NHS Southern Derbyshire CCG is to hold a series of events where people with diabetes can discuss their condition with fellow diabetics.

The Diabetes Conversation Cafe will open its doors at three different locations across the region to allow patients to discuss the help they need to manage their condition with clinicians.

Vanessa Vale, Long Term Conditions Manager at the CCG, said the events would reveal the “patterns and insights that will give us a much deeper understanding of the real issues that affect people living with diabetes.”

There are around 27,000 people in Southern Derbyshire with diabetes. That figure is expected to rise to around 35,000 by 2030. Between 2010-2012, hospital related admissions cost the NHS nearly £2 million.

“As diabetes affects a range of different groups we are encouraging people of all ages to attend the events so that we can learn from a range of experience,” said Vanessa Vale.

“Patients are at the heart of everything we do and it’s important that our diabetes patients benefit from a patient-centered service that is designed specifically around their needs. This is an ideal opportunity for patients to influence our next steps and help us to make good services even better.”

The events are planned for 10 June in Belper, 12 June in Mickleover and 19 June in Swadlincote. Reservations can be made at 01332 868727 or by email vanessa.vale@southernderbyshireccg.nhs.uk.

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Regular marijuana use reduces the risk of developing type 2 diabetes, according to a US study based on the National Health and Nutrition Survey.

Data for 2005–2010 show that people who reported recent marijuana use had 16% lower fasting insulin and lower insulin resistance.

The finding will strengthen the case for the medical use of marijuana, already licensed in 19 US states for use under conditions that avoid the health risks of smoking and excessive intake of the drug.

A synthetic form of its active ingredient, tetrahydrocannabinol (THC) is available in pill form and avoids the negative respiratory effects of smoking, as well as making doses easier to control.

The national survey covered 4,657 people. Participants answered questions about their drug use and gave fasting blood samples.

The link between marijuana use and markers of low type 2 diabetes risk (lower fasting insulin and insulin resistance) was stronger where the drug use was recent (within a month).

People with diagnosed type 2 diabetes were excluded from the data analysis, as their dietary patterns were likely to have been influenced by treatment.

Joseph S. Alpert, Editor-in-Chief of The American Journal of Medicine, commented: “We desperately need a great deal more basic and clinical research into the short- and long-term effects of marijuana in a variety of clinical settings such as cancer, diabetes, and frailty of the elderly.”

Diabetes UK has launched a major research programme in partnership with Tesco to develop a vaccine against type 1 diabetes.

Tesco, which has made Diabetes UK its National Charity Partner for this year, hopes to raise £10m for diabetes research through sales and staff fundraising.

While a vaccine to fully prevent type 1 diabetes remains elusive, researchers predict that combining existing treatments will delay the onset and reduce the severity of the condition.

A genetic auto-immune disorder, type 1 diabetes affects 300,000 people in the UK, reducing their life expectancy by an average of 20 years.

Dr Alasdair Rankin, Diabetes UK’s Director of Research, said that a vaccine for Type 1 diabetes is a realistic prospect but will need to be built up to. “There is a huge sense of excitement in the research community that the work being done today is building towards a future where Type 1 diabetes can be stopped in its tracks,” he said.

“It is likely that the first vaccines we see will allow people to live longer before they develop Type 1 diabetes, rather than preventing it entirely. But we know that if people who do develop Type 1 diabetes are treated early with a vaccine then it could provide some benefits that make their condition easier to manage.

“I am really hopeful that with the boost of the funding that has been made possible by our partnership with Tesco, within the next 20 years we will have a vaccine that can stop Type 1 diabetes developing,” he concluded.

A summit meeting to discuss new research into diabetes vaccine development will be used to develop a call for specialist researchers to apply for funding, developing a research programme from next year onward.

The Tesco fundraising campaign will include product promotions that carry a donation to Diabetes UK, donation by customers of club card points, and a donation of 0.0125p for every ATM transaction made at Tesco stores until 28 February 2014.

Public Health England will continue providing five-yearly health checks for all people aged 40–74 years, despite expert claims that these are of limited value.

The NHS health checks, introduced by the Labour government in 2010, have been criticised by leading GPs as diverting resources from those at higher risk.

As Shadow Health Secretary, Andrew Lansley also criticised the policy, saying the checks were “not entered into on the basis of research” and should be either scrapped or refocused on people with stronger risk factors.

The checks screen a total of 15 million people for diabetes, chronic kidney disease, chronic lung disease, cardiovascular disease, and stroke risk.

A recent review by the Cochrane Commission concluded: “General health checks in adults may not reduce morbidity or mortality from disease.”

However, PHE will not only continue the checks but will extend them to include dementia awareness and alcohol consumption.

A spokeswoman for PHE claimed the NHS health check programme to be “highly cost effective,” with an annual cost of £332m and an estimated annual benefit of £367m.

According to John Middleton, Vice President of the UK Faculty of Public Health, the checks should be selectively targeted: “Risk stratification and identification of people most at risk through practice lists may be a more cost effective approach.”

In Nottingham, Stoke and Sandwell, he added, such an approach is already being used to “identify unmet needs for treatment, particularly for hypertension and reducing cardiovascular risk.”

Lilly Diabetes and Disney Publishing Worldwide (DPW) have expanded their US collaboration to bring educational materials to children with type 1 diabetes and their families worldwide.

The educational resources will include a series of books featuring Mickey Mouse and his friend Coco the monkey, who has type 1 diabetes, to be translated and distributed initially in 18 countries.

The UK has recently seen an increase (as yet unexplained) in type 1 diabetes – a genetic auto-immune condition – among children, and lack of effective patient education has been identified by Diabetes UK as a significant problem.

The materials produced by the Lilly-Disney partnership will be available from diabetes healthcare professionals, and will aim to guide families in meeting the challenge of type 1 diabetes control in children.

Effective control of type 1 diabetes requires a blend of medication (injected insulin), carefully managed diet and exercise, and regular monitoring and dose adjustment. For many families, managing the condition in a child is disruptive and traumatic.

Speakers at the recent UK conference Diabetes: A Call to Action emphasised that a strict focus on blood glucose targets can be counter-productive, and that control needs to be integrated with a healthy and positive lifestyle. The Lilly-Disney materials reflect this philosophy, focusing on management of opportunities rather than on negative restrictions.

“We are excited to be part of this effort to bring informational material about type 1 diabetes to kids around the world who are living with the disease,” said Andrew Sugerman, Executive Vice President of DPW. “Lilly Diabetes’ expertise with the disease, combined with Disney’s tradition of great storytelling, gives us an opportunity to inspire and motivate children and families with type 1 diabetes.”

Andrew Hodge, Vice President, International of Lilly Diabetes, commented: “Lilly Diabetes’ objective is to bring safety, health, comfort and a bit of magic to children worldwide. We saw the positive impact our collaboration with Disney Publishing Worldwide had on families living with type 1 diabetes in the US over the last two years, and we are excited to expand our reach globally.”

Immunocore Ltd, an Oxfordshire-based biotechnology company, has appointed Eva-Lotta Allan as Chief Business Officer.

The role has been newly created to strengthen the company’s management team as it develops and commercialises innovative treatments for serious diseases, based on its immunity-strengthening drug platform.

Ms Allan brings two decades’ worth of experience in business development with successful biotech and pharmaceutical companies.

Immunocore’s ImmTAC platform is a T cell receptor technology that uses the body’s immune system to identify and kill diseased cells.

The company is developing a portfolio of drugs from this platform to treat cancer, diabetes and chronic infectious diseases. Its melanoma drug IMCgp100 is undergoing clinical trials in the UK and the US.

Ms Allan joins from biotech company Ablynx NV, where she has served as Chief Business Officer since 2006, contributing to its growth from a small private platform company to a significant public company.

As CBO of Ablynx, Ms Allan closed deals with leading pharmaceutical companies worth over €160m.

Previously, Ms Allan was Senior Director of Business Development and Site Operations (Europe) at Vertex Pharmaceuticals.

James Noble, CEO of Immunocore, said: “I am pleased to welcome Eva-Lotta to our senior Management team and Board of Directors at this critical point for Immunocore as we expand and develop our pipeline of products. She brings with her a wealth of knowledge and experience in business development.”

“I am delighted to be joining Immunocore at this exciting time,” commented Ms Allan. “I have been impressed by the quality of the science and unique and broad application of ImmTACs in cancer. I look forward to working with the Immunocore team and to establishing strategically important collaborations.”

The rapid pace of NHS reform means that the pharmaceutical industry needs new strategies for joint working to create and sustain commercial opportunities. Diana Vegh, NHS Partnership Manager at the ABPI, describes how the Association is working to develop a joined-up partnership strategy across the new NHS landscape.

The NHS has been going through one of the largest reorganisations since its inception – Sir David Nicholson famously describing it as “so big, you can see it from space” – and the implications for the pharmaceutical industry, particularly regarding the joint working agenda, are significant. So much so that the ABPI has established an NHS Partnerships Team, led by Kevin Blakemore, with one senior manager covering each of the four NHS England regional offices. The concept has been driven by Stephen Whitehead, our CEO, and was piloted several years ago as the ABPI Outreach Team – which made constructive inroads in the South-West, a challenging health economy to work in.

I am one of those regional managers, ex-NHS and industry, based in Devon, and covering a territory that stretches from Penzance to Margate. The population is 13.4 million, with a budget of £21.1 billion and 110 NHS organisations. There are 1,873 GP practices, 34 local authorities (with three unitaries), four clinical senates, five Academic Health Science Networks, seven Area Teams, three specialised commissioning hubs and 51 CCGs. And it’s a 14-hour return journey from one end to the other. Plus we’re a trade association, with limited resources. With such a large number of potential customers and new organisations, how do we make the best use of our time?

RIGS strike oil

Each of us has produced a regional business plan, aligned to member company priorities, broadly supporting our themes of value and partnership, and clustered around 11 core corporate objectives. These have all been discussed and agreed by our Board of Management, which is made up of member company executives. The most important objective for my team is improving the environment for access and uptake of innovative medicines. We’ve segmented our rapidly evolving customer base and developed stakeholder maps for engagement. But pivotal to helping us navigate this complex structure has been the establishment of our Regional Industry Groups or RIGs, one per region, which meet monthly. General managers of our member companies have nominated senior representatives to sit on these groups, and we are adding associates who will join us virtually, i.e. online, via WebEx and telephone conferencing.

My RIG is chaired by Lisa Rosewarne from MSD, and our deputy Chair is James Steed from Pfizer. We have agreed our Terms of Reference and work plan for 2013, with a series of five workstreams and virtual task and finish groups led by RIG members, focusing on industry-wide issues from medicines optimisation to the Formularies Good Practice Guide. We often have external speakers who may not meet with single companies but are happy to talk to a group – such as Steve Sparks from NICE, who manages the field-based Implementation Team, and who recently gave an excellent presentation at one of our meetings. We also connect our RIG to the national policy work we do, and communicate across the other ABPI teams.

We’ve had a number of ‘bids’ from the NHS and healthcare companies who are interested in working with the pharmaceutical that there is a need for external organisations to understand better what joint working truly means in terms of the ‘Moving Beyond Sponsorship’ work done by the ABPI and the Department of Health in 2010. Our key tool for this has been the Joint Working Guide, and in particular the sections on pages 7 and 8. One of our RIG workstreams is to use these guidelines to engage with potential partners in order to share constructive feedback and highlight examples of best practice that we are collecting from member companies.

We showcased this at a conference with the NHS Confederation in February this year, in London. We have a Memorandum of Understanding with the NHS Confederation and the ABHI to work on the Innovation, Health and Wealth agenda collectively; and this national policy work is essentially what we’re putting into practice in our regions.

Rules of engagement

In my day-to-day job and in my meetings with NHS stakeholders, I work to promote the whole pharmaceutical industry and a more mature working relationship with us. The majority of my discussions have been very positive, with a clear desire to move away from the old models of promotional metrics and explore a new way of working. Some CCGs, such as Torbay and South Devon, are striving to be ahead of the curve. Others are more conservative and prefer to agree a new policy on joint working first, and we’re trying to encourage the use of our toolkit and case studies.

But one thing I’m very clear to emphasise is that my team isn’t ‘the’ route into pharmaceutical companies. If an NHS organisation wishes to work directly with a company, of course it can. We are not competing with market access teams – we are enablers and facilitators – and the ABPI Code of Practice gives the NHS assurances about governance and conduct. But some organisations remain difficult to reach. I’m using good examples of joint working elsewhere in the NHS, or pragmatic discussions in other parts of the organisation, to overcome those barriers.

After all, partnership isn’t about pretending that everything’s fine and there aren’t any problems. But it is about moving to a place where you can agree to disagree, and solve your problems together even if you have differences. . e table above shows the framework I base my work on.

On the whole, projects seem to fall into three categories. The first category is disease specific projects, which often relate to long-term conditions such as COPD, diabetes or vascular health. Some of these can be quite broad, while others can be about specific service redesign projects in a particular health economy and relate to implementing new national guidance. The second category is projects that relate to an NHS priority, such as reducing inequalities, where industry expertise in social marketing and media has been put to excellent use. The final category, and the one expanding most rapidly, is where we have shared aims: improving patient safety, reducing medicines wastage, better adherence, realising the benefits of treatments – i.e. the medicines optimisation agenda.

Moving the goalposts

Those of you with a lot of experience may be reading this with a sceptical eye. Hasn’t this all been done before? Talked about before?

Yes. But this time, there are some key differences. The clinical voice is louder, and often in a leadership position. Attention is far more on quality than in the past, and the sanctions are greater. And while our austere financial climate is squeezing medicines spending, increasingly senior people are seeing that it is disingenuous to look at medicines solely as a cost pressure, and far more beneficial to see them as a means of improving health outcomes – on which the NHS is now being more tightly measured. New organisations also have a legal duty to innovate, which is now in primary legislation as part of the Health and Social Care Act. The new Academic Health Science Networks have been set up as companies, and though many focus on the earlier part of the medicines life cycle they will all be looking for new partnerships.

Pharmaceutical companies are also changing. We’ve gone from Share of Voice to Key Account Management, and the skills and competency mix of pharmaceutical field teams is very different from how it was a few years ago. When I’m out and about I’m meeting people with new roles, such as service development managers, NHS business managers and strategic account managers. And there have been a lot of redundancies in the NHS which have seen knowledge and skills move into the pharmaceutical industry. Today I had an email from a CCG asking me how they could second someone into an ABPI member company.

We are in a ‘perfect storm’ of policy, and the organisational turbulence we’ve all experienced is bringing some very forward-thinking and creative people into senior positions. Let’s make the most of that, and work together to get better outcomes for the populations that we live in and for the organisations that employ us.

Novo Nordisk, the world’s leading supplier of medicines for diabetes care, has joined the ABPI for the first time.

The decision reflects the Danish company’s growing involvement in the UK health market, where the importance of diabetes care is growing rapidly.

It also reflects the increased profile of the ABPI in negotiations affecting the UK pharmaceutical industry, including the adoption of value-based pricing for drugs.

Novo Nordisk recently launched a new basal insulin, Tresiba, in the UK and celebrated 90 years in the diabetes care market.

Peter Meeus, UK General Manager of Novo Nordisk, commented: “As a growing player in the UK pharmaceutical market, we felt the time was right to join the ABPI. The ABPI has undergone real transformation in recent years and we are confident that as our business continues to grow in the UK, ABPI engagement will complement what we are doing to ensure we are better positioned to face the challenges and the opportunities in an increasingly dynamic business setting.”

“Novo Nordisk is a very welcome and important addition to our membership and will further strengthen the ABPI as the voice of the pharmaceutical industry,” said Stephen Whitehead, ABPI Chief Executive.

“We will be looking to support them and our wider membership to ensure that once a medicine has been approved for use in the UK, the NHS is able to adopt it and patients can fully realise its benefits.”

Novo Nordisk has launched Tresiba (insulin degludec), a new basal insulin for adults with type 1 or type 2 diabetes, in the UK.

Tresiba controls HbA1c levels as effectively as the standard basal insulin Lantus (insulin glargine) while posing less risk of nocturnal hypoglycaemic episodes.

It is also the first basal insulin to allow flexibility in injection time, as it has a 42-hour action, requiring only a minimum of 8 hours between injections.

Compared to Sanofi’s Lantus, Tresiba has been shown to reduce the incidence of nocturnal hypoglycaemia in patients with type 1 diabetes by 25%, and in insulin-naive patients with type 2 diabetes by 36%.

The overall rate of hypoglycaemia was similar for both types of insulin – but nocturnal episodes are particularly dangerous because they are harder to treat. Severe hypoglycaemic episodes are estimated to be responsible for 6% of deaths in people with diabetes under the age of 40, and half of such episodes take place at night.

Professor Melanie J Davies, Professor of Diabetes Medicine, University of Leicester, said: “Many of my patients have difficulty taking their insulin at exactly the same time each day, for reasons which we can all sympathise with and understand. For example, picking children up from school or working irregular shifts at work.

“It is thus very useful that there is now an insulin which, because of its longer duration of action, is able to offer patients a bit more flexibility in terms of timing of their dose without compromising either their glycaemic control or risk of hypoglycaemia.”

Tresiba is available in two FlexTouch pens: FlexTouch U100 (1–80 units per dose) and FlexTouch U200 (2–160 units per dose).

The UK now has more than three million people living with diabetes, new research claims.

Analysis carried out by the charity Diabetes UK and its partner Tesco found that 4.6% of the UK’s population has either Type 1 or Type 2 diabetes.

More worryingly, a further 850,000 people are thought to living with Type 2 diabetes without being diagnosed.

Barbara Young, Chief Executive of Diabetes UK, said the charity was “hugely concerned” at the findings and had “no reason to think this will mark the end of what has been a rapid rise in the condition.”

The new findings indicate an increase of some 132,000 people who have been diagnosed with the condition in the last 12 months. Every year in England and Wales around 24,000 people with diabetes die earlier than expected.

Experts have now warned that unless the precedence of diabetes is tackled the NHS will be burdened with unsustainable costs in the future.

“This unfolding tragedy is already putting huge pressure on the NHS and will have potentially devastating consequences for those people who develop the condition. But this is not inevitable,” said Barbara Young.

“By identifying those at high risk of developing Type 2 diabetes, we can ensure they start getting support to make the kind of lifestyle changes that can help prevent it. And by making sure people who have Type 1 or Type 2 diabetes are already getting the care and support they need, we can help them avoid the devastating complications diabetes can cause.”

Diabetes UK and Tesco have now established a new national partnership with the aim to raise £10 million to help create a healthier future for diabetics. The partnership will fund the largest public awareness campaign aimed at some seven million people thought to be at risk of contracting Type 2 diabetes.

“I’m delighted Tesco has made Diabetes UK its National Charity Partner, as this will make a real difference in curbing the rise in the condition,” said Barbara Young.