Knowing me, knowing you: Meet the MSLs

by John Pinching 20. January 2017 10:13

 


In the ranks of pharma and the NHS there are people that speak the same language

 

In the curious ‘no man’s land’ that exists between industry and the NHS, Medical Scientific Liaisons (MSLs) break bread with healthcare professionals; conversing in a common vernacular, and maybe sharing the odd science-based joke.

This is a language that only they understand. Indeed, increasingly, industry views MSLs as the key to engendering trust and delivering on the promise of transparency.

No longer simply a loyal foot soldier – the MSL is leading the charge. A few pioneering pharma companies are instigating this remarkable rise – harnessing a passion for science and utilising an ability to communicate vital messages about life-changing products.

Motivated only by medical research, exciting therapy development and making a difference, MSLs are, perhaps, the future of pharma itself.

 

 

MSL in profile

 

Camila Marotta, Chugai Pharma UK

The role

As part of the Medical Affairs team, MSLs are the bridge between the pharmaceutical company and healthcare professionals – facilitating the exchange of unbiased medical and scientific information. We work throughout a product’s lifecycle, and pre-licence activities can include advanced budgetary notification to payors, medical educational meetings and advisory boards. We can also assist in formulary applications and investigator’s initiated trials. The primary objective of the MSL is to establish and sustain peer-to-peer relationships with therapy area experts at major hospitals and
academic institutions.

 

The difference

At Chugai Pharma UK we all have the patients’ interests at heart and are regularly reminded of why we do what we do. We believe that continual innovation, investment in research and partnerships, are the key drivers in targeting difficult-to-treat conditions and improving quality of life. As MSLs, we are at the forefront of sharing the clinical trial data, ensuring that clinicians have the information they need in order to make the right prescribing decision.

 

The reward

Medical educational meetings are one of the most rewarding parts of the role. I truly enjoy presenting and engaging on a relevant disease area and providing up-to-date information and support. We are currently working on delivering a series of meetings in the area of cancer cachexia, which is a very challenging and mostly undiagnosed condition.

 

The change

The pharmaceutical market is changing to accommodate the increase in personalised medicine, immunotherapy and fluctuating NHS budgets. There is great competition in the biopharma industry and, consequently, we need to be working in compliant collaboration with our internal partners, and to
the highest of standards.

 

The future

My personal ambition is to keep developing as an MSL – there’s always room to learn and develop. Aiming to be the best I can be at my job means that I’ll be delivering an improved service to my customers. I’m looking forward to being part of my first product launch as an MSL next year. Chugai Pharma UK has an exciting pipeline and 2017 promises to be a memorable year for all of us.

Go to chugai.co.uk

 

 

Steve Patmore, Janssen

The role

At Janssen UK, the MSL function represents the medical department of the company. As an MSL, I interact peer-to-peer with healthcare professionals; supporting education and facilitating the exchange of up-to-date scientific knowledge on new and current Janssen products, ensuring the best outcomes for patients.

 

The difference

As an MSL, I have a deep-seated responsibility to healthcare professionals, and the patients who come under their care. By ensuring that we build strong, ethical relationships with clinicians and provide the highest quality of education and service, we are in the best position to make a positive difference to the lives of patients. We support initiatives such as investigator-initiated studies and real world evidence data collection, and this research has the potential to enhance how treatments work, improve clinical decision making and, ultimately, transform patient care.

 

The reward

Peer-to-peer conversations with clinicians are really fulfilling – taking time to engage with them and understand their interests and thinking. The quality of these interactions – together with the information and education provided by Janssen – has resulted in increased engagement and a strong belief among clinicians in the value we offer. Being able to further support the clinicians I work with in their ongoing education, or within their appraisals, is also very rewarding.

 

The change

The MSL role is changing – expectation is no longer just on data delivery. I have become more heavily involved in projects which gather insights from internal and external partners, enhancing the quality of interactions with healthcare professionals. By recognising our strengths and demonstrating that we are willing to listen, the role develops in line with the needs of people we serve. From a clinician’s perspective, I believe they are looking for more from pharma companies – they value the clinical conversations that go beyond mere translation of data, and are interested in the evaluation of real world evidence and health outcomes.

 

The future

As the lead on customer feedback projects within Janssen diabetes, I am looking forward to evaluating responses. This will be the first time we have had the opportunity to know what our customers think and this supports us in realising our aspiration of being the best. In terms of my own education I am looking to completing a virtual diabetes course at the University of Copenhagen. My other interest is in ‘critical thinking’ and I’ll be looking to develop this in 2017.

Go to janssen.com

 

 

 

 

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Features

Patients please: The ‘missing link’ between industry and healthcare

by John Pinching 17. January 2017 09:03

 

 

The ‘missing link’ between industry and healthcare provision has arrived (and they mean business).

Not so long ago your GP was the all-seeing, all-knowing, god-like figure, with your healthcare record in their filing cabinet. Patients would live for decades with a condition they knew nothing whatsoever about – their life and, indeed, death had been obediently handed over to the healthcare profession.

A lack of input from patients – the very people for whom pharma and the NHS exist – has, over several decades, created a power vacuum and it has taken an entire digital revolution for ‘the patient’ to occupy that void.

Recognising that there has been cultural shift, a few buzz terms – designed to create solidarity between industry and the patient community – have emerged, such as ‘patient centricity’ and, the utterly vacuous, ‘focussing on the end user’. This was well-meaning enough, but, until relatively recently, patient presence at healthcare-driven events has been practically non-existent and, for those patients willing to provide personal data and assist with research, experiences have been mixed.

Meanwhile, the online patient voice has grown in decibels – to the extent that it can no longer be ignored. The rise has developed through shared experience, support networks and, above all, challenging the medical profession. This, in turn, has seeped offline and into society – the patient has come in from the cold.

People want to know about their condition, people want to manage their illnesses and they want better therapies and apps to enable them to do it. The patient voice is here and it’s getting much louder.

 

Here’s to you, Nick Robinson

The BBC’s former Political Editor, Nick Robinson – a self-confessed workaholic – was diagnosed with a rare form of lung cancer in 2015.

At the ABPI’s Patient’s First conference he appeared as the de facto ‘celebrity patient’ and was brilliantly candid about his experiences. “It’s been a curious public journey”, he confessed. “And, yes, being in the public eye, you do get more attention and support.”

He was brutally honest about the reality of illness and the fragility of life itself. “You’re not in control, your body is – but we can control how we react. We head straight for the internet, and it’s almost always alarming. Shut the page!”

Nick went on to talk about how it wasn’t death that worried him, but the fear that someone might know something that they weren’t telling him. He said that he was far happier when he discovered that the doctor didn’t know the outcome. When he realised that Nick was fine with that, the doctor was “much more open about uncertainty.”

He urged us, as patients, to use our voices. After a wretched first stage of chemo, Nick told the nurse it had been dreadful, and was given a different cocktail next time.

He also set himself a personal goal – to return to his television duties on election night. “That was my Mount Everest,” he said. And return he did.

“You can never put patients first enough,” he concluded.

Nick Robinson has recovered and currently hosts Radio 4’s Today programme.

 

 

Top talk

Memorable quotes from the ABPI’s inaugural Patients First conference

 

“Once you’ve invited us to the party, don’t exclude us, and talk to us in a language we understand.”

 Jane Taylor, Chair of Patient Insight Group, Arthritis Research UK

 

“Patient research must be in the community – empower people by explaining research outcomes.” 

Dr Doug Brown, Director of Research and Development, Alzheimer’s Society

 

“Patient data is at the core of innovation; experience of living with a condition shapes new treatments.”

Nicola Blackwood MP, Parliamentary Under Secretary of State for Public Health and Innovation

 

“Research must be demystified. Take away the white coat and test tubes, and change the language.” 

Angela King, Patient Advocacy Lead, Novartis

 

“Conditions affect society – not just one person. It’s about changing mindsets and improving quality of life.” 

Keith Wilson, Patient Research Ambassador

 

“Before starting chemo, I was told you could travel on the tube afterwards – you can’t! Patients are the experts.” 

Professor Trisha Greenhalgh, Professor of Primary Care Health Services, University of Oxford

 

 

View from the expert

Over the last few years, the patient voice has become more confident, more educated and more important. The digital revolution has led to increased access to information, and a brave new world of healthcare has emerged.

Discussion forums, Twitter, Facebook, Instagram and many others provide patients with a platform to openly discuss health concerns, research their condition and share thoughts about their day-to-day lives. This has resulted in the growth of more engaged patients – and those providing healthcare have had to listen to what they’re saying.

The increasing volume of the patient voice has also coincided with the squeeze on NHS services. Four years ago the Department of Health published ‘Liberating the NHS: No Decision About Me Without Me’. It specifically targeted healthcare professionals, with the aim of providing patients with better choices and more control over their health.

Drawing on years of running product trials, and cohort patient trackers through talkhealth, feedback suggests that if patients are informed and feel more in control, commitment to their healthcare routine is higher, with better compliance.

Some 17 years ago, my own GP – who I think was ahead of his time – admitted he had run out of treatment ideas and acknowledged that I knew more about my daughter’s condition than he did! This experience repeats itself across health forums, as those battling with health issues become 'professional patients'.

In his book, The Patient Will See You Now, Eric Topol said: “We’ve learned in general that doctors don’t like smart patients. But this sort of attitude will do little to hold back a new generation of increasingly smarter patients and more supportive and smarter doctors.”

With rapid advances in technology it will be fascinating to witness the further progress of patient empowerment over the next decade.  

 

Deborah Wyatt is Founding Director of talkhealth Partnership Ltd. Go to talkhealthpartnership.com

 

 

 

 

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Features

Crystal Ball: Healthcare predictions ‘17

by Amy Schofield 8. January 2017 11:54

 

 

2016 was a year of seismic shifts, but what does 2017 have in store for pharma and healthcare?

Having reflected on a tumultuous 2016 in the last issue, Pf has assembled a team of luminaries from across the NHS, industry and politics. They have been tasked with gazing into the 2017 healthcare crystal ball and sharing their predictions. Will we be dancing in the streets or hiding behind the sofa? Let’s find out...

 

 

Dr Charles Alessi, Senior Advisor, Public Health England

“2017 will be a year of turmoil for health and care in England. This will act as the spur for long awaited changes to implement a more locally-based delivery of care where local government and health are the important players and the person – not the patient – takes centre stage.”

 

 

Therapy areas and R&D

Chris Molloy, CEO Medicines Discovery Catapult

Patient charities hold the ‘long-term’ view, and that has helped fund continuing research into cancer, heart disease, Parkinson’s, Alzheimer’s and many others.

We are building a new model for discovery: disease–based syndicates, with patient research groups as the cornerstone. Engagement with their communities is critical to target selection, validation and proof of concept.

In an industry which takes over 10 years to bring products to market we should resist the temptation to continually refocus our R&D from one disease to another. Long-term global efforts in cancer have been needed to reach the current success in product flow and survival rates.

Quite rightly there has been a societal and scientific focus on dementia, helped by the excellent leadership and research focus of Alzheimer’s UK. Rates, however, may already be at a high watermark.

On a scientific level, if we are to take on the complexity of most non-orphan diseases we must look past the one-gene, one target, one medicine approach of old.

We remain horribly weak in the war on microbial disease. If the world does not invest, the UN foresees a $100 trillion impact on the global economy in the next 50 years – we are all at risk. There are economic barriers to overcome, but more worrying is the loss of expertise in the sector. A recent survey indicated the number of active, card-carrying experts worldwide may now be less than 2000.

An agreement at G20 on re-entry incentives will spark a renaissance in long-term funding, and the influx of money from the US will be a major step forward in 2017.

 

 

Ryan Wooller, Business Development Director, Star

“2017 will be the year of pharma understanding the game-changing nature of sustainability and transformation plans (STPs). Implications could pose both a threat and an opportunity for the pharma commercial model. Pharma supporting pathways of care could rise up the customer agenda.”

 

 

EU departure

Chris Molloy, CEO Medicines Discovery Catapult

Post-Brexit, 2017 will not offer the certainty that industry needs in terms of regulation or people movement. We should accept that situation and focus on things we can do – ensuring the UK remains a fertile place to discover and improve new medicines.

The UK has considerable public assets across academia and the NHS, and a financing hub that provides 30% of all European investment in biotech. It also has a strong, high-quality CRO community that can thrive in the modern ‘virtual’ discovery model.

Combining these capabilities is key to our industrial strategy in medicines and the significant increase in recent funding for InnovateUK. The £100M refilling of the Biomedical Catalyst provides the fuel.

  

Leslie Galloway, Chairman, Ethical Medicines Industry Group (EMIG)

We mustn’t judge the Government’s performance on a daily or weekly basis. Much of what is really happening will be behind closed doors and many compromises will be reached.

The messages that we need Government to receive are: 52% of people may have voted to leave the EU but many more, if asked, would have voted for a stronger economy that will support healthcare, education, law and order and living standards.

Having a vibrant economy is vital for any political party and the pharma industry should be at the forefront of any industrial strategy, because we don’t just deliver prosperity to the UK, we help deliver some of the best healthcare in the world.

We should retain as many of the benefits of EU membership as we can – the single market and access to the right people. We also need to focus on the opportunities that we can exploit with the Medicines and Healthcare Products Regulatory Agency and how we can become a global centre for research.

We have the opportunity to drop Corporation Tax to 10%, to attract international investment. If global companies are to invest in UK healthcare we need an NHS that is properly funded and a New Medicines Fund which delivers our new medicines to patients.

The UK – at 3% of the global market – may suddenly be perceived as a minnow and, if we have to develop a separate regulatory approval system, it could drop us down the ‘ladder’ of global pharma priorities.

 

 

Health and social care

Helen McKenna, Senior Policy Advisor, The King’s Fund

2017 promises to be a pivotal year for health and social care. NHS finances will continue to be a major concern – the Autumn Statement confirmed the NHS settlement set out in the last Spending Review, which means that 2017 will usher in three years of very little growth in the health budget.

Health leaders will be expected to get NHS performance back on track in 2017 – but this will be  tough. At the same time that budgets are squeezed, many NHS services are struggling to maintain their operational performance.

The latest NHS statistics show that services are under huge pressure and often failing to meet key targets, including the four–hour A&E and 18–week referral-to-treatment targets.

Demand for services keeps rising – the number of A&E attendances and emergency admissions to hospital are increasing rapidly. This increases the strain on services, with almost 11% of patients now spending more than four hours waiting in emergency departments. General practice, mental health and community services also remain under huge pressure.

There will be continuing calls on the government to identify a long–term solutions to social care funding. The social care sector is in a critical state – fewer people are able to access the care they need, delayed discharges from hospital are at record levels and there are deeply worrying warnings about the fragility of some large care providers. To find extra money, there will be a need to put social care funding on a sustainable footing for the future.

Although 2017 offers plenty of challenges, there are also some important opportunities. The new models of care being developed, in response to the NHS Five Year Forward View, along with the work being undertaken to deliver Sustainability and Transformation Plans, offer significant potential.

 

 

The political sphere

Alex Ledger, Deputy Managing Director at Decideum

2017 offers one unique opportunity for pharma – the chance for industry to work with Government to develop a new industrial strategy for Britain.

It goes without saying that Brexit has changed everything. The stakes have never been higher. The health of the UK economy is intrinsically linked to the success of its highly-skilled industry sectors and life sciences is the cornerstone of this, employing around 175,000 people, and with a £51bn turnover in 2015.

The UK wants to go toe-to-toe with the big US life sciences hubs in Boston and the Bay area on the West Coast. To do this – in a world unfettered by the regulations of the European Union – it must convince the global pharmaceutical industry that, in spite of potential barriers to accessing the European market, the UK offers unparalleled attractions, a world class research infrastructure and an innovation-open NHS, worthy of investment.

Q1 of 2017 will see a hive of activity on this strategy – coordinated jointly by the Secretaries of State for Health and for Business, and via the Office for Life Sciences. Indeed, some of this work is already underway and life sciences has been earmarked as one of the subjects which will form the Government’s overall post-Brexit plan.

Pharma has a rare chance to join together as an industry, look beyond marketplace competitiveness and provide the UK with the best prospect of competing independently on the global stage.

 

 

Robert Taylor, Head of Europe, Commercial Solutions, Quintiles IMS

“2017 will be a year of broadening the use of technology to support the sales process and the on–going emergence of the multichannel sales model. While the ‘human channel’ remains the cornerstone, interest in digital and remote engagement continues to grow, and demand for efficient commercial solutions which leverage different channels is increasing.” 

 

 

 

Primary care

Dr Anne Connolly, GP and Chair, Primary Care Women’s Health Forum

The main challenges will be coping with the fall out of local authority (LA) funding cuts. Delayed discharges, cancelled operations, higher emergency admissions and poorer community care are happening because of cuts in community placements, social support and staff in LA commissioned services, such as health visitors, school nurses and youth workers.

Other challenges include increasing demand and the poorer health of the population. Ageing and chronic long-term frailty problems, obesity and the link with metabolic syndrome, cardiovascular disease and cancers, mean that the self-care agenda will need to be prominent. There will be a push from GPs for patients to buy their own over-the-counter medicines and use online resources, pharmacists and other allied healthcare professionals before going to their GP or A&E.

All clinical commissioning groups are having to make cost efficiency savings, so more will want to make decisions about QIPP (Quality, Innovation, Productivity and Prevention) savings.

As GP practices develop into federations there will be a push for care closer to home, some care delivered by AQP (Any Qualified Provider) and better use of technology. The extended hours developments will need GP practices to work closer together to make sure that care can be delivered by primary care for longer hours.

Hospitals are under increasing pressure to reduce planned admissions and surgery as they struggle to cope with the extra unplanned and emergency work.

 

 

Peter Rutherford, Vice President Integrated Market Access, EMEA and Emerging Markets, Quintiles IMS

“2017 will be a year of increased focus on patient access requirements, as the need for scientific communications throughout the product lifecycle, and the numbers of complex new products requiring integrated patient support programs, continues to grow.”

 

 

The digital revolution

Dr Farzad Entikabi, GP and founder of Doctor Care Anywhere

The NHS is one of the most clinically advanced health services in the world, but the sector needs to implement innovation to find opportunities for improvement, as it faces the pressures of reduced budgets, rising demand and an ageing population.

Primary healthcare is one of the most strained areas of the NHS, with 60 million more consultations a year required compared to five years ago, and waiting times predicted to rise next year, from just under two weeks, to 17 days. Our recent research with YouGov found that due to the barriers of accessing a GP, 3.3million people have missed or put off seeing a GP, risking their longer–term health, and potentially costing the NHS more.

It is becoming clear that our primary healthcare services are stretched to breaking point and that, along with appropriate funding, innovation is also needed.

Technology – and specifically telehealth – is already offering solutions to these concerns, not only in terms of the diagnosis, monitoring and treatment of illnesses, but also in the way patients access healthcare. Indeed, 70% of GP appointments can be conducted via video or phone, and the next few years will see a significant change in how we access primary healthcare, with virtual GPs providing a quick, reliable and flexible healthcare service to a greater number of people.

Digital innovation is fuelling extraordinary developments in healthcare and will be a critical force in ensuring that existing health issues do not escalate into more significant problems.

 

 

Nick Lavery, Co–Founder & Managing Director, Republic M!

“2017 will be a year of growth for healthcare with continued market access pressure and greater competition. Return on investment will become increasingly important and the industry will accelerate adoption of innovative promotional and educational channels. This multi-channel approach will be integrated across the promotional mix to drive profitability.”

 

 

 

Clinical development

Divya Chadha Manek, Head of Business Development (Commercial), National Institute for Health Research (NIHR)

The NIHR Clinical Research Network predicts that the strapline for clinical development in 2017 will be ‘collaborate, collaborate, collaborate’.

2016 was a year dominated by mergers and acquisitions within the life sciences Industry. M&As are not a new thing within the sector, however, it is becoming apparent that for a company to be successful, there needs to be a shift in its approach to developing medicines for ‘tomorrow’s world’.

This move towards more open ways of working through strategic partnerships – spanning healthcare, academia, life sciences industry, the charitable sector and patient organisations – is gathering momentum. Mirroring the growing trend for outsourcing drug discovery, new and innovative collaborative models are emerging with the aim of accelerating medicines development.

Collaborations take many forms and bring many benefits. We are now seeing charities collaborating with the life sciences industry on multiple levels, allowing them to work in new ways and bring benefits to patients. Lab–based scientists and academics are coming together with clinical researchers, enabling them to share ideas and resources, driving forward drug discovery.

Similarly, life science companies are forming alliances with research delivery organisations and the NHS to optimise early phase testing of potential pharmaceutical products to expand their research and development programme.

Universities are joining forces to harness big data and find ways to support the safe use of patient data for medical research, while patient organisations are promoting initiatives to help finance generic drug trials for rare diseases.

The NIHR Clinical Research Network predicts more exciting collaborations. We often use the catch line: ‘The NHS is open for business’, but perhaps it’s time to say – ‘we are not just open for business, we are open for innovative approaches on how we do business.”   


 

 

 

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Features

Aimee Carr, 26, on living with two chronic conditions

by John Pinching 5. January 2017 14:55

The first of a unique series of interviews in which patients share their experiences - in their own words

 

Please tell us about you and your condition.

My name is Aimee Carr and I am 26 years old. I have been diagnosed with severe fibromyalgia and chronic fatigue syndrome. I am currently housebound most of the time and occasionally manage to go out for a few hours if a family member can take me out in the wheelchair.

 

What treatment or therapy do you use? 

Currently I am on a lot of medication and have tried many different therapies such as lidocaine infusions. Nothing is successful at the moment, but I am hoping to try more options as they become available.

 

What impact has it made on your life?

It has completely turned my life upside down. I went from being a girl who works 45 hours-a-week, two jobs and training for 5k runs, to not being able to leave the house or walk further than my car with a crutch. Training and hiking are my favourite things to do - I used to power through the pain, but now that it is so severe, and coupled with the fatigue, I can't do any of it anymore. People treat you differently when you're disabled, they stare when you pull up in a disabled parking bay. It makes you feel like everyone is living their lives, while you are left behind. My husband goes to work and out with his friends, while I am sat alone in the house every day - it makes you feel very insecure.

 

Is adherence - sticking with your treatment regime - a challenge?

I have overdosed with medication accidentally, because I have forgotten when I've taken them, so I now have a medibox. This is filled by a pharmacist and it shows me when I need to take my next meds.

 

What side effects, if any, do you have to manage?

I have side effects such as constipation and migraines from my pain medications. I have to take other tablets to manage those alongside my main meds.

 

Are you getting enough information about what medicine you take?

Yes, all of the medications I try are fully explained to me by my GP and specialist doctors.

 

Are you looking for an improved treatment?

I still haven't found any treatments that have improved my circumstances, so I am always hopeful that there will be more effective treatments available soon.

 

Do you think that the pharma industry listens to you?

Yes and no. When you get someone who is very understanding, it's brilliant, but if you get someone who doesn't really understand your condition, it can be very upsetting.

 

How would you like to see communication with drug manufacturers improve?

It would be good if they set up surveys or interviews, like this one, which could be sent to people who use their medications regularly. They could then act on the feedback about treatment side effects or effectiveness.

 

Are you feeling positive about the future?

At the moment, no. Previously I've been very positive but, unfortunately, I am getting to a point where there isn't much more for me to try.

 

‘The Patient Voice’ interviews are a collaboration between Pf Magazine and talkhealth.

talkhealth is one of the leading online health communities in the UK, providing free information and support to those with chronic health conditions; whilst collaborating with pharmaceutical and healthcare companies, charities and medical professionals to develop sustainable health programmes and solutions.

For advice and support go to ukfibromyalgia.com

 

 

 

 

 

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Features

What's your favourite Pf Magazine cover?

by Hazel Lodge 3. January 2017 11:40

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Features

Is pharma finally catching up with the future?

by Amy Schofield 22. December 2016 09:37

 


When it comes to science, pharma has left many other industries in the dust – but ‘digital’ has never been a straightforward bedfellow. Now, however, distinct silicon valleys are emerging in the terrain of pharma, and digital is no longer on the horizon – it’s here. 

 

Cloud cover 

David Bennett – Vice President of Strategy for Veeva Systems – on Sanofi Pasteur MSD’s transformative journey to cloud marketing  

More than ever, companies are putting the customer squarely at the centre. Engaging with them quickly and relevantly through digital channels is the new imperative – but achieving global brand alignment is a huge challenge for pharma. 

Almost three years ago, Sanofi Pasteur MSD embarked on that perilous journey and – with three products to launch – it incorporated new digital channels in the quest to maximise customer engagement. As a company entirely dedicated to vaccines – with nearly 1000 employees, across 19 countries – it realised the magnitude of the task, but the results were still greater than expected.  

“Our 2013 product launches were critical for the company,” explained Alexandre Gultzgoff, Sanofi Pasteur MSD’s deputy director of IT. “We searched for a modern platform that would enable a digital transformation and improve compliance quickly.” 

The company chose a leading cloud-based multi-channel solution – fully integrated across email, face-to-face and web. Subsequently, the company’s sales representatives immediately began sending emails directly from the system to customers and personally engaging with healthcare professionals via interactive web presentations. Indeed, field teams and brand managers embraced it so quickly that the company tripled expected adoption rates, six months ahead of forecasts.  

Over time, however, a pattern began to surface – after six to seven weeks, engagement would drop off. “It became very clear that we needed to change content much more often to keep customers engaged,” explained Gultzgoff.  

To improve the speed of content development, Sanofi Pasteur MSD took a two-pronged approach. Firstly, it sought to harmonise content, by consolidating its agency partners and harmonising content development and, secondly, looked to streamline material by adopting a cloud-based commercial content system.  

The results were remarkable – content production had become centralised, but local regions were still able to adapt it to meet specific regulatory or cultural needs.  

“The impact has been amazing,” said Gultzgoff. “We expect a return on investment in less than six months, due to content reuse alone.” 

It is now expected that the time to release commercial content will be reduced by at least one third, while medical, legal and regulatory review time will decrease by up to 50% per year. The company also projects efficiency gains of 17% in the first year, followed by a 33% annually in years two through to five.  

Furthermore, Sanofi Pasteur MSD is now looking forward to implementing a complete audit trail that puts brand owners in the driving seat, and makes them accountable for where an asset is being used and for what purpose, improving compliance in the process. 

“The next crucial step is to gain richer customer knowledge,” concluded Gultzgoff. “We can’t wait to see what else we can accomplish.”  

  

Egg timer 

Chris Knight – egg Innovation Director – on the use of digital to release the potential of instant data    

 Egg is the ‘innovation hub’ at Virgo Health, the global healthcare communications agency. egg’s mission is to develop products that make a meaningful difference to patient lives on a daily basis, while also supporting healthcare professionals and pharma. It recently launched with two proprietary white-label digital products.  

PRODIGI is a ‘Collaborative lnnovation Tool’ combining enterprise collaboration, project management and ideation technology. An early adopter of PRODIGI was Imperial College Health Partners – as part of Digital Health London it is using it to facilitate better collaborative working among practitioners in the area of atrial fibrillation. 

Meanwhile, TRIAL360 is a digital platform which optimises clinical trial efficiencies, without compromising standards. From protocol development to data milestone readouts, it provides education, resources and support. It is a pioneering example of how tech is better fulfilling the needs of investigators and – critically – patients, throughout the trial process. 

 

Keeping it real 

Nicholas Brooke - Patient Focused Medicines Development Chief Executive – on the rise of patients in the digital space 

Patient engagement is increasingly popular, but good practices aren’t being spread. Nobody has a clear picture of what initiatives are already in place, so efforts are often duplicated and resources used inefficiently. This knowledge gap makes it difficult to identify patient engagement opportunities that are relevant. 

That’s why Patient Focused Medicines Development has launched a global online tool to understand patient engagement. It digitally maps and categorises initiatives to provide much-needed structure to the landscape. Patients can search for initiatives, and healthcare stakeholders can track other projects to see where they fit. Most importantly, all users provide honest feedback on the successes and limitations of each initiative.  

Using this information, developers can easily improve their platforms, and create multi-stakeholder partnerships and working groups. All interested parties collaborate to synergise and globalise good practices, creating a pioneering framework, which takes patient involvement into the 21st century.  

The tool could mean big things for biopharmaceutical companies. Drug development is already expensive and time-consuming, so putting patient needs first ensures that the right things are prioritised and resources are not wasted. The tool will also streamline drug trials by identifying potential risks and barriers to patient participation at an early stage.  

Already, 15 biopharmaceutical companies are using the platform and sharing information on 42 different initiatives. Of course – as with any big data tool – the more it is used, the more valuable it becomes. Ultimately, we need users all over the world to participate and share their experiences.  

 

 

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Features

Our new columnist wrestles with the old ‘time conundrum’.

by David Thorne 13. December 2016 11:30

 

 

Back to the future: Our new columnist wrestles with the old ‘time conundrum’.

 

In my GP federation role I meet pharma professionals about five times-a-week. Typical questions include ‘do Sustainable Transformation Plans (STPs) matter, are CCGs merging, is St Swithins linked to the Princess Di Infirmary, what is an ACO, are we going devo and how does this all relate to our formulary application for Obscurex Once Daily Fast Tabs?’

When I tell them that many of these things are already happening, they ask: ‘When you say happening now, when, exactly, do you mean?” In reality, they have happened while people try to understand what is going on.

Further questions are surfacing – if two CCGs now share a Chief Officer, do you think they will be separate CCGs again? Why has 30 years of policy been reversed, so that STPs can manage their control total and move money between organisations? If an Accountable Care Organisation ditches ‘payment by results’, do you think they’ll ever reinstate it? Hospital chains have clear and present dangers for pharma, yet company value propositions and strategies remain largely unaltered.

Pharma needs to move much faster and closer to the NHS to accurately anticipate the developing landscape. I have long argued for the need to establish the positive role of medicines in the minds of managers who have no clinical or scientific training. Indeed, how many key opinion leaders do companies have who are clinicians or pharmacists, and do many industry folk have positive relationships with anyone in local authorities?

The consequence of not gaining traction in these areas is that STPs will reflect the paradigm of ‘medicines equating to a cost to control’. At the moment, I see no content that links medicines to increased health, decreased illness or reduced hospital activity. Pharma, therefore, risks being forced into reactive mode, defending itself against a Carter Review ‘race to the bottom’.

Complicated NHS nettles are being grasped and STPs are addressing the big rocks  acute hospitals and staff issues. The plans also signal the merging of trusts, centralised key specialisms and hospitals losing status to become ‘support sites’. Expect NHS terms and conditions to be attacked, giving rise to treatment restrictions, co-payment and other access limits.

The NHS has resorted to centralised control to force change and has thereby exposed the facade of Foundation Trust independence and CCGs being membership organisations. The new NHS, however, hinges on local authority collaboration, and those draft STPs that were published early, emerged from councils keen to cite democratic openness.

NHS commissioning has always lacked a mandate and a constituency of support to drive change. We could be about to witness a true public debate about the purpose, funding and boundaries of the NHS – and unless it acts decisively, pharma will be stranded on the outside.  

 

David Thorne is Chair, Washington Community Healthcare and Non-Executive Director, City and Vale GP Alliance. Go to blueriverconsulting.co.uk

 

 

 

 

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Reflections on 2016

by Amy Schofield 8. December 2016 12:06

 

The ‘annus horribilis’ of 2016 makes the Queen’s hell of ‘92 seem like a garden party. From the moment dear old Terry Wogan went ‘off air’, many more of our most cherished icons followed. Then the EU exit happened and so much was thrown into doubt. Then just when we thought things couldn’t possibly get any more unpredictable, Trump trumped Clinton, hailing a new era of bafflement and uncertainty.

The world of pharma and healthcare has inevitably been swayed by these seismic changes in the political landscape at home and abroad – although, the day after Trump’s victory, pharmaceutical shares surged in Europe. Meanwhile, the world faced challenges such as Zika, antimicrobial resistance and the news that an ageing population has led to Alzheimer’s disease and dementia replacing heart disease as the number one cause of death. Consequently, demands on industry to come up with solutions to these conundrums are at an unprecedented level.

As we momentarily gather around the log fire, let’s reflect on a turbulent year, and hope that the progress being made will encourage flames of order from the embers of chaos.

 

Top 5 Mergers & Acquisitions

 

1. $66bn (£50bn) Bayer and Monsanto

2. $32bn (£26bn) Shire and Baxalta

3. $25bn (£20bn) Abbott and St Jude Medical

4. $14bn (£11bn) Pfizer and Medivation

5. $7.2bn (£6bn) Mylan and Meda

 

 

NHS

 

Jan – Cold war

The junior doctors’ strike kicks off the year, as they fight back against Jeremy Hunt’s plan to impose a new contract. 

Feb – No trust

NHS trusts’ deficit is estimated at £2.3 billion as the NHS financial crisis deepens.

Mar – Temperature rises

The NHS cracks down on GPs’ conflicts of interest, as junior doctors take to the picket lines again. 

Apr – Your call

The junior doctors’ dispute rumbles on, while NHS England launches a programme to encourage patients to look after themselves.

May – Docs docked

A GP crisis is revealed as demand exceeds the rate of recruitment.

June – Euro vision

New A&E statistics show that emergency departments are facing a crisis. Brexit result brings more uncertainty.

July – Jeremy Beadle

Hunt has been removed by new PM Teresa May. Not true. Party poppers are returned to their original position, as is Mr Hunt.

Aug – Planning permission

Sustainability and Transformation Plans are hailed as representing a significant change in the way the NHS plans its services.

Sept – Health declines

NHS performance deteriorates and service needs to find £22bn to plug the gap.

Oct – Patients please

The much-trumpeted NHS Five Year Forward View is under threat as lack of funding jeopardises strategy.

Nov – Three strikes

Ellen McCourt, Chairman of the BMA strike committee, resigns, following her decision to call off further junior doctor strikes.

Dec – 1948 and all that…

Michael Sobanja, Director, MSC, predicts: “The NHS is about to enter the most critical phase since its inception.”

 

 

Brexit

 

The Brexit result has presented challenges in a number of areas, notably trading with other countries, attracting research funding, recruiting the brightest talent and dealing with regulation. But there are also opportunities.

Audrey Yvernault, ABPI’s Director of Government & External Affairs, said: “Before Article 50 is triggered and negotiations begin, it’s difficult to predict what Brexit will look like. Yet, during this period of uncertainty, it’s important that the UK’s existing strengths in science and innovation continue to be reinforced; that the full implications of exiting the EU are understood; and as far as possible, a predictable operating environment is maintained.

“So far we’ve been encouraged by government’s commitment to the pharmaceutical industry’s growth and continued success, and it will be welcome news to see the sector sitting at the heart of any new industrial strategy.

“What we do know is that navigating our way through the next few years will be complex, and will take some time. For the pharmaceutical industry, the wider life sciences ecosystem, as well as patients and the NHS, it’s vitally important we get this right.”

 

Therapy Breakthroughs

 

Cancer

Immunotherapy leads the way, with trials demonstrating remarkable results in types of blood cancer, using CAR T-Cell therapy. The next challenge is for the approach to successfully treat solid cancers too.

 

HIV

New ways of treating the disease are being discovered, including an antibody named ‘N6’, which neutralised 16 of the 20 strains resistant to other antibodies in a trial. Other promising approaches include immunotherapy, and PrEP.

 

Antibiotic resistance

Scientists are researching ways to combat the rise of this threat to global public health. Trials into phage therapy, plasmids and compounds, with the potential to kill gram-negative bacteria, are projects offering hope to millions.

 

Zika

The race to develop a vaccine for Zika is on, with several in development. The latest vaccine to show promising results harnesses immune responses for both preventing infection and improving symptoms caused by the virus.

 

Alzheimer’s

Great strides have been made in researching the disease – now the number one killer in England and Wales. The latest development has been the emergence of a drug which successfully targets toxic amyloid proteins in the brain, raising hopes that an effective treatment could be within reach.

 

Editor’s view:

 

And so it came to pass – 2016 will soon be gone, and it won’t return. Yes, it was turbulent and, yes, we all want to get off and board 2017. But in the final analysis, I’m not sure any industry has emerged with more energy, more resilience and more determination than ours. That’s something we can all be proud of.

 


 

 

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Features

Under the radar: This new Bill could change everything

by Alex Ledger 5. December 2016 09:44

 

 

Alex reminds us that there is political life beyond Trump

 

You would be forgiven for thinking that, unless a current story references either Brexit or the outcome of the U.S. presidential election, it is unimportant, not newsworthy or entirely irrelevant.

Gradually, however, a new piece of legislation is working its way through the House of Commons and it stands to make a significant impact on the life sciences industry. It doesn’t come with coiffured hair, or a catchy strapline like, ‘Brexit means Brexit’ and it doesn’t even come with a particularly appealing name.

What I’m referring to is the ‘Health Service Medical Supplies (Costs) Bill’. You need to know what it says, because it may well change the nature of the game when it comes to pharma in the UK and – quite possibly – it will arrive sooner than the UK’s departure from the European Union

So why care about this clumsily-titled piece of draft legislation? The Bill – rapidly becoming known as the ‘Costs of Medicines Bill’ – is designed to strengthen the Department of Health’s (DH) powers over the costs of medicines to the NHS.

It is currently being reviewed by a House of Commons committee, where amendments are being proposed. These will ultimately be voted upon, before being passed over to the Lords for further scrutiny.

And we’re not talking ‘Article 50, two-year exit period’ here – this legislation is on track to be passed in the coming months and would likely come into effect by spring 2017.

The idea behind the broad new powers for the DH is to prevent significant price rises for medicines, where a competitive market doesn't function properly. Although not considered a major problem in the UK, there have been several high-profile news stories in the U.S. recently, where unbranded, generic medicines – supplied by a single manufacturer – experienced significant price hikes. The Government wants to protect the NHS from that situation occurring here, although its new powers go some way beyond what would strictly be necessary.

This Bill will impact throughout all aspects of the life sciences industry that provides medicines to the NHS. Indeed, Keith Ridge, Chief Pharmaceutical Officer for NHS England, has already stated in front of the public bill committee, that provisions of the Bill will set the basis for future PPRS negotiations.

Ultimately, this is a clear indication that while chat rages on about Trump and Brexit, we must not overlook developments happening within our own, often quainter Parliamentary system.

 

 

Pill Bill Vol. 1: Key ingredients

 

The Bill has three vital provisions. Firstly, it introduces a ‘payment mechanism’ for companies whose medicines fall under the statutory pricing scheme, which applies to any manufacturer or supplier of branded medicines that is not a member of the voluntary Pharmaceutical Price Regulation Scheme (PPRS). It works by applying a 15% cut to the list price of medicines – whether branded or generic – and, according to ABPI figures, the statutory scheme covers about 20% of NHS spend on branded medicines, with the remainder covered by the PPRS.

The Bill proposes to replace the blanket 15% price cut with a system that would see companies paying a fee back to the DH, based on a percentage of their net sales. The exact level of this figure has not been disclosed in the Bill, but when the Government ran a consultation on the statutory scheme earlier in 2015, the level of the fee proposed was between 10% and 17% of net sales, including on sales of new products.

The rationale behind the proposed reforms to the statutory scheme are clear – the Government wants it to achieve at least the same level of savings as those delivered by the PPRS.

While the PPRS caps spend on medicines, the statutory scheme has grown over the last two years and the DH wants to balance its books and, in doing so, create some financial headroom for the rest of its stretched funding obligations. A consequence might be a migration of some statutory scheme companies into the PPRS, possibly increasing the level of fees required to be paid by PPRS member companies.

It is worth remembering that the PPRS is a voluntary agreement between Government and industry that places a cap on NHS spend for those branded medicines covered by the scheme. If the cap is exceeded, companies will reimburse the NHS for any additional spend it makes over the cap level. Such an arrangement ensures that the NHS spend on branded medicines is maintained within agreed limits and offers budgetary certainty to Government. The latest PPPRs came in force in 2014 and, since this time, the industry has paid £1.4bn to the DH in the form of a financial rebate.

The second key proposal from the Bill requires companies to provide additional information on how their medicines are priced. The draft legislation gives the DH power to require ‘any party in the medicines supply chain’ to provide profits data on a product-by-product basis. This is designed
to ensure that the reimbursement system and supply chain offers the NHS value for money, while also providing transparency.

It is expected that the Government will run a consultation with the industry on the scope of the information required by the Bill if it is passed into law. Further accompanying regulations will certainly be needed in any case. Companies currently provide data on medicines pricing and discounts to overall profitability, via existing systems, but not typically on a product basis. Supplying this degree of data is quite a step-change and is likely to be considered overly exacting by industry.

Finally, the Bill proposes new powers for the DH to decide upon acceptable prices of medicines where a competitive market is deemed to have broken down, including authorising a limit to the price of an unbranded generic medicine not covered by the PPRS.  

Alex Ledger is Deputy Managing Director at Decideum. Go to decideum.com. 

 

 

 

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Features

NHS uncovered: Revealing STP footprints

by John Pinching 25. November 2016 11:25

 

 

The NHS loves nothing more than a sub-plot, preferably nestled beneath an overarching narrative. Another acronym or abbreviation by the presiding administration is simply an additional layer on top of the most multi-tiered healthcare cake in the world – one that was lovingly prepared back in 1948, and has never stopped growing.

One of the latest strategies involves ‘Sustainability and Transformation Plans’ (STPs) – the kind of concept that keeps you up at night, as you try to decipher the ambiguity of its title. In reality, it deserved to be called something far more explicit like ‘Tailored Local Care Services’ (TLCs, if you will).

Indeed, STPs are part of a more tailored system, which focuses on the local populous and aims to help deliver the main objectives outlined in the ‘Five Year Forward View’ – a title which still makes you assume that whatever you’re targeting is perpetually five years away (the original paper was actually submitted in 2014).

Nevertheless, in NHS terms, STPs are pretty wild – they appear to encourage ambition, a results-driven culture, radical ideas and even calculated risk. Ultimately, the aim is to accelerate health and welbeing strategies in a specified zone.

A collection of 44 ‘footprints’ have been duly trodden into the turf of our beloved NHS landscape and, in January this year, local healthcare luminaries in each area convened to thrash out what the footprints would resemble – their heart and ‘sole’. Now it is about transforming the patient experience and the overall health of the nation across the board – using the sequence of footprints to reach the ‘Promised Land’.

Each region has also had a ‘leader’ appointed, who will act as a guardian, while the fledgling process starts to germinate within an already crowded infrastructure. The ‘footprints’ – while not possessing any real clout in terms of statutory authority or accountability – will have the ability to draw notable healthcare personnel for frank discussions on STP delivery.

The aspect of STPs that really sets them apart from other new NHS ventures – and, boy, there have been plenty since the 1950s – is the emphasis on local requirements and, encouragingly, a rejection of a one-size-fits-all nationwide ‘solution’. It is an acceptance that different areas of the country – through a range of reasons, such as alcoholism, unemployment, ethnicity, nutrition, mental health, heart disease and even the weather – have vastly contrasting needs.

The term ‘footprint’ itself is an intriguing and possibly deliberate one – there is a suggestion of the digital world in its use, while also indicating a forensic, personalised approach. Cynics may well assume, however, that ‘footprints’ – by virtue of their nature, may be brushed away at a moment’s notice.

 

There’s no place like home

STPs handle variables in a way that focuses on the specific needs of a demographic. This ‘new layer’ feels somewhat different – the cookie-cutter approach to healthcare appears to have been cast away, appreciating that there are fundamental differences between Bournemouth and Blackpool and Blyth.

Taken as an example, North West London’s STP has one of the highest population footprints in the UK, with two million people. Within that area there are several sub-regions, which all have very distinctive requirements. In Hillingdon there are only 20 rough sleepers, while 5.2% of registered patients above the age of 18 have depression, whereas a few miles down the road, in Westminster, the rate of depression drops to 3.9%, however, there is an explosion of rough sleepers, to the tune of 921.

Meanwhile, when you migrate upwards to Nottinghamshire in the East Midlands, there is a population footprint of one million, while an intimate and aspirational STP focuses on ‘what local people want’ including maintaining independence, quality care provision, joined-up services and healthcare set-ups which can offer a legacy to future generations.

Further up north, the Lancashire and South Cumbria STP – with a population footprint of 1.6 million – specifies needs across typical disease pathways. It states that control of hypertension, cholesterol and blood pressure are priorities, while noting that stroke patients’ time in the appropriate unit and patient access to psychological therapy completion must improve.

This all paints a picture of a very diverse Great Britain, which requires input from practitioners and demographic experts at 'street level', and STPs would appear to be a robust response to that. Identifying differences and homing in on solutions all seems like positive stuff.

Decideum’s Deputy Managing Director and Pf Magazine’s Political Correspondent, Alex Ledger, said: “STPs represent a practical invention by NHS England to unpick one of the changes, introduced by the Lansley reforms of 2012, by restructuring NHS commissioning and pooling budgets at a larger, regional level, rather than across 200+ CCGs. Critically, this nullifies the need to tinker with the statute book and introduce new legislation.

 

View from the expert

David Thorne is Chair, Washington Community Healthcare and Non-Executive Director, City and Vale GP Alliance

 

Thirty years of policy reversed in a year, suggests STPs matter more than you may think!

We now have one health economy joint plan for commissioners, providers and social care – the internal market has been abandoned and replaced by 'One Local Team NHS'. Integration, consolidation and collaboration will all be rewarded, but sanctions are applied to those not responding. Darwinian management has been enforced by NHS central control.

STPs have the ‘control total’ of local NHS virtual combined budgets. They can move money between NHS bodies, replacing ‘Payment by Results’, while funding is available to help CCGs join together. These major changes herald an imminent NHS with 44 integrated units along Accountable Care Organisations lines, so watch for changes to the named leads, as that will signal STPs evolving from planning to managing.

The absolute aim is financial balance and hitting ‘Key Performance Indicators’, so expect bullet-biting hospital rationalisation and intolerance of opposition to implementation and workforce reform. Stormy times ahead.

 

 

 

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