The DTC Perspectives blog reported today that according to the folks at Harris Interactive have polled the public, and found that the overall reputation of the drug industry declined again in 2007, dropping by two points to a new low of 26%. That means that 26% of the general public give drug companies a positive rating. The only industry with a lower rating is tobacco, at 10%.

As the post goes on to observe, one of the major issues driving this is the perception of overly high prices. This includes a lack of understanding of the availability of price-support programs, and the belief that drug companies make profits a higher priority than safety.

While none of this is good news, obviously, it’s interesting to think about loud about how bad it actually is for individual pharma firms. The answer may actually be “not very”.

A generalized animus towards the entire pharmaceutical industry — all $289 billion of it — is one thing. However, the perception of an individual patient taking a particular drug for a particular condition is an entirely different thing. One is the forest, and the other is the tree.

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For that individual patient, particularly if the disease is chronic or severe, the reputation of the industry matters a lot less than more specific concerns when they’re thinking about how to treat their condition, and how to stick with the treatment. As our Patient Power study (email us for a copy) has demonstrated, patients take most of their cues when thinking about healthcare from family, friends and other trusted, personal sources. They are concerned about cost, of course, but they’re also concerned about side effects, efficacy, and other details of their treatment.

And where it really gets interesting is after they’ve been on a drug regimen for a while, and they’ve emotionally integrated (or not) the treatment into their daily lives. They become intensely curious about what others taking the drug are experiencing, tips and approaches for managing a condition like MS or diabetes. This is particularly important when the condition is asymptomatic — like hypertension. Until something goes really wrong, a lot of patients with high blood pressure don’t see any day-to-day difference as a result of taking their medication. Consequently, they’re much more likely to stop, which is not good.

The point here is that when you are dealing with an individual patient, who is treating an ongoing, very serious, condition, what lies beneath the surface is at least as important as what’s on top. And I suspect that in that context, everyone’s general attitudes about pharma companies turn out not to matter so much after all.