SAN FRANCISO – "Obviously, in an election year this becomes more of a topic than in other years," Gilead Sciences Inc.'s president and chief operating officer, John Milligan, responded when the topic of drug pricing was inevitably raised during the company's breakout session at the J.P. Morgan Healthcare conference Monday morning.

No stranger to the controversy, Gilead has come under fire for the high price of its hepatitis C virus (HCV) drugs, Harvoni (ledipasvir 90 mg/sofosbuvir 400 mg), and Sovaldi (sofosbuvir 400 mg). The company has consistently – and continues to – defend its pricing strategy by citing the cure rates and shorter treatment regimens offered by the drugs.

Though he was speaking on competition in the HCV space, Norbert Bischofberger, executive vice president or R&D and chief scientific officer, pointed to Harvoni's benefits. "You really can't beat 99 percent response rates," he said, often in just 12 weeks of treatment – previous courses of HCV drugs would often require 24 or 48 weeks of treatment – and "with no appreciable side effects." (See BioWorld Today, Jan. 14, 2014.)

Defending other high prices and price hikes seems tougher. A Reuters story late last week on Pfizer Inc.'s New Year's move to raise the prices of more than 100 of its drugs, some by nearly 20 percent, drew only a brief statement from the New York-based biotech.

Pfizer, currently in the process of merging with Dublin-based Allergan plc, simply called medicines "among the most effective and efficient use of private and public health care dollars," and trotted out the usual fare of discounts and programs that result in the prices paid to pharma firms less than the wholesale acquisition price.

And then, of course, there's Turing Pharmaceuticals Inc., which generated the most public ire when it raised the price of a long-generic antiparasitic drug by 5,500 percent, a move even the rest of the pharma industry was quick to denounce as an unjustifiable price hike.

"It's like pornography: You know it when you see it," said Ron Cohen, president and CEO of Acorda Therapeutics Inc. and chairman of the newly renamed Biotechnology Innovation Organization (BIO), which booted Turing from its ranks three days after the story broke last year.

"It was the utter lack of innovation," Cohen said of Turing's move, calling it the "furthest possible thing from what . . . we stand for."

But does the biopharma industry as a whole deserve the harsh epithets of presidential candidates – "outrageous" price gouging, and "pure profiteering" – or the vilification by the public? asked moderator Mike Griffith, executive vice president of Inventiv Health.

After all, biopharma is the industry that transformed HIV from a death sentence into a chronic and manageable illness and discovered targeted therapies that have helped decrease the cancer death rate by 20 percent since 1991, just to name a couple of achievements, and yet it has a rating among the public even lower than that of Congress.

Speakers during Monday's plenary lunch at the Biotech Showcase meeting attributed that partly on irresponsible media, partly on insurance companies that put a disproportionate share of the blame on biopharma and partly on the industry's own lack of persistent messaging to the public.

But fixing that messaging will be a delicate operation in itself. Using the well-worn "too complicated to explain" excuse generally hasn't been received well. And, as several speakers noted, a pithy sound bite on greedy pharma firms is more memorable than a report from an organization such as the Tufts Center for the Study of Drug Development, which in late 2014 determined the average cost to bring a drug to marketing approval as $2.6 billion. (See BioWorld Today, Nov. 19, 2014.)

According to Cohen, BIO is working on a message to combat the media feeding frenzy, one that offers insight into the entire drug development ecosystem.

"There are roughly 1,300 [biopharma] companies," he said. Of those, he estimated about 90 percent are not profitable. "We know that a vast majority will fail, we just statistically know. We also know we can't pick the winners in advance. So the way the market works is that people invest across the board; some will win, but most will lose."

Patients want the next treatment for Alzheimer's or breast cancer, but "if you want those therapies, something has to pay for it," he added. "When something hits, which is rare, but when it hits, it has to get a sizeable return" to warrant further investment.

But Cohen stressed that investment is not company-specific; rather, it is across the entire field. For instance, Gregg Alton, executive vice president of corporate and medical affairs at Gilead, noted that 200 molecules were investigated and more than $50 billion invested to get to the drug that would eventually become Sovaldi, which Gilead got for $11 billion in its 2011 buyout of Pharmasset Inc.

The message to the public has got to be explaining how the industry is funded, "how innovation gets funded over the long term," with regards to total capital investment and risk across the entire sector, Cohen said.

But BIO's efforts likely end up being more about reputation boosting and damage control than any legislative change. Despite all the political swagger, the plenary speakers and several execs presenting at JP Morgan Monday, including Gilead's Milligan, are doubtful lawmakers will have much success, in part because the drug development and overall health care sector is too important to quality of life.

"The opportunity for meaningful change in the U.S. is actually quite low," Milligan said.