, in 2009,
relationships with patient advocacy groups.                                  we want to improve on the 68% of colleagues who believed that we
                                                                             are prepared to change. We know from your comments that a lot of you
     You can read more about this on pages 7, 13 and 19.
                                                                             are waiting to see where Attracting Debate takes us and we hope this
                                                                             report has convinced you that we are able to change as an organisation
                                                                             and respond to what people tell us. In 2009, we will make a more formal
                                                                             effort to involve all of our colleagues in Attracting Debate. To achieve
                                                                             this, we need you to get involved. If you weren’t one of the colleagues
                                                                             to respond to Attracting Debate last year, please do so now! If you did
                                                                             tell us what you thought during 2008, please tell us whether this report
                                                                             responds to the feedback you gave us.
42 AttractingStakeholder Report 2009
   Pfizer UK
              Debate




WHO WE’RE
TALKING
TO NEXT…
                                                                                                                     43     Attracting Debate
                                                                                                                            Pfizer UK Stakeholder Report 2009
                                                                                                                            Patients
                                                                                                                            Patient Advocacy Groups
                                                                                                                            Community Healthcare Professionals
                                                                                                                            Hospital Healthcare Professionals
                                                                                                                            Pharmacists
                                                                                                                            NGOs
                                                                                                                            Our People
                                                                                                                     k      Government
                                                                                                                     k      HTA Bodies
                                                                                                                     k      Think Tanks



GOVERNMENT                                                                   HTA BODIES
The National Health Service is the predominant provider of healthcare        There are three national health technology assessment (HTA) bodies
in the UK and the Government is therefore the main customer of our           in the UK: the National Institute of health and Clinical Excellence (NICE),
medicines. We engage with government a great deal, both independently        the Scottish Medicines Consortium (SMC) and the All Wales Medicines
as Pfizer but also together with other pharmaceutical companies,              Strategy Group (AWMSG). A key role of these bodies is to issue guidance
through the collective voice of the Association of the British               on the use of medicines. To do this, they weigh the clinical benefit that
Pharmaceutical Industry (ABPI). Issues of high importance to both            results from using a medicine against the costs to the NHS, in order to
parties, and which are commonly discussed, include managing the              estimate whether the medicine represents a good use of NHS resources.
costs of providing quality healthcare to patients, encouraging science       This is often referred to as a cost-effectiveness assessment.
and innovation in the UK and maintaining the competitiveness of the
                                                                             We have an important role to play in assessments of our medicines and
UK pharmaceutical industry.
                                                                             supply HTA bodies with comprehensive information about their clinical
For a great part of 2008, the pharmaceutical industry was engaged            and economic benefits. In practice, this is an extremely complex task
in a major negotiation with the Government on the Pharmaceutical             and we have a team of expert Pfizer colleagues who are dedicated to this
Price Regulation Scheme (PPRS). This came about as a result of the           work. Our commitment to HTA bodies is to supply them with all the
Government’s decision to terminate the existing agreement two years into     information they need to conduct their assessment.
the previously agreed five-year contract period. We felt that the decision
                                                                             Our relationship with HTA bodies generally, and NICE in particular, is
to end the 2005 PPRS prematurely was not justified. It was a shock to
                                                                             sometimes difficult. While we support the objectives of NICE, we don’t
industry and it challenged our trust in the Government’s willingness to do
                                                                             entirely agree with the methods they use to measure and value the benefit
business with us. It also undermined the stability of the UK as a country
                                                                             of medicines and as a result we have opposed decisions taken on several
in which to invest. The ensuing negotiation has been far-reaching and has
                                                                             of our products in the last few years. We also believe that NICE places too
encompassed many more aspects of our work with government than were
                                                                             much emphasis on these – often crude – cost-effectiveness assessments.
involved in previous PPRS negotiations. We have, more than ever before,
                                                                             While value for money is quite rightly an important consideration for HTA
worked with the Government to find new ways to ensure that alongside
                                                                             bodies, we believe that other factors such as unmet clinical need, the age
delivering value for money for the NHS, we have a system that encourages
                                                                             of the patient and the severity of their disease should be given greater
and rewards innovation. We have collectively developed new flexible ways
                                                                             weight when NICE develop their guidance. We also have concerns about
of pricing medicines, alongside patient access schemes, which will lead
                                                                             some of the processes NICE adopt. For example, we have long
to the improved use of new medicines in the NHS and greater confidence
                                                                             campaigned that NICE should be fully transparent and make available
within the Government that prices are fair.
                                                                             for independent scrutiny their calculations of the cost-effectiveness of
We continued to engage with government on a number of day-to-day             medicines. We are delighted that after a protracted battle through the
business issues in 2008 but the PPRS negotiations have, for some time,       courts, NICE will now make this information routinely available to all
largely dominated the agenda on both sides. In light of this, we decided     appraisal stakeholders. Despite our disagreements, we are committed to
that it would be inappropriate to conduct an extensive Attracting Debate     engaging with HTA bodies. In the past year, we have worked with a range
exercise until the negotiations were complete. 2009 should be a different    of stakeholders on projects that have the potential to significantly improve
story and we are hopeful that we will be able to engage widely with MPs,     the methodologies available to NICE, including quality of life evaluation
Peers and government departments, using Attracting Debate as the basis       and the application of HTA for rare diseases such as metastatic cancer.
for having open and constructive conversations about the wide-reaching
                                                                             Although we have not held many Attracting Debate conversations with
healthcare challenges that are faced in the UK and abroad.
                                                                             HTA stakeholders during 2008, we are committed to doing so during 2009
                                                                             and have identified opportunities to meet with HTA bodies in the coming
                                                                             months. Given the sometimes difficult nature of our relationship with
                                                                             HTA bodies, we believe strongly that the candid conversations that can
                                                                             come from Attracting Debate are more important than ever.
44     Attracting Debate
       Pfizer UK Stakeholder Report 2009




THINK TANKS
Pfizer works with a range of think tanks around the world, and in the
UK we have worked with think tanks on several projects during 2008.
These were initiated by the think tanks and, in general, it was they who
set the agenda. They invite relevant businesses and other stakeholders
to contribute in some way or other to their research which may later
contribute to the deliberations of policymakers. It is important that think
tanks operate independently from all types of industry and government.
Their views are important to decision-making and must be trusted as
impartial and, although industry – Pfizer included – often funds their work,
there is no influence over outcomes and findings.
We are part of a major two-year Health Project led by the Social Market
Foundation (SMF), together with BUPA, Standard Life and the NHS.
The aim of the project is to explore the future of the UK’s health system
in various dimensions, from commissioning to new technology. Several
background papers have already emerged from this study, and these are
made available to the public on the SMF website (www.smf.org.uk).
We are also contributing to the UK Knowledge Nomads study carried out
by DEMOS, a leading think tank and research institute in science and
technology as well as public services, cities and public space, arts and
culture, identity and global security. Pfizer is one of four case studies to
explore how the UK became a ‘magnet for talent’, so that policymakers,
business and academia can understand what inspires or inhibits highly
skilled workers from coming to the UK to work.
In conjunction with the New Statesman, Pfizer runs a programme, which –
similar to the way in which think tanks work – reports on the opinions
of eminent people on key healthcare issues of relevance today.
The programme is called The Pfizer/New Statesman Policy Forum and
is now in its third year. It takes the form of round-table discussions,
chaired and attended by thought leaders from government, media,
industry, academia, patient and consumer groups. Discussions have
ranged from ‘Understanding the Changing Face of Primary Care’ through
to ‘Biotech Britain’. The resulting reports are published as a supplement
to the New Statesman and are available online at www.policyforum.co.uk.
Our goal for 2009 is to discuss Attracting Debate with a range of UK-based
Think Tanks. We are confident they will be interested in taking part, as
organisations interested in gathering data, identifying priorities and
influencing changes to patient care and science innovation. So, in that
regard, what they do and what we want to achieve with Attracting Debate,
has much common ground.
This document is printed on Think4 White




Date of preparation January 2009
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