A few years ago, thinking the way all journalists think, we had an epiphany. The reportorial brain is the one we’re happily stuck with. But it often adopts a harshly negative, critical outlook that transcends age, geography and political affiliation. We resolved to outgrow that outlook.

Then, as luck would have it, we met a few journalists (at our old haunt, Bio-IT World) who saw the world a bit less darkly. Don’t get us wrong. It’s not that there is anything wrong with dark. We love dark. But with that world view, a journalist can miss other stories, which is an occupational handicap.

Three Types of Companies

The standoffishness of the pharmaceutical industry is a similarly troublesome quality. A certain aloofness is placing the life sciences in a shady reputational neighborhood. What do we mean? Have a peek at our chart.

In the old days, there were two types of companies.

The conciliatory companies took their critics to heart when bad news arose. They apologized and moved forward. The Tylenol scare of many years ago, which was handled deftly, is the textbook case of this.

Corporate Cohort

Bulldog companies, like those making tobacco, denied all misconduct. They knew a handsome group of people in Washington called lobbyists would help out in a moment of need. Our chart shows a fraternity of other complacent, formerly admired industries that pharma should distance itself from like the plague.

It’s painful for us, and for readers, but tobacco companies and drug companies are similar in the minds of the public. Both industries use government-mandated warning labels as shields from litigation.

Mattel, China As Models

But tobacco is hardly alone. Airlines, autos, music, mortgage bankers, ethanol. All of them operate with a certain “What we do is not illegal” mentality. Their attitude is, “Federal rules allow us to do this.” Yes, they do.

But when the mood of the country turns, and it does so frequently, the mere existence of favorable federal rules is no help.

Look at Mattel and its taste for lead. Or subprime mortgages, issued with high fees and no verification of income. Look at everything the Chinese grow or manufacture. Yes, the “rules” permit all of that. But consumers are horrified and turning away. It will take time to repair the damage to those reputations. Some food producers are begging for new regulation to restore consumer confidence.

Media Ignorance

In 2007, with instant global communication, it’s not enough to adhere to some minimal set of rules that your company helped to write. It’s about doing nothing that an idiot-savant from MSNBC could misinterpret.

Now there is better strategy. It is neither conciliatory nor combative. Rather it attempts to locate the highest possible ethical ground and camp out there no matter the costs of that terrain. Such companies set their own rules and enjoy excellent reputations. Need some case histories?

Toyota saw the need for hybrids, GM missed it. Southwest Airlines saw the need for simpler routes and cheerful employees; it prospered. United Airlines used a bankruptcy filing to crush its unions, ensuring especially sullen customer service. Apple saw the price-gouging of the music industry. The major record labels are still scratching their heads.

Hitting The Talk Shows

How should pharma adopt the third strategy? How can it claim the high ground and live in a better reputational neighborhood than Detroit’s car makers?

It’s simple. Outreach. Education.

Top scientists and executives at drug, device and biotech companies all need to be out doing interviews and talking about what the industry does. Start with local radio and newspaper outlets. For top-tier companies, consider the Sunday morning TV gabfests. Some of these interviews will go well. Some will not. Over time, if the entire industry does them, its reputation will rise as the American public realizes that the life sciences are honorable and decent. The American public doesn’t get that now.

In interviews, CEOs and research chiefs will need to be ready to answer the tough questions. Even personal ones. This will be what gives pharma a human face.

How many of your post-marketing trials did you fail to complete? What are the adverse events associated with your best-selling product? What prescription drugs do you take? Who in your family has struggled with the U.S. health care mess, of which drugs are but a tiny element? How many drugs did your company send to Africa last year? When you make lead toys or bad drugs, people want to hear the apology. Without that, the dog house is your only house.

Stop the Spin Cycle

Today the pharmaceutical industry is battered and bedraggled, sinking in polls that cannot be manipulated by lobbyists.

To protect itself, the industry must skillfully participate in the debate about its products. That is not happening now. The industry must repeatedly explain how endless the drug discovery process is. It needs to talk up just how frustrating and wearisome clinical development is. It needs to reduce the complex statistical challenges to simple numbers that high school graduates can fathom.

Put your salaried M.D.s out there. Let the press talk to your PhD’s and bench scientists. If the process is left to traditional news releases and public relations, it will end up with the same dismal results that approach has produced so far. Pharma will be a permanent resident of the tobacco-GM-airline-ethanol ghetto, and that is a place with only memories of its former grandeur.

Drug Safety Hangover

Sadly, the handling of the Avandia, Vioxx and Ketek drug safety issues shows that the industry has trouble fighting articulate, well-organized enemies. These enemies, often based in academia, don’t do public relations. They return their own phone calls—have you heard of such a thing? Like it or not, the absence of a high-level response from pharma is interpreted by the consumer media as a guilty plea.

Outside the industry, the industry is perceived as being above needing friends. Pharma has never needed friends more. By “friends” we don’t mean your lobbying firm. We mean ordinary people who appreciate what your company does and will shrug off periodic safety crises if—a big if—they find your company and its competitors to be honorable.

Public Education

The industry’s enemies will continue to write books, op-ed essays and peer-reviewed journal articles. What is your company going to do? Nothing? Gripe about the New York Times at DIA next year? How’s that working so far?

In such an environment, the industry’s enemies will fare well. They will seek to reduce the size and importance of industry-sponsored research, and to attack specific drugs and devices when that opportunity arises. Such attacks will fit their thesis of an industry that needs to be restrained. Merck’s legal victories notwithstanding, American juries will be primed to punish the industry in that climate of demonization. But foreign patient populations, now receptive to clinical trial participation, are also at risk. If they turn hostile, where will you fill your next trial? Neptune?

Your best defense, in the long run, is the unvarnished truth about your products. To understand that truth, you need a scientifically literate public that grasps the risks and benefits of drugs. Our educational system is not going to deliver that public. The industry will have to create it, or be resigned to being depicted in cartoon form instead.

Here’s a May 2007 ClinPage story on demonization. Readers with smart ways to manage drug safety data and drug safety issues are encouraged to contact the .