A Philip Morris iQOS smoking device. Picture: REUTERS
A Philip Morris iQOS smoking device. Picture: REUTERS

Vectura Group faces a growing backlash over its acquisition by a tobacco company, with some doctors and patients signalling they may switch to treatments made by rivals such as AstraZeneca and Teva Pharmaceutical Industries. 

Respiratory organisations plan to issue guidance within the coming weeks on how healthcare providers should handle Philip Morris International’s purchase of the UK 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, who suffers from severe asthma and has been using GlaxoSmithKline’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. In September, 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.

Patient wellbeing 

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’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 would not carry any significant risk to patient outcomes, according to a preprint 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 and Pfizer, as well as Teva and Orion, according to the paper. However, some specific drug combinations don’t have substitutes. 

Capstick, who has received funding from some pharmaceutical companies that compete with Vectura, said he doesn’t advocate a blanket switch of products or any change that would negatively impact the patient. 

UK Inhaler Group is among dozens of health organisations currently drafting guidance for patients and healthcare 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 healthcare providers involved in inhaler management need to have patients in shared decision-making on the choice of their inhaler device.”

Prescription guidance 

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 huge 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 with a higher bid. Vectura’s board recommended the offer despite complaints from scientific organisations and health charities. Philip Morris said Vectura’s expertise will help accelerate its move away from cigarettes and meet a target of at least $1bn 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 organisations 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 to 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.” 

Bloomberg News. More stories like this are available on bloomberg.com

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