While the Golden Age of the pharmaceutical industry is over, and its reputation similar to that of the tobacco and oil industries, there is hope at hand – according to former Merck CEO Roy Vagelos.

In a keynote address to the third annual meeting of the International Society for Medical Publication Professionals, Dr Vagelos suggested that a future golden age could be characterised by understanding genetics, producing as a result effective drugs for Alzheimer’s, cancer, etc, and thus re-establishing the pharmaceutical industry’s reputation.

For the present, though, he suggested three areas of concentration. The first has to do with pricing: how do you assess value? Productivity and lifespan factors have to be taken into account. “Most drugs are a terrific bargain,” he said, “but you have to weigh $25,000 a year to treat the once deadly HIV; or $50,000 for a cancer drug that extends life by four months.” The first represents value; the second does not, according to Vagelos.

The second area is in doing good works in the developing world. For example, Merck and other pharmaceutical companies are providing free drugs to combat river blindness and HIV in Africa… and a hepatitis B drug in China . Vagelos acknowledged that while these efforts are made for humane reasons “eventually these countries will be markets for us.”

The former Merck executive then turned to a third issue: the industry’s credibility. Some of this, he said, hinges on how well the company handles, for example, the Vioxx question. “Credibility will be restored as we respond appropriately,” he said. He went on to say that the FDA is undermanned, under resourced, and works with information technology that’s 25 years old, that drugs are coming off patent, and the fact that pharmaceuticals are no longer a growth industry means that clinical studies and manufacturing will both be outsourced.

Touching finally on the current debate over pharmaceutical reps’ access to physicians, Dr Vagelos acknowledged that some approaches might be inappropriate, giving the impression that physicians can be bought with free meals and trinkets. He chaired a meeting of 26 academics and for industry CEOs who came up with the idea of scheduled meetings in which pharmaceutical company scientists would explain drugs to academics and physicians. The committee also suggested training for physicians and for medical students about what drug development is all about.