GSK is in discussions with the Saudi health authorities to draw up new legislation to better regulate the pharmaceutical industry.

the authorities, but it has become something more for GSK.

“GSK was the first big pharma company to stop payments to HCPs to promote our products. It was a big decision for us, and nobody else has done it, though maybe other pharma groups will follow. Overall, it has had a net positive impact. Governments love it. They want all pharma companies to stop payments and we are advising them how to do it. It is a policy for the long term, good for patients and good for shareholders,” he said.

That initiative is set to have repercussions in the Middle East, where GSK has been involved for 65 years. Miles revealed that GSK is in advisory discussions with the Saudi health authorities to draw up new legislation to better regulate the medical and pharmaceutical industry in the Kingdom.

“We are in dialogue with the Saudi Food and Drug Administration (SFDA) in an advisory capacity, and I don’t think we’re far off some kind of enactment of major legislation on standards of transparency and engagement with the health care industry,” he said.

Saudi Arabia has been a focus of the company long before the 2000 merger between UK firm Glaxo Wellcome and American SmithKline Beecham that produced the sixth biggest drugs company in the world.

In different guises, GSK has had a manufacturing facility in Jeddah since 1992, currently employing 427 people. Between that facility, a distribution hub in Dubai’s Jebel Ali, and sales offices throughout the region, GSK covers a region of increasing interest.

“The GSK footprint in the region has a big heritage and has been expanding over the years,” he said. Quartet (ATQ) prompted some urgent changes to distribution channels earlier in the summer.

“Products are now going straight from Europe to Qatar, which used to come direct from the UAE, and we believe supply continuity is going well. We saw an increase in demand when the measures (blocking land, sea and air links with Qatar) were first announced, and some stockpiling of medicines,” he said.

“We are monitoring the situation. We think it could either escalate or de-escalate rapidly, but we don’t see it getting resolved quickly. It could be one or two years on the current status. But really it’s anybody’s guess,” he added.

Even without the distribution changes forced on GSK by the pay HCPs to speak on behalf of the science, but this was expensive and problematic. The main concern, however, was the potential conflict of interest involved. So in 2016 we took the decision to stop it completely. Now promotion is purely based on the science. We do still hire HCPs to work for us, to go out and talk about the products, but it is clear they are our employees,” he said.

“The second way was to pay sales representatives by the number of prescriptions issued for a product. We don’t do that anymore either, so again the potential conflict of interest is removed,” Miles added.

Health care is a major preoccupation in the Gulf and a top priority for policymakers, which has led to a boom in medicalrelated are too ready to prescribe or sell antibiotic treatments for even the most trivial of complaints. The scientific evidence suggests that this is leading to a new generation of “super bugs” that are resistant to traditional penicillin antibiotics, storing up big health problems ahead worldwide.

One of GSK’s biggest products in the region is the ubiquitous antibiotic Augmentin, and Miles concedes that the industry must do more, in conjunction with governments, to curb excessive selling or prescribing.

“There is a risk that the last line of therapy is no longer effective, but there are things that can be done about that. We can invest in new research and development to tackle the superbugs, and we are doing this. But it also revolves around the indiscriminate use of antibiotics. So we need to do more research to monitor the effectiveness and appropriateness of the existing drugs,” he said.

“We must also educate people on the use of antibiotics via prescription. Most illnesses are viral so they are no good anyway. There is a job of education to be done here with the health service providers. We need government support for regulation for the over-the-counter dispensation of antibiotics. The government is taking some steps but more needs to be done,” he added.

The other big issue for the region is in the related field of allergies and respiratory complaints, which have been chronic problems for many in the desert climate.

“We have a big presence in asthma treatment and have a new medicine which presents double the opportunity for asthma control, with a short-acting element to open the respiratory channels and a long-term part to maintain that.

“Maybe because of climate and environment, we’re also looking closely into chronic obstructive pulmonary disease (COPD) at the moment. We’re looking to unveil a ‘blockbuster’ in this area soon. It’s possible now to alleviate the rate of increase in COPD symptoms, and given up its license rights for anti-HIV products to local producers. In many cases, patients and hospitals in those countries could not afford advanced HIV treatments, so GSK in partnership with the Bill & Melinda Gates Foundation waived its right to license fees.

Meningitis is another area