Vital market intelligence

by Admin 2. July 2006 00:34
 

 

Vital market intelligence

With the NHS in turmoil, healthcare sales professionals need comprehensive and up-to-the-minute information about how their market is changing. Gordon Blackwell looks at what information you need and where you might find it.

The major medical product companies have traditionally sold high-value units to hospitals. Therefore the need to understand the twists and turns of NHS reforms has been minimal. However, the changing NHS marketplace is now creating many situations for products to be sold to new types of users, often for application in innovative ways in the non-hospital market. In order to exploit these opportunities, it is essential for companies to understand not only the tactics of the NHS but also its underlying strategy. Only then can the dynamics of the new marketplace be appreciated – making it possible to forge the kind of meaningful partnerships with NHS professionals on which successful business relationships depend.

The new NHS

It is necessary to understand that the Government is currently taking the NHS into uncharted waters. It believes that the advent of choice will cause patients to choose establishments that appear attractive in terms of waiting times, outcomes and overall patient experience, and thereby to reject less successful service providers. Then the unattractive units will need either to boost their market appeal or to face the ultimate consequences of a lack of income. In this new environment income is derived from activity, with payment following the patients. So decreasing patient numbers means less income; if that spiral continues, in the limit it means closure. How hard the NHS will be in practice remains to be seen, but the talk is tough. The Government acknowledges that in high-performing systems there is the possibility of failure. It talks of two types of establishment: those that are essential to the local healthcare economy and those that are contestable. Contestable services are those that would not be missed and could thus be allowed to disappear. This, of course, reckons without local pressure to ‘save our hospital’ – which governments ignore at their peril. It would appear that any closure is being seen as a worthwhile risk in the quest to make the NHS a really cost-effective and efficient public service.

Drivers of reform

Two additional factors are putting pressure on the acute trusts. The first is the drive to move services into the community that have traditionally been the preserve of the secondary sector. The White Paper ‘Our health, our care, our say: a new direction for community services’, published on 30 January 2005, promises a range of measures to switch NHS resources from hospitals to GPs, health centres and smaller community hospitals. This has the power to change the whole emphasis of healthcare in the UK. In the long term, it is likely to move the position of the hospital in the healthcare hierarchy from being a centre of excellence that rules the healthcare roost to being a community support service, used only as a last resort when the communitybased services have failed. The so-called Diagnostic and Treatment Centres are already creaming off some tasks that the hospital used to do, and here the second factor appears. Some of these are being run by the private sector, and the competition to NHS establishments is being further extended by the use of Alternative Providers of Medical Services (APMS). These could be private or third sector (voluntary or charity) bodies supplying service to Primary Care Trusts (PCTs) and to practices. The net result, apart from making hospitals vulnerable, will be a wide range of types of organisation looking for innovative ways of offering services in order to grab a share of the NHS budget. Patients would prefer to have services delivered locally and to avoid being hospitalised, so there is plenty of scope for change. One only has to look at the growth of the homecare sector in the USA to realise how large the opportunities are.

What this means for the healthcare industry

In term of its traditional market, the healthcare industry needs to be aware of the problems facing the acute trusts – which will need all the help they can get to increase their efficiency, deal with decreasing income and find ways of touting for business in the competitive environment. The industry has significant marketing experience, and sharing some with hospitals would be a good way to forge profitable partnerships. However, the really exciting opportunities are in the community setting. Many medical products can be used outside hospitals, and companies will need to keep abreast of changes in the pattern of providers and the way that care is being delivered. A major change is that the commissioning of care is moving to GPs. Since April 2005, many practices have been looking to create new care pathways to improve clinical outcomes and save money. They are likely to select particular therapy areas in which to try out new methods, and this again gives scope for companies to work with GPs to their mutual benefit. The PCTs may decide to commission services from APMS, and practices will be very keen to raise their Quality and Outcomes Framework scores and thereby boost their income. In this third year of the QOF system, there are opportunities to ensure that more patients are diagnosed (e.g. with hypertension) and so increase the value of each QOF point. From April 2006, the system has been extended to bring in more long-term conditions. However, the PCTs are being diverted from these tasks by the upcoming reconfiguration, which will see their number fall from over 300 to perhaps 130. So if the staff appear worried about the future and concerned for their jobs, it will be constructive to be understanding. So quite a lot is changing…

Facts at your fingertips

…and in this environment, those marketing and selling medical products are fortunate that their main customer is transparent in its plans, making it possible to understand where the opportunities are and what the customers’ problems are. The National Health Intelligence Service at www.nhis.info is an online data source with the aim of keeping you up-to-date with NHS movements, reforms and reconfigurations, so that you can understand what is happening and why. For example, apart from detailed information about the way the NHS is structured and how it plans and delivers healthcare, it will tell you:
  • the reconfiguration plans of PCTs and Strategic Health Authorities
  • which practices are in most need of help to boost their QOF earnings
  • where there is the greatest scope for increasing diagnosed disease prevalence
  • what progress is being made in practicebased commissioning
  • how much PCTs spend, per head, on a range of diseases.
It will let you search within all the reports and plans of the PCTs to find, at a stroke, any PCT that is concerned, for example, with the eye screening of diabetics. It will e-mail you when new data is added, according to your profile of interest. NHIS provides the kind of understanding you need at your fingertips, and it is backed by a range of other services to help you exploit opportunities. In the current climate, not to employ the available market intelligence could be a very bad decision.
Gordon Blackwell is the Director of Information Management at the National Health Intelligence Service
www.nhis.info For further information on NHIS, e-mail grb@nhis.info

 

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The Other Side 2

by Admin 2. July 2006 00:32
 

The Other Side 2:

Interview with a Medical Laboratory Manager

On Target asked Peter Coleborn, Head Biomedical Scientist at the Immunology Department, University Hospital North Staffs, some questions about his perspective on diagnostic sales.

What types of healthcare product do you purchase?

Mostly laboratory diagnostic kits (for example ELISA reagents for investigating autoantibodies to DNA, thyroid peroxidase and tissue transglutaminase), platforms on which to run these assays (such as instruments for specific IgE measurements) and plastics (mainly specimen tubes and pipette tips).

What factors affect your purchasing decisions?

The quality of the product is critical. We participate in a variety of externally-assessed quality assurance schemes. There is little point in buying cheap products if the goods don’t perform well enough – but that’s not to say that money isn’t important. My trust has a very keen supplies department, and they will do everything possible to get the best deal. Also important is ease of use (similar stages and incubation times between different assays is preferable), whether the kit gives reproducible results in diverse hands, and whether the method can be automated.

How often do you meet healthcare sales representatives? Do you turn down many requests to meet?

As infrequently as possible. But seriously… I don’t want to see representatives too often and so yes, I may turn down requests for meetings if I am not interested in anything they are currently pushing. I know that they have a job to do, but so do I, and it is amazing how quickly a 15-minute appointment can stretch to 30 or 45 minutes, or still longer. A number of these each month soon add up. However, if there is a particular product that I am interested in, a meeting may take longer – I have no issues with that. But I suspect there are some clinical staff who enjoy these interruptions to the routine.

How helpful are e-detailing and e-booking for you?

I am more than happy to receive details for new/updated products by e-mail (maybe as a PDF file or a link to a website). I don’t like to receive ‘cold telephone calls’ about new products. However, a follow-up call asking if I received the information, and booking an appointment, is fine. Of course, a telephone call is necessary when one is trying to sort out a problem – the personal touch can be vital. Sometimes I have booked appointments by e-mail, but this isn’t ideal because by the time one is booked it is inevitable that something else has cropped up. Confirming the appointment by e-mail is a good idea, especially if it was booked several weeks in advance – the e-mail acts as a gentle reminder.

What behaviour do you look for in a sales representative?

Representatives need to appreciate that folk who work in the NHS are under constant pressure due to lack of resources: time, staff, accommodation, budget (in fact, it always comes down to budget). Some representatives phone me up on Friday afternoons, no doubt working from home, trying to complete their weekly schedule – and I hate that! Friday is always busy for me, trying to ensure that as much work as possible is not left uncompleted before the weekend. Please don’t call me on Fridays. Otherwise, I would like representatives to be responsive to any problems and help us to resolve them – for example, if an assay or an analyser is performing poorly. When I have difficulty getting through to their company’s support line – or rather, getting those people to appreciate the urgency of my problem – representatives can be useful in championing my cause. If there is a new instrument on the market, I appreciate the opportunity to visit a site already using it, and of course the chance to talk to fellow biomedical scientists operating the machine. Being taken out for lunch is all very nice, but I am not that easily persuaded to buy products.

How, in your view, should you and your team behave towards sales representatives?

People who work in labs have to realise that representatives have a job – to sell diagnostic kits, new analysers, etc – in order to earn an income. Thus they should treat representatives as human beings – with respect and consideration. You know the saying: do unto others… Representatives can be a valuable resource, especially when things go wrong with the company’s kit. Avoid cancelling appointments with representatives without a good reason (I would suggest that all representatives ensure that their customers have their current e-mail addresses).

What do you find most problematic about representative visits?

Representatives can be rather ‘pushy’ at times. This doesn’t impress me: I hate the hard sell tactics that some use. I would not be encouraged to buy from their company if there were suitable alternatives. I’ve met a few overbearing representatives in my time.

"When I have difficulty getting through to their company’s support line – or rather, getting those people to appreciate the urgency of my problem – representatives can be useful in championing my cause."


How could these visits be made more useful?

If representatives simply want to keep in touch, to check that everything is fine, then a quick phone call is sufficient. It always seems a terrible chore to drive 50 miles up the motorway just to hear that the lab has no problems. Representatives can engender a good relationship by supporting a customer’s wish to try out new reagents, develop new methods, etc. The NHS will not readily fund the purchase of trial kits – at least, that’s my experience. And thus it I appreciate it when I am given kits to practise on; but customers should try not to accumulate a fridge full of reagents and then not use them. (I have been guilty of that, I’m afraid: I wanted to try out a new method, and thus obtained free kits. But then I lost staff and ended up with no time to test the products. Representatives, please appreciate this: it wasn’t intentional.) When representatives visit because they have a new product, they need to come armed with brochures and prices. It’s amusing how often they forget to bring this material; I guess that proves they are only human.

 

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Divide and rule

by Admin 2. July 2006 00:31
 

 

Divide and rule:

segmenting the healthcare market

How can marketing and sales teams share the challenge of making market segmentation work? Baba Awopetu and Akin Sawyerr take a look at the potential rewards of this strategy.

It’s time for the healthcare industry to prove it cares. In business, the objectives are always the same: sales growth and profit growth. We all appreciate that the secret of achieving these objectives is satisfying our customers. This article looks at the benefits that market segmentation offers to marketers and sales executives alike. Segmentation has lost its true meaning amidst a series of watered-down explanations of segments. The concept of segmentation dates back to the 1960s. Essentially, it is about grouping customers into clusters with the same attitude or behaviour – but more importantly, the same need. Organisations can then focus their efforts on targeting those segments where they can change perception or meet unmet needs. The idea of treating all customers equally contradicts modern business principles such as ‘customer intimacy’ and ‘customer orientation’. Fundamentally, customers are not a homogeneous mass.
Practices in other industries give us some insight. The product range of the toothpaste industry demonstrates how segmentation has helped it to deliver on the promise of customer orientation. The toothpaste market segments readily into whitening, protection, children and sensitivity, among others. These segments represent customers with specific needs.
Targeting these customers based on usage pattern or demographics could prove disastrous unless those characteristics correlate with their needs.

Not just about the product
How does this transfer to useful guidance within the healthcare markets? The application of segmentation in the healthcare arena needs to be carefully tailored and adapted. Effectively meeting customer needs requires different marketing mix elements: differentiated messages, meetings, support and promotions.
The products may not be easy to vary, but giving customers what they need and want remains paramount. Customer decisions about organisations or products are rarely based on the core product alone.
This principle is increasingly being adopted by healthcare marketing executives as the mature market impacts, with gains from the ageing demographic countered by increasing pressures from payers and consumers.
Reluctance to trust segmentation in healthcare is usually attributed to market peculiarities and the challenges of implementation. However, our research shows that some experienced representatives regularly segment their market. For example, one experienced sales representative segmented her customers for more effective service delivery as follows:

  • Science-focused – bases decisions on an in-depth look at published clinical information. Responds to arguments focused on clinical benefits and hard facts.
  • Gadget-focused – early adopter with a strong social network; considers information thoroughly, but will adopt quickly and influence others if convinced. Appreciates a balanced outlook and support for their credibility-building activity.
  • Patient-focused – views decisions primarily from the patient’s perspective. Responds well when patient benefits (clinical or emotional) are emphasised.
  • Self-focused – interested in personal advantage, so clinical benefits are only relevant if resulting in a gain for them (such as more free time).


This representative used different tactics (supported by the marketing team) in the field depending on which segment she felt the customer was in. The appreciation of these underlying factors enhanced relationshipbuilding and allowed resources to be deployed appropriately.
Most representatives and marketers recognise the customer segments described above or similar ones – so where does the friction come from where implementation is concerned? Can marketers and field representatives work together to achieve effective segmentation? The representative may argue that each customer interaction is unique, so there is no need for grouping. But in most markets there are key attitudes that prevail. Capturing and categorising these enables the marketing team to design its offering and programmes to meet segment-level need. Customer insights derived from market segmentation will accelerate changes in sales behaviour, leading to greater success.

Two teams, one goal
The knowledge that goes into identifying market segments must come from the field as well as from the marketers in head office – so teamwork is vital. The approach needed will vary depending on product type, customer culture and other market peculiarities. Segmentation gives a definite handle on clusters, not on individuals. It is a scientific art rather than a pure science. So it is important that imperfect data do not lead to the whole approach being abandoned.
Insight into the traits of each target segment leads to innovative and differentiated activities to engage the customers. The field force can enhance relationships with customers through the delivery of bespoke engagement plans based on the needs of each segment. Research by Agnito demonstrated a dramatic improvement in time spent with customers when a segmented approach is used rather than a generic one. Accurate segmentation is thus a key source of competitive advantage.
The problem is: how can we bridge the gap between field and head office? As one senior marketer said: “Good attitudinal-based customer segmentation holds the key to effective communication of key messages and ultimately ensuring the most appropriate use of resources to impact uptake and ultimately maximise ROI. Segmentation lives in the minds of everyone touching the brand, and forms the basis of all decisions from channel selection to message communication. It has been an extremely worthwhile exercise and has helped us become a lot smarter in what we are doing.” Effective segmentation is helping this team to win in its market.

Our research shows that effective segmentation depends on the ‘STRIKER’ principles:

Simplicity – the strategy need not be overly complicated. It should be built around the resources and capabilities of the field force.
Training – programmes must ensure that all involved are clear on the actions required and the benefits, and are comfortable with the approach.
Rationale – mature markets, decreasing access and customer dissatisfaction are some of the issues that make segmentation vital for the healthcare market. The field force need to understand why and how the strategy is being developed.
Involvement – this is vital for commitment. Representatives must be involved in data collection, testing and research to ensure that their concerns are accommodated.
Key successes – early successes at segment level should be communicated to reassure doubters and encourage early adopters.
Evidence base – the robustness of the evidence supporting this approach must be communicated. There are numerous case studies of how segmentation has changed the fortunes of major corporations.
Reinforcement – naming the segments and using them in communications will reinforce the message and inject fun into the process.


Beating the odds
When applied properly, segmentation benefits everyone. Sales teams achieve an improvement in their interaction and time spent with customers, while marketers can deploy strategies to complement the efforts in the field. When the two forces are aligned, the impact on performance should not be underestimated. Given ongoing issues with access, time with customers and pricing pressures in the healthcare market, the case for adopting segmentation is compelling.
The path to a segmented and successful future is tough, but the rewards are huge. The current environment is unforgiving, and we all need to adapt our practices in order to remain effective. The success of customer segmentation depends on the field force and the head office sharing their experience and insights.

Baba Awopetu
(btawopetu@yahoo.co.uk) is Senior Lecturer at The Marketer’s Forum and a freelance healthcare writer. Akin Sawyerr (sawyerrs@yahoo.co.uk) is Sales Manager at Recordati Pharmaceuticals.

 

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How do I succeed at interview

by Admin 2. July 2006 00:29

 

How do I succeed at interview?

In the competitive job market of healthcare sales, you need both style and substance to convince an employer that you have what it takes. Sam Kirkham offers a guide to that all-important first meeting.

Interviews can be a traumatic experience, and even the best of us can get nervous – but hopefully, by reading this article and taking time and care with your preparation, you can ensure that your nerves ‘give you the edge’ rather than destroy your confidence. As any good sales person will tell you, the key to success is preparation. This is especially true of interviews.

Points to remember
  • Make sure you gather as much information as possible prior to the event, including who you will be seeing and their position within the company, where the interview is being held, and any additional facts including job descriptions and company details.
  • Make sure you plan your journey in advance, including allowing plenty of time for delays. Plan to arrive ten minutes before the start of your interview.
  • A properly researched candidate is a strong candidate: always research the company, its place in the market relative to other healthcare companies, and its key competitors. Your research could include talking to staff in hospitals that use the company’s equipment, using the Internet and requesting company literature.
  • Part of the preparation process should include questions you may want to ask your interviewer. This will show the interviewer that you have taken the interview seriously and are able to plan. For example, ask about the role itself, any training on offer, the long-term opportunities, the problem areas and what they want the person in the position to achieve.
  • It is considered poor form to ask about salary and benefits at the first interview – wait until the second.
Ready for anything Spend some time thinking about the kind of questions you are likely to be asked. You don’t want to sound rehearsed – but equally, some solid competency examples and some prior thought about tricky questions that may come up could prevent an awkward pause! For instance:

What can you bring to this company/role? This is your chance to shine. Tell them about your achievements in your previous position(s) that are relevant to the position for which you are applying. You could include any key contacts you have – for example, clinical staff who would be the end users, procurement managers who may hold equipment budgets, and other influencers such as EBME departments.
Why do you want to work for this company? Emphasise the positive reasons for wanting to join the company, but avoid aspects such as ‘more money’ or ‘a smaller territory’. These may not endear you to a prospective employer. This is also an opportunity for you to impress the interviewer with your knowledge of their company. Give them a run-down of their products/services, sales figures, news, company figures, customers, etc.
What are your strengths/weaknesses? An oldie but a goodie! Have a couple from each sector prepared. Remember that a strength can often also be a weakness – for example, your great organisational skills may mean that you sometimes ‘over-prepare’ for meetings.

Also be prepared for scenario-based questions where you are required to give an example – for instance, “How would you handle a consultant who kept missing your appointments?” or “Tell me how you would defuse a difficult situation.” Rather than simply stating how you would deal with the situation, it is better to explain and back up with an example of when you actually did this. It makes you more credible, and reassures the interviewer that you really are capable of solving such problems.

Making an impression Appearance should also never be underestimated – first impressions really do count. It is has been repeatedly proven that most interviewers make up their minds about an individual within the first 30 seconds. Dress in a professional, businesslike manner. You should be in a smart suit with clean and neat hair, nails and shoes, and wearing minimal jewellery. Most interviews will expect to see a presentation folder or ‘brag file’, which should include an up-to-date copy of your CV. You will be remembered if you can demonstrate any (and ideally all) of the following: good sales figures; contacts that are relevant to this position; any letters of commendation or certificates that show relevant qualifications; brochures of some of the products that you have sold; and examples of projects with which you have been involved. Have any relevant paperwork readily to hand: do not rummage around in your briefcase among mounds of other pieces of paper.

Best foot forward In terms of actual interview technique, the following golden rules may seem obvious but can easily be forgotten:
  • A firm handshake, with an enthusiastic greeting and self-introduction and good eye contact, will make a positive impression. You may be nervous, but smile!
  • Be positive, confident and enthusiastic – your skills have got you this far, and this is your chance to show you have the personality to match.
  • Do not smoke or drink alcohol before or during the interview.
  • Do not swear or use any form of bad language during the interview.
  • Keep answers to the point – avoid the temptation to waffle and ‘fill’. If you do not know the answer to a question, say so. Something like “That’s an interesting question, I’ve never been asked that before…” will give you time to think of an answer. Do not be afraid to say you don’t know if you don’t!
  • Do not offer bad news unprompted.
  • Be professional – do not criticise previous or current employers or rival firms.
  • Tell the interviewers what you like about their company and what you feel you can offer. This is where your background research will pay dividends.
  • Close the interview by thanking them for their time. Establish the next stage and ask whether you will be included. If you are interested in pursuing the role, tell them you have enjoyed the interview and are now even keener to pursue the role. This is especially important for a sales role: you must be able to ask for the business!
  • Afterwards, it is worth writing the interviewer a thank-you note for taking the time to interview you. This will also give you an opportunity to remind the interviewer of your outstanding qualities.
  • Above all, be yourself. An interview is designed to see whether you and the company ‘fit’ – this can only be judged accurately if they see the real you.


Good luck!

Sam Kirkham, FREC, is co-founding director of Kirkham Young Ltd, a highly specialist sales recruitment agency dedicated to the commercial healthcare and scientific markets. For more details, see
www.kirkhamyoung.co.uk

 

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Clusters and partnerships

by Admin 2. July 2006 00:28
 

 

Clusters and partnerships:

the integration of the medtech industry

Unlike pharma, the medtech industry depends on the collaboration of smaller specialist companies. Michelle Dalton of Medilink WM looks at how the industry’s stars can form chains and galaxies to light up the healthcare sky.

The pharmaceutical industry is dominated by big business, in which there are only a handful of key global players. And often the needs of pharmaceutical shareholders, rather than improving human health, can appear to be the driving force as earnings are based on the patenting of new drugs.
A very different picture can be found in the UK medical technologies sector. While there are several big name companies with a major stake in the market – notably Smith & Nephew, Huntleigh Healthcare and Stryker – the industry is in fact ‘run’ by the higher percentage of small specialist companies working very hard (albeit often independently) to deliver their product to end users.
The sheer number of SME companies (Small to Medium Enterprise, characterised by less than 250 employees and £25 million in turnover) balances out the purchasing strength of the larger players, creating a more even playing field through the process of clustering. Medilink UK, representing SME medical clusters in England, Scotland, Wales and Northern Ireland, has a membership of over 1,200 companies with a significant proportion of their turnover in medtech.
The UK’s public organisations – UK Trade and Investment, regional development agencies and even local city councils – have realised the value of clustering, and are using this technique to promote the strengths of the UK sector overseas.

Partnering opportunities created by the NHS

The NHS Purchasing & Supply Agency (PASA) currently negotiates around 3,000 contracts with 1,700 suppliers, worth in the region of £4 billion a year. NHS procurement involves introducing competition to certain markets, identifying new products and suppliers, monitoring quality, ensuring continuity of supply and negotiating the best possible terms, which include the use of national contracts, collaborative hubs and regional purchasing.
To achieve its purchasing aims, the NHS needs to ensure that markets remain attractive to suppliers by effectively managing the supplier base. A large proportion of NHS business is conducted with SMEs. The NHS has made public its commitment to providing help and support to small and new businesses in order to encourage competition and ensure that the marketplace is accessible to all suppliers. Conversely, and increasingly, major NHS procurements are conducted through confederations made up of NHS Trusts. These confederations ‘club together’ for mutual benefit, pooling their information, expertise and resources – all designed to achieve purchasing savings and reduce costs.
So we have a situation in which a large number of smaller medtech companies are selling directly to the NHS, and being encouraged to do so – but at the same time, the NHS is trying to drive down prices through its current cost-saving measures. This puts the smaller companies at much greater risk than the multinationals, which are better able to absorb the loss of revenue through other income streams.
Because of the increased financial pressure on NHS purchasing and procurement, there is a greater need for partnering of SMEs in order to provide cost-effective solutions to the purchasing and procurement community. This should also lead to greater opportunities for SMEs to become more competitive with large multinationals and their subsidiaries in terms of quality, innovation, price and service. This situation has created a role for a marketing-led organisation with a branded licence – such as Medilink UK – to team up with manufacturers of medical products in order to supply directly to the NHS.

Bring in your friends from the outside

The majority of the funding available to companies in the R&D arena is intended to encourage collaborative partnering with universities: businesses working with academics to develop new products and services. This is the goal of the Knowledge Transfer Networks (KTN) and the Health Technology Portal, both of which have open calls for papers for companies working within the medical sector.
However, the need of healthcare professionals for innovative products and disruptive technologies has led to partnering and subcontracting arrangements that open up the supply to companies not currently in the medical and healthcare sector. The cluster model of collaborative interaction between a few or many companies has led to integration of technology from other industries into devices, sharing of information and expertise, and blurring of the lines between medtech, biotech and pharma in order to offer the NHS the best possible access to the best possible products. Keeping in mind the sensitive nature of these arrangements, some examples can be broadly described as:
  • drug-eluting stents: a technology company has integrated expertise from a metal manufacturer
  • ointment-impregnated pyjamas: textiles, technology and marketing companies have integrated
Subcontracting has led to many traditional manufacturers breaking into this market, and lending their expertise to product designers in order to deliver a cutting-edge product:
  • a bed hoist company working with a specialist anti-microbial coatings and materials company to produce a mechanical device designed not to cross-infect (as long as the nurses wash their hands!)
  • a metal component manufacturer and designer working with a drug delivery company to create aesthetically pleasing drug delivery devices
  • a textiles company working with a materials manufacturer to develop special glue for wound dressings.








“Our involvement with Medilink West Midlands over the last few years has definitely raised Clamason’s profile and accelerated our marketing efforts through the navigational help with government bodies, securing funding and tradeshow assistance they have provided us. We’re proof that active clusters work for business.”

Links for your company

Medilinks are membership organisations that work actively to increase the viability of the sector by giving local companies a competitive edge through direct business support, relevant commercial opportunities and personal introductions to prospective clients.
Medilinks operate regionally and feed into a national cluster that has developed immense credibility, and is now regarded as the voice of the medical technology SME community.
Medilink UK brings together regional support organisations in Scotland, Wales, Northern Ireland and most of the regions within England (there are still some regions without a formal support organisation).
Medilink West Midlands actively works to increase the viability of the medical and healthcare sector by giving local companies a competitive edge through direct business support, relevant commercial opportunities and personal introductions. With our partners and established connections in UK Universities and the NHS, we encourage innovation, new product development and diversification from other industries. The MedilinkWM network includes companies throughout the medical product supply chain, from materials and design to manufacturing, packaging and support services. Get involved now by calling 0121 452 5630 or logging onto www.MedilinkWM.co.uk.

A cluster in action

Recent research conducted among the 500 companies that make up the West Midlands medtech cluster shows that the medical and healthcare companies in the West Midlands are nearly all SMEs, with only a few companies having more than 250 employees.
This research also shows that in general, these companies are looking ahead: over the next five years, they expect to develop new products or services and enter new markets. The new markets most often cited are in the UK, Europe and the USA.
In a recent phone survey, 110 of these companies stressed the importance of the West Midlands cluster to the development of their business. They identified three determining characteristics of a beneficial cluster:
1. Who drives it and encourages
participation and opportunities.
2. Who actively participates.
3. Opportunities for networking, information sharing and brainstorming.
“Clustering works when companies actively participate and viable commercial opportunities arise,” notes Philip Salt, Chief Executive of Salts Healthcare. “But a lot has to do with who is encouraging the activity and their ability to talk with companies and see natural synergies. In the West Midlands we are lucky because our cluster is extremely active, spans the entire supply chain from materials and design companies right through to end products and the NHS, and real business opportunities come out of it.”

Working together

Medilink West Midlands launched a membership service in May 2003 to harness the strength of this cluster and use it to create additional and wider-reaching commercial opportunities. For example, it has:
  • Provided a subsidised trade show stand at the internally-acclaimed Medica and ComPaMed trade shows and the local MDT show, generating sales leads for companies such as Albion Spring, AK Industries, Clamason and MCS Medical.
  • Given introductions to potential suppliers of DNA analysis for key forensic services.
  • Set up a one-to-one meeting with the Chinese manufacturer and distributor KDL for Kimal Manufacturing, resulting in signed contracts.
  • Forwarded a distribution opportunity to a local company, which has secured an exclusive distribution contract for contactless soap dispensers.
  • Encouraged the local manufacture of a previously imported foot bath: facilitated talks and identified an appropriate West Midlands manufacturer, who now has an exclusive contract.
  • Assisted with the securing of product development funds for SDD Seating Technology and Intelligent Medical Microsystems.
This is just a brief list of regional and national successes – enough to show you that being involved in a local medtech cluster that encourages partnerships and opportunities is a necessary element in your marketing and sales plan.









Michelle Dalton is the Communications Director of Medilink West Midlands.

 

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A European tour of medical devices

by Admin 2. July 2006 00:26
 

 

In the holiday season, On Target Editor Chris Ross takes an express tour of the European medical device market and looks at how medical technology is making a difference – not only to public health, but also to the economy.

In the June issue of On Target, we looked at how investment in medical technologies holds the key to wealth as well as health. This article focuses on the medical devices market in Europe, which is estimated by Eucomed to be worth €55.2 billion. This represents a 30% share of a global sector worth €184 billion. To understand why the medical devices sector is worth investing in, we need to look at what makes it special: its distinctive nature (see Figure 1), its diversity (see Figure 2) and its growing importance for public health.

The big €

Germany, France, Italy, the UK and Spain account for almost 78% of the European medical devices market, with Germany and France alone accounting for 51%. However, even the most mature markets are beset with challenges in the current environment. In Germany, the largest European market, growth is being driven by good export performance as the domestic market battles healthcare reforms, financial difficulties and cost-containment policies. Similarly in France, performance has been badly hit by poor economic growth and government cost-containing measures, driven by an almost constant deficit in its national health insurance fund. Healthcare in Italy and Spain is also in a state of flux, with both countries trying to devolve administrative and financial responsibilities to the regions in order to control spending.
What are medical devices?
The European Union Medical Devices Directive (93/42/ECC), article 1, defines medical devices as: “…any instrument, apparatus, appliance, material or other article, whether used alone or in combination, including the software necessary for its proper application intended by the manufacturer to be used for human beings for the purpose of:
  • diagnosis, prevention, monitoring, treatment or alleviation of disease;
  • diagnosis, monitoring, treatment, alleviation of or compensation for an injury or handicap;
  • investigation, replacement or modification of the anatomy or of a physiological process;
  • control of conception;
and which does not achieve its principal intended action in or on the human body by pharmacological, immunological or metabolic means, but which may be assisted in its function by such means.”


The UK is Europe’s third-ranked market for medical devices. In fact, Britain is home to the largest number of medical technology companies in Europe. However, per capita spending is relatively low compared to other Western European countries. The UK invests around 7.5% of its GDP in health, but less than 5% of this amount is spent on medical devices. This is below the European average of 6.4%. While the NHS accounts for around 80% of all healthcare expenditure, a small specialist private healthcare sector also plays a role in the market. To reduce waiting times, preferred supplier status has been given to private healthcare groups in orthopaedics, ophthalmology, general surgery, primary care services and local procurement.

On Target Quick Read
  • Global medical device market valued at €184 billion
  • Europe has 30% share of world market, at an estimated €55.2 billion
  • The top five markets in Europe are Germany, France, the UK, Italy and Spain
  • Germany and France make up 51% of the global market
  • The UK has more medical device manufacturers than any other European country, but spends a lower than average % of GDP on devices
  • The European market will grow to $77.8 billion by 2010
  • The biggest single product segments are cardiovascular, orthopaedics and surgery


Saving lives and fighting disability

According to Frost & Sullivan, the total European medical devices market will grow to $77.8 billion by 2010. Cardiovascular devices are currently the leading European single product segment for devices (19%), followed by orthopaedics and surgery. Over the next five years, Frost & Sullivan forecasts that the cardiovascular devices market will grow by around 25%.
Eucomed reflects these trends by citing the following disease areas as key challenges in which medical devices can make an impact in the coming years: cardiovascular disease, cancer, diabetes and musculoskeletal conditions. Cardiovascular disease is the leading cause of death in Europe, killing 4 million people each year – 46% of all women and 38% of all men. Eucomed points out that interventional cardiology (including coronary angiography and coronary stents), arrhythmia and stroke management all provide great examples of the contribution medical technology makes to patient care. Such innovations not only improve patients’ quality of life, but also relieve the economic burden of lengthy hospital stays.
Cancer is the second largest killer in Europe. The World Cancer Report predicts that global cancer rates could increase by 50% between now and 2020. Medical technology assists the screening, diagnosis and treatment of cancer, as well as helping to restore quality of life post-surgery. Medical science shows that cure rates in cancer improve when early detection is combined with optimal treatment – a good example of how medical devices and pharmaceuticals can work together to improve public health. Diabetes is emerging as one of Europe’s major killers. Eucomed notes that medical technology plays a vital role in diabetic patient care, and can help to reduce the healthcare bill for the disease. Devices for diabetes treatment include insulin delivery products such as syringes, pens, automatic injectors, insulin patches and external or implantable pumps. Precise blood glucose monitoring can substantially reduce the risk of developing complications and slow the progression of the disease. Effective wound care reduces the frequency and length of hospital stays and the incidence of amputation in diabetic patients.
Finally, medical devices play a significant role in improving patient outcomes in four major musculoskeletal conditions: osteoporosis, osteoarthritis, rheumatoid arthritis and lower back pain. With populations continuing to live longer, osteoarthritis is projected to become the fourth leading cause of disability in Europe by 2020. Joint replacement surgery can restore the patient’s mobility, while new developments in bone, cartilage and soft tissue regeneration based on biomaterials can speed up the healing process.
Examples of medical devices
Anaesthetic machines and monitors
Apnoea monitors
Artificial eyes
Artificial limbs
Blood transfusion and filtration devices
Breast implants
Cardiac monitors
Cardiopulmonary bypass devices
Clinical thermometers
Condoms
Contact lenses and prescribable spectacles
CT scanners
Defibrillators
Dental equipment and dentures
Dental material and restoratives
Diagnostic imaging equipment
Diagnostic kits and tests
Dialysers
Electrosurgery devices
Endoscopes
Enteral and parenteral feeding systems
Equipment for disabled people
Examination gloves
Foetal monitors
Hearing aids and inserts
Heart valves
Hospital beds
Hydrocephalus shunt
Incontinence pads
Infusion pumps and controllers
Intra-uterine devices
Intravascular catheters and cannulae
Laboratory equipment
Lithotripters
Medical lasers
Medical textiles, dressings, hosiery and surgical supports
Orthopaedic implants
Operating tables
Ostomy and incontinence appliances
Pacemakers
Physiotherapy equipment
Prescribable footwear
Pressure sore relief devices
Radiotherapy machines
Resuscitators
Scalpels
Special support seating
Sphygmomanometers
Stents
Suction devices
Surgical instruments and gloves
Sutures, clips and staples
Syringes and needles
Ultrasound imagers
Urinary catheters, vaginal
speculae and drainage bags
Ventilators
Walking aids
Wheelchairs

Source: Healthcare Industry Task Force (2004). This list is not exhaustive, and is intended to illustrate the range of products manufactured by the industry.

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Career Insights

by Admin 1. July 2006 05:00

with comments from Lucy Randle, STAR Medical

Following his recent appointment to National Sales Manager with ALK-Abelló, Pf asked Mark Kneen for his perspective on Representative-Manager relationships.

What attracted you to ALK-Abelló?

Before considering a new role, it’s important to stop and think about exactly what it is that you want. It is all too easy to move in the direction you think, or your manager thinks, you should rather than in the direction that you actually want. For me, ALK-Abelló offered a Sales Manager’s dream job, the opportunity to be part of a specialist team, launching a new product within a relatively small company.

What do you feel are the benefits of working for a smaller company?

At ALK-Abelló we have an open and honest culture where everyone is expected to impact on our future. Anyone who has the desire and the ability can make a very big difference.

What do you find rewarding about working in sales?

A sales position is one of the few roles where it is totally clear what impact you are having on a business. I find it rewarding to be working with a team of people who not only have a genuine desire to achieve, but are also not afraid to challenge me or put forward their own ideas.

What advice would you give on how to build a successful

relationship with a manager? It’s not just the salesperson’s responsibility to make the relationship successful! As a manager, if the relationship with one of my team is not so good, I analyse where I may have gone wrong. Everyone is different and my ‘inputs’ can be interpreted in many different ways. The key to any successful relationship is communication. Make sure you understand what your manager expects of you. Don’t be afraid to ask if you are not clear and don’t be afraid to question “Why?” You are more likely to commit to something with enthusiasm if you fully understand why you are doing it! Don’t be afraid to challenge ideas, but try not to be confrontational. Before you do challenge anything, make sure you have a clear alternative that you think could achieve the same, or better, results. Diplomacy is the key. Don’t be afraid to tell your manager if you are having problems, either at work or at home. Any good manager will be entirely sympathetic and even grateful that you have approached them early on. Don’t forget that your manager has a manager too. They will also be asking for information. Missing deadlines, submitting expenses late or forgetting your monthly report can all bring unwanted attention not only onto you but also onto your manager.

How would you advise a representative on how to approach a disagreement with their manager?

Always head on. Allowing things to niggle away is the worst thing to do and can affect your performance as well as that of fellow team members. I would rather people told me directly if they have an issue. Your manager should take it as a compliment if people in the team feel that they can raise a disagreement, it’s a sign that they are encouraging an open and honest culture.

Lucy Randle comments on how to create and maintain a mutually beneficial relationship with your manager.


Communication

Always be open with your manager. Try to match your manager’s communication style. To help identify this, ask yourself the following questions:
• Is it better to approach my manager spontaneously or book an appointment?
• Does my manager like to discuss matters face to face or by e-mail?
• Is it better to appeal to my manager’s emotion (i.e. with an energetic approach) or their logic (i.e. a researched, more formal approach)?
• Is humour appropriate or should I just cut to the chase?

Your manager

Be a resource for your manager: always have a ‘can do’ attitude and be willing to take on additional tasks. If you are bringing concerns to your manager’s attention, ensure you have an alternative solution to hand. Be aware of the constraints that your manager is working within, and be sympathetic to their needs.

You

Know your own strengths and weaknesses. Consider your attitude to authority – have you found it difficult to deal with managers in the past? If so, think about how you can avoid future clashes. Encourage feedback and advice. Create your own development plan, update it and share it with your manager. Keep abreast of industry news and share your knowledge with the rest of your team. By doing this, you will build confidence in your ability and earn your manager’s respect.

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Growing from strength to strength

by Admin 1. July 2006 05:00

Sankyo and Daiichi are two leading Japanese pharmaceutical companies that have merged to build a new Top 20 Global Pharma Innovator called DAIICHI SANKYO. With a new name, new products and a new office in the UK, this dynamic company is now ready for even more rapid growth in the Cardiovascular and Diabetes markets!

New company name
    Sankyo Pharma UK Ltd has become one of the rising stars in the industry over the last three years by building a new organisation, introducing new processes, investing in new technology and developing our people to successfully launch the antihypertensive Olmetec® into one of the most competitive markets in the UK. The company is now ready to enter the next phase of its development by merging with another Japanese company called Daiichi and changing its name to DAIICHI SANKYO UK LTD.

    Sankyo was the third biggest pharmaceutical company in Japan, and its merger with Daiichi, the sixth largest pharma company in Japan, is going to create a new Global Pharma Innovator with 18,400 employees and worldwide sales of £4.6 billion! This means that DAIICHI SANKYO will become the second largest pharmaceutical company in Japan and the 19th largest in the world!

Excellent product pipeline
    The merger of DAIICHI SANKYO has also created an outstanding new product pipeline, and the company will be investing 22% of its global net sales into research and development. In fact, DAIICHI SANKYO has more than 50 new chemical entities in its pipeline, and ten of the most promising new

compounds are in the Company’s core cardiovascular and diabetes therapy areas:

CS-747 Anti-platelet DU-176b Anti-coagulant
CS-8663 Hypertension DZ-697b Anti-platelet
CS-011 Diabetes CS-3030 Anti-coagulant
CS-917 Diabetes CS-8080 Arteriosclerosis
CS-9883 Ischaemia P2Y-12 Anti-platelet

Investment in the UK

    DAIICHI SANKYO moved to a brand new office in Gerrards Cross, Buckinghamshire during June 2006 to provide the much-needed space and facilities to continue building the UK business in the future.

    In addition, DAIICHI SANKYO will be locating their European Research & Development Division in the same office building in the UK later this year. This demonstrates the importance of the UK in the company’s global clinical development programme, and it will provide an ideal opportunity to build even stronger Key Opinion Leader relationships in this country.


New DAIICHI SANKYO offices in Gerrards Cross

Ambitious vision

    DAIICHI SANKYO UK is an ambitious organisation, and is aiming to become ‘Our Target Prescribers’ 1st Choice for Cardiovascular Medicine’ by developing, recognising and rewarding high performance. The company also has a clear set of values, and these have formed the foundation of a unique set of competencies that define the way we work:

  • Obsessed about achievement
  • Before our customers ask for it
  • Integrity in our actions
  • Dare to be different
  • United. We go for it!

    The performance-driven culture of DAIICHI SANKYO UK involves setting high standards, working hard, playing hard and treating people as individuals, together with a high level of accountability and the transparency of individual performance measures across the whole company. This is reinforced with Quarterly Performance Reviews to ensure that the highest performers in every part of the company receive the competitive salaries, bonuses and promotions they deserve, regardless of how long they have been in their roles.
    Skills and career development are also driven proactively at DAIICHI SANKYO UK, and Performance Development Plans are reviewed and updated on a quarterly basis to ensure that they remain relevant. These plans may involve individual coaching or attending a training course, though they may also involve taking on additional team responsibilities, contributing to a multi-functional project team, or being seconded into another role in the company on a short-term basis.

Great place to work
    With strong leadership, innovative plans, great people and competitive rewards, DAIICHI SANKYO UK is a brilliant place to work for high performers with the drive and capability to succeed. The company was also nominated as the 15th most desirable employer to work for in the 2005–6 Pf Survey. And don’t just take our word for it: 85% of our staff completed our anonymous Internal Staff Survey in May 2006, and rated the company as follows:
96% Daiichi Sankyo UK is a good company to work for
91% I am proud to work for Daiichi Sankyo UK
90% I am clear about what I am expected to achieve
89% I am encouraged to make my own decisions
88% I believe that our future business prospects are bright
86% I can rely on my manager to give me the support I need
84% I received sufficient training to do my job
84% High performers are recognised and rewarded
83% Communication in my part of the business is good
83% Daiichi Sankyo UK offers a good range of benefits to me



DAIICHI SANKYO UK High Performers in April 2006



10 things you may not know about DAIICHI SANKYO

1st company to develop a statin for hyperlipidaemia
1st company to develop a glitazone for diabetes
Establish how practices will spend their indicative budgets. Which services will they support?
Identify how your products can deliver value to these plans. How can you help deliver cost savings and improve health outcomes?
2nd largest pharmaceutical company in Japan
3rd best cash launch of an AIIA antihypertensive in the UK
4% AIIA unit market share with Olmetec in less than 21/2 years
4.6 billion pounds of worldwide net sales
15th most desirable employer to work for in 2005–6 Pf Survey
19th largest pharmaceutical company in the world
22% global net sales to be invested in R&D in 2006–7
18,400 employees around the world


More information
Please look at our new websites on www.daiichi-sankyo.co.uk or www.daiichisankyo.co.jp
For more information on our company or telephone us directly on  (01753) 893 600  (01753) 893 600 .

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As easy as PBC: the changing NHS landscape

by Admin 1. July 2006 05:00

A NEW OPPORTUNITY

The adoption of practice-based commissioning may be slow, but the new structure provides unique market intelligence and powerful targeting opportunities for medical sales professionals. Pf’s Chris Ross explores the changing landscape.

IT IS WIDELY ACCEPTED that the full exploitation of Practice-based Commissioning will be in the vanguard of building the NHS as a primary care-led, patient-focused service. However, not all practices, or even PCTs, appear to have the level of enthusiasm for the project that the Department of Health would wish. Although some are fully engaged, many are lagging and could upset the end-2006 target of 100% coverage. Close monitoring of the progress made by PCTs in encouraging their practices to take on commissioning responsibility shows that adoption is slow. A new study by the National Health Intelligence Service (NHIS) demonstrates wide divergence in the movement towards universal involvement. Currently, some PCTs are able to provide full details of the composition of their commissioning clusters and the specialist programmes they are undertaking; while others, who are just starting, are clearly having difficulty in enthusing their practices.
However, it is clear that the data emerging from the study, which began in June, is of significant interest to pharmaceutical companies. It not only provides targeting information on which practices are doing what and where, but also gives details of specific disease and therapy specialisations.
Bearing in mind the recent White Paper, it is not surprising that dealing with the range of problems concerning hospital admissions is highest on many PCTs’ agendas. What is surprising, rather, is the very wide range of interests shown by the PCTs. From a sample of 100 PCTs, the top ten specialisations were:

Specialisation Percentage of PCTs
Dermatology 48
Orthopaedics and trauma 28
Diabetes 25
COPD 23
ENT 20
Diagnostics 16
Cardiology/Heart failure 16
Ophthalmology 15
Musculo-skeletal 15
Gynaecology 13


   Other specialisations include everything from audiology to urology, and from access to ultrasound.
    NHIS has already analysed data from 200 clusters, and the results are available to NHIS subscribers at www.nhis.info. It has found that the average cluster contains 10 practices, but a number of PCTs have formed a single cluster to cover the whole PCT. This is not quite what the Government envisaged as a reforming move.

The Pf guide to practice-based commissioning

What is practice-based commissioning (PBC)?
    PBC is about engaging practices and other primary care professionals in the commissioning of services. Through PBC, front-line clinicians are being provided with the resources and support they need to become more involved in commissioning decisions.
    Under PBC, practices receive information on how their patients use health services. This information can be used for the redesigning of services by front-line clinicians for the benefit of patients. Practice-based commissioning gives clinicians greater freedom and flexibility to tailor services to the needs of the local community.

Which practices does PBC apply to?
   The PBC Directed Enhanced Service (DES) applies to general practices only. The Department of Health guidance states that PCTs are required to offer the DES to all their general practices from April 2006. This guidance was written with the intention that PBC would apply to general practices, based on the criterion of a registered patient list. PCTs can, however, decide to delegate indicative budgets to other practices, provided that the budget can be clearly identified.

What will happen to the PCTs?
   The PCTs will continue to deal with the administration (contracting, payments etc), which should mean limited additional bureaucracy. Under PBC, all proposals for savings must be agreed at the outset and must be spent on patient services. Unlike fundholding, where GPs could negotiate the cheapest price for acute services, with tariffs there is no longer any incentive to bargain on price.

What are the PCTs responsible for?
   By the end of December 2006, the PCTs must ensure that:
• All practices are receiving information that will allow them to understand their clinical and financial activity compared with local and national indicators.
• All practices have received an indicative budget covering an agreed scope of services.
• All practices are receiving support from the PCT and the offer of an incentive payment (the DES or locally agreed payment) to support practice-based commissioning.
• Governance arrangements for practice-based commissioning are in place (these will be agreed in partnership between the practice and the PCT).

What is universal coverage?
   Universal coverage will be achieved when all PCTs have put in place the arrangements to facilitate PBC. The Department of Health expects all PCTs to do so by 31st December 2006. This will involve all practices receiving information about their referrals, information on their allocation of the PCT budget, an offer of support from their PCT, and details of the local governance arrangements. The Department of Health hopes the arrangements will mean that all practices are significantly engaged in PBC by the end of December 2006.

What GPs are saying . . .
   The BMA has cast doubt on Department of Health claims over the current adoption of practicebased commissioning. Dr Hamish Meldrum, Chairman of the BMA’s GPs Committee, said current implementation is "patchy" and GPs still face many barriers.

   Commenting on a statement from the Department of Health claiming that more than 40% of GP Practices in England were adopting practice-based commissioning – the system in which family doctors decide which health services to buy for local people – Dr Meldrum said: "The Government’s statement might lead people to infer that more GPs are commissioning services for their patients than is the case. The incentive scheme is there to encourage practices to put a toe in the water of PBC but does not mean that actual commissioning is under way. It seems disingenuous to suggest that taking the first step along the road to commissioning is the same as actually commissioning the services. Studying a map isn’t the same as making the journey."

   "Implementation of PBC is very patchy at the moment. While we support it in principle, we hear of far too many barriers being put in the way of GPs taking on a commissioning role. If the government seriously wants PBC to get off the ground in all parts of the country they need to take a close look at these barriers, which include significant PCT deficits, and instruct local NHS bodies – Primary Care Trusts – to work with and support practices instead of blocking the way ahead."

 

A new playing field
   So what does all this mean for sales representatives on the ground? Undoubtedly, practice-based commissioning has significant implications for interaction between sales professionals and clinicians. Close scrutiny and understanding of the changes within individual territories will provide invaluable opportunities for representatives to align their services and products with the specific objectives of PBC clusters.
   The key question is: how can sales professionals exploit the new system?

    The four-part plan for exploiting practice-based commissioning:

  1. Identify which PBC clusters exist in your territory. How many are there and where are they?
  2. Scrutinise the PBC plans for practices within your region. What are the priorities and the local health needs?
  3. Establish how practices will spend their indicative budgets. Which services will they support?
  4. Identify how your products can deliver value to these plans. How can you help deliver cost savings and improve health outcomes?
 
This information is invaluable in targeting your customers. There is a great deal of uncertainly in the marketplace as the new PCT structure unfolds, and many organisations will welcome help as they come to terms with the practice-based commissioning reform. With this in mind, NHIS is publishing a series of Practice-based Commissioning Tracker reports to give non-subscribers access to information on the structure of practice clusters in each PCT, the disease/therapy specialisations on which the clusters are focusing, the names involved and an analysis of the commissioning specialisations.
   Exploiting the obvious opportunities will be more effective for those armed with detailed market intelligence.

The National Health Intelligence Service provides local and national intelligence to support sales activities within the health sector. As the premier source of knowledge about the way the English NHS works, the NHIS is a mine of up-to-date structured and ‘contexted’ information.

Practice-based Commissioning Tracker Reports can be delivered to NHIS either as hard copy or electronically. The late entries to the process will be followed up over time to make the available data as complete as possible.

For more information, e-mail pbc@nhis.info.

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Breakthrough decision on Herceptin

by Admin 1. July 2006 05:00

– but where’s the cash?+

After months of national debate, NICE has fast-tracked its decision on the breast cancer drug Herceptin, which was licensed in May. This is good news for patients, but could be a nightmare for an NHS already in financial crisis. Pf reports.

LEADING CANCER CHARITIES have welcomed NICE’s recent decision to allow the use of Herceptin in early-stage breast cancer, but have urged the Government to do more to help PCTs fund the treatment.
    Campaigners heralded the decision as a major breakthrough in the treatment of the disease, but the NHS Confederation has warned that funding it will have major financial repercussions for the NHS. In response, charity Cancerbackup has led calls for the Government to set up an ‘Innovations Fund’ to help local PCTs finance treatment.

No more postcode lottery
    Joanne Rule, Chief Executive of Cancerbackup, said that the decision brought an end to the postcode lottery of Herceptin, and that women with early breast cancer who are HER2-positive will feel immense relief. "Breast cancer patients across England and Wales are currently experiencing a dreadful postcode lottery: denied Herceptin because of where they live or how ‘exceptional’ their lives are deemed to be. This can stop now. The Government’s Health Service Circular 1999/176 makes it crystal clear that PCTs do not need to wait for guidance to fund licensed treatments."
    However, Rule warned of funding battles ahead and encouraged the Government to take action. "We hope this means that no woman will be forced to fight for treatment to help save her life," she said. "We urge PCTs to implement this guidance by funding the treatment to patients when clinicians recommend it. The Department of Health should help PCTs by announcing an Innovations Fund to assist local areas absorb the costs of new treatments."
    Cancerbackup’s thinking has also been mirrored by Breakthrough Breast Cancer, a leading UK charity that fights breast cancer through research and education. Jeremy Hughes, Chief Executive of Breakthrough Breast Cancer, agreed that the decision could signal the end to postcode prescribing, but said this would only be the case if women were sure that they could be tested to see whether Herceptin was suitable for them.

QUICK READ – HERCEPTIN IN BRIEF
NICE has issued draft guidance that Herceptin should be prescribed to appropriate women with early-stage HER2 breast cancer • Final guidance will be published this month • SMC has issued final guidance recommending that Herceptin be made available immediately • PCTs in England and Wales have three months following the final decision to put mechanisms and money in place so that women in their area can be given Herceptin • Herceptin targets the HER2 protein, which can fuel the growth of breast tumours • It is already licensed for use in women with advanced breast cancer, where the disease has spread within the breast or to another organ. • Around 41,000 women are diagnosed in the UK each year with breast cancer, most with early-stage disease • Only a fifth of breast cancers are HER2-positive, and around 10% of women with HER2-positive cancers will not be allowed Herceptin because they have heart conditions • Herceptin costs around £20,000 for one year’s treatment. • Analysts predict the drug could cost the NHS £100 million per year.


"Herceptin has highlighted challenges for the NHS in ensuring patients receive new, targeted and effective treatments."
– Jeremy Hughes, Chief Executive of Breakthrough Breast Cancer

    "Nationwide, HER2 testing is being put in place and all women diagnosed with breast cancer need to know this test will be available quickly," Hughes said. "Herceptin has highlighted challenges for the NHS in ensuring patients receive new, targeted and effective treatments. Breakthrough’s research scientists are part of a world-wide programme to bring more treatments like this from the lab bench to the hospital bed. We welcome the speed with which NICE has assessed Herceptin under its new fast track system. Attention must also be given to ensure PCTs plan to fund such new treatments."

The campaign for breast cancer treatments has been a high-profile debate.


Are cutbacks inevitable?
    While the approval is clearly good news for health outcomes, the economics of the decision have not met with the same enthusiasm. Herceptin has been shown to benefit women with HER2-positive breast cancer, which comprises around a fifth of all breast cancer cases in the UK. Although 10% of this figure will not be allowed the drug because of concern that it could exacerbate heart problems, over 5,000 women would still be entitled to receive Herceptin. Analysts have predicted this could cost the NHS over £100 million each year, and could trigger cutbacks elsewhere within the NHS budget.
    Dr Gill Morgan, chief executive of the NHS Confederation, which represents over 90% of NHS organisations, welcomed the NICE announcement and reiterated the Confederation’s belief that the licensing and regulatory processes are there to ensure that new drugs are both safe and effective. However, she said there was no doubt that the Herceptin ruling would present a significant financial challenge to some NHS organisations. "Primary care trusts plan their expenditure some 18 months in advance and so when a new and expensive drug is licensed, and no new funding provided, it inevitably causes difficulties."

"There will always be a finite amount of money and difficult decisions will always need to be taken. We strongly believe that those decisions are best made by clinicians and trusts locally."

– Dr. Gill Morgan, Chief Executive, NHS Confederation



    PCTs receive a fixed allocation of money to deliver all the services for their local community, and have to make difficult decisions on competing priorities. This year, Morgan said, many PCTs have been faced with decisions about spending money on expensive drugs, cutting waiting lists and investing in infertility treatments. "Every decision about spending taxpayer’s money is a moral one because a pound spent on one drug means a pound less for another. There will always be a finite amount of money and difficult decisions will always need to be taken. We strongly believe that those decisions are best made by clinicians and trusts locally."
    Dr Jonathan Fielden, Deputy Chairman of the BMA’s Consultants Committee, told the BBC: "The NHS will now have to find the money to fund this treatment. We have already heard how huge amounts are being wasted on management consultants. The government needs to rethink its strategy and spend money that has been earmarked for the NHS on benefits to patients, not pie-in-the-sky political ideas."

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