What really goes on at the science end of treatment discovery?

by John Pinching 22. May 2017 09:57


At the business end of pharma it is all too easy to forget the trials (quite literally) and tribulations of the science that precedes it.  

The currency – beyond pounds, dollars and euros – of research and development is what pharma ultimately trades in. It is the gauge with which a company can judge itself and it is the platform upon which employees, stakeholders and, yes, patients can build – whether it is commercial reputation or improved health. 

Having a clear understanding of the exhaustive process involved in bringing a drug to market is essential. While defeat at any stage of the cycle often comes with severe implications, overcoming each hurdle and reaching the mecca of approval has far-reaching benefits, often with a global impact.

Here, Claire Bale from Parkinson's UK takes us through each vital step on the journey.


Hit selection

To develop treatments that can tackle the underlying causes of Parkinson’s we need to change the way brain cells work. The key is finding small molecules that target the process that has gone wrong in the cell. Up to half a million drug-like molecules are screened, quickly identifying any that may have potential. 


Hit to lead

To discover more about the chosen molecules, they are tested to identify those with the most promise. Any that fail, or cause problems in other organs, or are known to produce serious side effects, are discarded. Each molecule is tested for strength and it must be soluble in water. Biotech company Oncodesign is currently developing a class of compounds in the Hit to Lead phase that prevent the enzyme LRRK2 from activating. LRRK2 is often found in genes that are associated with Parkinson’s.


Lead optimisation

Now the group has been whittled down to molecules with genuine promise, it’s time to start developing them into drugs – this step needs skilled scientists who are specialists in drug design. They painstakingly tweak the structure of the remaining molecules to achieve the best possible effects, while minimising any negative reactions. Throughout this process, molecules are refined and then tested repeatedly – this can go on for years.


Candidate nomination

After all the lab testing, tweaking and modifying, scientists will finally look at the best possible candidates to create a new drug, and select the best contender. After years of research, if successful, the compound will be taken forward and moved into preclinical drug development.


Preclinical studies

Before any new experimental treatment can be used on people, it first needs to be rigorously lab-tested. At the preclinical development stage, pharmacologists and toxicologists test the new drug under experimental conditions. Firstly, the scientists will use computer programmes – in silico – before testing the active compounds in test tubes or petri dishes – in vitro. Finally, animal experiments – in vivo – help scientists understand the complex effects of the drug.


Clinical Trials: Phase 1

The new drug is ready for clinical trials on a small number of people, testing for safety, side effects and best dose. Studies involve a small group who may be healthy volunteers or people with the condition. Two different Parkinson’s vaccines are currently being tested in early stage trials  – one developed by US firm Prothena, and the other by Austrian company Affiris.


Clinical Trials: Phase 2

These studies include a comparison group who receive a placebo, allowing researchers to see whether people who receive the treatment do better than those that ‘imagine’ they have taken it. Exenatide, a drug that is currently used to treat type 2 diabetes, has shown potential for slowing the course of Parkinson’s. A phase 2 trial of the drug is now complete and results are expected in 2017.


Clinical Trials: Phase 3

Later clinical trials often take place across many countries, involve hundreds of participants and run for several years. Apomorphine is already used by many people with Parkinson’s to help control symptoms. Phase 3 trials are now underway in the US and UK to test a new way of delivering that involves placing a special strip under the tongue. Results are expected in 2017.  


A new frontier in development

The pathway to creating new drugs is a long, expensive and difficult journey. Each step in the process is vital, and a drug can fail at any stage along the way. For every potential therapy that enters the process, perhaps only one in a thousand will end up being approved for use.

Over the years, investment that would push forward promising early-stage research for Parkinson’s into drug development has gradually dried up – leading to a bottleneck in the drug development pathway and less research making it through to clinical trials.

Now, Parkinson’s UK is embarking on a radical new programme of work to shake-up the drug development process. Funded by a new campaign, ‘We Won’t Wait’, Parkinson’s UK will act as a biotech company to highlight important research and develop it for further investment.

Without building labs, employing teams of scientists or buying expensive equipment, the charity will work ‘virtually’ in partnership with a range of other organisations – companies, universities or other charities – that have the facilities to carry out scientific work. Parkinson’s UK will be able to rapidly invest in promising research projects and make early-stage research more attractive to investors.

While we can’t know exactly what will happen next in terms of treatments, we can be optimistic about ongoing research. We’re confident a cure is there – it just needs to be developed.


Claire Bale is Head of Research Communications at Parkinson’s UK. Go to wewontwait.parkinsons.org.uk







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Could spider venom be an antidote to stroke-incurred brain damage?

by Amy Schofield 22. May 2017 09:41


Don’t believe the hype: health headlines dissected



Most of us would insist on a safe distance from massive poisonous spiders, but not our intrepid scientist friends ‘down under’, who not only got close, but secured their venom as well. In the process, they might have stumbled across a protective therapy for people who have suffered a stroke.

While studying venom from the deadly funnel-web spider, researchers at the University of Queensland (UQ) and Monash University happened upon a compound which they say could protect the cells of the brain from damage, even hours after a stroke.



While sequencing the DNA from three of the lethal arachnids – which were reportedly “milked exhaustively” of their venom – the scientists discovered a protein, Hi1a, that resembled two copies of another chemical known to be capable of protecting brain cells.

Professor Glenn King, Group Leader, Chemistry and Structural Biology Division Investigator at the UQ Institute for Molecular Bioscience– whose research ‘harnesses the chemistry of venoms’ from arthropod predators, such as spiders, scorpions and centipedes, to develop novel pharmaceuticals – said that Hi1a “proved to be even more potent” than the other protective chemical.

In a series of studies on rats, Prof. King and his team demonstrated that a small single dose of the spider venom molecule protected neurons in the brain from strokes.



Not only did administering Hi1a two hours after stroke reduce the extent of brain damage by 80%, but the compound remained effective eight hours after a stroke, reducing the amount of brain damage by around 65% when compared with untreated animals.

The researchers concluded that Hi1a is “a powerful pharmacological tool and a promising lead for the development of therapeutics to protect the brain from ischemic injury”.



“We believe that we have, for the first time, found a way to minimise the effects of brain damage after a stroke,” Prof. King enthused.

The Australian team hope to start human trials of the compound in the next two years, however, further trials must be carried out first. If these trials are successful, treatment of stroke patients could potentially be transformed.


What the press said:

“Deadly spider venom could ward off stroke brain damage, say doctors” The Guardian

“Spider venom may offer stroke therapy” BBC News

“Can spider venom protect brain cells after a stroke?” Spectator Health.  




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Ask the ABPI - your most important questions answered

by J Pinching 21. May 2017 09:51


Regulation questions:

Our readers take the opportunity to ask ABPI leaders questions about the industry landscape, the regulatory environment, the future and much more.  


Andreas Knight, Senior Recruitment Consultant, CHASE: 

With the impending exit from the EU, how does the ABPI think UK pharma will be impacted and are there immediate plans in place?


Rebecca Lumsden, ABPI Head of Science Policy:

As part of the UK/EU ‘Life Sciences Transition Programme’, the ABPI is working alongside our members at the BioIndustry Association to engage the life sciences sector and outline the work needed to create a world-leading life sciences environment in the UK, outside the EU.

We have welcomed the Government’s commitment to our industry and the broader Life Sciences ecosystem so far. ‘Making the UK the best place for science and innovation’ is one of the Prime Minister’s 12 Brexit negotiation priorities and a core pillar of the new industrial strategy, with new funding made available by the Chancellor for science.

Research and development, however, is a global endeavour. To ensure the UK continues to ‘punch above its weight’ we need to continue welcoming highly-skilled talent and maintain access to international scientific networks. Access to international collaborations, such as the Innovative Medicines Initiative, are highly valuable for both academic and industry researchers.



Polly Appleby, Account Manager, Star Medical: 

What has most impressed the ABPI about UK pharma’s recent digital initiatives?


Aileen Thompson, ABPI Executive Director, Communications:

Digital campaigns allow us to celebrate the scientific advances our industry is making and share these with new audiences, including the patients and public. Earlier this year we launched ‘Only Just Begun’ – a major digital campaign focussing on the value of the pharmaceutical industry in the UK, and the commitment and passion of the people who work within it.

From the £4.2 billion we spend in the UK on R&D, to the £30.7bn contributed to UK GDP in 2015, we are promoting our achievements now, more than ever, by sharing content. We’re also seeing an uptake in activity and engagement across our social media channels, including Twitter and LinkedIn. It’s great to see the interest growing in our industry through digital platforms.



Lucy Pohling, Account Executive, GCI Health: 

How will the ABPI continue to drive joint working, transparency and innovation in the future?


Harriet Lewis, ABPI NHS Engagement Partner (North):

Our industry already works in partnership with the NHS, charities and other healthcare organisations for the benefit of patients. This year, we have made the first steps towards a unique new partnership with the NHS in Manchester. The agreement will allow Greater Manchester to explore new ways of paying for medicines based on patient outcomes – enabling the £1 billion spent on medicines in the region to be as beneficial to the local population as possible.

The partnership will also enable companies to work with Greater Manchester Health and Social Care Partnership to improve the utilisation of medicines and the adoption of innovative medicines, using the unique data capabilities of Greater Manchester.

The Salford Lung Study – effectively a real time clinical trial for chronic obstructive pulmonary disorder – is another example of how collaborative joint working is helping develop a new swathe of medicines. Initiatives like this show that when the NHS embraces innovation, patients benefit, while industry expertise is recognised and welcomed across the country in a growing number of collaborations.



John Pinching, Editor, Pf Magazine: 

The ABPI has had some high-profile gains in terms of members in recent times – what are the organisation’s immediate aims for 2017?


Sam Ogden, ABPI Chief of Staff:

The ABPI welcomed seven new innovative, research-based large, medium and small biopharmaceutical members companies in 2016. Together our members provide 80% of branded medicine to the NHS. This is an exciting new era of biosciences in the UK and we are sure that 2017 will be a seminal year for the life sciences sector, and the country as a whole.

Our focus this year is to continue demonstrating the story of our science, innovation and value to healthcare, patients and the economy. This focus is consistent with our priorities, which include enhancing our industry reputation, delivering the current PPRS, improving access and uptake of new medicines and building our relationship with the NHS.

We want to continue to identify opportunities and make the UK domestic landscape attractive for clinical development and the manufacturing of medicines. We would say to any prospective new members – come and join us and help to shape this.


Hannah O’Neill, Operations Director, Virgo Health: 

Patient groups’ perception of pharma has declined in every area – what does the ABPI make of this and what action must UK pharma take?


Karen Borrer, ABPI Head of Reputation:

The pharmaceutical industry is on the brink of a golden age of innovation, with some 7000 medicines in the pipeline. As medicines development becomes increasingly complex and we enter an era of ever more personalised medicines, it is critical that we engage with and use the knowledge of patients by involving them at every step.

Industry works with patients through the European Patients’ Academy, for example, which focuses on increasing the capacity and capability of patients to understand and contribute to medicines research and development through education.

We also continue to work on improving the pharmaceutical industry’s reputation. Disclosure UK makes the transfer of value between the pharmaceutical industry and healthcare professionals more transparent than ever before, with payments or benefits made in kind to health professionals and healthcare organisations in the UK, publicly accessible on a searchable database.

Initiatives like this help us to assure patients and members of the public that we are committed to open-working with colleagues in the NHS and charities. We cannot make the medical advancements needed without working together with patients, health professionals, academics and other experts and we must find ways to do this in a transparent and open way. We have made good progress on this and will continue to look for ways to improve further.


Julian Given, Chief Officer, Washington Community Health Care: 

How do you view the proposal document – published in January – about changing the arrangements for NICE appraisals?


Paul Catchpole, ABPI Value & Access Director:

The ABPI is clear – we believe changes, which have now been put in place by NICE/NHS England and will introduce a £20m budget test for innovative new treatments, break the Conservative Party’s 2015 Manifesto promise to speed up the introduction of cost-effective medicines into the NHS.

In a recent member survey – when asked about the impact of the Budget Test – 71% of respondents said they believed it meant their companies would prioritise launching new medicines in European countries over the UK; and 89% said they believed it will mean patient access to cost-effective medicines in the UK will decrease.

Thousands of patients may have to wait longer for treatment for conditions like cancer, heart disease and diabetes, while those medicines which will often stand to benefit the most people are caught up in the system. If the NHS became more effective in its planning it could manage the introduction of new medicines in a more coherent way.

Use of new medicines in the UK is already low, with patients seven times more likely to get a newly launched medicine in places like Germany or France. While Scotland and Wales are both making some helpful strides in improving the use of new medicines, English patients appear to be facing more barriers than ever before. As we head towards Brexit, we should be catching up with Europe, not falling further behind. Ultimately, we would like to see these plans paused while better solutions are found. 


Go to abpi.org.uk




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Astellas partnership helps to raise awareness of childbirth injury

by Amy Schofield 8. May 2017 10:10



Astellas is working with the Fistula Foundation to raise money and awareness of a little known but life-shattering childbirth injury.


Obstetric fistula is a problem that you may not have heard of, but this devastating childbirth injury and the stigma surrounding it ravages the lives of a million women worldwide.

As Kate Grant, CEO of the Fistula Foundation, says: “Fistula is not an issue that most people know or care about – the predominant injury is a hole in the vagina; there’s not many things that are tougher to talk about than that.”

Thanks to Astellas’ involvement in the three-year corporate giving program ‘Action on Fistula’, and the overwhelming generosity of its employees, however, this little known issue is receiving much-needed funding and support – transforming women’s lives in the process.

Kate was first contacted by Astellas three and a half years ago. The company was interested in doing something to address the problem of obstetric fistula in Kenya. The representative asked Kate and her small team to submit a proposal about how they would tackle it. It was a competitive process, but Astellas chose the Fistula Foundation’s plan, and the Action on Fistula programme kicked off in May 2014.


All in

Kate says that working with Astellas hasn’t simply been a case of them providing the cash – there is true engagement on a corporate and employee level. “The Fistula Foundation has what I would truly term a partnership with Astellas – they’ve been with us every step of the way,” reflects Kate. “It wasn’t a situation where they gave us the money and we never heard from them again. We have the financial and moral support of the company, but Astellas has always been more than a ‘cheque writer’, they’ve been a cheerleader.”

Astellas’ employees also raised money for the Foundation, demonstrating their true commitment to the cause. The company works with a number of charities, and the employees also nominated the Foundation to receive an additional $100,000 of funding. “The employees chose us. That commitment goes to demonstrate the ‘all in’ phenomenon there,” Kate enthused. “The more subtle benefit is that Astellas is getting behind fistula, not only as an issue, but also backing the Fistula Foundation – those things are important too.”


Unlimited need

There are many bigger charities than the Fistula Foundation, but this is one that punches above its weight. Despite its small size, the Foundation raised just over $10m last year – up by a factor of five in the last decade – and did more fistula surgeries than the U.S. Government.

Together, they get money to over 30 countries. It’s deliberately run by a small team to keep operations as swift and efficient as possible: “We ask, ‘Is that going to help women get treated?’ If the answer is no, we’re not going to do it,” explained Kate. “We try to get eight out of 10 dollars to those who need them.” It’s still a drop in a vast ocean, however, and there is almost an unlimited need for funds.

The Fistula Foundation says that to successfully treat fistula, three elements are needed: a patient, a trained surgeon and a properly equipped facility.

The women suffering from obstetric fistula often feel ashamed and suffer in silence for years, concealing their condition, not knowing that it is treatable. This makes them hard to find. There are not enough surgeons available to treat the growing numbers of women in need, and some facilities lack even basic equipment.

The statistics show that one million women worldwide, in low–resource countries, suffer from obstetric fistula as a result of giving birth without access to medical help. Out of these, one in 50 get treatment – around 15,000 per year on average* – and thousands more cases develop each year. “It’s relentless,” says Kate. That’s why the committed support of organisations such as Astellas, which is providing funds of €1.5m over three years for the programme in Kenya, is so vitally important. *globalfistulamap.org


International awareness

The International Day to End Obstetric Fistula, held on 23 May, and approved at the UN four years ago, is an essential tool to leverage awareness of the problem facing so many voiceless women. “There’s a camaraderie around it, even if there aren’t New York Times headlines,” insistes Kate. “We try to leverage opportunities as much as we can, but it’s a challenge.”

Back when Kate was first working on the Action on Fistula plan with Astellas, she identified her dream, which was to get a network of treatment centres, train doctors, create a community of practice, and form a centre of excellence for surgery excellence.

“Astellas bought it,” says Kate. “I thought it could work, but it is gratifying to see how incredibly well it does. It’s exciting.”   

Go to fistulafoundation.org





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5YFV next steps - what they mean for commissioners

by John Pinching 8. May 2017 09:54


Step change: ‘Next Steps on Five Year Forward View’ is here, but what does it mean for commissioners?


The Five Year Forward View (5YFV) was Simon Stevens long, imploring, ultimately optimistic love letter to NHS England. That original manifesto, with its neo-healthcare, Atlantic-crossing ideas and crusade against the old order, promised a fresh perspective.

Now that it’s half way towards the original vision – or two and a half years into the five at any rate – the whole country watches and waits for the green shoots of change. Meanwhile, ‘Next Steps on the Five Year Forward View’ has been duly published, with new targets in some key areas – notably commissioning.

In order to shed some light on what this means we’ve got an expert who could not be closer to the action.


Julie Wood, NHS Clinical Commissioners Chief Executive

View from the expert:

Long before the publication of ‘Next Steps on the Five Year Forward View’ it was clear that the commissioning landscape was evolving. Clinical Commissioning Groups (CCGs) have been playing key roles as architects of this changing landscape and I’m pleased that the Next Steps document has the potential to support the vision that we and our members called for in our ‘future of commissioning’ paper, published last year.

Next Steps recognises just how far clinical commissioning has come since the ‘Five Year Forward View’ (5YFV) was published. Having local clinical leadership at the heart of healthcare commissioning has had immense benefits for patients. While, going forward, we are unlikely to see a single model of commissioning, it is evident that the local clinically-led element must remain, or the NHS will be poorer for it.


Facing up to the challenges

The delivery plan didn’t ignore the challenges. There was a welcome focus on improving primary care, urgent care, cancer and mental health, all of which are priorities for our members. The willingness to relax the 18-week waiting time was an important recognition that the NHS can’t deliver everything that is being asked of it within the resources provided by Government.

That said, the plan won’t solve every problem. The NHS is still being asked to deliver an awful lot with finite funding. CCGs are certainly up for the challenge of working with what they have and creating a sustainable health and care system – but this involves making tough decisions. That means working with those who provide care to establish how best to spend the NHS pounds – they can only be spent once.


Effective prioritisation

There must be recognition that sustainability needs to involve transformation and doing things differently. The NHS provides high-quality cost-effective care, but its ability to continue will be restricted if we can’t prioritise areas which get the best outcomes for patients, while also getting the best value for our limited budget.

Part of this relates to the work that NHSCC are carrying out on medicines spend, referred to in the delivery plan. We’ve worked with our members to produce a list of items that could be considered low priority for NHS funding , either because they offer no or minimal clinical value – because cheaper and equally effective alternatives are available – or are otherwise low priority.

We’re not calling for a blanket ban – there must be flexibility to allow individual patient needs to be met. Through NHSCC our members will work with NHS England, the professions and patient groups on the best way to implement this, ensuring we are taking these needs into account, while making the most effective use of NHS funds.

This work forms only one part of what will be needed to transform the NHS. Clinical commissioners are ready and able to play their part. They continue to work with partners – through Sustainability and Transformation Partnerships, as well as other local arrangements – to deliver a health and care system fit for the future.

Next Steps has the potential to help and drive forward the transformation agenda. It is vital that we work together across the system to make sure its vision becomes a reality, especially if we are to close the gaps laid out in the 5YFV – not in finance and efficiency but, critically, in health and wellbeing, and care and quality.


The Stevens Legacy

Words by John Pinching


In spite of a long cross-party, intercontinental career at the higher echelons of healthcare change management, Simon Stevens remains an enigma – a man on a journey where the destination has not come into sharp focus. Even so, his determination to navigate the chaotic landscape feels very real and there is no doubt that this NHS explorer has gained some very useful traction.

It is perhaps his lack of allegiance to a party (he has worked successfully under Labour and Conservative), and a seemingly stealth-like will to fundamentally and positively change the NHS, which have allowed him to avoid the extremities of political bun fighting. Indeed, Simon Stevens is not an unpopular operator and, when you compare that with Jeremy Hunt’s beleaguered public image, you realise that even a mild approachability in the hostile terrain of public health, is a remarkable achievement.

There have been elements of his conduct which provide clues to his modus operandi. When he told people in Britain to lose weight – he lost weight. He is passionate about reducing sugar from the diets of British citizens, and particularly children – he clearly worries about the same things we do. Furthermore, he hasn’t been afraid to bring elements of what he learnt during his spell in America at United Health, such as Accountable Care Organisations, into an antiquarian NHS. This raises the possibility that the public – contrary to popular belief – don’t reject change to our 1948 institution. We simply respect an honest approach and Stevens has adhered to that.

The targets laid out in the 5YFV and, in particular, his determination to integrate fragmented services – attaching GP surgeries to hospitals – use resources more efficiently and place an emphasis on public responsibility, could represent his lasting legacy.

Ultimately, Simon Stevens’s magic bullet could be a combination of political impartiality, an ‘I’m a user too’ mentality and a ‘Stateside’ perspective, but if the journey ends with an NHS that is both ‘beloved’ and functioning within its means, the appointment of Simon Stevens could just be the greatest decision David Cameron ever made.  




Making sense of the Five Year Forward View

by Amy Schofield 28. April 2017 09:40


Parallel Learning’s second webinar addresses how pharma can support the NHS in how care is delivered.

Go to parallellearning.co.uk

The performance of the NHS is firmly under the microscope, as increasing demand amplifies the already intense pressure on services.

The second Parallel Learning webinar focussed on the NHS’s Five Year Forward View (5YFV) – the comprehensive strategy for the future of the NHS in England – asking what progress has been made. Originally published in October 2014, can the 5YFV deliver sustainable care, and how can pharma work with the NHS to deliver it?


The opportunities

Guest speaker Paul Maubach presented delegates with an overview of the 5YFV, along with the key opportunities and challenges he sees arising from it. The original vision of the 5YFV was to address the quality, care and efficiency gaps across the NHS.

Paul pinpointed where the biggest opportunities will arise from new care models and working differently. These included moving towards a more outcomes-based way of working, which began 15 years ago with the advent of payment by results.

In today’s population, however, at least one third of people are living with one long-term condition or more, while rising cohorts have multiple complex needs, which require complex care co-ordination.

“The game-changing shift that we are looking at now is moving away from payment by results, to an arrangement which genuinely incentivises outcomes for patients and populations,” said Paul. “This has the potential to be one of the biggest drivers for change.”


The challenges

Paul set out the biggest challenges to the delivery of new care models. Notably, the complexities of governance and statutory responsibilities; the stress of managing change; bringing organisations together and cuts in social care and public health services.

Paul proposed that for the 5YFV to work, the successful systems and organisations of the future will be ones that create a partnership way of working that supports staff in the community with patients and the public. This would require a different culture which works with people in their own homes and communities.

Chair Michael Sobanja pointed out that patients should expect the same level of service and outcomes wherever they are geographically. Paul responded by saying that there is a need for common dialogue with the public about which outcomes are the most important.

“More work is needed around a shared vision; what are the standards we expect, and what are the standards that our public would expect? There could be some real benefit in national debate and dialogue to establish clear national standards.”


What can pharma do?

Given that such a large proportion of the population is now living with chronic conditions and multiple complex health needs, Michael asked Paul his view on what the pharmaceutical industry can do to support or work with the NHS.

“One of the fantastic things about the pharma industry is that drugs are one of the most disruptive technologies we have, for example, where the introduction of new drugs results in a substantial change in the way care is delivered. The reason that more of us are living longer with a long-term condition is because of the success of the pharmaceutical industry in providing drugs that enable us to stably manage those conditions.”

Paul pointed out the importance of pharma’s role in the delivery of a more efficient NHS. “The pharmaceutical industry has a tremendous amount to offer the NHS. Spending on prescribing is significant, so it is a substantial part of our resource and our options for intervention.”

The webinar moved on to what the NHS might expect from the pharmaceutical industry, and how the NHS can better understand the potential of medicines to support people with their long–term conditions. According to Paul, the risk of these patients’ use of higher cost secondary health services reduces with the use of the ‘right drugs at the right time’, which could result in a reduction of need for more complex and costly care.

“One of the things that the pharma industry is very good at is the evidence base. For the right compliance, the right conditions management, really enabling us to reduce avoidable demand elsewhere,” Paul said.

Paul explained how it all comes down to the individual and empowering them to better manage their own health and wellbeing. “There is a lot more that the pharma industry could do to work with the NHS in establishing common standards that we should be working towards. We need to ask how we more proactively support individuals to self–manage. If we’re going to have more sustainable care, we need to be able to do more to support the individual.”  

Go to parallellearning.co.uk




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Patient 2.0: The digital-savvy patient has arrived

by J Pinching 21. April 2017 09:18



Patient 2.0: The digital-savvy modern patient has truly arrived and industry must be ready.

The modern patient is here. The digital revolution has prompted the biggest communal reboot since 1948 and patients are increasingly likely to go online for access to health information, to liaise with communities and study treatment options. Consequently, self-care is on the rise – indeed, there are currently 500 million people worldwide accessing healthcare apps, while iTunes offers 43,000 health-based applications.

Our panel of experts – from patient advocacy, health communications, support forums, healthcare solutions and big pharma – talk about the potential of the empowered patient to make decisions, take control and add essential input. 

They will also focus on the challenges that industry and wider healthcare face in providing worthwhile digital engagement.


Get smart?

Too much time on smartphones has been linked to weight gain, sleep deprivation and depression, while too much reliance on information has caused misdiagnoses, dangerous approaches to self-care and an unwillingness to access ‘orthodox’ healthcare.


Engagement parties

Rebecca Galbraith is Practice Area Head, Patient Support and Adherence at QuintilesIMS


A goal of any patient-focused support programme is to engage patients, helping them to take action to improve their health; to be involved in decisions about their healthcare and have useful discussions with healthcare teams about the care they receive.

With some groups – like younger patients, those with chronic illnesses and people with higher incomes – there is a strong trend towards increased engagement.

The use of digital channels including mobile and wearables, to connect with patients, provides tailorable resources that can be incorporated into daily lives. These devices help track symptoms, encourage positive behaviours and improve adherence.

There will be patient populations, however, who exhibit a lack of engagement, and may not be able to interact with digital tools. This could be due to demographics, symptomology or psychological challenges associated with their condition.

Our experience shows that one size does not fit all patients. A multichannel programme, providing the right mix of both digital and in-person interactions with – for example, a nurse – can dramatically improve patient engagement.


True lives

Marc Boutin is Chief Executive Officer of the American National Health Council


The digital era has simply accelerated a fundamental truth - and made it harder to ignore. Patients want to be listened to and have their say. They don’t want the development of health ‘solutions’ that do not meet their needs.

After decades of frustration, patients are taking to the digital arena, and this pressure is beginning to see results. The pharma industry has begun to make changes – for the benefit of both patients and companies.

No matter how ‘good’ your product, it is useless if the patient doesn’t value it. The industry must co-create health solutions, not for patients, but with patients.

Right from the start, we need to ask patients which outcomes matter most and base our approach on data. The National Health Council is a founding member of the global coalition ‘Patient Focused Medicines Development’ (PFMD) for that very reason.

PFMD runs a crowdsourced online tool which aims to bring together diverse stakeholders – including patient organisations, industry and regulatory bodies – and embed the patient voice throughout the medicine lifecycle.


The influencers

Emma Morton is Senior Media Strategist at Ruder Finn UK


Modern patients research their condition online, where they can find the latest news on clinical trials, research and treatments.

Numerous platforms now offer robust medical information and reliable advice, as well as support from those experiencing similar symptoms. Many value the experience of comparing their lives with fellow patients, detailing highs and lows.

Our digital team at Ruder Finn have constantly monitored online consumer trends, observing that ‘influencers’ are one of the greatest changes to the healthcare landscape. Patients are frequently turning to posts made by ‘real people’ and medical experts for updates on treatments.

This reliance on the web means that industry needs clear digital strategies to consolidate their online presence. They must engage with patient groups and online influencers – whether they are peers, healthcare professionals or company voices – through appropriate channels.

And, crucially, they should ensure their sites carry jargon-free medical information. Details such as product usage instructions and contraindications are vital as increasing numbers prefer to self-care, particularly for minor conditions.

Strong visuals are a must for patient sites, with online images providing a clear picture of certain conditions.

Public health communicators have long been aware that the young patients are more likely to look at their smart phones, rather than posters, and are developing campaigns with this in mind.

As it grows stronger, on a daily basis, the impact of digital influencers needs to be explored in more depth by the pharmaceutical industry.



Era defining

Deborah Wyatt is Founding Director of talkhealth Partnership Ltd.

There’s little doubt that the 21st century patient is very different to the 20th century patient of my era. Much has changed and technology has been the key driver.

Today’s patient is more informed. The internet provides access to a wealth of information, enabling patients to better understand their condition. They talk with like-minded patients in online communities and engage across social media. They are open about their symptoms, share information and support each other.

As for the future, research has shown that informed patients are more proactive in making decisions about their health, often leading to improved adherence and better health outcomes. Patients should be at the centre of what happens next. Pharma needs to engage with patients, providing them with what they want and need.

At talkhealth we have helped thousands of patients to interact online with health professionals, charities, fellow patients and carers. This allows them to take control over decisions about their condition and approach their situation positively.

There’s much talk about ‘patient centricity’. Now is the time for healthcare and pharma to involve them at the very start and the very heart of everything they do.


Case study: Boehringer Ingelheim

Breathing new life


Boehringer Ingelheim has over 90 years of heritage in respiratory disease, having launched several treatments in areas of high unmet need.

As part of its commitment it is looking ‘beyond the pill’ to provide platforms which support patients, caregivers and healthcare professionals.

The patient activation campaign ‘Think. Act. Breathe’, for example, aims to help people with asthma to identify if they are still symptomatic and, therefore, at risk of an asthma attack. 

Go to thinkactbreathe.com

Also, in light of the increasing global health burden of COPD, the company is running a COPD awareness campaign – ‘COPD Your Time to ACT is Now’. The goal is to help patients and the healthcare community to challenge management of the disease, giving patients the best chance of maintaining a good quality of life. Go to yourtimecopd.com

Meanwhile, for healthcare professionals working with patients who have idiopathic pulmonary fibrosis, inIPF.com is a global on-line portal, which provides resources on IPF diagnosis and management. 

Boehringer Ingelheim seeks continuous dialogue with patient advocacy groups to deepen our understanding of their needs and inform future developments. Our focus has always been on improving the quality of life of patients and, for us,  delivering value through innovation means coming up with new and better ways to improve their health.

Allan Hillgrove is a member of the Board of Managing Directors at Boehringer Ingelheim with responsibility for the Human Pharma Business Unit.


Web of intrigue*

50% of the UK population self-diagnose online

75% search the web for health info

2% have reported a digital interaction with the NHS

96% GP practices have digital clinical records

4% Offer online patient access to records

90% Of patients would use an online appointment**

13.7 million people in Europe will use a connected care system by 2019

*Sourced by the Nuffield Trust

** From a survey of 7,000 people





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We’re all living longer, but dementia is casting a long shadow

by Amy Schofield 18. April 2017 09:26



Time catches up


Now the leading cause of death in England and Wales, dementia is an increasingly prevalent threat to public health.

While some treatments can help people to live with symptoms a little better, there are no treatments that slow or stop diseases like Alzheimer’s. Research, with a strong focus on drug discovery, is our only hope.

Dementia is the biggest cause of death for UK women and the second biggest for men. Furthermore, the age-standardised mortality rate for dementia and Alzheimer’s has more than doubled over the last five years for both males and females. In 2015, 61,686 people died of dementia or Alzheimer’s disease, which equates to 11.6% of all deaths. Among those aged 80 or over, dementia and Alzheimer’s accounted for 21.2% of fatalities among women and 13.7% of male deaths.

Dr Matthew Norton, Director of Policy at Alzheimer’s Research UK, said: “Dementia is our greatest challenge, but we are unable to offer the 850,000 people living with dementia a treatment to slow down or cure the diseases underlying their condition.”


Feeling the strain

Dementia is not only a terrible disease for sufferers and their loved ones to face, it is also a massive strain on the economy.

According to Alzheimer’s Research UK, it costs the UK over £26bn each year, with this number expected to double over the next 25 years. Although investment in research is increasing, experts are concerned that it is not enough to keep up with intensifying demand.

“Dementia research has been historically underfunded, particularly compared to other disease areas, and we must bridge this gap if we are to defeat it,” stated Dr Norton.

“Recently there has been a greater focus on dementia, particularly with this Parliament committing to invest £300m in research. The £250m UK Dementia Research Institute (DRI) is also being established, bringing together world-leading expertise in biomedical, care, public health and translational dementia research. While we welcome this rise in support, the job is not done yet,” he added.


Hope for the future

Recent setbacks in clinical trials for Alzheimer’s – including Merck’s decision to halt the trial of experimental drug, verubecestat, and the late-stage failure of Eli Lilly’s solanezumab – have not diminished hope of a treatment for dementia.

“We must continue to push forward. It is now more important than ever to focus on a variety of approaches for drug development,” reflected Dr Norton.

The neuroscience area of the Novartis Institutes for Biomedical Research (NIBR) is harnessing new technologies to build human models of neurological disease, and researchers are currently working on new treatments for Alzheimer’s disease and frontotemporal dementia.

Meanwhile, scientists at the UCL Dementia Research Centre, a hub for clinical research into various forms of dementia, are focussing on identifying and understanding the disease processes that cause dementia and how best to support people with dementia and their families.

Alzheimer’s Research UK is also supporting dementia research projects worth over £27 million in leading universities across the UK, including its pioneering DRI.

“As the UK DRI takes shape, we are confident that the expertise being brought together will move us closer to finding a life-changing treatment, which will have a huge impact on our society,” explained Dr Norton. “Success will require a step-change in commitment and ambition not just from government, but from charities and industry across the world. If we could delay onset of dementia by five years, this would result in 469,000 fewer people living with the condition by 2030.”


Rachel’s story

Reflections on a relative living with dementia

My Grandad was diagnosed with dementia 10 years ago at the age of 85.

It was obvious that things hadn’t been right for a while – his behaviour was becoming erratic and the once quiet, gentle Grandad I knew started having aggressive episodes. My Grandad is now in Stage 6 of dementia and no longer knows who I am. Stage 7 is ‘final’.

One of the scariest things about my Grandad’s dementia is trying to remember what he was like before. Sometimes I worry that I might forget. I do try to remind myself how lucky we are to have had the Grandad I once knew – the one who taught my Mum her love of literature and who would always sneak me a square of Cadbury’s chocolate from his secret stash.

It’s been extremely difficult for my entire family, because there’s nothing we can do; there’s no way to slow it down. But we don’t let it defeat us and try and keep everything in perspective. For example, we’re fortunate that my Grandad’s care home is hugely supportive and the staff are wonderful.

I think it’s important to ensure the right care is given to those suffering from dementia, but also that support is provided for loved ones. I hope that the government will increase their investment in finding a cure for dementia but, in the meantime, I would like to see more access to free care and services.

I’m feeling hopeful for the future – I’m here fighting with Grandad.  


Dementia facts

1. Dementia itself is not a disease – the word ‘dementia’ is an umbrella term for the symptoms caused by different diseases.

2. Alzheimer’s disease is the most common cause of dementia, but other dementias include vascular and frontotemporal dementia.

3. Dementia has a bigger impact on women – half a million women in the UK are now living with dementia.

4. Research into the condition still only receives around 3% of the UK government’s medical research budget.

5. Recent research has discovered that factors linked to dementia include loneliness, high blood sugar and protein in urine.


Dementia research desperately needs volunteers. ‘Join dementia research’ is an initiative to help people with and without dementia register their interest. Go to joindementiaresearch.nihr.ac.uk





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Does putting the clock forward risk IVF failure?

by Amy Schofield 13. April 2017 09:45



Don’t believe the hype: health headlines dissected



Following winter, many of us welcome the extra hour of daylight when the clocks go forward in spring. A recently published study, however, looked at the effect of daylight savings time (DST – a similar system to British Summer Time) on pregnancy and pregnancy loss rates in women undergoing in vitro fertilisation (IVF).

Cycles showed that rates of loss were significantly higher in spring. Could that extra hour actually be an unwelcome change for pregnant women, and if so, why? The secret may lie in the disruption to our natural circadian rhythms – the 24-hour ‘biological clock’ that all living beings abide by.



A group of U.S. researchers from Boston University School of Medicine and IVF New England, Massachusetts, conducted a retrospective analytic sample of 1654 patients at a single fertility centre, from 2009 to 2012. The sample included patients undergoing autologous IVF cycles prior to and during DST.

The researchers looked at whether the shift into DST during the women’s treatment was associated with their likelihood of getting pregnant or their risk of miscarriage.

Three study groups representing varied timings of DST, in relation to the embryo transfer date, were created. In the first group, DST occurred between day one of ovarian cycle stimulation and the day of embryo transfer. In the second, DST occurred within 21 days after embryo transfer while, in the control group, DST happened a minimum of 10 weeks after day one of the ovarian cycle stimulation.



The researchers discovered that, although pregnancy loss rates were comparable between the two seasons (15.5%, 17.1%), women were significantly more likely to have a miscarriage (24.3%) if the clocks went forward within 21 days of an embryo being implanted.



Previous research into the effect of DST has shown a link between a number of negative events, including an increase in the risk of heart attacks, strokes and a higher rate of fatal road traffic accidents.

These events are primarily observed in spring, and may be linked to the anomaly caused by the artificial one-hour adjustment to time. It is not known why these things happen, but it is thought that natural ‘circadian neuroendocrine rhythms’ influence our physiology and behaviour. In turn, a fragile biological process, such as pregnancy, could also be influenced by the effect of DST.

The study, however, only looked at a small group of women at one clinic – cause and effect has not been established. The researchers concluded: “Further investigation by prospective study is required before assuming that this association is causal, clinically significant or necessitates intervention”.

Some of the headlines were misleading, failing to mention that the study involved women undergoing IVF, which could needlessly worry other pregnant women too.


What the press said:

“Miscarriages for women on IVF ‘double when the clocks go forward’” Mail Online

“Clock change linked to miscarriage”
The Times; “Women who undergo IVF treatment within 21 days of clocks going forward are TWICE as likely to miscarry” Mirror.co.uk  


Spring forward, fall back

Benjamin Franklin suggested the idea of DST in 1784 as a way to save on sunlight and burn fewer candles

Countries including Venezuela, Kenya and Saudi Arabia don’t adjust their clocks

British Summer Time begins on the last Sunday of March





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Biggest Pf Awards ever celebrates industry brilliance

by John Pinching 6. April 2017 15:18



Pf Awards 2017

The biggest Pf Awards ever celebrates new heights of industry brilliance. 


View the full Pf awards 2017 brochure here.


As the seventeenth Pf Awards unfolded at the Lancaster Hotel in London it was clear that these unique accolades continue to thrill and inspire everyone involved with them.

Melanie Hamer and her team again delivered an unforgettable evening, as they have every year since the turn of the century. Over the years, the Pf Awards have realigned according to change – recognising cultural shifts within a rapidly evolving industry.

Embracing these changes has ensured that the awards remain the pinnacle of achievement in our industry, and perhaps explains why this year was the biggest, brightest and most brilliant Pf Awards ever.

Comedian and actor Marcus Brigstocke oversaw proceedings with a masterful commentary on the challenges of living in modern Britain, targeting many of the audience in the process, before distributing the awards to their grateful recipients.

The reaction of winners varied from triumphant cheers to stunned disbelief, but the one common theme was utter delight. History had witnessed that, for those taking one of the glorious trophies home, life will never be the same again.

The pharma-based joy continued long into the night, helped along by a unique atmosphere, well-deserved cocktails and even some jazz. Needless to say, some were talking about what would happen next year.


Champions league

The smiles on display during the Pf Awards Dinner perhaps belied exactly what participants had to go through in order to take their seat at the top table.

‘Assessment Day’ is not for the faint-hearted and has a well-deserved reputation for being one of the toughest challenges in the industry calendar. It is where candidates present the skills they use on a daily basis and allow them to be scrutinised, dissected and judged by a panel of independent healthcare and pharma experts.

This year’s day of reckoning took place at the King Power Stadium, home of reigning Premier League Champions, Leicester City. Indeed, as the patrons of that ground are discovering this season, there is absolutely nowhere to hide when the focus is on you. Your only choice is to come out fighting. With this considered, it was noticeable how many of our industry people were prepared to step up with confidence and lay everything on the line.

GSK’s Kim Lafferty, winner of the Learning and Development Award, said: “We particularly enjoyed this year’s judges, the questions they asked and the level of intensity with which they listened to our story.”

“The questions we had demonstrated the really high level of professionalism, and it was a great experience,” added Agnes Svilpaite, Bayer Pharmaceuticals’s Sales Team Award winner.

Meanwhile, Rebecca Denny from Republic M! UK LTD, joint winner of the e-Representative Award, paid tribute to the competition. “It was even tougher than last year and I knew that I was up against a lot of good people.”

Despite of the high levels of performance, there was also camaraderie among the candidates. “There was so much support from the different companies for each other,” reflected Secondary Care Specialist Award winner, Alison Duncan, from Abbvie Ltd.

As they say, fortune favours the brave, but many of the 2017 winners will remember the nerves on Assessment Day as much as the relief when their names were finally announced.  


The story of the Pf Awards 2017 from a selection of winners and sponsors

“This is the absolute pinnacle – the last few years I’ve been working in Germany for a pharmaceutical company but, in the UK, the level of expertise you need for this type of award is beyond belief.” 

Isidore Duru, Grünenthal Ltd, Sales Team Award sponsor


“It’s a dream come true – I’m really pleased with my achievements tonight and to be recognised in front of industry is fantastic.”

Rob Turnbull, Thornton & Ross, Regional Manager Award winner


“Our industry and our customers are getting more and more challenged every day, so it’s great to have the opportunity to recognise people publicly for their efforts.” 

Steve Howson, Ferring Pharmaceuticals Limited, Secondary Care Specialist Award sponsor


“I have never won anything before. We are just nurses and to get this is amazing.” 

Kathy Wadhams, Ashfield, Clinical Nursing Award winner


“It’s so fantastic to know that everything you’re doing is really worth it and to get an award at the end is just amazing.” 

Ashley Strong, Forte UK, Primary Care Specialist Award sponsor


“The real winners are the patients, who continue to benefit from new treatments, and are kept up to date as they come along.” 

Jo Underhill, Astellas Pharma Ltd, Experienced Account Manager sponsor


“I’m overwhelmed that it’s been recognised – thank you so much.” 

Tracey Murphy, Coloplast Ltd, Acccount Project Award winner


“I came away feeling like I’d been challenged – it was hard work but I enjoyed it.” 

Ben Clark, Astellas Pharma Ltd, New Account Manager Award winner


“This is the second year we’ve sponsored this event and to see another set of young, bright, enthusiastic people is just fabulous.”

Colin Watson, Ashfield Commercial & Medical Services, Account Team Award sponsor


“I’d like to inspire other people to give it a go as well next year.” 

Catherine Pollard, Abbvie Ltd, Medical Scientific Liaison Award winner


“The Pf Awards are critical in showing that individuals are making a huge difference to healthcare providers and patients across the UK.” 

Dr Priya Agrawal, MSD, Account Project Award sponsor


To take part next year, go to pfawards.co.uk.

View the full Pf awards 2017 brochure here.





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