The high fives of Innovative cancer treatments

by Amy Schofield 22. June 2016 08:06

 

1 CANCER IMMUNOTHERAPY

Treatments that harness the inherent powers of the immune system to fight cancer are hailed as the most promising new treatment approach, since the development of chemotherapies in the late 1940s.

The process selectively targets and kills cancerous cells, without damaging healthy ones, meaning fewer side effects. Recent experimental research into CAR T-Cell therapy on patients, with acute lymphoblastic leukaemia, found that the symptoms in 94% of participants with this blood cancer completely disappeared.

The approach is universal, and can be used to treat almost all cancers. The ability of the immune system to ‘remember’ means that immunotherapy could also offer long-term protection against cancer.

 

2 NANOTECHNOLOGY

Nanotechnology is one of the hottest new areas of medicine, based on microscopic particles, with distinctive properties related to their chemical structure, mobility, and ability to absorb energy.

In South Australia, nanotech ‘smart packages’ - delivered with chemotherapy drugs - have been found to target and destroy cancer cells, while reducing side effects. 

The minuscule ‘trojan horse’ vehicles are 100 nanometres in diameter, and contain folate molecules which find and attach themselves to cancer cells. Anti-cancer drugs in the smart packages are then released, killing cells in the process.

 

3 TARGETED MEDICINES

These interfere with the specific molecules - molecular targets - that are needed for tumours to grow, progress and spread. As a monotherapy, targeted medicines are already a formidable addition to the cancer-fighting arsenal. 

Therapies act on specific molecular targets, associated with cancer, and are deliberately selected to interact with their target, without destroying surrounding healthy cells.

They do have their limitations however - one of which is the risk of cancer cells becoming resistant to the treatment, for example through mutation. Which brings us on to combination therapies.

 

4 CANCER COMBINATIONS

Combination therapy has been a hallmark of cancer treatment for years, as a way of killing cancer cells and halting the progression of the disease.

Earlier this year, research on 257 women showed that the combination of two drugs - lapatinib and trastuzumab - could shrink, or even eliminate, breast cancer tumours in 11 days. Around a quarter of women with aggressive HER2 positive breast cancer benefitted.

Professor Nigel Bundred, Professor of Surgical Oncology at the University Hospital of South Manchester, said: "This has ground-breaking potential.”

 

5 VACCINES

The HPV (human papilloma virus) vaccination, which protects against cervical cancer, is already widely offered to 12 and 13-year-old girls, as part of the NHS childhood vaccination programme. 

A unique phase one trial is now underway to test a new cancer vaccine, designed to harness the power of the immune system to destroy tumours, wherever they are in the body. The trial will run over the next two years and involve up to 30 volunteers.

The vaccine contains a small fragment of protein from an enzyme called ‘human telomerase reverse transcriptase (hTERT)’. This enzyme allows cancer cells to continuously divide.

By injecting the antigen into the patient, along with a low dose of a chemotherapy drug, it is hoped the immune system response will be stimulated, making antibodies that will kill cancer cells, but leave healthy cells alone.

 

Facts and stats:

Worldwide:
14.1 million people a year worldwide are diagnosed with cancer

8.2 million of those will die

That is one person every 4 seconds dies

Deaths from cancer are expected to double by 2030*

UK:
2.5 million people in the UK have cancer

Over 300,000 people are diagnosed with cancer each year

Over 160,000 people a year die of cancer

Breast, prostate, lung and bowel cancers together accounted for over half of all new cancer cases in the UK in 2013

42% of cases are preventable*

 

*From cancerresearch.org

 

 

 

Tags: , , , ,

Features

AIDS: death sentence to daylight

by John Pinching 6. June 2016 09:10

Chastening AIDS into submission is surely man’s greatest achievement.

In many ways HIV/AIDS was the classic horror film set up. A community suddenly and inexplicably targeted by a demonic predator. It was Halloween, it was Jaws and it was any number of vampire movies. And it was made all the more terrifying, because this enemy came without a name or a face. 

The HIV/AIDS plot began 35 years ago in California. After years of secrecy the gay community had started to find its voice, coming out in a whirlwind of art, music, nightclubs and, understandably, sexual defiance. The new generation of homosexuals were no longer prepared to endure prejudice and, instead, flaunted their physiques, and expressed freedom through promiscuity.

By 1981, however, a mysterious illness threatened to ruin the party. Predominantly young, gay men were dying from a new virus, defined by a period of sudden weight loss, lesions and the shutdown down of a hitherto healthy immune system. The situation triggered panic, and also prompted celestial posturing from those who pronounced it ‘a punishment from God’. The ignorance was almost as harmful as the illness itself.

By the end of that first year, 152 deaths had been recorded, but it was an isolated fatality that most puzzled the scientific community, for one of those infected was not a homosexual, but an intravenous drug user – the first indication that this condition impacted on everyone.

The gay community’s reaction was impressive and they called on an already finely-tuned expertise in activism. Even in the throes of unimaginable suffering they marched, campaigned for accelerated treatment approvals and lent themselves to cohort studies. While some refused to give up their sexual liberation, others wanted to help those they left behind. It was altruism in its purest form.

Meanwhile, in the UK, immunology departments braced themselves as the ‘new disease’ crossed the Atlantic. Amazingly, one of the first diagnosed cases was not a sexually reckless homosexual, but a ‘normal’ housewife, with only one sexual partner (her husband) – this was the moment the ‘gay problem’ became society’s problem. 

By 1982/83 the mysterious condition had a name – ‘acquired immune deficiency syndrome’ – and an unforgettable acronym; ‘AIDS’. Experts in the UK attempted to educate the public with a polite letter, printed in national newspapers, but, after it failed to receive attention, a shocking information film was broadcast, which left nothing to chance. The word AIDS was chiselled into a tombstone, lilies were tossed on a grave and a chilling voiceover told you the deal.

There were also a few high profile deaths, but it was Rock Hudson’s, back in the US, that convinced any remaining cynics that this was serious – a symbol of enduring strength was dead, and he had died of AIDS.

In 1987 the first effective treatment – a nucleoside reverse transcriptase Inhibitor (NRTI) – called AZT, began to be widely used and, thereafter, a flurry of anti-retroviral therapies emerged, as pharma’s mission came into sharp focus. While these treatments temporarily fooled the replication system of the virus, patients would eventually be overwhelmed, and die from AIDS-related complications. 

The 1990s heralded wider solidarity against a common foe. Freddie Mercury’s death raised awareness further, while the tale of two very different Johnsons – Magic and Holly – proved that there was life after a positive result. The former, a hugely popular basketball star, and the latter, the charismatic lead singer of Frankie Goes to Hollywood, have fought the disease in the public gaze, and are both alive in 2016. 

Campaigns continued through a number of female figureheads, notably Princess Diana and Elizabeth Taylor, and the red ribbon became a fashion statement – disease awareness was immersed in pop culture in a way that had never been seen before.

In the second half of the decade indinavir – a protease inhibitor – was combined with two existing NRTIs, and the game changed. It suppressed the virus indefinitely and frequently rendered it undetectable. Thousands of people avoided death, illness and even hospitalisation, as a stranglehold on AIDS was established and it became a long term treatable condition. 

The single pill therapy, REZOLSTA, has recently become available for HIV-1 patients, and represents a significant move towards better treatment discipline, in an area which requires at least 95% adherence. Meanwhile, the brilliantly-abbreviated PrEP (from the not quite as sexy, ‘pre-exposure prophylaxis’), is a controversial combination of tenofovir and emtricitabine, which blocks the setting up of an infection, in HIV-negative individuals. It has been argued that people will abuse it in a sexual frenzy, whereas I would suggest that all alternatives to getting AIDS should be celebrated.

Indeed, in the great tapestry of human behaviour history will remember HIV/AIDS, not by mankind’s struggle, but how it reached unchartered heights of humanity. How ‘we’ have dealt with it – as healthcare professionals, as pharma and – most resolutely – as people, has set the template for how all diseases should be approached. 

In the final analysis AIDS/HIV has been a most profound study of the human condition but, curiously, it has not been so much about death, as what it is to be alive. 

 

Witnessing history

John Pinching talks to Professor of Clinical Immunology Professor Anthony Pinching about his reflections on HIV/AIDS.

 Prof. Anthony Pinching, witnessed the arrival of AIDS, treated its earliest patients and saw at first-hand how the story unfolded. 

1. How satisfying is it to you personally that HIV/AIDS is now a treatable long term condition rather than a death sentence?

In the early 1980s, when we started to see this condition in the UK, a patient being diagnosed as having AIDS had an average life expectancy of some nine months. While some died sooner from their first presenting illness, others lived quite a bit longer – I remember some living for as long as three years. Once we were able to identify people with HIV infection, before they were ill, we recognised that they could remain well, and without immunodeficiency for many years, although there was a steady and relatively high rate of progression to AIDS over 5-10 years of follow-up.

Initial treatments were based on treating presenting opportunist infections and tumours, and maximising health and well-being, together with adjustment to the condition and its prognosis amongst a generally young group of people. This could achieve a certain amount in treating acute events, and maximising health inbetween bouts of illness, but the underlying condition would continue to progress.

We then saw single-agent anti-retroviral therapy (zidovudine) making a small, but useful, difference in life expectancy, initially demonstrated in those with AIDS, where it almost doubled. It was later shown to help people with HIV infection and adverse prognostic markers, leading to lower rates of progression.

The breakthrough – and it really was that – came with the clinical trials, demonstrating the impact of combination anti-retroviral therapy in the mid-1990s. While the theoretical concept was logical and attractive, the actual impact was unexpectedly massive. It transformed life expectancy, and indeed the whole landscape of HIV/AIDS treatment. We were surprised and delighted to see the extent to which the immune system could recover when HIV was effectively suppressed. What had been, in effect, a terminal illness, became a chronic treatable disease, with life expectancy increased by more than an order of magnitude. The impact on individuals and on populations were remarkable for those of us at the front-line.

Studies subsequently have consolidated this impact, refining the approach, and optimal timing of intervention, monitoring treatment impact, minimising side-effects and maximising convenience and adherence, as well as showing reductions in HIV transmission from effectively treated HIV-infected persons – most strikingly in mother-to-infant transmission. 

As someone involved in treating patients from the outset of the pandemic, this change was truly extraordinary to witness. It was a very satisfying outcome to all the enormous investment of ideas and money, by many people and organisations across the world. As a clinical researcher, it was great to see how the systematic pursuit of clinical research had achieved such results in such a relatively short time. As someone involved in public policy, as well as helping in addressing the challenge of HIV in Africa, it was immense, and heartening. It was especially good to see these treatments made available in Africa and other developing regions, contrary to early predictions.

2. Are you surprised at the relative speed at which it has happened?

The pace of the improvements in HIV/AIDS treatment –  in real time – seemed frustratingly slow because, as clinicians, we saw the immediacy of need in our patients, and yet we had to do our best with more limited tools, while the necessary research was done. From a wider perspective, however, the speed with which we went from first recognition of the disease (1981), to first HIV tests (1985), to first effective treatment (1987), through to combination anti-retroviral therapy (1996), was unprecedented.

It required massive investment, great focus, and tremendous collaboration between scientists, clinicians, the pharmaceutical industry, governments and – above all – patients. It showed what could be done with that sort of focus and collaboration. It wasn’t easy – indeed it was quite ‘bumpy’ at times, but we got there!

3. Do you think the social stigma regarding HIV/AIDS has lifted in recent years?

Yes, to a substantial degree, although there is more to be done. Extraordinary work across many sectors, important community advocacy, valuable public policy changes, and cumulative shifts in society have all played a part in reducing stigma. But problems remain in a number of respects in the UK, and even more so in other parts of the world. It will take a generation or two to get to where we need to be, but there has undoubtedly been change for the good, and some came surprisingly soon. The response to HIV/AIDS has also had a positive impact in reducing stigma and discrimination for people with a wide range of other health problems.

4. Do you think it's possible that a cure could emerge in the next decade?

‘Cure’ is not a helpful word for most diseases – it has a very particular meaning, signifying something that is very rarely achieved with chronic disease. I do think that what has already been achieved for HIV/AIDS, however, represents something of the same order: an eminently treatable chronic condition that may be compatible with near-normal life expectancy. I wouldn’t have imagined much of what has transpired!

Professor Anthony J Pinching, DPhil, FRCP, Emeritus Professor of Clinical Immunology, PCMD

 

Illustration by Alex Buccheri

Tags: , , ,

Features

Is obesity really catching? Don’t believe the hype

by Amy Schofield 31. May 2016 09:12

Obesity is contagious, according to the Telegraph and Daily Mail. The papers were attempting to interpret a study into bacteria living in the human gut. The Telegraph headline yelled, ‘Obesity could be contagious like superbug C.diff, suggest scientists’. ‘Is obesity CONTAGIOUS?’ The Daily Mail blustered.


The Story

The Telegraph story compared a decade-old study – which found that taking gut microbes from overweight mice, and adding them to thin mice, could make them gain weight – to a new study, which suggests that gut microbes can live outside the body, become airborne and potentially ingested. The article then put two hundred lbs and two hundred lbs together and made five. 

The five being that unsuspecting people in close proximity, for example families, can breathe in microbes and ‘swallow’ obesity.

The Study

The research, published in Nature, was conducted by scientists from the Wellcome Trust Sanger Institute, in the UK, Hudson Institute of Medical Research and Monash University in Australia. 

Number of participants: Six 

What the researchers did: Took stool samples, grew cultures of bacteria to identify the types of bacteria found, then studied how long the bacteria lived outside the human body.

What press said: ‘Spores of bacteria from the guts of fat people could spread to healthy individuals’ ‘Obesity could be a contagious condition’


The Results

The research studied the role of gut bacteria and transmission of infection from person to person – crucially however, the study does not look at obesity. It focuses on gut bacteria and puts forward ways in which they might survive and spread between humans.

The headlines were surmised from a line in a quote by the lead researcher, Dr Trevor Lawley: “I think there are definitely diseases that are caused by an imbalance in microbiotia. If you look at something like inflammatory bowel disease. Or obesity, that’s a possibility.” 

A possibility, not a research finding. But let’s not let that get in the way of an attention-grabbing story.

 

The Deal

The human microbiome is becoming an ever more fascinating and growing field of research. The billions of bacteria in our gut affect our health in ways that are only just being discovered. The research did not find bacteria in the gut responsible for causing obesity, a link between obesity and C.diff, or evidence that obesity spreads between people by bacterial transfer.

The study actually found that around a third of bacteria in our guts are likely to be capable of surviving and spreading from person to person, which could ultimately lead to a deeper understanding of disease.

 

 

Tags: , , , , ,

Features

Rise of the Vaccines

by John Pinching 26. May 2016 09:10

We are climbing the mountain of inoculation history, and the view is spectacular – but complicated.

In the western world, two iconic images have come to define ‘needles’, vaccinations and the general melting pot of injections (it’s striking how many people still don’t make any distinction between these categories!). The first is the filth and degradation of heroin dependency, popularised in the film Trainspotting and – in glorious contrast – the second, is the trypanophobic image of a rotund nurse, wielding an impossibly large syringe, as weeping school children queue, paralysed by fear. 

Indeed, I still have vivid infantile recollections of being summoned to the nurse, for my TB jab, and having to make a detour to a remote convenience, in order to compose myself. There, pacing among the urinals, I found the ‘toughest boy in the year’, evidently shaken to the core – tortured by the thought of a gargantuan, poison-laced spike savaging his flesh. Bonded by terror, we carefully went through the possible scenarios, when it came to being vaccinated, and this included – as I recall – death. 

The irony was entirely lost on the young Pinching, and it genuinely never occurred to me that the jab was, in actual fact, saving me from a deadly disease which, hitherto, had killed thousands. Eventually, my fellow ‘fear prisoner’, and I, completed the walk of shame, to the nurse’s room. When it was his turn, the ‘toughest boy in the year’ emitted a short, sharp scream – as he was inoculated – before emerging, from behind the curtain, and fleeing. We never spoke again – we were just two more guys with a dark secret. What should not be shrouded in secrecy is the vital role that vaccinations continue to play in the survival of the human race. In spite of what some view as a medicine delivery system that belongs in the asylums of a bygone age; vaccines remain at the cutting edge of science – offering salvation to millions worldwide. Treatment breakthroughs are surfacing at a faster rate than ever before, and history will witness that, for vaccines, and the companies developing them – this is the second coming. 

The intrepid scientific breakthroughs have been timely – but have also come at a price. Ebola has, before our very eyes, fallen off the dreaded red ticker tape of 24 hour news; we no longer read about the suffering of those people in North Africa, whose ommunities were devastated by this unrelenting condition. 

The outbreak began in 2013 and – following WHO’s unprecedented license to ‘experiment’ with possible treatments – a race for a preventative vaccine duly unfolded. Small US-based firm Novavax experienced some success with their early version of a vaccine in 2014, and the guys at National Microbiology Laboratory, in Canada, brought us the 100% unpronounceable, but ‘100% effective’, VSV-EBOV vaccine, which has made it to phase III trials. Furthermore, GSK demonstrated a fearless approach – not to mention creative zeal – by using a chimpanzee’s cold virus, in the development of its candidate, which is also at an advanced phase. 

In spite of the success, and speed at which these medical marvels have been realised, there is still sneering from the, mainly, British press. They will – with no appreciation of what it takes, in terms of cost, personnel and technology, to jump into the serpent’s pit of deadly diseases – ask arbitrary questions, like ‘why wasn’t it discovered earlier?’ and, ‘if we’ve known about it so long, why are you only doing something now?’ 

The British press, far from celebrating the milestones achieved by pharma in the area of vaccines, have a long history of ignorance, which belongs more to the speculation of witchcraft, than modern science. The MMR jab is still reeling after more than one tabloid newspaper insisted – without corroboration – that it could lead to autism in children; that somehow an infant could be ‘injected’ with ‘emotional disconnection’. While children should have enjoyed the benefit of disease protection, to the power of three, parents were instead wrestling with a moral dichotomy. In reality, there was no scientific basis for this ‘judgement’. It was a bit like suggesting that someone who consumes a ham sandwich, is 70% more likely to commit a homicide, within three hours of lunch. It’s all so much baloney. 

Vaccines have, however, formed a complex maze – morally, socially and politically – in our collective consciousness. This is underlined by the current meningitis B maelstrom. In the UK this ground-breaking vaccine is only being offered to children below one year of age, leaving anyone above that threshold vulnerable. In the opinion of this author, if we have the knowledge and means to protect our children, that is precisely what we should be doing – and, tragically, there have been some very notable examples of why we should get on with doing it. 

Indeed, we may well ask, if we are prepared to treat people with lung cancer – who knew the risk of smoking – should we not help innocent children, who have done nothing to deserve the suffering brought on by meningitis. If money is the problem, then perhaps a hasty exit from the EU is further incentivised – two weeks’ worth of membership fees would, not only protect our children, but also provide another shot in the arm for an already upbeat pharma industry. If we have any left over, we can ship a consignment off to the developing world. See, you don’t have to know the special handshake, of an anachronistic society, if you aspire to humanitarian ideologies. On that note, it is also worth raising a salute to some remarkable vaccine-based victories achieved by pharma in recent times. Sanofi Pasteur MSD – who have since announced their amicable separation – received the go-ahead for immunising children, between nine and 14, against cervical, vulvar, vaginal and anal cancers. 

Impressively, Boehringer Ingelheim have – once again – defied the perception of big pharma, by helping to fund the development of Amal Therapeutics’ colorectal vaccine, ‘ATP 124’, while also backing its KISIMA technology platform, for a therapeutic tumour vaccination. 

Meanwhile, the summit of vaccination territory, remains immunity against HIV – the cloud that still casts its spectre over mankind, from the nightclubs of London, to the desolate wastelands of India and Africa. Many have hung tantalisingly from the precipices of widespread inoculation, only to fail at advanced phases of the climb. With billions invested, more clinical trials in the pipeline and the promise of game-changing status, an HIV vaccine would not only rid the world of a malignant enemy, but trigger a shift in pharma’s cultural status. 

From a company perspective, vaccines certainly represent a chance to impact on the greatest number of lives, in the shortest amount of time. Or, as a slightly cynical pharma veteran, who shall remain nameless, put it, "rather than providing a few ill people, with treatment they do need, its far better to provide 100,000 vaccines to people who don’t." Actually, the motivation, when it comes to global pandemics, is largely irrelevant. I’m in no doubt, however, that pharma is on a crusade against these diseases, because having a fair chance, is a basic human right, and protecting that – and the citizens of the world – is the enduring reason that this industry exists at all.

 

Check out how the ABPI is committed to the ongoing use and development of vaccines

 

Illustration by Alex Buccheri @this_is_bucci

 

Tags: , , , , ,

Features

Industry gets upgrade at PM Society Digital Awards

by John Pinching 25. May 2016 09:32

For a while ‘the future’ has been imminent, but the PM Society Digital Awards was the most convincing evidence yet that pharma and digital are dating – and they’ve got past second base.

Rachel Farrow – co-chair of the society – had the idea of exclusively recognising digital excellence years ago, when pharma marketing was still a pen and ink pot operation. Boy, what a prophecy that has turned out to be!

Revolutionary digital wizardry

Pharma’s digital community gathered within the exposed brickwork walls of The Brewery, in London, and while a kaleidoscope of strobe lighting danced across their faces, the delegates laughed as they discussed real world data and meta-tags and ‘breadcrumbs’. This scenario was unthinkable a decade ago. It was like being immersed in a giant healthcare tech-hub, populated by nerds, who were gleefully changing the old order.

I was keen to check out some of this revolutionary digital wizardry but, for the life of me, I couldn’t find the exhibition. The woman I asked smiled sympathetically, and led me to a state-of-the-art virtual experience, on a touch screen monitor, and with that, dear reader, the last of my brain’s analogue settings were vanquished for eternity. 

Meanwhile, Jason Manford proved an inspired host. Unleashing a tirade of anti-southern rhetoric, and resembling a club comic from the 1970s, he was an amusing contrast to the futuristic vibe of the evening.

Among the big winners were ‘The Trouble with Dragons’, which used playful animation to help parents and their children manage ADHD, and ‘Virtual Valve’ – a combination of striking infographics with astonishing biological ‘tours’. My personal favourite, however, was the social media campaign, ‘Sniffers’. A brilliant parody of a drugs bust, the film features a squad of ‘STI police’, accompanied by dogs, entering a nightclub and ‘sniffing out’ people with undiagnosed conditions. It even appeared on porn sites although, naturally, I cannot verify this.

It seemed to me that the ideas emerging from all the finalists, represented a changing of the guard, where patients are not filed under their disease area, but encouraged to rise above it and – as individuals – take ownership of it.

Indeed, at the heart of all these extraordinary devices was genuine patient and healthcare professional engagement. This was pharma talking and listening to patients and, critically, providing them
with a platform to make a difference. 

In the final analysis, the digital monolith is here, and there’s no getting away from it. By the end of the evening I felt part of a new era-defining moment, and couldn’t help dancing to the algorithm of the night. 

Go to pmsociety.org.uk

 

Gold getters

Selling tools & CLM initiatives RFA More than a name idetail

HCP education & support emotive Virtual Valve

Multichannel campaign McCann Manchester The Trouble with Dragons (pictured)

Healthcare partnerships GM AHSN Stroke Landscape Tool

Patient initiatives The Earthworks Transplant360

Market access emotive EYLEA Commissioning Toolkit

Mobile apps Incuna Risk Factor Calculator

Social media Langland Sniffers

Congress/Meetings emotive Virtual Valve

Pharma corporate comms McCann Manchester Elvanse Adult Brand Tool App

Film Langland Sniffers

Gamification Halesway The Restoration Game

Animation Langland JINARC MOA

Agency self-promotion 90TEN Life-changing website

Innovation Pegasus MS Explorer

Digital Account Manager Radical Departures Catherine Silk 

Social media company of the year Boehringer Ingelheim

 

 

 

 

 

 

Tags: , , , ,

Features

3D technology set to revolutionise pharma and healthcare

by Amy Schofield 24. May 2016 13:28

It might be before your time, but some of us remember how excited we were when 3D technology first burst onto the scene in the 1980s. Flimsy 3D glasses, complete with red and green lenses, were given away in cereal packets - this was the future and we could feel part of it. Then we quickly lost interest and 3D disappeared for decades. 3D films are now taken for granted by children of today, such is the pace of technology. But now 3D is finally being applied to healthcare and the infinite possibilities of 3D medicines, treatments and the pharmaceutical industry generally are something grown-ups are getting really excited about. 

Indeed, 3D technology is shaping the future of the life sciences and pharma industry, and recently its impact on the wider healthcare landscape is beginning to be felt – we are at the dawn of a new age. 

Printed pills

The development of 3D printed medicines is seen by industry insiders as representing a major change in how the pharma industry delivers drugs to patients. 

Simon Shen, CEO of 3D printer brand, XYZprinting, thinks that 3D printing of pills will allow for personalised medicines which address the needs of different patients. 

“The true advantage of 3D printing in pharmaceuticals is a capacity for personalisation. 3D printing can tailor the content and size of drugs to a patient’s needs, as their condition progresses,” he said.

“The pharmaceutical industry will likely become far more individually tailored and thereby more effective. The ability for pharmacies to print prescriptions on demand will be the one of the most significant shifts that this technology will bring to the healthcare landscape, impacting on costs of production and creating a deeper understanding between practitioners and patients,” he added.

According to Design Engineer Jeremy Kooyman, of Cambridge Design Partnership, precision printing of pharmaceutical products will “fundamentally change how patients and payers interact with their pharmacists and the healthcare system”. 

“Rather than a one-pill-fits-all approach, a pharmacist could modify a blueprint to tailor a treatment for a patient’s body mass or gene profile, while customising the shape and taste to encourage dosing compliance,” he elaborated. “You could even imagine combining multiple medicinal products together to reduce the number of pills a patient would need to take, drastically reducing the potential for under/overdoses, missed doses, and incorrect doses – all of which are linked with a startling rate of mortality in the developed world.”

Possibilities

The future for 3D printing is taking us into a new era, although there is still some way to go: “In the longer term 3D printing offers the possibility of printing biological implants, or even entire replacement organs, such as kidneys. This is a little further off, however, and it is still in the proof-of-concept stage,” said Cyan Collier, Innovations Director of Incuna.

Collier adds that 3D printing additionally offers improvements in areas such as prosthetics and replacements for plaster casts and braces, in the short term. 

“For example, a 3D printed plastic lattice cast will be lightweight and allow a patient with a broken arm to take showers with their cast. This technology is pretty much ready to go, and it is just a matter of time before we start seeing it entering mainstream use,” he explained.

Holographic imaging

Edinburgh-based Holoxica is helping to develop a prototype holographic 3D video representation to visualise medical images from CT, MRI and ultrasound scanners. The display is able to create 3D images in mid-air, allowing doctors, consultants and surgeons to visualise scans live. This is expected to lead to better outcomes for patients, including faster diagnosis, improved treatment and better quality surgery.

The technology addresses the visualisation of 3D volumetric data from medical scanning devices, such as ultrasounds and MRIs. Driven by the need to deliver faster, more efficient and cost-effective healthcare, these devices have increasingly appeared in hospitals and medical centres over the past two decades, while their performance has also continued to improve.

Holoxica’s CEO Javid Khan insists that this application of 3D technology will have a positive impact on outcomes and patient experience within the NHS: “The benefits of the holographic volumetric display include quicker interpretation of 3D scan images, faster surgery and better quality surgical procedures,” he explained. “In addition, it will be possible to educate patients and provide them with a more intuitive overview of complex procedures.”

Medical professionals and students will also benefit, through teaching, training, diagnostics, planning and live surgery. Holoxica is currently selling static digital holograms to university medical schools, teaching hospitals and medical imaging research centres. 

“We have already holographically imaged the entire human anatomy, plus all of the organs from all modalities; CT, MRI and ultrasound sonography.”

According to Khan, the UK is currently lagging behind on developing this technology – Holoxica is the only commercial group working in this area. 

“There are a smattering of university groups working on this, including Cambridge University. Most of the research is being conducted by the US military, and groups in Asia [Japan, China and Korea], where next generation holographic 3D technology is enshrined in their national R&D programmes,” he said. “We have no such programmes here in the UK or Europe – most of our activities tend to mirror things happening elsewhere.” 

Organs

Dassault Systèmes have an entire division devoted to 3D life sciences and CSO Reza Sadeghi is optimistic about the potential of organ production: “Major advances have been made in the 3D printing of human tissue. Organovo has commercialised 3D-printed human liver tissue for preclinical drug discovery testing and progressive research at the Wake Forest Institute for Regenerative Medicine. This has led to 3D printed human kidneys and has paved a path for 3D printing of more complex organs in the future, such as the heart.” 

It is now possible to create, from standard medical imaging – such as an MRI – a 3D patient-specific ‘digital twin’ 3D model of the heart for detailed analysis, which could lead to much more personalised medicine.

“Conditions, such as mitral valve regurgitation, can be reproduced in 3D silicone,” enthused Sadeghi. “Treatment options can be simulated digitally to identify the most effective treatment.” 

It is becoming clear that 3D has gone from being a disposable novelty to a highly-sophisticated healthcare reality which has could save millions of lives. For pharma, it is taking us to another dimension – quite literally. 

 

Images courtesy Dassault Systémes

 

 

 

Tags: , , ,

Features

Light shade: The two sides of pharma revealed

by John Pinching 3. May 2016 11:25

 

Most people don’t know it, but pharma is everywhere.

Shade

It’s in our films, books, music, and even in our medicine cabinets. Culturally, pharma is as ubiquitous as tea or Apple.

When five-time grand slam champion, Maria Sharapova, recently stood before a lectern – and a stunned global audience – to perform a toe-curling, hopelessly stage-managed ‘confession’, it placed pharma firmly on the front page. Not that anyone outside pharma would necessarily see it.

While the Russian superstar strained every sinew to look sad-eyed, doleful, apologetic and – most challengingly – human, most of the world saw this as simply a ‘doping scandal’ or, even, a tennis story. But, actually, and intriguingly, this was a pharma tale of our times.

Sharapova’s failed drug test had been the result of the heart condition drug, Mildronate (aka Meldonium), being found, during a routine blood test in Australia. The discovery, its consequences and the sequence of events – taking place over a decade – leading up to the exposure, made it a story firmly entrenched in a bizarre healthcare labyrinth.

It should be pointed out that the medication in question has been, historically, used to help people with heart conditions to recover; usually over a six-week prescribed course. The treatment provides improved blood flow; essential to a patient’s survival. Why, then, was an incredibly fit, young athlete taking a heart condition medication, since 2006!? 

Let’s assume, for a second, that it was being used to speed up recovery times, in a person without a heart condition – that a legitimate, legal pharmaceutical product was being used for something other than which it was intended, in order to achieve results it was not designed for. Some might suggest that this is doping in its purest form – enlisting a synthetic solution to the age-old problem of exhaustion. Or, in this case, perhaps, the age-old problem of Serena Williams (Sharapova has an ego-sapping, ‘heartbreaking’ head-to-head of 19-2 against her). Enough to drive anyone to a ‘meld-down’, you might say.

There were also some fascinating linguistics used in order to yield public sympathy. In her press conference Sharapova made it clear that this was a drug prescribed by her ‘family doctor’. To the untrained ear this was – not a fabricated and cynical PR stunt – but
a claim that, just like you and I, she has to book an appointment with the 'family doctor', wait in the family doctor’s ghastly waiting room, while reading the family doctor’s well-thumbed copies of Bella, from 2009. She’s just like you and I, making the pilgrimage to the family doctor, and picking up a prescription from the family doctor. What could be more normal?

Well, I don’t know about you, but I don’t have a globe-trotting team of fully-qualified, full-time health professionals looking after my every nutritional and medicinal need. 

This story will run, and it won’t end well for Sharapova, but it does serve to remind us – industry folk – that we are often woven into the fabric of mainstream stories, but the true message is lost in a welter of gossip and ‘victims’. Don’t let research, development, science and the thousands of miles that representatives travelled in order to change lives, get in the way of a good story! The truth is that Meldonium was not created to win Wimbledon, but it has altered the course
of history for thousands of patients.

Light

Beyond the tabloid headlines, UK pharma is in a period of revolution, while re-establishing itself as one of the most pioneering industries on the planet. In spite of the scientific and technological breakthroughs, however, it is unlikely that any young people are kept awake at night by the prospect of a career in pharma, let alone dreaming of transforming millions of lives in the process. 

For a complex set of reasons – not least the draconian restrictions imposed on pharma by governing bodies – we have been conditioned not to ask ‘how and why Aunt Edna has been able to live until 126’. Indeed, I doubt that one per cent of all university leavers even know that a job in the commercial side of pharmaceutical products evens exists. 

People are still more likely to ‘land’ in pharma, due to an unusual set of circumstances – like glancing at a job ad in someone else’s newspaper, on the train – or simply ‘by accident’. In my experience, hardly anyone works at a pharma company by design. Given that the modus operandi for industry is – in essence – to keep people alive, that’s quite weird. 

If people don’t really know what pharma is, it’s a bit like not knowing what a computer does, or never having heard of space travel. Although pharma has much to do when it comes to public image, for the people entering industry – by hook or by crook – or those already ensconced in it, a glorious new chapter is being embarked upon; days are there to be seized, as the ‘sales template’ is dumped into non-recyclable waste, and the prospect of a role, in which individuality can thrive, emerges. 

Digital is taking off – a little later than expected – and the production line of identikit representatives has been shut down for good. In the brave new pharma universe, most representatives are tech-savvy, disease-aware product gurus, with a penchant for engaging communication. It is no longer possible to rock up to a doctor’s surgery and rely on auto-pilot. Modern medicine is accelerating at such speed that presentations can undergo fundamental changes, and compelling additions, at a moment’s notice. 

Someone turning into a hospital carpark, in Ipswich or Hull or Basingstoke, may suddenly be confronted with real world data, on their iPad, which has materialised from an extensive trial in Cape Town, New York or Beijing. Someone in Milton Keynes may be pacing towards a commissioner’s office when they suddenly receive word that a cancer drug has been approved. These factors will need to be candidly incorporated into the discussion and can – quite literally – mean the difference between life and death. 

Star Medical’s Polly Appleby is probably better qualified than anyone to observe the significant movement in the force, and how pharma has become a different solar system to the one she first entered, over a quarter of a century ago.

“Our customers’ environments have changed,” she told Pf Magazine. “They’re taking on additional responsibilities, beyond patient care. This has led the industry to shift its focus, from volume, to account management. Using sophisticated targeting, it is now essential to put the best people in the right places.” 

“It’s also much harder to see customers,” she added “So hiring resourceful, determined and persistent people, who can deliver value, that’s tailored to each customer’s unique circumstances, is critical. Sales people are working larger territories, and using their initiative, to deliver more, with less. There’s a greater sense of accountability.”  

Polly also thinks that the future will yield more change. “Our focus on the environment will drive more demand for outsourced and syndicated teams. As a Regional Business Manager with the Star Medical Syndicated Team, I’ve helped them build a talented, positive and agile resource – informed by sophisticated technology – which can flex, in order to optimise the strongest environments.”

 

So, as we begin to begin to fully comprehend the possibilities of a neo-pharma odyssey – in which very different individuals roam – flexible pharma freestylers are already offering bespoke packages, encouraging commissioners to confidently open their doors. With the possible exception of Maria Sharapova’s ‘family doctor’, that is. 

 

 

 

Tags:

Features

‘Continuity of change’ conundrum at NHS England

by Claudia Rubin 27. April 2016 03:00

 

Our resident political guru deconstructs the ‘continuity of change’ conundrum at NHS England. 

Does NHS England stand alone as the most changeable of organisations? With a budget of over £116bn, we should, perhaps, expect the government to oversee an appropriate mix of continuity and change. 

Lately, the long list of additions to senior management, and clinical teams, seems to suggest another wholesale change to decision-making at the top of the NHS. Many of the highly-regarded figures, now exiting, were apparently making good strides in their roles, but now they’re off to pastures new. There is often no clarity on the strategic decision-making behind these developments – it’s troubling for those of us that want transparency in our public institutions. 

Whether there are meaningful trends to be identified, depends on one’s own reading of the personalities and politics behind the changes. With many of the senior roles undertaken on a part-time basis – as occupants retain second jobs elsewhere – the extent to which they are able to deliver on their targets, remains to be seen. 

NHS England Chief Executive, Simon Stevens, seems to place much store on continuity. Indeed, it was one of his ‘guiding principles’ outlined in the 2016/17 Business Plan. 
But as we lurch ever further into the NHS financial crisis, does continuity allow scope for required change? As Kings Fund Director, Chris Ham, noted in his recent Guardian piece, the crisis presented by hospitals, which are running up growing financial deficits (£2.3bn, with three quarters of hospitals and other providers in the red), may mean the NHS needs something more fundamental. 

Melanie Philips, in The Times, even suggested the abandoning of the ‘deceitful’ NHS model, looking instead at social insurance schemes, such as those predominant in Europe. 

Ultimately, the public must be asked to consider these options. In the meantime, we should engage with NHS England’s new Business Plan, closely examine the incoming personnel, and use our stake in their success to hold leaders to account. In order to do that, let’s find out more about them. 

The Famous Five: New faces at the NHS rock face 

Dr Jonathan Fielden 
Director for Specialised Commissioning 
Dr Fielden has enjoyed a meteoric rise; through anaesthetics, into health policy. Mind you, rationing the budget for specialised services – while various technologies vie for a share – is not a job many would want. Dr Fielden will also serve as a deputy medical director to Sir Bruce Keogh. He certainly represents the one element of operations that have been continuous – change. 

Cally Palmer CBE 
National Cancer Director 
Although she retains her current role, as Chief Executive of the Royal Marsden NHS Trust, Palmer leads the implementation of the NHS Cancer Taskforce’s five year strategy for cancer care improvement. In her new position, she takes the lead on new cancer Vanguards, using outcomes-based commissioning to redesign care, and the patient experience. 

Dr Arvind Madan 
Director of Primary Care 
As a practising GP, Dr Madan retains his regular clinical commitment at his London practice. He also provides clinical leadership for the transformation of primary care provision, which includes stabilising existing services, reform and modernisation of the primary care provider model, and supporting the development of co-commissioning, with clinical commissioning groups. 

Pauline Philip 
National Urgent & Emergency Care Director 
Philip will retain her role as Chief Executive at Luton and Dunstable University Hospital Foundation Trust. She will be working with Professor Keith Willett to provide national leadership for the delivery of the Urgent and Emergency Care Review, and aspects of the NHS Five Year Forward View. Patients are spending over four hours in A&E – this is a challenging part-time role. 

Matthew Swindells 
National Director for Commissioning Operations and Information 
Swindells has 18 years of operational and senior management experience, in the NHS. He was also Director General at the Department of Health, and led the health team at the Cabinet Office. He takes over from Dame Barbara Hakin, who oversaw the development of the new commissioning architecture of the NHS, and the establishment of CCGs. 

These senior figures are now complemented by the appointment of 18 national clinical directors – and seven associated clinical directors – among whom, a number of trends emerge. Firstly, no one can deny that, despite the record low morale of its medical staff, NHSE is still able to attract top talent. Secondly, much of this talent will have, or even take on, second jobs and – like their predecessors – find their time stretched. Thirdly, the appointments do seem to reflect the growing burdens, on the NHS, of obesity, diabetes and an ageing population, perhaps at the expense of less obvious challenges, such as harnessing innovation. 

Cancer 

Replacing Sean Duffy, as NCD for cancer, is Professor Chris Harrison who, like his predecessor, has a background in obstetrics and gynaecology, but has also occupied public health and cancer directorship roles. He has taken this role on a part-time basis, while simultaneously becoming Executive Medical Director, at The Christie hospital, 
in Manchester. He has a number of key tasks, as he supports Cally Palmer, not least making significant improvements in cancer outcomes. The 62-day cancer treatment target has been missed for 21 of the last 24 months, while CDF reform is in total disarray. It’s fair to say that Prof. Harrison has a bewildering maze to navigate. 

Mental Health 

There have also been multiple appointments in mental health – perhaps the first high-visible sign of some substance to the otherwise farcical ‘parity of esteem’ claim. Again, the appointment of Prof. Tim Kendall must be seen as a coup. His roles at the Royal College of Psychiatrists, UCL and Sheffield NHS Trust, give him the clinical, and policy, experience required, in a position that acts as a bridge between both. With the loss of Dr David Bateman, championing neurology, Prof. Kendall’s role, together with that of the other mental health appointments, is welcome for a field that lacks policy, industry and scientific focus. His award winning 2004 paper on selective publishing, by the drug industry – in terms of antidepressants – may indicate his intention to encourage scientific rigour, as well as triggering some nerves among pharma. 

Older People 

It must be presumed that the gap in clinical leadership, created by the dissolution of Martin McShane’s role in long-term conditions (LTCs), is now incorporated into the two posts of NCD and associate NCD for Older People. With people aged over 85 becoming the fastest growing section of our population, and old people’s frailty now considered an LTC, new appointments must have credibility. Dr Martin Vernon, as NCD, will be supported by associate NCD and GP, Dr Dawn Moody. They will be largely preoccupied with the development of new care models, and the ever-closer integration of health and social care. Dr Vernon has strong links to Manchester, and could well 
be influenced by what is unfolding there. 

Crunch time 

With the national clinical directors now in post, these reforms – first trailed back in November – may not be as far reaching as first predicted. Although NHS England has reduced the number, from 23 to 18, they have also recruited seven new ‘associate’ NCDs, and have not made any substantial changes to the structuring of directors. The planned introduction of a three-tiered system, categorising each NCD, and their remit, did not materialise – a relief to those therapy areas that would have been de-prioritised, such as cardiac, stroke, respiratory and musculoskeletal medicine. 
The degree, therefore, to which Simon Stevens has managed to ‘slim down’ the organisation, cut costs and create ‘a more coherent structure’, is questionable. To what extent these leadership and structural changes signify fundamental continuity, you decide. Plus ça change plus c’est la même chose. 

Claudia Rubin is a Government Affairs Strategist at Decideum. Go to decideum.com

 

 

Tags: , , ,

Features

Pf Company Focus: ProStrakan

by Admin 18. March 2016 11:15

A rapidly growing specialty pharmaceutical company

ProStrakan Group plc is a rapidly growing specialty pharmaceutical company engaged in the development and commercialisation of prescription medicines for the treatment of unmet therapeutic needs in key EU territories and the US. A less well known independent company just a few years ago ProStrakan is now a subsidiary of Kyowa Hakko Kirin Co. Ltd. (KHK) and is making its mark on the international stage.

Being part of KHK means ProStrakan has access to a substantial product pipeline. KHK are working to discover and create new ways to improve wellness and treat disease with a special focus on oncology, nephrology, immunology and CNS.

Both KHK and ProStrakan are growing rapidly with an innovative portfolio of products and driven by a highly motivated global team. The corporate group thrives on responding flexibly to changes in local markets and external environments whilst continuing to open up business opportunities.

The focus however remains firmly on providing patient centred medicines helping improve patient lives in all the key markets in which they operate.

Sajid Babariya, UK Country General Manager

ProStrakan was established in 1995 as a small pharmaceutical company based in Galashiels, Scotland. The development and growth in the company over the last 18 years has transformed it into a flourishing international enterprise and a member of KHK. The aim is to become a Global Speciality Pharmaceutical company providing medicines to help patients all over the world.

The success of the company has arisen due to the way in which it focuses on ensuring the customer receives a first class service and a quality product. This is still very much the case today. ProStrakan is focused on helping to improve the lives of patients. This principle helps us from the recruiting stage to the delivery and value proposition on our products.

One aspect of our business that continues to evolve is in the delivery of our medicines to patients. Our portfolio of products is changing and will continue to expand.

In the UK alone, we have launched 12 new products in the last 13 years and this pattern is set to continue long into the future. We have a strong pipeline with over 30 products, many of which are in phase 2 and 3. The majority of these are within the specialities of oncology, nephrology, immunology and CNS. As an adjunct to that, partnership opportunities such as the one we have recently signed with Fuji Film will allow us to enter into different markets and gain access to products such as biosimilars. Furthermore, in 2012, we had 10 new products enter clinical trials.

ProStrakan offers an exciting environment in which to work where each and every employee is highly valued; our mission is to help improve patient lives and we are passionate about this philosophy in all that we do.

Ross Moat, UK National Sales Manager

Maintaining ProStrakan’s position as an international specialty pharmaceutical company is an exciting challenge; full of ideas and ambition for the future, we are determined to continue to play our part in achieving this aim.

Our sales force is the pride of the company, underpinned by a culture of mutual support, whereby work is also fun and rewarding. Our sales team live and breathe our vision: keeping the patient at the centre of activities.

Undoubtedly our success in the UK is due to our people, who reach out via healthcare professionals with the sole aim of improving patients’ lives. To support these teams we place significant emphasis on implementing an optimum level of development; this is achieved by coaching from the management team or via our tailored training programmes. These are designed to ensure everyone in the business is fully prepared to help provide solutions to healthcare professionals within our disease areas.

Gail Long, Senior Medical Representative

I’m proud to be a representative with ProStrakan. I am fortunate to be able to promote three excellent products, all of which increase the quality of life for our patients on a daily basis. Knowing that I can make a difference to someone’s life brings me great satisfaction - it’s what I love most about my job.

The company is highly patient focused, putting patients at the heart of everything we do and our product portfolio is growing, spanning many different therapeutic areas.

Training and development is paramount; by investing in increasing our knowledge base through learning, we can continue to improve. Our training is tailored to individual need, ensuring we have a clear, focused plan of action.

The culture at ProStrakan is open and transparent, with a family atmosphere. We encourage the sharing of ‘best practice’ ideals and an open acknowledgement of success.

Our values and loyalty play a vital part in our daily roles. It is a pleasure to work for a company where everyone matters and feels valued.

Tags:

Career Centre | Features

Pf Company Focus: A hybrid NHS

by Admin 19. February 2016 16:08

The new NHS demands fresh skills and a fresh approach from industry. Naveed Babariya discusses how companies can shift from selling to negotiating.

It is said that the one constant in life is change, and that couldn’t be truer for the NHS as it stands today. Be prepared for a permanent revolution. Gone are the days when you could call on your best customers every couple of months, with a callback to determine their prescribing habits regarding your product since your last call.

So many things have changed and so fast. With the dissipation of Strategic Health Authorities and Primary Care Trusts and the birth of Clinical Commissioning Groups, the question arises: who exactly are your customers?

This isn’t like other NHS reforms where, over time, people get used to their new titles and settle back down again into their day jobs. Rather, the new system will allow changes to occur more frequently and rapidly.

As an adjunct to this, your customers may change, possibly on a more frequent basis and with evolving responsibilities.

With pressures on pharmaceutical companies about pricing from the new PPRS scheme, and private companies showing interest in delivering services for the NHS, there are going to be definite winners in this race – namely those companies that can demonstrate flexibility and adapt to change early. One thing is certain: the pharmaceutical industry will struggle to negotiate with clients who are disorientated, or who are the Richard Bransons of the NHS and well ahead of the game. So what is the answer?

Deals, not sales

There needs to be a dual-edged approach to the NHS reforms. First, the industry needs to recognise, understand and adapt to the new NHS. There are several phases of change management for any of us who go through a major change in our lives. These phases usually take the form of initial denial, anger, confusion and depression; then we embrace and adapt to the change, and acceptance follows; and eventually a new-found confidence arises.

Once a pharmaceutical company recognises where it is in the change management cycle, it can move onto the second phase of adapting to the NHS reforms. This is where the customer interface with the representative takes on a whole new meaning. Unless the customers’ needs are placed first, you may as well leave the room. It is no longer a quick sell that can occur in a six-minute call, but rather moving on to a new and more mature level of communication.

Selling skills are a thing of the past and razor-sharp negotiating skills are now required. Each call has to result in a win-win situation: the pharmaceutical representative and company have to gain a result, but more importantly the customer has to gain from their investment of time.

Listen to learn

The industry, company and representative need to be seen as a partner whereby the sales of your drugs are a by-product of your call.

What is important, and wins hands down in any industry, is putting people first and business second. A whole new dimension of skill-sets has to emerge in order to succeed in this hybrid NHS.

Understanding customer needs has never taken pole position as much as it does today. Think back to a time when you felt understood. How good did that feel? You probably felt motivated to do more than was strictly required for that person who understood you. Now imagine you are the customer who was listened to and understood by a representative. Why wouldn’t you want to provide something back for the representative, giving a win-win result? The key is that listening to understand and listening to respond are light years apart in terms of outcome.

 

Naveed Babariya is the Director of Synergize Training Solutions. To learn more about how your company or sales professionals can adapt to the NHS reforms, contact Naveed on 07817 218094 or 0845 116 8094 or visit www.synergizetraining.com

Tags: , , , ,

Career Centre | Features

TextBox

Tag cloud

Calendar

<<  June 2016  >>
MoTuWeThFrSaSu
303112345
6789101112
13141516171819
20212223242526
27282930123
45678910

View posts in large calendar

Month List