11 October 2021
Vectura Group Plc faces a growing backlash over its acquisition by a tobacco company, with some doctors and patients signaling they may switch to treatments made by rivals such as AstraZeneca Plc and Teva Pharmaceutical Industries Ltd.
Respiratory organizations plan to issue guidance within the coming weeks on how health-care providers should handle Philip Morris International Inc.’s purchase of the U.K. company that makes treatments for lung illnesses. Some are already voicing discomfort.
“At my next hospital appointment I’ll be asking my consultant to switch,” said Edinburgh-based Olivia Fulton, 35, who suffers from severe asthma and has been using GlaxoSmithKline Plc’s Ellipta device that Vectura receives royalties for. “I do not want a tobacco company to profit from my ill health.”
Vectura — and its broader role in pharmaceutical research — has been under scrutiny since Philip Morris, the maker of Marlboro, won a bidding war in August to acquire it. Last month, Vectura was dropped as a participant and sponsor from a major medical conference in Oxford.
“It is a great shame that doctors are being put in the position of having to use an effective treatment owned by a tobacco company,” said Andrew Goddard, president of the Royal College of Physicians.
Putting patients first should be the only concern for those prescribing and dispensing medicine, said Moira Gilchrist, Philip Morris’s vice president of strategic and scientific communications. She added that successful lobbying efforts by a handful of doctors and pharmacists would set a dangerous precedent.
Gilchrist also pointed to a recent survey, commissioned by Philip Morris and conducted by Povaddo, where almost half of respondents considered the manufacturer to be the least important factor for a doctor to consider when prescribing treatments.
Vectura declined to comment.
Vectura’s intellectual property is used in 13 approved inhaled products, including Novartis AG’s Breezhaler and GSK’s Ellipta range. Its products were used by more than 10 million patients around the world last year.
There are a range of alternatives available for people currently using Vectura products that wouldn’t carry any significant risk to patient outcomes, according to a pre-print paper co-written by Nicholas Hopkinson, professor of respiratory medicine at Imperial College London and honorary consultant chest physician at The Royal Brompton Hospital, and Toby Capstick, consultant pharmacist for respiratory medicine at the Leeds Teaching Hospitals NHS Trust.
Alternatives include inhalers and drug preparations made by AstraZeneca, Germany’s Boehringer Ingelheim GmbH and Pfizer Inc., as well as Teva and Orion Oyj, according to the paper. However, some specific drug combinations don’t have substitutes.
Capstick, whose employer has received payments from various companies, including some associated with Vectura, said he doesn’t advocate a blanket switch of products or any change that would negatively impact the patient.
A spokesperson for GSK said the drugmaker understands why patients and healthcare professionals are concerned about the sale of Vectura and it is actively engaging with them to address those concerns. He said none of GSK’s inhalers or other products are purchased from or made by Vectura and minor royalty payments it makes, for patent licenses related to a company acquired by Vectura, expire in the next three years.
UK Inhaler Group is among dozens of health organizations currently drafting guidance for patients and health-care practitioners.
“The patient voice will be stronger than ever before,” said Omar Usmani, a professor and consultant physician at the National Heart and Lung Institute in London who chairs the UK Inhaler Group. “Now more than ever, all health-care providers involved in inhaler management need to have patients in shared decision-making on the choice of their inhaler device.”
Nevertheless, doctors considering switching patients from Vectura products would have to ensure that the alternatives were equally effective and suitable for the individual patient, as per the General Medical Council’s guidance. Doctors should also not share their private moral views with patients unless explicitly invited to do so, according to the British Medical Association.
Ricardo Jose, a lung doctor in London, said a massive shift from Vectura is unlikely.
“Are we going to change someone’s management just because of who is funding it?” Jose said. “This will likely be a discussion we can have with individual patients and strongly consider for new prescriptions.”
Philip Morris caused a stir when it announced plans to acquire Vectura in July, eventually elbowing out private-equity firm Carlyle Group Inc. with a higher bid. Vectura’s board recommended the offer despite complaints from scientific organizations and health charities. Philip Morris said Vectura’s expertise will help accelerate its move away from cigarettes and meet a target of at least $1 billion in sales outside nicotine by 2025. The tobacco company said it intends to keep Vectura autonomous and increase its research and development spending.
The European Lung Foundation and its sister organizations are now considering whether a stronger alliance is needed. Such an international coalition would discuss the long-term goals for respiratory health under the changed conditions, and potentially have a stronger advocacy group in contact with policymakers and legislators to try and prevent more such acquisitions in the future on an international level.
“The takeover is clearly not in the public’s interest,” said Kjeld Hansen, the chair of the European Lung Foundation. “But now that it has happened, we have to be stronger and more focused in our advocacy efforts.”
(Michael R. Bloomberg, founder and majority owner of Bloomberg News parent Bloomberg LP, has been a longtime champion of tobacco control efforts.)