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GSK CEO Andrew Witty in Wajir, Kenya, during a trip with Save the Children in May 2013.

GSK CEO Andrew Witty in Wajir, Kenya, during a trip with Save the Children in May 2013.

Save the Children/Sven Torfinn

GSK to make cancer drugs more accessible in poor countries

Andrew Witty, who has headed GlaxoSmithKline (GSK) since 2008, recently announced that he would retire in March 2017. But the 51-year-old Witty, a marathon runner who has been with the company for his entire career, has a vision for the pharmaceutical giant that stretches far beyond his tenure. A central tenet is his conviction that big pharmas have to be more in step with the needs of the global society. And his finish line for GSK is to give poor countries faster access to its cancer drugs if they prove effective.

Building off a scheme the company has used for its anti-HIV drugs, GSK announced today that it intends to sign agreements about drugs in its cancer portfolio with the “Medicines Patent Pool,” a U.N.-backed organization that helps generic manufacturers license and produce products. GSK says it also plans to take a more “graduated” approach to filing and enforcing patents for other medicines to encourage generic drug companies to make and supply GSK products now available mainly in developed countries.

Under Witty, GSK has made several moves that may seem unusual for a publicly owned, profit-driven drug company. In an attempt to discourage sales representatives from hyping the value of GSK medicines, the company stopped paying them commissions. Similarly, it no longer pays doctors to give talks to colleagues—which often happened at fancy restaurants—about its products. (GSK in 2012 agreed to pay a $3 billion fine to the U.S. government for unlawfully promoting prescription drugs, but the company says the new policies are unrelated.) A push for more transparency led GSK also to create a database that includes the results of all its clinical trials, regardless of whether the medicines worked or failed.

 Witty spoke with ScienceInsider on 30 March, and with the candor of a CEO who isn’t worried about job security. This is a condensed and edited version of that interview.

Q: Why are you concerned about your future drugs reaching poor countries?

A: We’re trying to streamline and simplify our overall approach with intellectual property (IP) protection around the world and to essentially graduate what we do around IP according to economic maturity of the countries. We don’t think you should treat Malawi the same way as you treat Britain. It ought to be more customized in many dimensions.

With oncology I’m keen to get ahead of where the world got to with HIV 20 years ago. [It took nearly a decade before most poor countries could access anti-HIV drugs proven effective in 1996.] We’re pretty enthusiastic about what we’ve got in oncology; we have a lot of leadership position in epigenetics and immuno-oncology. Whether or not they’re going to make it we have to wait and see, but we’re trying to lay the groundwork.

Q: The big excitement in cancer is immunotherapy, and those products potentially are going to be very expensive. Are you including those?

A: They would be included. They not only are likely to be expensive but they’re going to require pretty sophisticated medical systems and technologies around them. I’m not saying this is going to solve everything. It won’t. Some of these things will just be out of reach in some of these countries. But we are keen to say if there are opportunities for our medicines to be accelerated in terms of access in the developing world, and if the systems are capable of using them, then we want to make sure that’s being done.

Q: Pharmaceutical companies exist to make money. Obviously companies want to be seen in a good light, but you have shareholders. How do you separate making a profit and doing good?

A: You start by trying to do good and do the right thing first, and try to profit maximize second. We’ve all seen examples of lots of companies in lots of sectors that have done it the other way around. They look great for a few years and then something awful happens. Somehow, the front pages of the newspapers tend to catch up with the business section.

Over the last several years, we’ve increasingly been prepared to challenge and change our core business model. Rather than saying let’s compete in the market place like everybody else, let’s instead ask how we can fundamentally change the way we operate. Each of the things we’ve done has led to a sharp intake of breath by others, but over time people have followed us. And if you look at the fourth quarter of last year, 16.5% of our pharmaceutical sales came from new products, which is the highest for any big pharma. That says you can indeed innovate your business model to do something I think is more in step with society and at the same time do very, very well for the shareholders.

Q: Has expanding your markets in developing countries paid off financially?

A: Certainly we’ve expanded our position dramatically in emerging markets. We absolutely have a lower average selling price than our competitors, but we have a substantially higher volume. About one-third of everything GSK makes in the world we make and sell in India.

Q: But there’s a gap between wanting to do good and doing good. GSK put its anti-HIV drug dolutegravir, which has become extremely popular in wealthy countries, into a patent pool in April 2014, but it’s still not widely available in developing countries.

A: In America, Europe, and Japan, dolutegravir is very much one of the key drugs of choice, but that has just begun to happen on a very accelerated basis over the last year or so. It always takes time for the establishment of a treatment protocol to trickle down through the entire market place and into developing world programs. And inevitably, particularly with countries that have to husband their resources very carefully, they rightly take some time before they adopt new drugs.

We expect a voluntary license will be issued to a generic company to make dolutegravir within the next 18 months. Hopefully that will coincide with the increasing adoption of the drug.

Q: You speak about how the company wants to position itself to improve how it’s viewed by society. We’re coming out of an era where the pharmaceutical industry was vilified. Are these new initiatives linked?

A: Every industry has had its share of challenges and criticism.

Don’t underestimate our long-term commitment. There’s no point in having a business model or a mindset that was very in in the 1980s. You need to have a mindset that fits with the 2020s, the 2030s, and the 2040s. There’s no value in innovation that doesn’t reach the people who need it.

It’s not been an either/or choice. Could we have been marginally more successful in the short run? Maybe. But would we have been more successful in the long run? I don’t think we would have.