GE Healthcare has launched a new compact MRI scanner that provides accurate images of a single targeted limb without whole-body insertion.

The Optima MR430s extremity scanner optimises patient comfort, thus reducing the likelihood of accidental movement.

The scanner has a relatively low cost of acquisition and installation while delivering high image quality (1.5T).

Used for musculoskeletal imaging of the whole arm or leg, the Optima MR430s allows the patient to rest on a padded, adjustable chair with only the targeted limb within the scanner.

The system, which is small enough to pass through a doorway, can help to relieve a hospital’s patient backlog for MRI scans.

“GE’s Optima MR430s extremity scanner stands out because it ensures high-quality images and a more refined, comfortable MR experience for those who have suffered injuries to an arm, leg or even a wrist or ankle,” said Dr. William B. Morrison, Director of Musculoskeletal Radiology at Thomas Jefferson University in Philadelphia. “This scanning technology helps eliminate the anxiety and discomfort often associated with full-body MR technology.”

“Greater patient comfort with uncompromised image quality is at the heart of the design of this system,” commented Jim Davis, General Manager for GE Healthcare’s MRI business. “By making MR accessible to more patients and providing imaging that’s both advanced and cost-effective, the Optima MR430s provides a remarkably improved experience for patients.”

The Optima MR430s is an addition to GE’s ‘healthymagination’ portfolio of products that address four key priorities for innovation: low-cost technology, healthcare IT, accessibility and consumer focus.

 
Optima MR430s

NICE has published final guidance supporting the use by the NHS of a new cardiac output monitor during major or high-risk surgery.

The final guidance from the Medical Technologies Advisory Committee (MTAC) confirms the approval of the CardioQ-ODM system from Deltex Medical published in draft NICE guidance in October 2010.

CardioQ-ODM is used to assess cardiac output in order to help the surgeon optimise blood flow during an operation. A single-use probe is inserted into the oesophagus via the mouth or nose, and the device generates a low-frequency ultrasound signal to determine blood flow.

MTAC found that using CardioQ-ODM instead of a central venous catheter during the operation reduces average hospital stay by two days and reduces average operation cost by £1,100, as well as reducing the risk of post-operative complications.

The report supports the use of CardioQ-ODM during major or high-risk surgery or other surgery where invasive cardiac monitoring is required.

However, MTAC was unable to support the routine use of CardioQ-ODM in the critical care environment. The committee said further research was needed to compare CardioQ-ODM with other methods of cardiac output monitoring during critical care, and noted that trials are ongoing.

Dr Carole Longson, Director of the NICE Centre for Health Technology Evaluation, said: “We are delighted to advise that CardioQ-ODM should be considered for patients undergoing surgical procedures who would otherwise require invasive cardiac monitoring. This new device offers potential cost savings for the NHS together with improved experiences for patients.

“The Medical Technologies Committee found strong evidence for adopting CardioQ-ODM in the NHS in specific surgical settings, and we hope it will be used consistently to deliver proven clinical and cost benefits.”

Deltex Medical is based in Chichester, West Sussex.

 
CardioQ-ODM

The majority of US doctors believe that pharma companies and their sales representatives are useful sources of information about prescription medicines, a new study says.

According to more than 500 American Medical Association (AMA) members, nearly eight out of ten physicians view pharma, their reps and company-sponsored programmes as helpful.

John J. Castellani (pictured), President and CEO, Pharmaceutical Research and Manufacturers of America (PhRMA) – who supported the study – says the information helps doctors “make the most informed treatment decisions possible”.

The doctors also rated continuing medical education (CME) courses, peer-reviewed medical journals, and also fellow physicians as other useful sources of information.

The study revealed that more than 90% of doctors said that interactions with reps allow them to learn about new indications for approved medicines, potential side effects and emerging benefits and risks. 

Just under 70% of doctors said they use the information provided by reps in making their own prescribing decisions as part of a wide range of information they call upon, including their own clinical knowledge.

More than 80% of doctors also said their meetings and interactions with representatives give them a useful opportunity to provide feedback to pharma companies about their experiences with products.

“What is clear from the results of the survey is that physicians review and integrate information from many sources in order to stay informed about medicines,” Mr Castellani said.

The NHS could save hundreds of millions of pounds each year if general practice improves its quality of patient care, a report by The King’s Fund has found.

A major inquiry found that at least £200m a year could be saved by more efficient prescribing of drugs and £700m by improving the management of medical conditions in the community.

Sir Ian Kennedy, Chair of the inquiry’s panel (pictured), says that GPs must “seize the opportunity” provided by the introduction of GP commissioning to improve services and quality of care.

Improving the quality of care in general practice: Report of an independent inquiry commissioned by The King’s Fund concluded that the majority of care provided by general practice is good.

However, there are widespread variations in performance and gaps in the quality of care delivered which GPs need to improve.

Questions were raised over the variations in the quality of clinical care after analysis found that one-third of patients with stomach or oesophageal cancer that require urgent referral to hospital are given a non-urgent referral.

Differences in the experience of patients and co-ordination of care were also found during the inquiry.

To correct the variations found, the report encourages GPs and other primary care professionals to build on the changes taking place and transform the way general practice operates by:

· accelerating the trend for practices to work as multi-professional teams

· delivering a ‘new deal’ for patients

· accelerating the shift away from small practices working in isolation towards ‘federated’ networks of practices working more closely with one another and with other professionals, and

· practices looking ‘beyond the surgery door’ by focusing on prevention, taking a more active role in public health issues such as obesity, and reaching out to deprived communities.

The report adds that is strongly endorses the principle that GPs should be generalists rather than specialists. But with GPs set to be given the majority of the NHS’s budget and a central role in implementing the Government’s health reforms, it calls for general practice to “embrace radical change” if it is to maintain its international reputation for excellence.

Chris Ham, Chief Executive of The King’s Fund, hoped the findings would “spur” GPs and others working in general practice to accelerate the pace of change.
“Although general practice in this country remains the envy of the world, there is no room for complacency,” he said.

“While many practices have been at the vanguard of innovation and quality improvement, too many GPs remain unaware of significant variations in performance and do not give priority to improving quality.”

A new report from the National Audit Office (NAO) says that NHS planning, procurement and use of high-value capital equipment items such as CT and MRI scanners would be cheaper if co-ordinated as bulk purchases at a national level in the same way as the purchase of disposables.

The report, Managing High Value Capital Equipment in the NHS in England, states that Trusts are failing to save money by collaborating, and that grouping requirements for new machines would reduce costs.

NHS purchasers will face a 17% reduction in capital spending over the next four years, the report notes – but half of all CT and MRI scanners currently in use are due for replacement in the next three years.

The report has been welcomed by NHS Supply Chain, which offers medical equipment supply deals at a national framework level. “The NAO report acknowledged that 75% of the NHS Trusts are utilising NHS Supply Chain frameworks and are enjoying lower acquisition costs and equipment cost savings,” commented Andy Brown, NHS Supply Chain’s Managing Director Diagnostics.

“We have demonstrated savings for Trusts purchasing individually, and the report acknowledges that further aggregation of demand and providing commitment to manufacturers can deliver additional NHS savings.”

Regarding the impending shortage of MRI and CT scanners, Mr Brown said: “This will provide a significant challenge for NHS Trusts, and our range of frameworks to plan, aggregate, purchase or lease and maintain high-end equipment will be invaluable. There is no reason why the bulk purchasing arrangements we have already implemented could not be applied to CT and MRI with support from the NHS to co-ordinate and aggregate requirements.”

 
MRI scanner

Valeant Pharmaceuticals has made a bid for US company Cephalon, causing a surge in the value of shares for both companies.

The larger company has made a proposal to acquire Cephalon for $73.00 per share in cash, a total of approximately $5.7 billion.

Valeant has also announced its intention to secure approval from Cephalon’s shareholders to replace the company’s current Board of Directors with its own nominees.

Despite several letters to Cephalon’s management, Valeant said in a statement that it has been “disappointed by Cephalon's unwillingness to engage in discussions in a timely manner” and so decided to make its proposal public.

“We have taken a close look at Cephalon's business and believe we put forward a very compelling offer for Cephalon's stockholders,” said J. Michael Pearson, Valeant Chairman and CEO.

“We intend to be disciplined on price as we believe we have submitted a full and fair offer for Cephalon based on the information available to us. If our offer does not have the requisite support of Cephalon's stockholders, we will focus our attention on other opportunities to invest our capital.”

Canada’s Financial Post has described Pearson as a “brash new dealmaker”, as Valeant has made 22 acquisitions since he took over as CEO in 2008, and was itself acquired by Biovail.

Cephalon shares surged nearly 30% following Valeant’s proposal, while Valeant’s own share price rose 16%.

Pf Assistant Editor Iain Bate asks how having the right negotiation skills can make the difference in all areas of life.

Dr Ravi Powar’s recent article in the March issue of Pf raised some interesting questions. Focusing on the art of negotiation, she highlighted that all of us in our everyday lives encounter some sort of ‘give-and-take’.

On the surface it would seem that negotiations only take place during contract discussions or sales meetings at work and on a car forecourt. However, Ravi explains that almost every aspect of our daily tasks involves some sort of bargaining.

Be it arranging a time to meet a friend for lunch which is convenient or trying to close an important deal at work, improving our negotiations skills is something well worth focusing on. When you consider that even the smallest of agreements are made by negotiating, finding a style that is effective could be the deciding factor in whether you close that important deal at work, or have to watch the eighth soap opera of the evening at home!

But for any negotiation to take place there must be a variable which both parties are happy to settle for. Of course in the business world one party will be interested in obtaining a cost-effective price whilst the other will aim to maximise their returns or order. This is often where stumbling blocks occur.

Ravi says that negotiation is a “form of Alternative Dispute Resolution”. Whether or not clients or friends are actually in dispute when discussing potential deals or arrangements is questionable; but by using the tips she has acquired through her years in the pharmaceutical industry, realising the right time to commence discussions on important decisions or understanding the difference in being an accommodating or competing negotiator could be the deciding factor between success and failure – in everything you do.

 

Contact the author: iain.bate@healthpublishing.co.uk

Successful negotiation skills can be the difference between completing a deal or losing out to a competitor. Dr R K Powar explains key skills to use the next time you’re trying to secure a key contract.

Negotiation is the means by which a discussion takes place with a viewpoint of producing an agreement. Negotiations, whether between individuals or groups, are essentially a process whereby parties relevant to the negotiation come to an agreed outcome that should hopefully best serve everyone’s interest. Negotiation is regarded as a form of Alternative Dispute Resolution.

It takes place every single day in almost every facet of our lives, from friends finding a suitable time to meet for coffee, in marriages and parenting, to companies negotiating on working time agreements, and on trying to agree the price when purchasing a car.

Negotiation is an inter-personal process which is influenced by each party’s skill, attitude and style. Negotiation requires calmness: the focusing on issues rather than personalities with the outcome often pre-determined by the attitude one has before entering the negotiation process. It is worth noting here that every negotiation situation is different.

Negotiation is not about one party dominating or imposing power on the other. Instead, it can be used as an opportunity to build trust which can be used to help to forge relationships for all concerned. Negotiation is not about arguing and proving the other person to be wrong, or a ‘winning at all costs’ or a blaming exercise. It is also worth highlighting that negotiating differs from ‘influencing’ and group decision making.

At times, because there is uncertainty on what might be the outcome of the discussions, negotiations have unpleasant feelings attached to them; for some it feels like a chore, and in the worse case scenario a conflict.

A PRACTICAL PERSPECTIVE

Practical negotiation skills

The negotiation process is one that is complex and needs a lot of care, both before and during discussions. When negotiating the proposal or suggestion this works best if it offers a win-win solution where both parties involved do not feel hard done by. The negotiating process should begin by having an understanding of the person one is negotiating with, requiring an understanding of their needs and interests. A style then needs to be adopted whereby the other person is made to feel valued, understood and appreciated rather than belittled or dismissed – please refer to Management skills: getting the best from others in the July 2010 edition of Pharmaceutical Field. One also needs to be mindful of the external factors such as the background, culture and politics.

Win-win solution

One of the main characteristics of negotiation is that the parties involved in the process feel satisfied that an appropriate deal has been achieved. The deal does not need to be the one with the best possible outcome, but one that all parties are happy to agree to and is realistic. Therefore, from the onset it is important to know what you want, but equally what the other party requires as well. For this to happen good listening is required with empathy to the other party’s concerns rather than objections, the willingness to compromise and accommodate, and taking the stance of building relationships helps.

It is important to be fair. Only then can a win-win situation be achieved. Work out if what it is you’re asking for is fair and justifiable and that you deserve what it is you’re asking for. If you’re asking for something and don’t believe you deserve it yourself, it may be very hard to convince the other party.

Using variables

In all negotiation processes parties have various variables they can employ. Some of these cannot be compromised on, i.e. the must haves. Some are ideals and some can be traded to get the outcome desired. Therefore, in the example of a Key Opinion Leader meeting being organised, they might be the must have, a certain venue the ideal, and the day of the meeting is carried out as the trading variable.

Silence

Silence is a very powerful tool. Often underestimated for its potential it is one of the most powerful tactics in persuading others. At a practical level this means keeping silent after a request has been made during the negotiation. On most occasions in the negotiation process after a request is made it is helpful to keep quiet – as in most cases the request will be met – but all too often people keep speaking to justify their request which in turn leaves the other person less inclined to help.

Have alternatives

It helps if one has alternatives in case what you want from a situation is not achieved or achievable. It is worth mentioning an alternative that both parties could agree if the initial plans are not going as hoped.

NEGOTIATION STYLES

Accommodating: in this style a greater importance is made on preserving relationships and solving the other party’s issues. Accommodators tend to be sensitive and pick up on the verbal signs of other parties. The negative side of this style is that they feel taken advantage of, especially in cases where the other parties pay little importance to relationships.

Avoiding: in this case negotiation only happens when it has to. When it finally does happen, negotiators tend to defer the confrontational aspects of negotiating, yet on the surface appear to be tactful and diplomatic.

Collaborating: individuals that tend to enjoy negotiations and solving problems in a creative manner prefer this style. Collaborators are good at using negotiations to understand the concerns and interests of the other parties. Their downfall is that they at times turn simple situations into complex ones.

Competing: competing negotiators are strategic focusing on usually the winning element. They are often perceived as dominating with little if any importance on the human side of the relationship.

Compromising: compromisers tend to do what is right and fair for all the parties involved in the negotiation process and want to close the deal. The downfall here is that they tend to rush the negotiation process and make concessions quickly.

The negotiation situation

It is important to understand the situation in which you are negotiating in. For example, negotiating a time to meet with a friend is very different to negotiating in a business environment. In the former, one is more knowledgeable of the needs of both parties and hopefully there is a good understanding of each other and more than likely the negotiation is going to be more informal.

In the case of negotiating in the business and work situation, it would be important to know one’s position and rights and where possible an understanding of the other parties’ negotiating style. As well as keeping positive, staying calm and being reasonable sometimes can be helpful in getting the advice from an expert on the subject area before negotiating. In the work situation it would be helpful to think politically and get the outcome confirmed in writing.

The right time

Finding the right time when to negotiate can play a major role on the outcome. For example, it would be a bad start to try to negotiate when either party was tired, angry, stressed or pre-occupied.

AN ACADEMIC VIEWPOINT

Principled negotiations

Roger Fisher and William Ury, members of the Harvard Negotiation Project, focused on the psychology of negotiations finding an acceptable compromise by determining which needs are fixed and which are flexible.

In their work the success of an agreement is essentially judged by three criteria that are: the agreement should be a wise one; if an agreement is possible, it should be efficient; and, it should improve the relationship between parties, or at best not damage the relationship.

Fisher and Ury in their 1981 book Getting to yes: negotiating agreement without giving in argue that their method can be used virtually in any situation, and the four steps of principled negotiations are:

1. Separate the people from the problem

2. Focus on interests not positions

3. Invent options for mutual gain

4. Insist on using objective criteria

The main theme is that all negotiators should adopt the view that they are problem solvers rather than adversaries, with the aim being to reach an outcome “efficiently and amicably”.

Fisher and Ury stress that when adhering to the above points it should offer a successful outcome. Negotiation can be difficult because the negotiators may have very differing negotiation styles – as listed above. The authors conclude with three main points to consider:

1. What goes on in principled negotiations is common sense, i.e. “You knew it all the time”.

2. Like in everything else, to be a better negotiator one needs practise, i.e. “Learn from doing and mistakes”.

3. Winning: “to win in the context of a better way to negotiate in achieving the aim of what you want and also negotiating decently”.

A prescriptive solution cannot be offered that would be suitable in all negotiations, and whilst there are commonalities across negotiations, each one is different. It would be helpful to be mindful of the process and negotiation styles mentioned above. However, because of the variables that could be involved at any given time in a negotiation, the greatest skill would be to have a grasp of the situation in the moment and adapt as appropriate.

Dr R K Powar has over ten years’ experience in the pharmaceutical industry and provides a range of tailored programmes to develop staff to help an organisation improve on their Softer Ss skill base. Dr Powar can be contacted on r11osyconsultants@yahoo.co.uk or 07962 342 140.  For further information visit
www.r11osyconsultants.co.uk.

The European Commission has granted a marketing authorisation for Trobalt (retigabine) as an add-on treatment for adults who suffer from partial onset seizures.

The licence was supported by the results of Phase III studies that showed a reduction of 50% or more in seizure frequency when Trobalt was added to patients’ existing therapy.

Susan Hall, Head of Research and Development at Valeant Pharmaceuticals says the company is pleased to have reached “such an important milestone”.

Retigabine, referred to as ezogabine in the US and Canada, is being jointly developed by GSK and Valeant.

The European authorisation represents the first license for Trobalt after it was granted a preliminary authorisation by the Swiss Agency for Therapeutics Products in December last year.

Dr Tony Hoos, Senior Vice President, European Medical Affairs, GSK, says that both patients and clinicians will benefit from the drug’s approval.

“The European authorisation of retigabine is very welcome as it will provide neurologists within Europe with a new therapeutic option for the management of appropriate patients with uncontrolled partial onset seizures,” he said.

Merck KGaA has submitted an indication extension to the EMA for the approval of Erbitux (cetuximab) to treat advanced or metastatic non-small-cell lung cancer (NSCLC).

The extension for Erbitux in combination with standard first-line platinum-based chemotherapy is for patients with NSCLC with high epidermal growth factor receptor (EGFR) expression.

The submission is based on a new biomarker analysis of EGFR levels from the Phase III FLEXa study which showed the response rate significantly increased with the addition of Eribtux to standard chemotherapy from 28.1% to 44.4%.

Merck has also analysed further clinical data for the submission and says it plans to present the results at upcoming congresses.

Erbitux has been approved for the treatment of colorectal cancer in 87 countries and the treatment of squamous cell carcinoma of the head and neck (SCCHN) in 84 countries.

In Europe, lung cancer is the leading cause of death from cancer, accounting for one fifth of all cancer deaths. NSCLC currently accounts for approximately 80% of all lung cancer cases.