GAMECHANGERS HEALTHCARE MAGAZINE SIX SEVENTEEN

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CONTENTS cover

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WE HELP OUR CLIENTS CHANGE THE WORLD, ONE LEADERSHIP TEAM AT A TIME ®

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The best in B2C pharmaceutical and healthcare content marketing

EY M&A and Fire Report

35 HIGHMARK HEALTH ANNOUNCES CINDY DONOHOE APPOINTMENT TO EXECUTIVE VICE PRESIDENT, CHIEF MARKETING OFFICER GameChangers™ welcomes news and views from its readers. Correspondence should be sent to gamechangers@acq5.com For more information about GameChangers™ visit www.acq5.com/posts/ gamechangers/ GameChangers™ Copyright © 2017 GameChangers™ No part of this magazine may be reproduced, stored in a retrieval system or transmitted in any form without permission.

SAFE HARBOR The interviews in this publication may contain certain forward looking statements with respect to the financial condition, results of operations of the businesses profiled. These statements and forecasts involve risk and uncertainty because they relate to events and depend upon circumstances that will occur in the future. There are a number of factors which could cause actual results or developments to differ materially from those expressed or implied by these forward looking statements and forecasts. The statements may have been made with reference to forecast price changes, economic conditions and the current regulatory environment. Nothing in these announcements should be construed as a profit forecast.

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A Outlook epower 2017

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How healthcare marketing is moving beyond the pill

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The menopause at work

Healthcare

Digital Health: Total Convergence Integrating technology to solve the world’s healthcare challenges A report by The Economist Intelligence Unit

Will payer leverage and post-election optimism shift dealmaking into a higher gear?

Payer pressure is growing across a wide spectrum of the health care sector. Price increases have been blunted by election-year rhetoric and competition in key global pharmaceutical markets. Continued portfolio rationalization, a professed preference for bolt-on deals, and lower target company valuations continue to sharpen global appetites for acquisitions into 2017. A distinct ďŹ repower advantage combined with suddenly friendly political and tax climates in the US should allow big pharma to seize the M&A agenda.

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SPECIAL REPORT: EY M&A Outlook and Firepower Report 2017

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an Economist Intelligence Unit business Healthcare

Digital Health: Total Convergence

TEAM David Rogan - President & Editor-In-Chief Jon Van Dyke - Editorial Director James Wiltshire - Publisher EDITORIAL J Robson - Editor-At-Large L. B. Kooler - Deputy Editor P Ramone - Senior Editor J LaRusso - Copy Chief M-C Fisher - Editorial Assistant B Sancheze - Senior Staff Writer ADVERTISING A Bott - Digital Advertising Director J Downey - Advertising Director Z Wolfel - Business Development Director C Thomas - Account Executive H Smith - Account Executive ADMINISTRATION A Kessler - Finance & Admin Director T Dolby - Technology Manager P Hughes - Operations Coordinator T. A. Black - Office Manager

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‘SKYPE FOR GRANNIES’ DOCTORS TAKE MEDICAL PIVOTS TO DIGITALISE TRAINING OUTDOORS ELDERLY CARE Finnish tech startup Pieni piiri refocuses its business from a ‘Skype for grannies’ app to a provider of digitalised elderly care services. To fund the growth of its new business, the company has launched an equity crowdfunding campaign.

The story of Pieni piiri – Finnish for ‘small circle’ – began in 2010, with a recently widowed grandmother. The founder Matti Kari noticed that even that her granny was in good physical condition, she was almost completely lacking in peer contacts. It was soon discovered that she wasn’t the only one suffering from isolation and loneliness - up to 50% of the elderly receiving home care report feeling lonely in countries across the Europe.

Pieni piiri’s business builds on its original ‘granny-proof’ tablet application. Essentially, the application can be used to make digital services accessible to elderly end users without any previous IT skills. The application is used by a number of health and care organisations, including the Hospital District of Helsinki and Uusimaa (HUS), Mainio Vire, and the Finnish cities of Vantaa and Kotka.

“We found out that most care organisations are unable to reshape the ways they work,” says Mikko Järvinen, CEO of Pieni piiri. “To overcome this issue, we’ve decided to build our own 100% digital elderly care organisation. We believe to serve thousands of elderly customers by 2020.”

By building the new digital service organisation, Pieni piiri Oy will pivot from software business towards digital elderly care services. The initial market focus will be in Finnish home care, but at later stages the company will expand to other elderly customer needs on new markets.

While the crowdfunding round has been open for public for only a week, Pieni piiri’s equity offering has already raised over 40,000 euros. The target is to raise at least 100,000 euros for sales and marketing to break profitable with the new model.

“I believe we can truly be the change we want to see. At the same time, we can save money from our public health care system and, by means of our digital community, improve the quality of life of the elderly,” says Matti Kari, the founder of the company.

“Digitalisation is coming to all industries, and virtual home care visits are a great example of how digitalisation of elderly care services can both reduce the costs of providing the services as well as making them more accessible by eliminating costly logistics. Pieni piiri is doing in elderly care what we at Invesdor are doing in finance, and we are happy to be able to help,” says Mikko Savolainen, communications manager at Invesdor.

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Traditionally, the vast majority of doctors in the UK have spent their entire careers working within the confines of hospitals and clinics. But, spurred on by increasing pressure within the NHS and looking for medical experience elsewhere, medical professionals of all ages are looking to broaden their horizons and work in more unusual areas.

World Extreme Medicine’s Expedition and Wilderness Medicine course in Keswick, Cumbria from 13 to 16 March 2017 will see a group of medics from across the UK hone the skills that will help make them integral members of teams providing advanced medical care in remote areas.

The format of the course – which combines lectures with practical learning – will push attendees mentally and physically over four days, which will culminate in a largescale search and rescue exercise in the famous Lake District landscape.

Although it takes place in the UK, the four-day crash course will give participants a grounding in a number of different areas of non-hospital medicine that are useful on different sorts of expeditions: tropical medicine, hot and coldweather medicine, altitude medicine and diving medicine.

They will also cover areas like team leadership in extremes, communications systems and pre-expedition planning and casualty evacuation, which they may be unfamiliar with.

The course will be led by Claire Grogan, an expedition doctor whose career has taken her to Belize, Nepal, Morocco, Iceland, France, Italy, Switzerland, the Arctic, Tanzania and the Philippines, and whose experience in jungle, desert, mountain and Arctic maritime environments will be invaluable to the course attendees. Claire said, “The Expedition and Wilderness Medicine course is a first step for any medical professional who is considering a career outside of a traditional hospital environment.

“Attendees range from those who are curious about different sorts of work within the medical sphere, to those who are already decided on a portfolio career in extreme environments, to more experienced expedition medics.

“As the human race pushes into more of the world’s inhospitable places in search of natural resources or enjoyment, or in the name of science, there need to be doctors who can follow and keep people safe.

“This generation of medical professionals has the opportunity to have the most exciting careers in history!”

Mark Hannaford, founder of World Extreme Medicine, said, “Every extreme medic starts somewhere, and we may just find that the time in the Lake District ignites the expeditionary spark in some of the attendees.

“From there, they can go anywhere. They could provide medical support for scientists working in Antarctica, or with more training go on to work in other exciting areas such as deserts, high mountains or in conflict zones.”

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CONCEPT LIFE SCIENCES GROUP ANNOUNCES MULTIMILLION POUND EXPANSION PROGRAMME AND REBRANDING Concept Life Sciences Group, the business formed in 2014 to break into the international Discovery & Development and Analytical markets, has announced its intention to significantly increase its investment in laboratory capacity and scientific staff.

Michael Fort, Concept’s Executive Chairman said “The last two years has seen our company successfully integrate its acquired businesses and build a fully joined up service in chemistry, biology and analytics to our markets in biopharmaceuticals, agrochemicals, consumer and environmental services. During 2017 we plan to expand our laboratory operations by over 30% and our scientific staff by a similar number. By the end of the year we expect to employ 200 staff qualified to higher degree and PhD level bringing our total complement to 700 heads. This is a reflection of both the growth experienced during 2016 and on early indications for 2017.”

The Group has been formed from the merger of Scientific Analysis Laboratories, REC, Peakdale Molecular, CXR Biosciences and Agenda1. To reflect the integrated nature of the Group, all business will trade under the brand Concept Life Sciences from March 1st and into sub divisions of Integrated Discovery & Development Services and Analytical Services.

Further acquisitions are expected over the coming months to complement its recent service additions into computational chemistry and translational biology. Additionally, new services in food technology through its Analytical Services Division are planned in 2017. Dr Paul Doyle, recently appointed as Group Chief Scientific Officer commented “The expansion of our scientific facilities across the group, together with the recruitment of senior scientific staff represents a multimillion pound investment drive to give an international client base a world class integrated service. We are currently also recruiting at a senior level in the US, particularly on the West Coast, to specifically address that client group.”

The Group has also been buoyed by the appointment of Professor Trevor Jones CBE as an advisor to the board. A former Head of R&D at Wellcome and visiting Professor at Kings College London, Professor Jones brings a wealth of international scientific experience to the Group.

Concluding, Michael Fort added “The rationale for the creation of the Concept Life Sciences Group was the recognition of a need in the market for a first class service organisation that is science led, with a proven track record in discovery and development science, problem solving and collaboration. We have built an organisation that delivers one of the widest range of analytical services available in Europe.”

PREXTON THERAPEUTICS SERIES B FINANCING ROUND RAISES €29 MILLION ($31M) TO ADVANCE ITS NOVEL PARKINSON’S THERAPEUTIC • Forbion & Seroba co-led funding, forming international consortium of Merck Ventures, Ysios and Sunstone • Funding to finance two Phase II trials in Parkinson’s disease Prexton Therapeutics (Prexton), a biopharmaceutical company developing novel therapeutic compounds for the treatment of Central Nervous System (CNS) conditions, announced the closing of a Series B financing round of €29 million ($31M).

Forbion Capital Partners (NL) and Seroba Life Sciences (IE) co-led the financing round, which includes current investors Merck Ventures (NL), Ysios Capital (ES) and Sunstone Capital (DK). Marco Boorsma (Forbion) and Alan O’Connell (Seroba) will join the board of directors at Prexton.

The Series B funding will be used to finance two-phase II studies of Prexton’s lead product, Foliglurax (formerly known as PXT002331) in Parkinson’s disease (PD). The phase II trials will start in 2017 and will take place in specialist centers in Europe and the US. PD is a devastating progressive neurological condition affecting around 6.3 million people worldwide. The disease is caused by the degeneration of dopaminergic brain cells.

The main symptoms are resting tremor, muscle rigidity (‘OFFtime’) and uncontrolled movements (‘Dyskinesia’).Current treatments aim to replace dopamine or to mimic its effects.

Patients are administered with the dopamine precursor L-DOPA. This treatment provides adequate symptomatic relief initially, but over time, it loses efficacy as the disease progresses and patients experience serious debilitating side effects, such as dyskinesia.

Prexton’s approach is to stimulate a compensatory neuronal system that is unaffected by PD. Instead of targeting the dopaminergic system, Foliglurax activates a specific target of the glutamatergic system (mGluR4). The aim is to treat the motor symptoms of PD. A phase I trial with Foliglurax was successfully completed in September 2016. The results showed that Foliglurax was safe and well-tolerated at doses well above those that produce robust effects in PD primate models.

“It is a testament to the potential of Foliglurax that we have successfully completed such a significant funding round from high quality investors,” said Francois Conquet, CEO of Prexton Therapeutics.

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“We have developed a strong package of primate and phase I clinical data with Foliglurax. We are now keen to begin our phase II efficacy trials and continue the development of Foliglurax as a potential new therapeutic for Parkinson’s disease.”

“We have been very impressed with the science behind Foliglurax and the alternative route being explored

by Prexton to treat this difficult disease. Early data is encouraging and we believe Prexton’s approach could make a significant difference in developing new treatment options for patients,” said Marco Boorsma, Forbion. “As part of the funding round, we are helping Prexton set up operations in The Netherlands and supporting the company in starting trials. We look forward to working with the team.”

Commenting on the announcement Alan O’Connell, Seroba said: “Late stage Parkinson’s disease is poorly controlled by existing treatments. This creates very challenging issues for patients. We were attracted to Prexton by its potential to help address this significant unmet clinical and commercial need.”

NEW CANCER CURE – MODIFIED YEAST Scientists have created yeasts capable of triggering immune responses that target cancer, as part of a project funded

by Université Paris-Saclay in France. Clément de Obaldia, a former air traffic controller, retrained in synthetic biology with the aim to find a cure for cancer. In a few months, by forming a team and raising funds, he created a vaccine which, in mice, induces an immune response against skin cancer cells. He modified baker’s yeasts so that they show cancerous cell markers on their surface. Injected close to the tumour, these yeasts cause an immune response and the production of cells called lymphocyte killers, which detect and eliminate cancerous cells.

The approach is now undergoing clinical trials in the USA and, so far, no side effects have been detected. “Most immunotherapy treatments tested today attempt to boost the immune system by raising certain barriers that normally prevent the system from attacking its own cells, cancerous or not,” says Clément, “This approach can bring about serious auto-immune diseases, which a yeast based vaccine approach does not, since it simply aims to guide the immune system. “Like teaching a dog to recognise certain smells, the targeted cancerous markers are identified by an algorithm that compares the DNA of healthy and cancerous cells, then technology allows us to obtain – in less than a week – a yeast that can target the new marker that has been detected.”This opens the door to personalised medicine that could one day allow the development of therapies adapted to each individual. Clément’s start-up, Inovactis, is based at Génopole d’Evry, the first BioPark in France dedicated to genetic and genome research. Their work has been possible thanks to a grant of 16,700 Euros from Université ParisSaclay.

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UK MEDICS HEADING TO ARCTIC NORWAY Just as the UK looks set to warm up, a group of doctors and medical professionals is heading to the cold extremes of Alta, a town in the far north of Norway, to learn medicine and survival skills that will help them on future expeditions in polar conditions. The course, run by West Country firm World Extreme Medicine, has been developed for medical professionals, expedition and wilderness medics working in cold and high-altitude environments, and will run from 26 February to 4 March 2017. The Polar Medicine course aims to use the winter evenings to cover the essential expedition medical skills required to care for and treat injuries and illnesses likely to occur in this harsh environment, whilst the days are spent in the field, learning practical skills.

The course takes place over seven days and nights, and participants will encounter challenges such as shelter construction, cold water immersion and navigation. At the same time, they will learn about common cold temperature conditions such as frostbite, hypothermia and plan for these eventualities. London-based Matt Edwards, a senior Emergency Department doctor and prehospital physician in Kent, Surrey and Sussex, will lead the group. He has experience of medicine in cold extremes, having spent a couple of seasons providing medical cover to scientists with the British Antarctic Survey, and supported Across the Divide Arctic dog sled expeditions.

Matt said, “With the pressures on NHS doctors and nurses constantly increasing, the polar medicine course gives medical professionals an opportunity to experience working outside of a hospital environment, in conditions that are hostile to humans. “While the skills that they learn in Norway equip them to support expeditions into the Arctic and Antarctic regions for science, exploration or industry, we find that the attendees’ learning’s serve them well on their return to clinical environments in the UK. “The course focuses on treatment of medical conditions and situations that are common in the Polar Regions, but within a framework that teaches attendees survival skills in austere conditions. Doctors have to experience the challenges of moving around and living in the freezing cold in order to be useful expedition medics in these areas.” The fact that this course is useful to hospital medicine has been recognised by the Royal College of Surgeons of Edinburgh, which awards 30 Continued Professional Development points to attendees.

Mark Hannaford, founder of World Extreme Medicine, said, “This course gives attendees the chance to test themselves in a real-life extreme environment, possibly for the first time in their careers. “Every extreme medic starts somewhere, and we may just find that the week in Norway ignites the expeditionary spark in some of the attendees. “From there, they can go anywhere. They could provide medical support for scientists working in Antarctica, or with more training go on to work in other exciting areas such as deserts, high mountains or in conflict zones.” The next instalment of the World Extreme Medicine Polar Medicine course will take place 23 – 28 July in New Zealand.

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TOP PHARMACOVIGILANCE TREND IN 2017: THE EXPANDING ROLE OF PHARMACOVIGILANCE IN RAPIDLY CHANGING REGULATORY AND COMMERCIAL CLIMATES BY PRODUCTLIFE GROUP An important new industry study from ProductLife Group highlights the ways good-pharmacovigilance-practice (GVP) guidelines, increased globalisation, and heightened business demands have propelled pharmacovigilance up the life sciences agenda and expanded the demands and challenges regulatory teams face.

Implications for safety and quality assurance extend far beyond the boundaries of regulatory affairs by requiring advance cooperation and data sharing between a range of operational functions. A further trend is an emphasis on risk– benefit balance: companies are now expected to consider the benefits of a product in terms of what it means to patients.

Intensifying commercial pressures also have a bearing on the role of pharmacovigilance to the extent that a new type of pharmacovigilance professional is now emerging – one who blends expertise in safety and quality with a rounded understanding of global regulations and requirements as well as business and budget management expertise.

The study highlights: • The effect GVP guidelines are having on the role of pharmacovigilance and its relationship with quality • The role safety must play in the decision-making process • Skills gaps and recruitment implications • Global complexities, including different regions’ changing GVP requirements and the implications for affiliates Drawing on the findings, captured through in-depth interviews with key life sciences industry figures, PLG Evolve – ProductLife Group’s thought leadership programme – will present a Webinar detailing the top pharmacovigilance trends for 2017, the effects they’ll have on the expanding role of pharmacovigilance, and the challenges faced by those involved.

Speakers • Guest presenter Lesley Wise, PhD, is managing director of Wise Pharmacovigilance and Risk Management, a consultant to companies, contract research organisations, and independent research groups. She has more than 15 years of experience in pharmacovigilance both in medicines regulation as head of the risk management and pharmacoepidemiology group at the Medicines and Healthcare products Regulatory Agency and in the pharmaceutical industry, most recently at Takeda Pharmaceuticals. Lesley has a doctorate in statistical genetics/genetic epidemiology. She is an honorary lecturer in pharmacoepidemiology at the London School of Hygiene & Tropical Medicine and an associate editor of Therapeutic Advances in Drug Safety.

• Erick Gaussens, PhD, is chief scientific officer at ProductLife Group. He has deep knowledge of risk management and regulatory requirements in the life sciences industry and brings immeasurable expertise in cognitive science.

His extensive R&D experience across several innovative and highly regulated industries gives him unique insight into the impacts of new regulations, new technologies, and the evolution of product life cycle management from both information management and business process perspectives.

Erick’s doctorate in mathematics and Docteur d’État are from Université Paris-Dauphine.

• Cheryl Key, MBBS, is head of pharmacovigilance platform services and principal PV medic at ProductLife Group. She has gained more than 16 years of drug safety experience by working at pharmaceutical and biotech companies, for contract research organisations, and for regulatory authorities. Before joining what is now the Medicines and Healthcare products Regulatory Agency, Cheryl spent several years in medical practice. She has a medical degree from Charing Cross and Westminster Medical School.

USC PUBLISHED PRE-CLINICAL RESULTS OF A NOVEL FASTING MIMICKING DIET THAT MAY FOR THE FIRST-TIME REVERSE DIABETES BY REPROGRAMING PANCREATIC CELLS TO RESTORE INSULIN GENERATION A Landmark study published on Feb. 23, 2017 in the journal Cell, finds that providing mice or human cells with a temporary, specifically formulated Fasting Mimicking Diet (FMD™) promotes the growth of new insulin-producing pancreatic cells and reduces symptoms of type 1 and type 2 Diabetes in mice.

In type 1 and late-stage type 2 Diabetes, the pancreas loses insulin-producing beta cells, increasing instability in blood sugar levels. The study showed a remarkable reversal of Diabetes in mice placed on the FMD for four days each week. They regained healthy insulin production, reduced insulin resistance and demonstrated more stable levels of blood glucose —even for mice in the later stages of the disease.

The research revealed that genes normally active in the developing pancreases of embryonic/fetal mice are reactivated in diabetic adult mice during the cycles of fasting-mimicking and normal diets. This increases production of a protein, neurogenin-3 (Ngn3), and as a result, promotes the creation of new, healthy insulin-producing beta cells.

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The researchers simulated type 1 Diabetes in mice by administering high doses of the drug Streptozotocin (STZ)— killing the insulin-producing-cells—and studied mice with type 2 Diabetes, characterized by insulin resistance and eventual loss of insulin production, which have a mutation in the gene Lepr. Both types of Diabetes were reversed by FMD cycles. Researchers also examined pancreatic cell cultures from human donors and found that, in cells from type 1 Diabetes patients, nutrients mimicking fasting also increased expression of the Ngn3 protein and insulin production. The results suggest that a fasting-mimicking diet could alleviate Diabetes in humans.

A growing body of evidence published by the Longevity Institute of the University of Southern California (USC), led by Professor Valter Longo, indicates that the Fasting Mimicking Diet is beneficial. Last week, a study published by the same group in Science Translational Medicine demonstrated that FMD reduced risks for cancer, Diabetes, heart disease and other age-related disease in human study participants who followed the FMD for just five days each month for three months. Prior studies on the diet have shown potential for alleviating symptoms of multiple sclerosis, increasing the efficacy of chemotherapy for cancer treatments, and decreasing visceral fat.

“These findings warrant a larger FDA trial on the use of the fasting-mimicking diet to treat human Diabetes patients,” Longo said. “Hopefully, people with Diabetes could one day be treated with an FDA a fasting-mimicking diet for a few days each month—and eat a normal diet for the rest of the month—and see positive results in their ability to control their blood sugar both by producing normal levels of insulin but also by improving insulin function.”

USC’S PHASE II CLINICAL TRIAL PROVES PROLON FMD IS THE FIRST FOOD TECHNOLOGY THAT TREATS AGING AND REDUCES RISK FACTORS FOR MULTIPLE AGE-RELATED DISEASES A new study finds that providing the body with a temporary, specifically formulated Fasting Mimicking Diet (FMD™) called ProLon® causes cellular changes normally generated by several days of consecutive water-only fasting, and may increase health and lifespan by partially turning back the aging clock.

After publishing in Cell Metabolism the animal results showing that this FMD reduces incidence of cancer and inflammatory diseases and extends lifespan, the Longevity Institute at the University of Southern California (USC) today publishes in Science Translational Medicine the results of a randomized Phase II clinical trial demonstrating that ProLon targets the aging process and reduces risk factors for age related diseases such as diabetes, cancer, and cardiovascular disease in humans.

These effects are believed to be caused by an increase in stem cell number and regeneration. This 100-participant landmark clinical study stems from over two decades of molecular, animal, and clinical testing at USC’s Valter Longo laboratory under the sponsorship of the National Institute of Aging and the National Cancer Institute of the NIH. This breakthrough FMD nutritechnology is exclusively licensed by USC to L-Nutra Inc.

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The Los Angeles-based company has launched the first FMD in the U.S. under the brand name of “ProLon” since it was designed to Promote health and Longevity. Low in calories, sugars, and protein but high in good fats, ProLon is a gluten and dairy-free proprietary formulation of 100% vegetable based soups, energy bars, energy drinks, teas, and supplements.

Pre-clinical studies demonstrated that ProLon provides the body with the necessary macro and micronutrients while keeping it in a fasting mode and activates stem cell-based regeneration in multiple organs and systems. ProLon is perhaps the first success story in a new but rapidly developing nutri-technology field.

The understanding of the molecular connections between specific food components and genes that regulate aging and regeneration allows food to be used to promote cellular changes that are safe but more coordinated than those caused by drugs.

In the current publication, researchers tested the effects of three monthly ProLon cycles on metabolic markers and risk factors associated with aging and age related diseases. Each ProLon cycle lasts five consecutive days and does not require alteration to lifestyle during the remaining days of the month.

Findings in humans were consistent with mouse studies showing a spike in circulating stem cells and delay in biological aging by promoting regeneration in multiple systems.

Body weight, BMI, total body fat, trunk fat, waist circumference, systolic and diastolic blood pressure, cholesterol, insulin-like growth factor 1 (IGF-1), and C-Reactive Protein (a marker of inflammation) were significantly reduced, particularly in participants at risk for diseases, while relative lean body mass (muscle and bone mass) was increased. Low levels of IGF-1 are associated with a lower risk of cancer and diabetes. No serious adverse effects were reported. Water-only fasting for several consecutive days (called periodic fasting) may have some beneficial effects. However, water-only fasting carries many risks including hypoglycemia, hypotension, and/or gallstones.

Furthermore, most people are unable to adhere to water-only fasting or very low calorie diets. The ProLon nutri-technology allowed participants to benefit from the positive effects of fasting while allowing them to consume food. ProLon’s five-day “fasting with food™” program features meals ranging from 770 to 1,100 calories per day and is clinically proven to:

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• Promote effects on a wide range of markers that contribute to aging, such as cholesterol, triglyceride, blood pressure, inflammation, IGF-1, and fasting blood glucose;

• Drive DeVilbiss’ acquisition of Sidhil Ltd., the UK-based manufacturer of DME, including beds, chairs and lifting products. Clearwater International advised Sidhil on the transaction; and

Inc., the US-based developer of steerable catheter technologies and the vascular closure and electrophysiology businesses of St. Jude Medical and Abbott Laboratories, for €1.0bn.

• Help people lose an average of five pounds of fat and 1.2 inches of waist circumference, while preserving lean body mass (muscle and bone); and

• Indutrade’s acquisition of Sunflower Medical Ltd., the UK-based medical furniture manufacturer, providing design and refurbishment equipment services.

Phoenix Equity Partners Limited, the UK-based private equity firm acquired Rayner Intraocular Lenses Limited, the UK-based manufacturer of intraocular lenses and associated instruments used in cataract surgery.

• Provide the body with healthy, plantbased ingredients (free of any additives or chemicals) including essential vitamins, minerals and amino acids, low-protein, low-carbohydrate, and high good fat ingredients.

Over 3,600 ProLon boxes have been consumed during the pilot launch phase and market research shows an over 86% satisfaction rate and 92% recommendation rate. Individuals who want to optimise their health and wellbeing intend ProLon for use.

CLEARWATER INTERNATIONAL’S HEALTHCARE SECTOR COMMENT – MEDICAL FURNITURE - FEBRUARY 2017 In a month where the availability of hospital beds in the UK has come to the forefront of that nation’s consciousness, we have seen a spike in activity in the durable medical equipment (DME) sector. Driven by the ageing demographic and the need for hospitals and care homes to replace old, tired stock, and use innovative products that produce better clinical outcomes, the market for DME including beds, mobility products, bathing aides and other health furniture is set to continue to grow at a steady pace.

In the last month alone we have seen the following deals close in the DME sector: • Clayton, Dubilier & Rice’s acquisition of a controlling stake in Drive DeVilbiss Healthcare, the US-based manufacturer of DEMs including mobility & bariatric products and wheelchairs;

At Clearwater International we have significant expertise in the sector with recent credentials including advising Sidhil in the deal mentioned above, advising Direct Healthcare Services on its sale to NorthEdge Capital and advising Prism Medical on the sale of its UK subsidiary to LDC. We believe we will continue to see innovation, which is specifically designed for the end user, making products more efficient and effective.

A taste of deals in January Medical Equipment and Supplies Marc Miribel, the private investor acquired a 42.74% stake in M.P. Hygiene, S.A.S, the France-based company that manufactures and distributes paper wipes, non-woven wipes, disposable safety products and hand cleaners. Clearwater International advised the shareholders of M.P. Hygiene on the sale of its stake in the business.

Convatec Group plc, the listed UKbased company that develops wound and ostomy care products acquired EuroTec B.V., the Netherlands-based manufacturer of ostomy appliances, for €25m.

Abbott Laboratories, the listed USbased company offering diagnostics, medical devices, nutritionals and generic pharmaceuticals acquired St. Jude Medical, the listed US-based manufacturer of cardiovascular medical devices, for €26.3bn.

WerfenLife, the Spain-based manufacturer of in-vitro diagnostics products and medical devices acquired Accriva Diagnostics, the US-based developer of devices for blood diagnostics, for €357m.

Terumo Corporation, the listed Japanbased manufacturer of medical devices, equipment, pharmaceuticals and supplements acquired Kalila Medical,

Ansell Limited, the listed Australiabased provider of protective healthcare products acquired Nitritex Limited, the UK-based manufacturer of cleanroom consumables, and medical and safety products, for €67m.

Health and Social Care National Health Industries, Inc., the US-based home healthcare provider acquired an 80% stake in CHS Home Health, the US-based Medicare home healthcare provider, for €117m.

WellCare Health Plans, Inc., the listed US-based provider of managed care services to the public sector acquired Care1st Health Plan Arizona, Inc., and ONECare by Care1st Health Plan Arizona, Inc. both US-based providers of managed healthcare plans and services, for €140m.

HC-One Limited, the UK-based nursing care home operator acquired Helen McArdle Care Limited, the UK-based nursing care home operator.

Global Medical REIT, Inc., the listed US-based real estate investment trust acquired Geisinger Imaging Centre and Clinic Property in Central Pennsylvania and a 25,814 square-foot Medical Office Building in Cape Coral, Florida, for a combined €14m.

Primary Health Properties plc, the listed primary healthcare facilities investment vehicle acquired Carden Medical Investments Limited, the UK-based owner of medical care facilities, for €8m.

Pharmaceutical and Biotechnology Boehringer Ingelheim, the Germany-based researcher and developer of pharmaceutical products acquired Merial S.A.S., the France-based manufacturer of veterinary pharmaceuticals and vaccines, for €11.4bn.

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LG Chem, Ltd., the listed South Korea-based conglomerate acquired LG Life Sciences, Ltd., the South Korea-based manufacturer of fertility pharmaceuticals, animal health products and speciality chemicals, for €1.1bn. Accord Healthcare Ltd., the US-based developer of generic pharmaceuticals acquired Actavis UK

Ltd. and Actavis Ireland Ltd., both generic pharmaceutical manufacturers based in the UK and Ireland respectively, for €685m.

Pharmaron, Inc., the China-based outsourcer of development, manufacturing and clinical research has acquired Xceleron

Inc, the US-based accelerator mass spectrometry specialist. LDC, the UK-based private equity firm acquired Fishawack Communications Ltd., the UK-based provider of communications services to pharmaceutical and life sciences companies, for €44m.

Clearwater International advised LDC on backing the management buyout.

ADVANCED TO DRIVE FORWARD DIGITAL HEALTH TRANSFORMATION Leading software and services provider Advanced, has been awarded a place on the new Clinical & Digital Information Systems Framework Agreement (CDIS), launched by NHS London Procurement Partnership (LPP). The framework includes Advanced’s software solution for the health and care sector, its hosted patient management solution Carenotes, which covers all aspects of community, mental and child healthcare.

LPP’s CDIS framework, which has a potential value of up to £1.3bn, has been developed at the request of the London NHS Chief Information Officers’ Council and the consortia of 38 NHS trusts which built the first Clinical Information Systems Framework in conjunction with LPP in 2013. More information on the framework is available here.

“Securing a place on this important NHS purchasing framework is significant as it demonstrates that our solutions meet the demanding criteria set by the NHS LPP. We know that these frameworks maximise the purchasing power of the NHS and represent a smart way of ensuring a sustainable future. It will also ensure the health and care sector gets access to the highest quality services whilst making sure this offers the best value for money,” said Nick Wilson, Managing Director – Public Sector, Health & Care – Advanced.

“We’re seeing many NHS Trusts looking to become digital leaders to enhance everyday service to patients. Being included in this framework agreement is an important endorsement of the positive outcome our solutions can deliver,” concludes Nick.

Advanced solutions are already being used widely across the NHS, examples include: • Camden and Islington NHS Foundation Trust is using Carenotes from Advanced to ignite its digital revolution for mental health services.

• Several NHS Trusts are using its Odyssey clinical decision support software, which uses a unique Bayesian approach to guide clinicians to provide the right treatment and its patient management solution, Adastra. East Midlands Ambulance Service NHS Trust, for example, has seen significant cost savings through reductions in unnecessary ambulance journeys, instead allowing emergency calls to be responded to with appropriate telephone advice.

• Likewise, South Central Ambulance Service NHS Trust has enhanced the way it manages its NHS111 service through Advanced’s solutions, helping them to provide more tailored and timely care through instant access to their caller’s health history.

3 SIDED CUBE CELEBRATE REACHING 1 MILLION DOWNLOADS OF THEIR AWARD WINNING APP, BLOOD DONOR When the American Red Cross approached 3-SIDED CUBE in early 2014, they were looking for a solution to combat the significant drop-off of blood donors in the US. They wanted a mobile platform booking system that would encourage, motivate and engage potential and existing blood donors, allowing them to save lives across the country. With blood bank reserves running low and a slightly outdated outreach program, we needed to give the American Red Cross the tools to help them continue the great work they had done so far. UK based digital agency 3 SIDED CUBE developed an innovative mobile solution that has won several international awards including a Webby for Best Health App but more importantly helped to bring in over $70million in revenue for the charity.

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The challenge Working alongside the American Red Cross we realised that there were a few barriers that needed to be overcome. Potential donors, particularly the younger sector, weren’t engaging with the existing marketing literature, appointments were being forgotten, cancelled or ignored and after an initial donation, they wouldn’t return to donate again.

Mobile was identified as a relatively untapped resource that could help to change the behaviour of both potential and existing donors and so Blood Donor was developed and launched in September 2015.

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What does the app do?

The main aim was to make Blood Donor convenient for the user. The easier it is to schedule or reschedule appointments, the more likely that donors would book their slots at a blood drive near them. Appointment reminder notifications mean that they are more likely to show up, and geo-targeted blood shortage alerts let users know if their blood type is particularly needed near them.

But it’s not just the logistics that Blood Donor helps with – it works on a reward basis to encourage repeat visits and donations. Users can earn badges to proudly share their achievements with friends and family and can even claim rewards from selected retailers for their efforts.

One of the most exciting features is without a doubt the Blood Journey. Donors can actually track their blood and see the hospital that it ends up at and when it has arrived. Being able to obtain this level of detail is amazing and can really encourage donors to keep going as they can appreciate the

lives it is going to save, rather than wondering where it goes after it’s packed up and they’ve walked off with a cookie in hand.

The results A whole host of features and ultimately the simplicity of the app, have made Blood Donor into the success story it is today. With over a million downloads and almost 470,000 donations made, as a result, it means that potentially 1.5 million lives have been saved. The app has also boosted show rates. Before the app, just over half (57%) of appointments would be fulfilled, now, with Blood Donor, this has rocketed to 83%.

We’re incredibly proud to have experienced this level of success that we have with this app, and it makes it all the more satisfying to know that we’ve had a hand in saving lives across North America. We hope that the numbers will continue to grow and Blood Donor will aid the American Red Cross in their mission to prevent and relieve human suffering.

CAPIO S:T GÖRAN’S HOSPITAL WINS COMPETITION LAW CASE IN PATENT AND MARKET COURT OF APPEAL The Swedish Patent and Market Court of Appeal has announced its judgment in a case concerning a subcontracting agreement, related to a public procurement of clinical physiology services.

The Patent and Market Court of Appeal dismissed the Swedish Competition Authority’s request for fines and acquits Capio S:t Göran’s Hospital (CStG). The judgment sets aside a previous District Court judgment from 2015.

The procurement at issue, for clinical physiology services such as physiological tests for sleep apnea and stress echocardiography, took place during 2008 and was completely separate from the hospital’s main contract with the Stockholm County Council (SCC).

At the relevant time, CStG’s primary aim was to secure the direct award of a contract for physiological services from SCC, in the same way as the other emergency hospitals in the Stockholm area, in order to ensure expertise and availability for medical examinations of this kind. Since SCC deemed this not to be possible, CStG was instead encouraged to participate in the tender and enter into the subcontract that was later contested in this case.

In order to provide a competitive and separate tender in full competition, and to ensure good availability for our patients, CStG entered into a subcontracting agreement with Aleris.

The agreement was expressly mentioned in CStG’s tender, and was also approved by SCC in connection with the award of the contract. In November 2012, SCC also extended this agreement to June 2014.

In 2013 the Swedish Competition Authority filed a claim with the Stockholm District Court to contest the subcontract. The District Court’s judgment was delivered in December 2015.

The court partially upheld the Competition Authority’s claim and ordered Capio S:t Görans Sjukhus to pay a fine of 1.1 MSEK. CStG did not share the views of the District Court and appealed the judgment. Hearings in the Patent and Market Court of Appeal took place during 2017.

The Patent and Market Court of Appeal’s judgment means that the court does not share the Competition Authority’s view that the subcontracting agreement could restrict competition.

This ruling cannot be appealed, and thus the case is closed.

– We entered into this agreement with the patients’ best interests in mind, and with the conviction that the agreement was in accordance with applicable laws and regulations. Now the court has dismissed the Competition Authority’s request for fines.

Naturally, we consider it positive that this issue has finally been settled, says Sofia Palmquist, CEO of Capio S:t Göran’s Hospital.

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OMRON HEALTHCARE SUPPORTS WORLD RECORD-BREAKING ATTEMPT FOR LARGEST CLINICAL BLOOD PRESSURE SCREENING CAMPAIGN EVER May Measurement Month (MMM) aims to screen millions of blood pressures in 1 month across the world.

Omron Healthcare has donated over 10,750 Blood Pressure Monitors (BPMs) to the International Society of Hypertension (ISH) and World Hypertension League (WHL). These devices will be used to record blood pressure readings of millions of patients in nearly 100 countries across the world during May 2017. Achieving this many blood pressure readings in one month in one study will make it the largest medical screening project ever.

Raised blood pressure (BP) is the most significant single contributing risk factor to global death and to the global burden of disease. This impact is largely shown through increased rates of coronary artery disease, stroke and renal disease. Raised BP currently causes approximately 9.4 million deaths each year worldwide and this figure is expected to raise given an expanding and aging global population. The aetiology of raised BP is largely explicable by identified environmental factors such as overweight, excessive intake of alcohol and dietary salt, and insufficient exercise.

As a leading company in cardiovascular business with its main product being blood pressure monitors, Omron Healthcare has set its ambitious vision to help patients, consumers and healthcare professionals improve their quality of life and get closer to “zero cerebral and cardiovascular events”.

To realise this vision Omron Healthcare have partnered with professionals and are forging ahead with the development of technologies, products and services. As part of this effort, Omron Healthcare has made the decision to contribute to this screening programme, which is a good example of a partnership with the healthcare community.

Supporting ISH helps contribute to increasing the awareness on hypertension and the significant impact it can have on quality of life.

Commentating on the donation President of the ISH, Neil Poulter said “This is a much-needed donation of devices which will help our volunteers across the world”. The CEO of Omron Healthcare Europe, Andre van Gils added, “Omron Healthcare is very proud to be helping May Measurement Month. Hypertension can be a devastating condition and raising awareness of it will help drive improved healthcare for people across the world”.

DEVONIAN MARK HANNAFORD SEES WORLD’S FIRST CROWDFUNDED HOSPITAL OPEN IN SYRIA Hope Hospital, which was set up and supplied following the People’s Convoy in December 2016, has opened and is now the world’s first crowdfunded hospital.

Mark Hannaford, a Devon local, was involved in the convoy and his firm Across the Divide provided the logistical support that it would need in its 2,600 mile journey from the Chelsea and Westminster Hospital, London to the Turkey / Syria border, where the supplies were handed to local partners.

After targeting £91,000 for the convoy, organisers CanDo received an overwhelming response from members of the public, raising a final figure of £246,000, which will fund the setup and stocking of the hospital, and its running costs for the first six months. Fellow Devonian Paul Conlon joined Mark on the convoy, an ex-war photographer who was returning to Syria for the first time since he was badly injured in an attack that killed fellow journalists Marie Colvin and Remi Ochlik.

Mark Hannaford said, “Thanks to the generosity of the public and the tenacity of Rola Hallam of CanDo and other charity supporters, we have been able to provide aid in Syria, where many children have no access to medical aid. “This has shown that crowdfunding can be used effectively for charity purposes as well as for business start-ups, and

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I hope that other good causes can look at the People’s Convoy and see how crowdfunding really caught people’s imagination.” Mark Hannaford is an Honorary Senior Lecturer on the University of Exeter’s Extreme Medicine Masters course, and the founder of Across the Divide, which provides logistical support to expeditions and fundraising events such as the BBC Children in Need Rickshaw Challenge with Matt Baker.He also founded World Extreme Medicine which trains doctors to work in austere environments, whether that be on expeditions to Everest or the poles, or in disaster response efforts across the globe. World Extreme Medicine counts NASA, Médecins Sans Frontières (MSF) and the Royal College of Surgeons as some of their many partners.

The People’s Convoy was conceived and planned by Dr Rola Hallam of not-for-profit CanDo. The organising committee included charity Doctors Under Fire, which was launched recently by Dr David Nott, Saleyha Ahsan, Hamish de Bretton Gordon and Toby Cadman, and the Syria Campaign. Other organisations that partnered CanDo and Doctors Under Fire include Physicians for Human Rights, Women’s International League for Peace and Freedom, and the Independent Doctors Association, based in Turkey. Across the Divide was chosen as the logistics partner for the convoy.

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FIRST IN GLOBAL MEDICAL TOURISM: INTEREST-FREE INSTALMENT PLANS FOR MEDICAL TRAVEL WITH LONGEVITA Longevita, the UK’s leading medical travel group who attract patients from over 100 countries to Turkey for medical treatments, have begun offering interest-free instalment plans for medical tourists seeking hair transplants, plastic surgery and cosmetic dentistry.

Longevita’s payment plans, prepared in liaison with the UK’s consumer finance firms, help position Turkey as the leading destination for affordable high quality private healthcare. Longevita provides all-inclusive medical travel packages comprising of private medical procedures, luxury hotel accommodation, VIP private transfers, hosting, and translation services to international patients. Now, patients can spread the cost of their treatments, over 12 months, interest-free.

Longevita Executive Director Kagan Seymenoglu stated: “We are proud to be the first and only medical travel provider offering interest-free payment plans to international patients.

It is no question that price is one of the most important decision factors in medical travel.”

“Financial institutions in Turkey would not lend to international patients because they would not be able to chase non-residents to claim losses if the loans are not repaid. Similarly, financial institutions in the UK would not lend against medical procedures performed in Turkey, because the qualifications of the healthcare providers are not valid in the UK.”

Longevita is set to act as a bridge between the UK and Turkey, addressing the differences in legal, health and financial systems across these countries. For example, with Longevita’s £1400 hair transplant in Turkey package, patients can pay £200 upfront deposit and spread the rest of the cost over 12 months for only £100 a month interest-free.

This means it is now possible to get a FUE hair transplant in Turkey with Longevita for only £100 a month.

The exact same procedure would cost £10,000 in London, £6000 in Manchester, or €10,000 in Dublin. Similar 0% APR payment plans are available for other types of procedures such as breast surgery, rhinoplasty or dental implants.

Executive Director Kagan Seymenoglu added: “The plan in the near future is to benefit from the low interest environment in the UK and start offering longer terms for procedures like a hair transplant in Turkey, with these payment plans. For example, over 48 months, one should not be surprised to see Longevita offering a hair transplant in Turkey for only £1 a day, less than a cup of coffee at Starbucks.”

Longevita has been operating since 2012 out of offices in London, Istanbul and Izmir. Their medical representatives hold regular consultations every quarter in London, Manchester, Birmingham, Glasgow, Edinburgh, Belfast and Dublin.

MANAGE YOUR HEALTHCARE FROM YOUR IPHONE - FORTIUS CLINIC LAUNCHES AN EASY TO USE PATIENT APP Fortius Clinic, the UK’s leading private orthopaedic and sports injury group, has announced the launch of a new patient App. This app aims to streamline the patient pathway, allowing patients to take control of their own appointments, reminders, payments and more. The iOS App is designed to make every step of a patient’s journey as quick, efficient and simple as possible. Each Fortius patient will now be able to book new consultations, follow-ups, imaging appointments, upload and view documents, as well as pay outstanding balances and check payment history. It has created a patient experience that is cutting edge, breaking the mould of the industry.

Although the majority of patient interactions with healthcare organisations are predicted to be mobile by 2018, the limited availability of mobile apps that can easily and securely integrate with legacy clinical information systems remains a major barrier.

Chief Executive Jim McAvoy recognises this. “Designing a patient centric experience might feel natural to a customer service organisation, but it requires a cultural shift in many parts of the healthcare industry. Too often our processes exist as a function of our internal systems and the patient experience is about keeping back end systems and processes ticking over.”

The App development was led by Fortius Group company Fortius Digital, which deployed an open source software based proprietary technology platform to harness the data that is provided by the group’s transactional systems. “From the outset Fortius has identified the capture, harnessing and analysis of data as major differentiator. Re-imagining the patient experience in a world awash with data is a must. We have a responsibility to use the data we collect for the benefit of our patients - to make their lives better, not ours. This new App has been initiated by Fortius Digital and is a major step forward in our progress towards the provision of digital healthcare – it will improve the Fortius experience and deliver consistency in every touchpoint our patients have with our business. “ In developing the new Patient App, the Fortius Digital team worked with Nimbletank, an awardwinning mobile and digital agency. Johnny McAvoy, Founder of Fortius Digital and leader of the Fortius internal project team, explained why. “Delivering change requires talent – people who can stay focused on the goal but most importantly can work together around a shared objective. We chose Nimbletank as our development partner because they were in tune with what we were trying to do. Throughout the project they worked collaboratively with our internal team, playing to the respective strengths in the partnership to create a solution that is simple, innovative, and effective.”

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NEW PULSE PLATFORM LAUNCHED TO BOOST HEALTH AND WEALTH IN INDIA

“ECCO stands for multidisciplinarity in cancer care, and therefore seeks to advance the case for all professions involved in ensuring the best outcomes and experiences for patients. That naturally includes the role of specialised cancer nursing which is why ECCO has been pleased to support the European Oncology Nursing Society’s project Recognising European Cancer Nursing (RECaN).

To develop new ways to innovate and support food enterprises in the pulse supply chain, the McGill Centre of for the Convergence of Health and Economics (MCCHE) has launched the Pulse Innovation Platform (PIP)-India in New Delhi on March 9th, 2017.

This project aims to consolidate evidence to clarify and effectively position the contribution of specialised cancer nursing as an essential supportive function during the cancer journey for the benefit of all patients, as well as European health systems.” – Peter Naredi, ECCO President.

In the presence of the Honourable Lawrence MacAulay, Canada’s Minister of Agriculture and Agri-Food, PIP-India became the first national platform of PIP-Global, a worldwide initiative that promotes pulses like lentils and peas as a food source to tackle undernutrition and manage chronic diseases such as diabetes while maintaining profitability.

“Specialist care should be delivered by specialist cancer nurses! Cancer care is increasingly complex and the nurses that deliver, monitor, evaluate and follow-up on cancer treatment need specific skills, education and recognition through appropriate career structures.” – Daniel Kelly, EONS President.

With 2016 declared as the International Year of Pulses by the United Nations, pulses – given their high amount of fiber, low glycemic index, affordability, and nitrogen fixing properties – are in a unique position to advance food- and farm- based solutions to health and nutritional challenges across the globe. PIP-India convenes leaders from food processing, marketing, nutrition, public health, and finance sectors. Activities include creating an accelerator at the National Institute for Food Processing Entrepreneurship and Management (NIFTEM) to develop food product ideas into market-ready goods. The accelerator will assist entrepreneurs with packaging and labelling as well as help design nutritional profiles to offer health benefits.

Through the RECaN project, ECCO supports the following characteristics of contemporary cancer nursing:

Organisations involved in creating PIP-India and working towards a vibrant pulse ecosystem in India include NIFTEM, Tata-Cornell Agriculture and Nutrition Initiative (TCi), the International Food Policy Research Institute (IFPFI), the Public Health Foundation of India (PHFI), Tata Chemicals Ltd., INCLEN, and the Indian Pulse Growers Association (IPGA).

PIP-India will also help shape government policy in line with the Government of India’s special initiatives for supporting pulse research and farming, innovation, as well as food security, nutrition and health.

NEW WILDERNESS MEDICINE COURSE TAKES UK DOCTORS TO ICELAND

SPECIALIST CANCER NURSES: THE KEY TO BEST CARE FOR CANCER PATIENTS Nurses make a central contribution to cancer care and are integral to effective multidisciplinary team working.

A new position statement released by the European CanCer Organisation (ECCO) ahead of the 1st European Cancer Nursing Day on 18th May 2017 reveals that specialised cancer nursing continues to be frustrated by a continuing lack of uniform regulation and recognition across Europe.

Yet, despite this situation, cancer nursing provides an undeniable added value in terms of patient outcomes.

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• Cancer nurses as core members of the multidisciplinary team.

• Cancer nursing should be a recognised speciality across Europe based on a mutually agreed educational curriculum.

• Education for specialist cancer nurses (across all tumour types and phases of care) should be made available.

• Enhanced free movement of cancer nurses across Europe should be promoted and facilitated to help address rising demand.

More than ever before, the human race is exploring parts of the world that are hostile to life, whether that be scaling mountains like Everest, conducting scientific experiments at the South Pole, searching for natural resources in inaccessible places or journeying into space. Away from hospitals and ambulance services, and exposed to dangers such as extremes of hot and cold, challenging and dangerous terrain and tropical diseases, expeditioners would be vulnerable without doctors and medics equipped with a specific and rare set of skills. But how do medics adapt their conventional medical training that is geared towards medicine in a controlled clinical environment to work without complex equipment or an established team?

On 20 June 2017, 25 UK practitioners from various areas of medicine will fly to Iceland for a new intensive four-day course run by World Extreme Medicine, which will put them into situations a traditional medical career would never demand. World Extreme Medicine, a world-leading provider delivering courses in expedition medicine, tailored for a number of environments and specialities, is running the course in partnership with Icelandic expedition firm Midgard Adventure.

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Led by experienced UK expedition medics Alex Rowe, Claire Grogan and Jamie Pattison, with local guides Sigurður Bjarni Sveinsson and Arnar Páll Gíslason, the course attendees will trek to Eyjafjallajökull, the volcano whose 2010 eruption famously disrupted air traffic over much of Europe. The trek will take two days, and will involve camping on a glacier.

On the way, the medics will undertake realistic simulated emergencies, and will be taught to react in a way that maximises positive outcomes for the patient in an austere environment.

This hands-on course will take place in the 24-hour daylight of the Icelandic midsummer.

Course leader Alex Rowe, said, “This course is designed to challenge doctors who are competent and confident in a conventional clinical environment, and encourage them to think in a totally new way.

“It’s going to be practical, physical and will give attendees a grounding in the skills, mindset and confidence they’ll need to take part in larger-scale expeditions and adventures. “As more and more people head into Earth’s wild places, the demand for medics with this sort of experience is growing.

Extreme medicine is incredibly exciting and rewarding.”

Mark Hannaford, Founder of course organisers World Extreme Medicine, said, “With the NHS under mounting pressure, motivated doctors are looking at opportunities within medicine but outside of a traditional hospital environment.

“Because of the rapid improvement in technology in recent years, people are spending more and more time exploring areas outside the human race’s comfort zone: in deserts, at the poles, at the top of huge mountains, in space.

“When humans travel far from hospitals and clinics, and the advanced medical technology associated with those facilities, they need healthcare professionals with a very different set of skills.

“Extreme medicine is a great alternative to a traditional clinical career, and can work in parallel to a job in a hospital environment. Anecdotally, it’s been found that medics gaining this experience return to their core clinical roles with mental resilience and additional team-working, leadership and management skills.”

The Expedition and Wilderness Medicine course in Iceland will take place 21 – 25 June 2017 (flights out on 20 June) and will cost £1,295.

THE WORLD’S FIRST CROWDFUNDED HOSPITAL OPENS IT’S DOORS TO PATIENTS IN ALEPPO Tomorrow, Hope Hospital, which was crowdfunded by people from all over the world opens to treat the children of Aleppo.

Last December CanDo spearheaded the People’s Convoy campaign, alongside partners organisations; Across The Divide, Doctors Under Fire, Hand in Hand for Syria, Phoenix Foundation, The Syria Campaign, UOSSM, raising money to rebuild the last children’s hospital that had been bombed out of action in Aleppo.

The campaign resonated with public figures, humanitarian organisations and the public globally and resulted in raising a staggering £246,505 (270% of the fundraising target) in just 14 days, which in addition to rebuilding the hospital, also provided enough funding for six months of running costs.

The convoy departed from Chelsea & Westminster Hospital in London on December 17th 2016 to a buzz of media attention. The heavy goods vehicle carrying the hospital equipment and supplies drove over 2,600 miles passing through France, Belgium, Holland, Germany, Austria, Hungary, Romania and Bulgaria, before crossing Turkey and finally reaching Turkey’s border with Syria on January 2nd 2017.

With over 4,800 single donations mostly from the UK and USA, the People’s Convoy sent a strong message of solidarity to the Syrian doctors (the Independent Doctors Association) who were rebuilding this children’s hospital for the seventh time after the six previous buildings had been bombed out of action.

Inspired by the public display of generosity and solidarity the IDA decided to name the facility Hope Hospital.

Dr Hatem from The Independent Doctors Association (IDA) said “After evacuating from Aleppo our hearts ached, because we had been building the Children’s Hospital in Aleppo for two years and then lost everything. There was something in my heart that said we would have to give up and not work inside a children’s hospital again.”

He went on to say “After we saw the People’s Convoy, something rebuilt within ourselves. The hope returned to me when I realised that there are people thinking about us and supporting us. It means all the people in the world aim to save children lives wherever they are and whoever they are. It means the world knew what we were doing inside Aleppo: serving the children, the civilians. So we began working hard to build the new children’s hospital (Hope Hospital). For us, it represents a new place where we can work and still imagine ourselves back in Aleppo.”

CanDo’s Founder and CEO, Dr Rola Hallam also added “‘Hope Hospital’ is a clear victory for humanity. While it might seem like a small victory in the face of the continued adversity in Syria, it marks a significant milestone.

From the thousands of supporters and the tens of organisations that endorsed the convoy, to the media supporters and the breath-taking resilience of the IDA team, the achievement is a celebration of the human spirit.”

The hospital will serve Jarablus district (Northern Aleppo) community of 170,000, treating over 5,087 children each month - which is likely to grow as more communities become displaced from continued evacuations and news of the hospital spreads.

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TRAUMA PATIENTS WILL REAP REWARDS OF GAME CHANGING DEVICE Teeside patients are getting to surgery faster thanks to the innovative thinking of The James Cook University Hospital trauma team.

Every year up to 200 people undergo ankle fracture surgery at the Middlesbrough hospital. For some this can mean spending up to a week in a hospital bed waiting for the swelling to reduce to a level on which surgeons can operate.

But now a neuromuscular electro-stimulation device known as a geko™ is being used to help reduce the swelling to get people into the operating theatre quicker.

The geko™, which looks a bit like a watch, sticks onto the patient’s leg above their plaster cast and causes the muscles to contract to help increase blood circulation and reduce swelling.

The device is more commonly used to help prevent DVT (deep vein thrombosis), but experts at James Cook recognised that it could potentially benefit trauma patients so they teamed up with manufacturers Sky Medical Technology to trial the idea.

An initial study involving 20 patients produced extremely positive results – patients were happy to wear the device and in many cases swelling had greatly reduced within 24 hours.

Orthopaedic surgeon Paul Baker is now planning to carry out more in-depth research and to use the device on future patients.

“This could be a game changer for the treatment of swelling for ankle fractures,” he said. “As far as we are aware this has never been used for ankle fractures before.

“It’s much better for patients as sitting in a hospital bed for a week can be very frustrating and can also cause people to lose muscle mass.”

Senior sister Stacey Brown said it was exciting to be the first to use the device in this way: “Patients have tolerated it really well and the results have been remarkable.”

The collaboration helped Sky Medical Technology scoop a Medilink North West Healthcare Business Award for partnership working with the NHS.

TXCELL AND INSERM COLLABORATE TO DEVELOP NEW CAR-TREGS IN TRANSPLANTATION AND MULTIPLE SCLEROSIS Expansion of TxCell’s CAR-Treg platform to develop novel proprietary population of CD8+ regulatory T cells TxCell SA, a biotechnology company developing innovative, personalized cellular immunotherapies using regulatory T cells (Treg) to treat severe inflammatory and autoimmune diseases as well as transplant rejection, and Inserm Transfert, on behalf of Inserm (French public organization dedicated to human health) and the Nantes University (Nantes, France), announce the signature of a R&D collaboration agreement.

This collaboration agreement complements the December 2016 exclusive worldwide licensing agreement pertaining to a new subset of Treg cells originated in one of the Inserm laboratories.

The agreement covers R&D activities to take place between TxCell and the Center for Research in Transplantation and Immunology (CRTI), a center of excellence in the field of transplantation and immunology. The CRTI is a research unit (UMR 1064) affiliated to both Inserm and to the Nantes University. TxCell and the CRTI will collaborate on the development of Chimeric Antigen Receptor (CAR) engineered CD8+Treg cells (CAR‑Tregs).

These comprise a proprietary Treg cell population expressing the CD8 marker (CD8+ Tregs). The collaboration will concentrate on the treatment of transplant rejection and autoimmune diseases, specifically focusing on multiple sclerosis. In addition, TxCell and the CRTI will develop a manufacturing process to enable clinical proof-of-concept studies. The collaboration will expand TxCell’s research efforts, which were focusing so far on engineered CD4+ Treg cells, to explore the therapeutic potential of engineered CD8+ Treg cells in parallel. These CD8+ Tregs are noncytotoxic and display a unique and highly immunosuppressive mechanism of action, mediated through the release of cytokines with anti-inflammatory and tolerogenic properties.

The transplantation arm of the collaboration announced complements the ongoing collaboration between TxCell and the University of British Columbia (UBC) in Vancouver, Canada. Since October 2016, TxCell and UBC have been working together on the development of a CAR-Treg-based cellular immunotherapy to prevent graft rejection in the context of Solid Organ Transplantation (SOT). The TxCell-UBC collaboration is focused on CAR‑Treg cells made from CD4+ Treg cells.

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“TxCell is now benefiting from the CRTI’s expertise on these novel CD8+ Treg cells in addition to the intellectual property secured in December 2016,” said François Meyer, Head of Research of TxCell. “Evaluating CAR-CD8+Treg cells in preclinical models of transplantation and autoimmune diseases to confirm their therapeutic potential will continue to push development in key target markets for TxCell.”

“This TxCell-CRTI collaboration represents a robust synergy between translational immunotherapy scientists and an experience biotech company.”

“This collaboration with TxCell will help us set in concrete the clinical development of innovative therapies based on CAR-CD8+Treg cells. We look forward to evaluating with TxCell the potential of these specific CAR-Tregs in the treatment of graft rejection and multiple sclerosis,” said Dr. Carole Guillonneau, CRNS scientist and co‑director of the CRTI team number 2.

In December 2016, TxCell gained exclusive worldwide rights to two patent families covering the new type of CD8+ Tregs for all autoimmune diseases and transplantation-related disorders. The CRTI team has already demonstrated the efficacy of these CD8+ Tregs in a number of preclinical models of inflammation, including heart allograft, human skin transplant rejection and graft-versus-host disease (GvHD) in mice with humanized immune systems. In these models, the administration of CD8+ Treg cells has been shown to prevent the occurrence of skin graft rejection and GvHD, respectively.

“TxCell’s expertise in the industrial development of CD4+ Treg cells will be a major asset to move towards a potential use in the clinic of the CD8+ Treg cells we have identified,” added Dr. Ignacio Anegon, INSERM scientist and co‑director of the CRTI team number 2.

In addition to the background intellectual property already in-licensed in December 2016, TxCell now also has an exclusive option on programs and products developed under the collaboration agreement announced. Financial terms of the agreement have not been disclosed.

LAG-3IG (IMP321) DEMONSTRATES POSITIVE SAFETY AND EFFICACY QUALITIES IN BREAST CANCER CLINICAL TRIAL • Breast cancer clinical trial demonstrates LAG-3Ig (IMP321) is safe and well tolerated • Data shows IMP321 in combination with chemotherapy leads to a sustainable increase in antigen presenting cells (APC), CD8 T cells and an improved pre-dose Th1 status • Encouraging activity with a disease control rate of 87 percent Prima BioMed Ltd (ASX: PRR; NASDAQ: PBMD) (“Prima” or the “Company”) has announced positive safety and efficacy data from the safety run-in stage of its clinical trial for IMP321 (LAG-3Ig) in metastatic breast cancer (MBC) at the American Society of Clinical Oncology (ASCO) 53rd annual meeting in Chicago, Illinois.

AIPAC (Active Immunotherapy PAClitaxel) is Prima’s multicentre, Phase IIb, randomised, double-blind, placebocontrolled study in hormone receptor-positive MBC patients receiving IMP321 or placebo as adjunctive to first-line weekly chemotherapy, paclitaxel.

The safety run-in phase trialled the safety, immunemonitoring and activity of 15 patients. At both the 6mg and 30mg dose levels, IMP321 was shown to be safe and well tolerated. The higher 30mg dose demonstrated a stronger immune response, and was determined to be the recommended phase two dose (RPTD) for the ongoing randomised phase of 226 patients.

In addition, the safety run-in phase demonstrated that IMP321: • in combination with paclitaxel shows an encouraging disease control rate (DCR) of 87 percent; • leads to a sustainable (more than 6 month) increase and activation of antigen presenting cells (APCs), the primary PharmacoDynamic (PD) marker; and

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• leads to a sustainable (more than 6 month) increase in CD8 T-cell and natural killer (NK) cell numbers, together with an improved pre-dose Th1 status, the secondary PD marker.

Prima’s Chief Medical Officer, Dr Frédéric Triebel, said: “This very positive data is a major milestone for our AIPAC trial. It further supports previous clinical data in metastatic breast cancer, which led to Prima designing and starting AIPAC along with Scientific Advice from the European Medicines Agency (EMA). The similar disease-free rate to that 30 patient trial, and stronger immune response from the higher 30mg dose further underpins the randomised phase for AIPAC currently underway.

“The increase of APC numbers in the blood and their activation, which stimulate the body’s immune response to fight cancer cells, has not previously been seen with other immune checkpoint inhibitors as IMP321 has a broader mode of activation, not restricted to T cells. Furthermore, the increased numbers of CD8 T cells and natural killer cells, and corresponding baseline Th1 status is a very positive indicator of the potential efficacy of IMP321 as these are known to be related to anti-tumour efficacy in patients.”

The poster presentation, titled “Combination of paclitaxel and LAG-3Ig (IMP321), a novel MHC class II agonist, as a first-line chemoimmunotherapy in patients with metastatic breast carcinoma (MBC): Interim results from the runin phase of a placebo controlled randomized phase II” was delivered by lead author, Dr Francois P. Duhoux from Université Catholique de Louvain, Cliniques universitaires Saint-Luc, Brussels, Belgium on Sunday, June 4 The full poster presentation can be found on the Prima BioMed website at www.primabiomed.com.au. Details of the AIPC study are posted on www.clinicaltrials.gov (clinicaltrials.gov identifier NCT 02614833).

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WINNING COMBINATION OF LEXACOM ECHO AND LEXACOM CONNECT FREES UP 20 HOURS PER WEEK AT EXETER PRACTICE Southernhay House Surgery in Exeter has dramatically reduced time spent dictating and transcribing referrals thanks to a winning combination of cloud-based Lexacom Connect digital dictation and medical speech recognition software, Lexacom Echo.

Southernhay House Surgery is an 8100-patient practice operating from two sites. In 2016, a staffing shortage prompted the practice to review its reception and administrative functions. This resulted in the creation of a new role of ‘administrator’ covering both typing and reception roles across the two sites. Although the practice was using digital dictation, its usefulness was limited due to the lack of ability to share workload effectively across sites. As a forward-thinking team, Southernhay wanted a solution that would not only support multi-site working but could also be expanded to take in federated working with other practices in the future.

Lexacom was able to offer exactly what the practice needed, and more. Lexacom Connect is an advanced, cloud-based digital dictation system. The software integrates fully with Southernhay’s clinical system, SystmOne, and allows the practice’s seven GPs and administrators to work seamlessly, regardless of location. Cindy Flatt, Practice Manager, said: “The idea of a cloud-based solution was very attractive, and Lexacom Connect has already made a considerable difference to our team and our patients.

Only last week a GP consulting at our branch site dictated a referral in an evening appointment and the member of staff at the reception desk had typed it ready for checking and sending before the next patient had finished their appointment.”

In a further step to improve efficiency, Southernhay purchased Lexacom’s speech recognition software, Lexacom Echo. Cindy Flatt continued: “We had a demo of Lexacom Echo and could immediately see it was very user friendly. Because it was new to GPs and the administration team, everyone learnt the new system together.” Lexacom Echo is now being used by six clinicians in the practice, with a consistently high level of accuracy since October 2016.

The practice believes Lexacom’s software has been instrumental in improving their efficiency and freeing up staff time. “It is rare that a referral isn’t typed, checked and sent within 24 hours.” Cindy added. “Introducing the combined administrator role alongside Lexacom Echo has freed up at least 20 hours a week. We love Lexacom Echo and would highly recommend it to others.” she concluded.

Southernhay’s next step is to extend the use of Lexacom Connect to share secretarial resources with other practices to support federated working and reduce the impact of staff shortages.

NHS SBS ADDS PKL’S GARBAGE GUZZLER AND SPACE STATION TO PROCUREMENT FRAMEWORK

Both products address issues faced by public sector caterers: the Space Station opens up new revenue streams and is an easy-to-implement ‘queue buster’ and the Garbage Guzzler helps reduce organic waste costs.

NHS Shared Business Services has added two PKL products to its popular procurement framework.

The NHS SBS Framework is a management and procurement service that helps public sector organisations easily source skills and products without going through a long, expensive and complicated tendering process.

PKL was listed on the NHS SBS framework in February for its modular kitchen solutions, making it quick and easy for public service providers to purchase and hire them.

Every company on the framework has been vetted and checked to make sure they are the best of the best.

This month PKL has been celebrating the addition of two new products to the framework: the Space Station and Garbage Guzzler.

PKL Managing Director, Lee Vines, said he was delighted to see the Space Station and Garbage Guzzler added to the NHS SBS Framework.

The Space Station is an innovative self-contained modular servery that allows any catering operation to set up a café facility almost anywhere. Its compact, mobile design enables it to be easily moved between different locations to take advantage of higher footfall, and it can be set up and packed away in a matter of minutes.

“I’m really pleased to see these two products added to the framework because I know how much difference they can make to hospital and other public service operations,” he said.

The Garbage Guzzler is an on-site organic waste digester that can reduce food, cardboard packaging and horticultural waste by 70 per cent in as little as 24 hours.

“The Space Station is the perfect way to bring in new revenue streams from underused spaces and reduce queues at points of congestion. The Garbage Guzzler is a revolutionary product that will change the way caterers think about organic waste, reducing disposal costs and offsetting overheads.”

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ARVATO SYSTEMS & PARTNERS PROVIDE THE FRAMEWORK FOR PHARMACY EXPERTS TO MEET AND SHARE PERSPECTIVE2019 – Serialization in the pharmacy industry • Arvato Systems and partners invite the European Pharmacy industry to industry specialist events • The series of events focuses on serialization requirements providing insights, practical ideas and networking opportunities From February 9, 2019 only prescribed medications with a verifiably unique serial number on the packaging can be included in the delivery chain in the EU. With the PERSPECTIVE2019 series of events, Arvato Systems and their partners offer ideas, practical examples and networking opportunities for European pharmaceutical companies facing implementation of the EU delegated regulations (EU) 2016/161.

The delegated regulations offer clarity in many areas for CMO (Contract Manufacturing Organizations) and MAH (Marketing Authorization Holders).

However, practical implementation of the agreed regulations is highly challenging with respect to the individual situations of many pharmaceutical companies.

Each PERSPECTIVE2019 event is oriented around serialization implementation requirements in the country where it is held.

Real-life examples demonstrate to pharmaceutical companies how challenges have been successfully met. Technical tips and insights are also on offer as well as a preview of the year 2019.

The first event takes place on June 22, 2017 in Abcoude in the Netherlands, with the focus on the Dutch and Belgian MAH and CMO. www.IT.arvato.com/...

The free events across Europe are provided by Arvato Systems working with Partners Systec & Services and WIPOTEC-OCS.

NEW YOU BOOT CAMP RELEASE THE GUT HEALTH BOOT CAMP New You Boot Camp have launched the first boot camp truly specialising in educating clients about gut health during their residential week courses.

The course is based in the beautiful country house in Sparkford, Somerset, England Their therapeutic nutrition squad have developed a bespoke therapeutic diet to enhance gut flora and to start their client’s on the road to recovery during their stay. The menu consists of a plethora of beautiful natural and fermented foods, prepared and served at every snack and meal time.

Alongside this the chefs teach the clients at cookery demonstrations, how to prepare quick snacks and food.

The traditional New You Boot Camp fitness programme is held throughout the week to support the gut health programme and encourage healthy changes through fitness and nutrition.

New You Boot Camp and their therapeutic nutrition team have always educated clients on gut health but have never concentrated on the topic, until today.

Now, we have taken the step to empower all of our clients to understand the enormous benefits of excellent gut health weight loss, increased motivation, good hormone balance, stress relief, happy mood, depletion in anxiety, depletion of any inflammatory ailment - eczema, PCOS and many more.

The benefits our clients have seen to date are incredible and we continue to spread the word and educate.

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“Gamechanger, what we define as an individual or business that aims to create a new model that leaves the older model obsolete.

Gamechangers impact how the game is played from one objective and ruling model to a completely new vision – changing the face of how we know something.�

Gamechangers Gamechangers 0

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CAPIO TO ACQUIRE THE DANISH HOSPITAL GROUP CFR HOSPITALER Capio AB (publ) has signed an agreement to initially acquire 70% of the shares in CFR Hospitaler A/S “CFR” in Denmark.

The CFR Group comprises four specialized hospitals and four radiology units with estimated net sales in 2016 of MDKK 280. The acquisition of CFR represents a new market entry for Capio, adding to the Group’s Nordic home base and pan-European footprint for driving Modern Medicine and increased productivity in healthcare services.

CFR operates four hospitals, of which two are located in the Copenhagen region, one is located in Odense on Fyn and one in Skørping, North Denmark (Nordjylland).

The Copenhagen hospitals represent approximately 70% of the CFR Group’s net sales. Specialized in orthopedics, spine surgery, gastrointestinal surgery, urology and earnose-throat disorders, CFR annually performs more than 80,000 consultations and 8,000 surgeries. In addition to the hospitals, CFR comprises four radiology units, one in each of the hospital facilities, offering MRI, mammography, ultrasound and X-ray diagnostic imaging. CFR is active in three out of five regions in Denmark.

Thomas Kiær, the founder and former main owner of CFR will continue as CEO of CFR Group after the acquisition and will remain as a shareholder of CFR. “We are very pleased with the opportunity to acquire CFR Hospitaler, a well-established and professionally operated healthcare company. CFR matches Capio’s core medical specialties and shares our fundamental view of delivering high quality healthcare. I am looking forward to further developing CFR together with Thomas Kiær, his management team and medical staff”, says Thomas Berglund, President and CEO of Capio AB. “We are very happy and look forward to being a part of the Capio Group in the future. We are well-established in Denmark, and have focused on delivering healthcare of highest medical quality for a long time. Together with Capio, we see an opportunity to continue this development with a very experienced and strong partner with a long track record of delivering good quality healthcare in several European countries. As CEO of the company, I look forward to being part of an experienced and well-managed international group focusing on high quality healthcare”, says Thomas Kiær, CEO of CFR. The Danish healthcare environment is similar to the one in Sweden and other Nordic countries, with a growing share of elderly population and increased GDP spend on healthcare.

The market for healthcare in Denmark is estimated to be worth approximately BDKK 105, with a small private hospital share of 2%. Denmark has come far in Modern Medicine with a high share of day surgery and short AVLOS (Average Length Of Stay), but has availability challenges and productivity can be further improved.

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Hence, the outsourcing of public contracts is expected to gradually increase in line with the development in other Nordic countries. Enterprise value is MDKK 199 for 70% of CFR and Capio has the option to acquire the remaining 30% of the shares after two years. The acquisition is estimated to be closed and included in the Capio Group from January 2017. CFR is expected to have a positive impact on Capio’s earnings during 2017.

After the acquisition, Capio will have operations in five countries; Sweden, Denmark, Norway, France and Germany.

The Danish operations will be included in the Nordic segment.

CAPIO TO ACQUIRE THE SWEDISH HEALTHCARE GROUP BACKA LÄKARHUS Capio Närsjukvård AB has signed an agreement to acquire 100% of the shares in Backa Läkarhus AB “Backa” in Sweden. Backa operates eleven primary care centers and nine rehabilitation centers in Region Västra Götaland, and one medical care center in Region Halland. Estimated net sales for 2016 is MSEK 345. The acquisition of Backa complements and strengthens Capio’s presence and medical offering within primary care in the western parts of Sweden.

The largest part of the operations, including the eleven primary care centers and nine rehabilitation centers, is operated under free healthcare choice. The medical care center located in Kungsbacka south of Gothenburg is operated under a publically procured contract valid until December 31, 2018.

The primary care and rehabilitation centers are located in the Gothenburg area and in other growing areas north of Gothenburg. In total, Backa has 83,000 listed patients and is since its inception in 2002 a well-established healthcare provider in the region. The primary care operations are remunerated based on Region Västra Götaland’s free healthcare choice models for primary care and rehabilitation and represents more than 90% of Backa’s net sales. The company has a strong brand reputation and is known among its patients for high availability and good service.

After the acquisition, Capio will have 24 primary care centers and nine rehabilitation centers with more than 200,000 listed patients in western Sweden. In total, the business area Capio Proximity Care will have primary care centers including rehabilitation centers at 87 different locations spread over twelve county councils and regions in Sweden, with a total of more than 750,000 listed patients.

“The acquisition of Backa will further distinguish Capio Proximity Care as a leading primary care provider in Sweden.

It strengthens our presence in the growing western region of Sweden and offers a broader platform to further develop and drive e-health solutions”, says Thomas Berglund, President and CEO of Capio AB.

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The owners and board of Backa are happy to receive Capio as a strong and long-term owner. Following Capio’s high quality and care for its patients and employees, it feels good to hand over Backa to Capio”, says George Eliasson, Chairman of the board. Capio Närsjukvård AB has signed an agreement to acquire 100% of the shares in Backa Läkarhus AB “Backa” in Sweden.

After the acquisition, Capio will have 24 primary care centers and nine rehabilitation centers with more than 200,000 listed patients in western Sweden. In total, the business area Capio Proximity Care will have primary care centers including rehabilitation centers at 87 different locations spread over twelve county councils and regions in Sweden, with a total of more than 750,000 listed patients.

Backa operates eleven primary care centers and nine rehabilitation centers in Region Västra Götaland, and one medical care center in Region Halland. Estimated net sales for 2016 is MSEK 345. The acquisition of Backa complements and strengthens Capio’s presence and medical offering within primary care in the western parts of Sweden.

“The acquisition of Backa will further distinguish Capio Proximity Care as a leading primary care provider in Sweden.

It strengthens our presence in the growing western region of Sweden and offers a broader platform to further develop and drive e-health solutions”, says Thomas Berglund, President and CEO of Capio AB.

The largest part of the operations, including the eleven primary care centers and nine rehabilitation centers, is operated under free healthcare choice. The medical care center located in Kungsbacka south of Gothenburg is operated under a publically procured contract valid until December 31, 2018.

The owners and board of Backa are happy to receive Capio as a strong and long-term owner. Following Capio’s high quality and care for its patients and employees, it feels good to hand over Backa to Capio”, says George Eliasson, Chairman of the board.

The primary care and rehabilitation centers are located in the Gothenburg area and in other growing areas north of Gothenburg. In total, Backa has 83,000 listed patients and is since its inception in 2002 a well-established healthcare provider in the region. The primary care operations are remunerated based on Region Västra Götaland’s free healthcare choice models for primary care and rehabilitation and represents more than 90% of Backa’s net sales. The company has a strong brand reputation and is known among its patients for high availability and good service.

Enterprise value is MSEK 300 and the acquisition is estimated to be closed and included in the Capio Group from March 2017. Backa will be part of the Nordic segment and yearly synergy effects of in total approximately MSEK 10 are expected to be realized over the coming two years.

The acquisition, which is subject to approval by the affected county councils (Region Västra Götaland and Region Halland) and subject to unconditioned approval from the Competition Authority, is expected to contribute positively to Capio’s earnings during 2017.

PAREXEL ANNOUNCES DEFINITIVE AGREEMENT TO ACQUIRE THE MEDICAL AFFAIRS COMPANY Acquisition will strengthen and add scale to current commercialisation and medical affairs services PAREXEL International Corporation, a leading global biopharmaceutical services provider, announced that the Company has entered into a definitive agreement to acquire The Medical Affairs Company, LLC, a leading provider of outsourced medical affairs services to the pharmaceutical, biotechnology, and medical device industries.

The acquisition is expected to close in February. Terms of the transaction were not disclosed.Founded in 2007, TMAC is a full-service contract medical organisation. TMAC offers strategic and tactical medical science liaison (MSLs) and clinical nurse educator support services in addition to medical affairs consulting, medical communications support, and direct placement services. TMAC is based in Kennesaw, Georgia, and has approximately 200 U.S.-based employees.Outsourcing medical affairs services presents a compelling option for biopharmaceutical companies as a way to reduce fixed costs.

The increasingly complex nature of new products, and the need to demonstrate the therapeutic and reimbursement value of a product, is creating demand for credentialed healthcare professionals, such as MSLs, to lead clinically robust dialogues with key medical stakeholders on a peer-to-peer level.

“The commercialisation-outsourcing market continues to grow as biopharmaceutical clients increasingly require medical affairs solutions to optimise awareness and understanding of their products in development or already on the market,” said Josef von Rickenbach, Chairman and CEO, PAREXEL. “As a company, we are focused on opportunities within commercialisation, market access, regulatory, pharmacovigilance, and medical outsourcing. With TMAC, PAREXEL will gain new and distinct medical affairs outsourcing capabilities that will strengthen and expand our commercialisation and market access offerings.”“We are excited to become a part of PAREXEL and offer our clients a comprehensive range of services delivered by a single company. Working together, PAREXEL and TMAC will deliver greater value to clients and meet evolving client needs, throughout the lifecycle of their products,” added Evan Demestihas, MD, RPh, Chief Executive Officer, TMAC. After the close of the acquisition, the TMAC management team will remain in place and continue to manage its employees and the services it currently provides to clients.

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ELEMENTIS SIGNIFICANTLY INCREASES THE SCALE OF ITS PERSONAL CARE BUSINESS WITH US$360 MILLION ACQUISITION OF SUMMITREHEIS Acquisition adds a high quality business with significant potential for further growth in the attractive personal care segment Elementis plc (“Elementis” or the “Group”) announced that it has entered into an agreement to acquire SRLH Holdings, Inc. (“SummitReheis”) from an affiliate of One Rock Capital Partners, LLC (“One Rock”) for an enterprise value of US$360 million, (the “Acquisition”).

SummitReheis will become part of an enlarged personal care business within Elementis. For the year ended 31 December 2016, SummitReheis is expected to report revenue of US$134 million and underlying EBITDA of approximately US$28 million. The acquisition enterprise value is equivalent to approximately 11.8x SummitReheis expected underlying EBITDA for 2016 (including run rate cost synergies).

SummitReheis is a high quality, high margin specialty chemicals platform that produces a range of critical active ingredients and materials tailored for use in personal care, pharmaceutical and dental products. SummitReheis’ anti-perspirant actives business (more than 60 per cent. of its sales) is the global leader in the manufacture and sale of active ingredients for anti-perspirants and has long standing relationships with key consumer product companies across the Americas, Europe and Asia.

Transaction highlights: • Acquisition creates an enlarged personal care business with annual sales of approximately US$200 million, significantly increasing the Group’s presence in this important end market • Enhanced growth potential driven by the combination of complementary products, customers and a broader geographic presence which together offer cross-selling opportunities • Critical components for the US$13 billion anti-perspirant market with growth driven by increasing penetration in emerging markets and demand for premium and higher efficacy products in established geographies • Acquisition will be funded from cash resources and new debt facilities of US$475 million which will be supported by the cash generation characteristics of the enlarged Group • Expected to deliver material earnings accretion and substantial free cash flow accretion in the current financial year • Return on invested capital (“ROIC”) expected to be in line with Elementis’ cost of capital in the first full year of ownership Notification of Results and Special Dividend: • Elementis will report its Full Year Results for the year ended 31 December 2016 on 1 March 2017 • The Board of Elementis can confirm that it expects earnings per share for the year to 31 December 2016 to be in line with current market expectations • The Board confirms that its consideration of special dividends in respect of 2016 will not be impacted by the Acquisition

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Paul Waterman, CEO of Elementis plc, said: “At our recent Capital Markets Day presentation, we highlighted the growth prospects in personal care as a key opportunity for Elementis, driven by long term positive demographic trends and an increasingly sophisticated consumer. Our leading position with proprietary hectorite and Rheoluxe® rheology modifiers will be augmented by SummitReheis’ complementary position in specialty additives for anti-perspirants, pharmaceuticals and dental products.”

“The Group is well positioned to capitalise on this acquisition through the enhanced geographic footprint and strong customer relationships that it brings. Together with our existing business, the acquisition of SummitReheis is transformative for our personal care business, creating a substantial, high return platform that will help accelerate our Reignite Growth strategy.”

Strategic rationale • Personal care market is a significant growth opportunity for Elementis • Anti-perspirants is a highly attractive, growing segment of the personal care market • Acquisition creates a ~US$200 million personal care business of Elementis with critical mass and significant growth prospects • Combines SummitReheis’ key active ingredients for anti-perspirants with Elementis’ enabling technology of hectorites and synthetic polymers • Accelerates growth for both SummitReheis and Elementis as a result of the expanded footprint with key customers and broader geographical reach • Combined business has strong relationships with key consumer products companies • SummitReheis products differentiated by their superior quality and certifications (for example, FDA requirements in the US and ECHA requirements in Europe) • Benefits expected from the realisation of additional growth opportunities Financial highlights • Enterprise value of US$360 million on a cash free, debt free basis • Immediate adjusted earnings per share accretion expected in the current financial year and double digit adjusted earnings per share accretion in 2018 • Expected to enhance Elementis’ group margin in the current financial year • Run rate cost synergies of up to US$3 million per annum identified • ROIC expected to be in line with Elementis’ cost of capital in the first full year of ownership • Funded through Elementis’ existing cash resources and US$475 million of new debt facilities • Elementis to remain prudently financed post acquisition

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Information regarding SummitReheis SummitReheis’ primary focus is the manufacture and sale of aluminium and zirconium based active ingredients for antiperspirant products to global consumer products companies.

It is the global leader in the fast growing anti-perspirant actives (“AP actives”) market with locations in the US, Europe and Asia.

Its technologies provide the base ingredients providing sweat-blocking characteristics in all types of anti-perspirant products such as aerosols, sticks and roll-ons. Over 60 per cent. of SummitReheis’ sales are from its AP actives business.

SummitReheis’ Pharma Actives business is a leading European producer of the active ingredients for indigestion and heartburn remedies.

These products have similar chemistry and manufacturing processes to the core business and long-term customer relationships in the pharmaceutical industry. SummitReheis’ Specialty Dental business manufactures dental plasters, alloys, discs and moulding materials that are used to make dental crowns, bridges, replacement teeth and in other applications and has a leading position in Germany.

SummitReheis is headquartered in Huguenot, New York. In June 2015, SummitReheis acquired the European AP actives, pharma and dental businesses of B.K. Giulini.

SummitReheis’ financial profile For the year ended 31 December 2015, SummitReheis reported revenue of US$103 million, EBITDA of US$15 million and operating income of US$8 million.

Pro forma for a full year contribution from the acquired B.K. Giulini businesses, SummitReheis would have reported underlying EBITDA of approximately US$25 million in the year ended 31 December 2015. As at 31 December 2015, SummitReheis had total assets of US$208 million and net assets of US$12 million.

For the year ended 31 December 2016, SummitReheis is expected to report revenue of US$134 million and underlying EBITDA of approximately US$28 million.

Transaction details and timing Completion of the acquisition is expected to take place in the second quarter of 2017 following receipt of anti-trust clearances in the US and Germany.

Elementis intends to fund the acquisition through existing cash resources and US$475 million of new debt facilities which will also be used to refinance Elementis’ existing debt facilities.

The new debt will be provided through a new fully underwritten US$275 million revolving credit facility and US$200 million term loan facility. The new debt facilities have a 5 year term and are on terms in line with the Group’s existing facilities. Elementis will remain prudently financed post acquisition.

MAVEN CAPITAL PARTNERS COMPLETES £6.5 MILLION MBO OF HEALTHPOINT LIMITED Funding package will enable Healthpoint to drive growth through new product development and further penetrate grocery multiples, value retailers and export markets Maven Capital Partners (“Maven”), one of the UK’s most active private equity houses, has completed a £6.5 million management buy-out of Healthpoint Limited (“Healthpoint”), which sources and supplies healthcare and beauty products into the retail sector. The equity investment was funded through Maven’s co-investment network for professional clients ‘Investor Partners’, with debt and working capital funding provided by Barclays plc.

The investment will enable Healthpoint to fund further new product development, with around 30 new product lines in the pipeline for launch in the next year, and support the business in driving organic growth from its long-established relationships. The company is also focused on a buy-andbuild strategy with follow-on funding available from Maven to grow the company by acquisition.

Blackpool based Healthpoint has carved a successful niche within the rapidly expanding ‘value’ segment of the personal care and beauty market. Its portfolio of branded products, which include ‘Derma V10’ and ‘Clear & Simple’, offer an affordable, high quality alternative to the premium branded products. Healthpoint’s products also include a range of over the counter (“OTC”) medicines bearing the “Healthpoint” brand, with the OTC range set to expand significantly following the investment.

Founded in 1996, the business has grown to become one of the largest suppliers of tertiary branded healthcare products in the UK. In 2014 the business was sold to the current management team, led by Managing Director Amanda Parkinson, who implemented a focused commercial strategy leading to a number of industry awards and growth within the customer base. Healthpoint now supplies over 300 product lines to retailers, wholesalers, healthcare and pharmacy chains, as well as the export market.

Amanda Parkinson, Managing Director at Healthpoint, said: “We are passionate about delivering high quality products and excellent customer service to our growing customer base, and are delighted that Maven shares our vision for the business. We have plans to drive the value of our brands, increase the number of products across the whole product range, capture market share and also target overseas sales growth. ” Ryan Bevington, Investment Director at Maven, added: “We are delighted to have completed the investment in Healthpoint, which is a leading player operating in a growing segment of the market. We look forward to working with Amanda and her team to help the business continue its impressive growth over recent years. Healthpoint is another

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example of a high-growth portfolio company which is bringing a large number of new products to market over the coming year and planning to target the export market which provides hugely exciting opportunities.“ Key advisors to the transaction were: • Corporate Finance and tax advice provided by Paul Kaiser, Katy Lamb and Stephanie Davidson at UNW

• Legal advice to Maven by Paul Jefferson and Katie Porter at Gateley plc • Commercial due diligence by RPL • Insurance due diligence by Vista • Financial due diligence by RSM • Management due diligence by Stratton HR • Legal advice for management provided by Schofield Sweeney

SHARDUL AMARCHAND MANGALDAS & CO ADVISES IN RELATION TO BULK TRADE OF APOLLO HOSPITALS SHARES BY INTEGRATED (MAURITIUS) HEALTHCARE HOLDINGS Shardul Amarchand Mangaldas advised in relation to the bulk trade by Integrated (Mauritius) Healthcare Holdings Limited (“IHH”) (owned by Khazanah Nasional Berhad) in shares of Apollo Hospitals Enterprise Limited. As a part of the transaction, IHH sold over 6% stake in Apollo Hospitals Enterprise Limited, for US$ 160 million, through an accelerated bookbuild, with the Deutsche Bank Group acting as the sole bookrunner.

The Capital Markets team of Shardul Amarchand Mangaldas advised the Deutsche Bank Group on this transaction. Ms. Manjari Tyagi led the team as Partner and included Ms. Ishita Kashyap as Associate.

Other legal advisors involved in the transaction were Herbert Smith Freehills LLP (International legal counsel to Deutsche Bank Group) and Desai & Diwanji (Indian legal counsel to IHH).

The trade was undertaken on March 3, 2017.

SENSITIVE SKIN CHALLENGER BRAND PAI SKINCARE SECURES GBP3.45M SERIES A INVESTMENT Pai Skincare, the London-based sensitive skin care brand, has closed a GBP 3.45m (EUR 4m / USD 4.5m) Series A investment led

by Luxembourg based CAP Invest.

Pai plans to double-down on e-commerce, hire an experienced CTO / Head of E-Commerce and expand its global direct retail operation.

With 6 websites covering Europe, North America and Australia, Pai will launch its first online stores in Asia, scale up online marketing and bring web development in-house.

Founder Sarah Brown says of the new investment: “Pai has empowered thousands of women to tackle their sensitive skin issues. Our ambition is to help millions, which this investment will help us do.”

CAP Invest are adding to their already comprehensive portfolio of brands including Oh My Cream, Big Fernand, Gault & Millau and StaffMatch. Thomas Riccobono of CAP Invest comments: “Pai has a clear sense of direction, and successfully differentiates itself in the market. The honesty and integrity of the brand especially resonated with me. It extends beyond the beauty category, and operates in that wellness and healthy lifestyle space, which I found to be a refreshing approach.”

Founded by Sarah Brown in 2007 as a solution to her own skin condition, Pai’s certified organic* products have become the premium choice for those who have tried everything in their search for skin confidence.

High profile devotees include Natalie Portman and Emily Watson.

Pai began in Sarah’s converted garage in West London where she made all products by hand. In July 2017 Pai will open a new purpose built manufacturing facility at its London HQ. The investment will help create new highly skilled NPD and manufacturing jobs in London.

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M OVES

CARDIOME PHARMA (CRME) NAMES JUSTIN RENZ AS CFO; JENNIFER ARCHIBALD APPOINTED CHIEF BUSINESS OPERATIONS OFFICER Cardiome Pharma Corp. (NASDAQ: CRME) has announced a number of changes to its senior management team.

Commenting on the changes, William Hunter, MD, CEO and President of Cardiome, said “Cardiome is a very different company than it was even a few years ago. We are no longer focused on a single drug and are now a diversified Company selling multiple medicines. We have built a fully integrated pharmaceutical company that sells its products into almost every major pharmaceutical market in the world outside of the United States. We have licensed and acquired compelling medicines and expect to add more products in the foreseeable future via our robust business development pipeline. We feel that we are on the cusp of significant operational momentum and our Team will evolve as necessary in order to maximize the Company’s potential.”

Changes to the Management Team: • Justin Renz joins Cardiome as its new Chief Financial Officer (CFO), • Jennifer Archibald, Cardiome’s current CFO, has been appointed to the position of Chief Business Operations Officer, • David Dean, Cardiome’s VP Business Development and Investor Relations, has been appointed to the position of Chief Business Development Officer, • Hugues Sachot, Cardiome’s SVP Commercial, has been appointed to the position of Chief Commercial Officer.

• Commenting on the appointment of Mr. Renz as CFO, William Hunter, MD, CEO and President of Cardiome said “We are thrilled to welcome such a talented and energetic executive to our team. Justin’s experience in fast-paced environments and leading multiple activities across a diverse set of business functions makes him an ideal fit for our organization.”

“I am extremely excited to join Cardiome’s management team. I view this as an exceptional opportunity to work alongside proven industry leaders and to increase the profile of Cardiome amongst industry peers as well as investors and analysts. I believe that Cardiome’s current operations will prove to be an outstanding platform to build upon,” said Justin Renz.

Mr. Renz has extensive experience in the biopharmaceutical industry. He most recently served as Executive Vice President, Chief Financial Officer and Treasurer at Karyopharm Therapeutics, which he joined in August 2014, where he led core business and finance functions. Prior to Karyopharm, Mr. Renz was Executive Vice President, Chief Financial Officer and Treasurer at Zalicus Inc. (formerly CombinatoRx, Inc.), which he joined in September 2006.

He oversaw multiple rounds of equity and debt financing and led the company’s asset monetization strategy and two reverse mergers. Prior to Zalicus, Mr. Renz served in senior finance and accounting roles at Serono, Inc. and Coley Pharmaceutical Group, Inc.

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Earlier in his career, Mr. Renz held increasingly senior finance positions at ArQule, Inc. and Millipore Corporation. Mr. Renz began his career with Arthur Andersen LLP in 1993.

He received a Bachelor of Arts in Economics and Accounting from the College of the Holy Cross, a Master of Science in Taxation from Northeastern University and a Master of Business Administration from Suffolk University.

Commenting on the appointments of Ms. Jennifer Archibald, Mr. David Dean and Mr. Hugues Sachot, William Hunter said “Cardiome’s operations have grown significantly and the appointments reflect both Cardiome’s, and these executives’ development. Jennifer has been critical to ensuring the efficient financial operation of Cardiome’s global business, which crosses dozens of borders and operates in very complex environments; her new role reflects those talents as she will be responsible for driving operational excellence in the organization globally beyond finance. David has proven himself key to many aspects of Cardiome’s business but today, Cardiome’s future potential is significantly greater as a result of the business development pipeline currently under negotiation. It consists of some of the most compelling acute care medicines the industry has seen in years. With a recently bolstered balance sheet, we are confident that we will announce exciting additions to our product portfolio in the foreseeable future. Hugues has done a magnificent job establishing and growing our commercial footprint, including the recent addition of our Canadian sales force.

The distribution business that he put in place worldwide has grown to become a material component of our revenues. I congratulate Jennifer, David and Hugues on their achievements to date and look forward to their continued contributions.”

GRAZIANO SEGHEZZI APPOINTED MANAGING PARTNER OF SOFINNOVA PARTNERS Sofinnova Partners, a leading European venture capital firm specialized in Life Sciences, has appointed Graziano Seghezzi as Managing Partner. He joins Antoine Papiernik, Denis Lucquin, and Monique Saulnier in the company’s Managing Partnership. Graziano’s appointment boosts Sofinnova Partners’ international leadership.

Graziano began his career in venture capital in 2001 at Sofinnova Partners where he was in charge of identifying and assessing investment opportunities. Throughout his career, he has focused on company creation through the establishment of start ups, spin-offs, and accelerators. He was the seed investor of Omthera Pharmaceuticals, listed on Nasdaq and then sold to Astra Zeneca, of Glycovaxyn sold to GSK and of Creabilis sold to Sienna Biopharmaceuticals.

He also invested and is on the Board of Breath Therapeutics, Corvidia Therapeutics, Crescendo Biologics, Hookipa Biotech, Inotrem and Mission Therapeutics. Graziano also co-founded BiovelocITA, Italy’s first biotech accelerator. Between 2003 and 2006, he worked at Index Ventures in Geneva.

A scientist by training, Graziano spent five years working in academic research at NYU School of Medicine (USA), studying oncology and cardiovascular diseases. He holds a degree in genetics and microbiology from the University of Pavia (Italy) and an MBA from RSM-Erasmus University (Netherlands).

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Graziano Seghezzi says: I have tremendous respect for the Sofinnova team both on a professional and on a personal level; I am therefore particularly happy to be promoted Managing Partner. This new role comes at a pivotal moment for the partnership, which has devised an ambitious growth strategy. With my extensive international expertise, I am looking forward to actively contribute to further develop

Sofinnova Partners’ global leadership in Life Sciences.

Antoine Papiernik, Chairman of Sofinnova Partners adds: Graziano came to Sofinnova Partners fifteen years ago, as he was changing careers from academic researcher to biotech investor. Today, he has built a true investment track record both in Europe and in the United States; we are very pleased to welcome him to the Managing Partnership.

GW PHARMACEUTICALS ANNOUNCES THE APPOINTMENT OF SCOTT GIACOBELLO AS CHIEF FINANCIAL OFFICER AND ADAM GEORGE AS MANAGING DIRECTOR - UK GW Pharmaceuticals plc (Nasdaq: GWPH, “GW,” “the Company” or “the Group”), a biopharmaceutical company focused on discovering, developing and commercializing novel therapeutics from its proprietary cannabinoid product platform, announced the appointment of Scott Giacobello as Chief Financial Officer on 6 March 2017. Reporting to GW’s Chief Executive Officer Justin Gover, Mr. Giacobello will be based at the Company’s U.S. headquarters in Carlsbad, California. Related to this appointment, on 6 March 2017 Adam George, GW’s Chief Financial Officer since 2012, became Managing Director - UK, a newly-created executive role with broad leadership responsibilities for UK operations, also reporting to Justin Gover.

“These important leadership appointments reflect GW’s continuing evolution into a transatlantic commercial-stage biopharmaceutical company. In anticipation of Epidiolex approval and launch, and with GW now solely listed on Nasdaq, we expect to transition from being a Foreign Private Issuer reporting under IFRS to become a domestic registrant reporting under USGAAP and in US dollars in future years. Scott’s significant financial and accounting expertise will be a major asset to the organization as we make that shift,” stated Justin Gover, GW’s Chief Executive Officer. “In addition, with Adam having served as CFO since 2012, his new Managing Director – UK role leverages the broad knowledge he has of our business and provides continuity of strong senior UK-based leadership, essential elements to our continued success.”

Scott Giacobello brings 25 years of finance and operational experience to GW Pharmaceuticals. He is an accomplished executive who most recently and until its acquisition by Allergan, Inc. in late 2016, served as Chief Financial Officer for Chase Pharmaceuticals Corporation, a clinical stage biopharmaceutical company focused on the development and commercialization of improved treatments for neurodegenerative disorders. From 2008 through 2015, Mr. Giacobello held senior level finance positions at Allergan, Inc., most recently serving as Vice President of Finance for Global Research & Development.

While at Allergan, he also served as Vice President of Corporate Finance and Vice President of Internal Audit & Compliance.

Scott’s previous experience includes financial positions at the Black & Decker Corporation and Ernst & Young, LLP. Mr. Giacobello holds a bachelor’s degree in business administration from the University of Notre Dame and is a Certified Public Accountant. As Managing Director - UK, Adam George will be instrumental in ensuring our UK operations achieve our strategic and operating goals, which include pipeline development, manufacturing scale-up, and European commercialization. Mr. George will continue as Company Secretary and will provide Mr. Giacobello with full support through the CFO transition.

JOHN TUCKER APPOINTED AS CHIEF EXECUTIVE OFFICER OF SCPHARMACEUTICALS scPharmaceuticals, Inc. a privately held biopharmaceutical company transforming patient care and healthcare costs through innovative subcutaneous drug delivery, announced the appointment of John Tucker as president and chief executive officer, effective immediately. Mr. Tucker was also elected to the board of directors of scPharmaceuticals.

“John has both the strong leadership skills and the business expertise required to successfully position scPharmaceuticals as a leading biopharmaceutical company,” said Jack Khattar, scPharmaceuticals board member who led the search committee. “John’s experience building commercial ready infrastructures in both private and public companies, as well as developing new markets, will be enormously beneficial to scPharmaceuticals as we advance our lead program and continue the transition from a research and development company to a commercial-stage organization.”

“I am very honored and excited to join scPharmaceuticals, a growing biopharmaceutical company. We have a tremendous opportunity to reduce the burden to the patient while

meaningfully reducing the cost of care in the management of heart failure and infectious disease through innovative subcutaneous drug delivery,” said John Tucker. “scPharmaceuticals’ lead investigational drug product – proprietary subcutaneous furosemide, enabled by the patented sc2WearTM Infusor – has been developed to facilitate convenient patient care while reducing overall costs to the healthcare system.”

Mr. Tucker has over 25 years of experience in the pharmaceutical industry where he has held various executive positions in major pharmaceutical and biotechnology companies. Prior to joining scPharmaceuticals, Mr. Tucker served as Chief Executive Officer of Alcresta, developer of enzyme-based products for patients with acute and chronic diseases. While at Alcresta he led regulatory and financing strategies resulting in Alcresta’s first product approval and product launch. Prior to Alcresta, he served as senior vice president and chief commercial officer of Incline Therapeutics, a hospital-focused specialty pharmaceutical company. There, he developed and drove the overall

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commercial strategy in support of the company’s lead product, IONSYS™, resulting in a $390 million purchase of Incline by The Medicines Company. He joined Incline from AMAG Pharmaceuticals, where he was senior vice president, commercial operations, responsible for all sales and marketing activities for the company.

Previously, as president, U.S. operations at Basilea Pharmaceuticals, Mr. Tucker developed the strategy and organization for the planned launch of a hospital-focused

product and led the company’s commercial development team. Prior to Basilea, Mr. Tucker was executive vice president, sales and marketing at Indevus Pharmaceuticals.

Earlier in his career, he held a variety of both hospital and retail-based sales and marketing positions with increasing levels of responsibility at Ortho-McNeil Pharmaceuticals, ALZA Corporation, VIVUS and UCB Pharma. Mr. Tucker holds a BA from Plymouth State College and an MBA from New Hampshire College.

RITA M. O’CONNOR APPOINTED CHIEF FINANCIAL OFFICER OF PLX PHARMA Former CFO of Mucinex Innovator, Adams Respiratory Therapeutics, joins company PLx Pharma Inc. (NASDAQ:PLXP) (“PLx” or the “Company”), a late-stage specialty pharmaceutical company focused on commercializing two patent-protected products, Aspertec™ 325 mg and Aspertec™ 81 mg (referred to together as “Aspertec”™), announced the appointment of Rita M. O’Connor as Chief Financial Officer (CFO), effective July 1, 2017. Ms. O’Connor succeeds David Jorden, who has served as the Company’s Acting CFO since June 2015 and previously served as a PLx board member since 2005. Mr. Jorden will transition at the end of July. Ms. O’Connor, the former CFO of Mucinex® innovator, Adams Respiratory Therapeutics, brings an extensive background in finance, strategic partnering, merger and acquisitions and equity fundraising in both public and private offerings to PLx, which recently completed its merger with Dipexium Pharmaceuticals, Inc (“Dipexium”).

“David has been a valued partner, and we are grateful for his contributions as Acting CFO and through PLx’s recently-closed merger with Dipexium. Our transition to a full-time CFO is part of a natural and planned process that recognizes PLx’s status as a newly public company. We wish him well in his future endeavors,” stated Natasha Giordano, President and Chief Executive Officer of PLx. “We are pleased to welcome Rita to PLx at this important juncture in our development as we transition into a commercial-stage pharmaceutical company. Her considerable financial acumen and wide-ranging, senior management experience will be important assets as we seek to commercialize Aspertec, and essential to our continued success,” added Ms. Giordano.

Ms. O’Connor joins PLx from the Kent Place School, an all-girls college preparatory school, where she has served as CFO since 2013. She was previously the CFO and Chief Information Officer at Xanodyne Pharmaceuticals, an integrated specialty pharmaceutical company focused on women’s health and pain management, prior to which she was Chief Financial Officer and Treasurer of Adams Respiratory Therapeutics, a specialty pharmaceutical company focused on OTC and prescription products for the treatment of respiratory disorders. Earlier in her career she held positions of increasing responsibility during an eight-year tenure at Schering-Plough Corporation. She began her career at Deloitte and Touche. Ms. O’Connor is a licensed certified public accountant and earned her Bachelor of Science in Accounting from Rutgers University. Respiratory Therapeutics, a specialty pharmaceutical company focused on OTC and prescription products for the treatment of respiratory disorders.

Earlier in her career she held positions of increasing responsibility during an eight-year tenure at Schering-Plough Corporation.

She began her career at Deloitte and Touche. Ms. O’Connor is a licensed certified public accountant and earned her Bachelor of Science in Accounting from Rutgers University.

UNDER NEW CEO, ALEXION CONTINUES OVERHAUL OF LEADERSHIP • Alexion Pharmaceuticals is conducting a sweeping shake-up of its executive leadership, announcing the departure of recently installed Chief Financial Officer David Anderson, along with its chief commercial officer, head of R&D and chief human resources officer.

• Brain Goff, a biopharma exec who most recently served as chief operating officer at Neurovance, Inc., will replace Alexion’s outgoing CCO Carsten Thiel on June 1. A search for replacements for the other positions is underway.

• The leadership changes come only two months after former Baxalta Chief Ludwig Hantson took office as Alexion’s new CEO. The drugmaker’s former head, along with its then CFO, left in December after an internal investigation was launched into company sales tactics.

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Alexion, a rare disease specialist which sells one of the most expensive drugs in the world, has had a turbulent few quarters. Hantson’s appointment as CEO in March ended a months-long search for a replacement of ex-CEO David Hallal. But it appears the leadership overhaul hasn’t yet reached its conclusion. CFO David Anderson, who will resign at the end of August, was only appointed to the role in December, filling the opening left by outgoing financial chief Vikas Sinha.

While Alexion appointed an interim CEO as it searched for a permanent replacement, Anderson was an outside candidate with more than a decade of experience running Honeywell International’s books. Taken together, the changes

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suggest Hantson seeks to turn the page on the struggles and setbacks of the past months, which have damaged the company’s image. While Alexion’s internal investigation into its sales practices found no evidence of improper accounting, the company faulted an inappropriate “tone at the top” for weakening financial controls.

According to company statements, senior management improperly pressured staff to meet sales targets for its pricey best-seller Soliris (eculizumab). Soliris — approved to treat a rare blood disorder and an inherited disease caused by the formation of blood clots — accounts for more than 90% of Alexion’s revenue, despite a relatively small pool of treatable patients.First-quarter sales of the drug checked in higher than expected, but the company still faces challenges in expanding the drug’s label and market opportunity.

Scrutiny has not ended with the company’s all-clear signal.

Brazilian authorities raided Alexion’s Sao Paolo offices as part of a probe into Soliris sales tactics, Bloomberg reported earlier this month.

The departure of Alexion’s R&D head could also signal a shift in direction. “We need to do a better job with our R&D productivity,” Hantson said on an April 27 earnings call.

Before Hantson arrived, Alexion announced a restructuring that would cut 7% of the company’s workforce and a focusing of resources on the most promising R&D programs.

One month before that, the company ended further development of drug candidate SBC-103, a potential treatment for mucopolysaccharidosis (MPS) IIIB that was picked up in the $8.4 billion acquisition of Synageva in 2015.

HIGHMARK HEALTH ANNOUNCES CINDY DONOHOE APPOINTMENT TO EXECUTIVE VICE PRESIDENT, CHIEF MARKETING OFFICER Highmark Health has announced that Cindy Donohoe has been appointed Executive Vice President and Chief Marketing Officer for Highmark Health, a newly created position that will oversee marketing across the entire organization, including the Highmark Health Plan and Allegheny Health Network.

“When Cindy joined the Highmark Health Plan in 2015, she ushered in a new paradigm that transformed the organization’s marketing function,” commented David Holmberg, President and Chief Executive Officer of Highmark Health. “Through her willingness to drive change by continuously challenging herself and her colleagues to be bold for the good of the people we serve, I expect that the marketing organization will continue to grow as a strategic and value-added partner.”

Cindy Donohoe has more than 14 years leading marketing functions grounded in business strategy, shaped by customer insights, and characterized by agility and transparency. As a result, in early 2016, she assumed responsibility for the entire Highmark Health marketing function and built a seasoned team focused on what quality and value really mean to members and patients, helping Highmark Health deliver on its vision of a better health care experience.

An important outcome of this important work is Highmark Health’s highly successful #LivingProof campaign. Through conception to execution, Ms. Donohoe and her team worked with colleagues across the enterprise to bring to life AHN patients’ and Highmark members’ stories, and display the groundbreaking work of transforming health care.

Previously, Ms. Donohoe served as senior vice president of growth and customer experience at Physicians Immediate Care, a top-10 urgent care provider backed by Anthem, where she helped expand the clinic base by 40 percent in one year. As a divisional vice president for Walgreens, Ms. Donohoe led marketing for the company’s $47 billion pharmacy and healthcare division, and doubled pharmacy sales driven by marketing with campaigns that won global awards and achieved the company’s highest branded recognition.

Cindy Donohoe, Executive Vice President / Chief Marketing Officer, Highmark Health

Ms. Donohoe was also chief marketing officer for UnitedHealth Group’s $20 billion federal programs serving Americans age 50+, where she helped achieve the highest national market share for Medicare Part D. She launched consumer-driven healthcare at Great-West Healthcare (now CIGNA). At Netscape and AOL, Ms. Donohoe led product management for some of the world’s first enterprise e-commerce products.

Since relocating to Pittsburgh in 2015, Ms. Donohoe has become active in the local community, joining the Board of Directors of Riverlife and the Women’s Center & Shelter of Greater Pittsburgh.

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DATES ANNOUNCED FOR 2017 WORLD EXTREME MEDICINE CONFERENCE, EDINBURGH The organisers of the World Extreme Medicine Conference and Expo have announced that the 2017 event will take place at Dynamic Earth in Edinburgh, from 25 to 27 November 2017. The attendees will represent an eclectic mix of disciplines, united by one thing: they all specialise in medical practice conducted away from a usual clinical setting, typically in remote and sometimes dangerous locations.

Three core disciplines will covered by key speakers: disaster and humanitarian medicine, extreme, expedition and space medicine, and prehospital medicine. Over 60 speakers are expected to talk at the three day conference, which will welcome 900 attendees.

The 2016 instalment of the conference was a great success.

Dr David Nott OBE, an NHS war surgeon who spends several months of each year working overseas for Médecins Sans Frontières and the British Red Cross and works actively in Syria, took the opportunity to launch Doctors Under Fire, a new charity campaigning for the protection of medical professionals in conflict zones such as the Yemen, where they have been targeted by the military.

Eoin Walker is a Pre-Hospital Mass Casualty Incident Management Paramedic with the London Air Ambulance, and will be discussing prehospital care at the conference.

Eoin said, “As we strive for ever-better outcomes for patients, it’s easy to forget the huge crossovers in research and knowledge between different areas. We’ve seen great synergy before between people working in fields such as prehospital care, expedition medicine and pioneering hospital treatments.

“The medical community can keep people safest by collaborating and working together to consider best practises and break down the traditional siloes between different areas of medicine and science.

“The World Extreme Medicine Conference is a collaborative environment that opens discussions and new ways of thinking for medical professionals.”

World Extreme Medicine Founder Mark Hannaford said, “With the NHS under mounting pressure, you might think that doctors would be hard-pushed to attend a three day conference, but the reality is that the levels of interest are growing as motivated doctors look into the possibility of opportunities within medicine but outside of a traditional hospital environment. Anecdotally, it’s been found that medics gaining this experience return to their core clinical roles with additional team-working, leadership and management skills.

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“Because of the rapid improvement in technology in recent years, people are spending more and more time exploring areas outside the human race’s comfort zone: in deserts, at the poles, at the top of huge mountains, in space.

“When humans travel far from hospitals and clinics, and the advanced medical technology associated with those facilities, they need healthcare professionals with a very different set of skills.

“The area of extreme medicine is in growth, and our message is that it’s a great alternative to a traditional clinical career, and can work in parallel to a job in a hospital environment. Doctors who work in less traditional medical environments bring back unique skills to hospitals, which they can share with colleagues.

There’s never been a more exciting time to work in medicine, and the fascinating speakers at the World Extreme Medicine Conference will prove that point. We will make further announcements about speakers throughout the year.”

World Extreme Medicine is offering a range of sponsorship and exhibitor opportunities for companies and causes that want to reach a very focused, highly motivated and adventurous group of medical professionals, from entry-level to whole-event contracts.

NEW WILDERNESS MEDICINE COURSE TAKES UK DOCTORS TO ICELAND

More than ever before, the human race is exploring parts of the world that are hostile to life, whether that be scaling mountains like Everest, conducting scientific experiments at the South Pole, searching for natural resources in inaccessible places or journeying into space.

Away from hospitals and ambulance services, and exposed to dangers such as extremes of hot and cold, challenging and dangerous terrain and tropical diseases, expeditioners would be vulnerable without doctors and medics equipped with a specific and rare set of skills. But how do medics adapt their conventional medical training which is geared towards medicine in a controlled clinical environment to work without complex equipment or an established team? On 20 June 2017, 25 UK practitioners from various areas of medicine will fly to Iceland for a new intensive four-day course run by World Extreme Medicine, which will put them into situations a traditional medical career would never demand.

World Extreme Medicine, a world-leading provider delivering courses in expedition medicine, tailored for a number of environments and specialities, is running the course in partnership with Icelandic expedition firm Midgard Adventure.

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Led by experienced UK expedition medics Alex Rowe, Claire Grogan and Jamie Pattison, with local guides Sigurður Bjarni Sveinsson and Arnar Páll Gíslason, the course attendees will trek to Eyjafjallajökull, the volcano whose 2010 eruption famously disrupted air traffic over much of Europe. The trek will take two days, and will involve camping on a glacier.

On the way, the medics will undertake realistic simulated emergencies, and will be taught to react in a way that maximises positive outcomes for the patient in an austere environment.This hands-on course will take place in the 24-hour daylight of the Icelandic midsummer. Course leader Alex Rowe, said, “This course is designed to challenge doctors who are competent and confident in a conventional clinical environment, and encourage them to think in a totally new way. “It’s going to be practical, physical and will give attendees a grounding in the skills, mindset and confidence they’ll need to take part in larger-scale expeditions and adventures.“As more and more people head into Earth’s wild places, the demand for medics with this sort of experience is growing.

Extreme medicine is incredibly exciting and rewarding.”

Mark Hannaford, Founder of course organisers World Extreme Medicine, said, “With the NHS under mounting pressure, motivated doctors are looking at opportunities within medicine but outside of a traditional hospital environment. “Because of the rapid improvement in technology in recent years, people are spending more and more time exploring areas outside the human race’s comfort zone: in deserts, at the poles, at the top of huge mountains, in space. “When humans travel far from hospitals and clinics, and the advanced medical technology associated with those facilities, they need healthcare professionals with a very different set of skills.

“Extreme medicine is a great alternative to a traditional clinical career, and can work in parallel to a job in a hospital environment. Anecdotally, it’s been found that medics gaining this experience return to their core clinical roles with mental resilience and additional team-working, leadership and management skills.”

IMPRIVATA SHOWCASES HEALTHCARE SECURITY SOLUTIONS AND DISCUSSES CRITICAL ISSUES FOR E-HEALTH AT FUTURE HEALTH 2017 Imprivata attends global healthcare event with partner Triangle Health Stand 47, CityWest Convention Centre, Dublin, Ireland UK - Imprivata®, the healthcare IT security company, will be showcasing its latest solutions for authentication, access management, and patient identification at Future Health 2017 (24-25th May) in Dublin, Ireland with its local partner Triangle Health. Imprivata will be demonstrating Imprivata PatientSecure® a patient identity solution, as well as Imprivata OneSign® and Imprivata Confirm on the Triangle Health stand 47, at the e-Health Summit. Dr. Saif Abed, Medical Director EMEA at Imprivata, will also be presenting and chairing at four sessions in the ‘Festival of eHealth’ conference stream over the course of the two day event.

Dr Abed will present the session on Day 1 entitled, ‘Making the Business Case for eHealth – It’s More than Money’, sharing his experience at Imprivata of working with clinical, political and management leaders to develop business cases that help deliver successful health IT projects. Dr Abed will participate in panel discussions covering topics including clinical risk and workflows, with colleague Claire Reilly, Clinical Workflow Specialist, and how to optimise the relationship between the private and public sector in complex e-health projects.

He will also chair a panel of fellow industry leaders and members of the Council of Clinical Information Officers Ireland on the final workshop session entitled, ‘The Future of Digital Health in Ireland’. Imprivata OneSign gives clinicians No Click Access® to clinical administrative applications by replacing passwords with a single badge tap or swipe of a fingerprint, saving time for the clinician and allowing them to focus more on patient care. When measured, this can save clinicians 45 minutes per shift, releasing valuable time back to patient care. Imprivata Confirm ID provides a single, centralised solution that enables users to access and transact

patient health information securely and conveniently across clinical applications and medical devices, ensuring that sensitive patient data is protected. Imprivata PatientSecure uses palm vein biometric information to create a direct match between individual patients and their unique medical records across disparate systems. It stops patient misidentification errors at the source and prevents the creation of duplicate medical records, providing a safer and more streamlined patient experience.

Dr Saif Abed said; “This conference is a great event for Imprivata to share our experience as frontline clinicians and IT strategists with other medical practitioners. Our knowledge of the clinical, operational and financial mechanisms underpinning the areas of governance, patient safety and clinical risk and clinical engagement can help health organisations realise the benefits of health IT projects.”

Carina Edwards, Senior Vice President Customer Experience at Imprivata commented; “Future Health is an important forum for healthcare professionals to look forward as to how healthcare will be transformed in the digital age. At Imprivata we employ clinical professionals who understand the challenges that clinicians face on a daily basis and have developed our technology solutions to address those issues today.

“Our solutions make cybersecurity as easy as possible for both clinicians and patients across the many different devices that are used to access medical records in healthcare settings. Patients can rest assured that their sensitive personal information is kept safe at all times.”By providing a comprehensive platform for single sign-on, authentication management, and positive patient identification, Imprivata is able to enhance and streamline clinical workflows, making access to patient information seamless, accurate, and much quicker. To learn more about Imprivata solutions visit; www. imprivata.co.uk

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The 5 Best Health Technology Innovations at CES 2017 The biggest tech event of the year, CES brought stunning new health technologies to the stage in 2017 as well.

As reviewed by Medical Futurist, we take a look at gamechangers this year.

QardioCore

Chest strap to monitor your hearth QardioCore promises a discreet as well as easily usable hearth monitor without patches and wires. The FDA-approved, medical-grade wearable uses sensors to record clinically accurate continuous ECG, heart rate, heart rate variability, respiratory rate, skin temperature, and activity data, which can be shared with medical professionals or synced to the free Qardio app or Apple’s Health app on iPhone or iPad. It was first introduced at CES 2015, and the first batch of these smart and tiny chest straps will be shipped to their lucky users as early as April 2017.

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MIO Slice

If step count is not enough for you!

What if reaching 10 thousand steps a day is actually great for your annoying co-worker, Nathan, but bad for your health? Every single person has a different body in need of a personalized fitness plan and health solution. And Mio Slice wants to take that into account. At first sight, it looks and acts like a fitness tracker. It measures steps, calories burned, distance, all day heart rate and sleep. However, it adds to it its very own Personal Activity Intelligence (PAI) index. PAI provides you with a personalised target score which reflects your body’s response to physical activity based on heart rate. It can reform the market of fitness trackers!

2breathe

Falling asleep without the need for counting sheep Okay, if you dread to think of panpipe music, this app will not work for you, but in most cases 2breathe’s sleep inducer has a pretty good success rate. It combines a Bluetooth sensor, a smartphone app and some soothing panpipe melodies. The wearable around your waist analyses your breathing patterns, and then your phone gives out guidance in the form of smooth, lilting melodic tones to prolong exhalation and reduce brain activity, thus making you sleepy. It’s pretty easy. And believe me, you do not have to count sheep anymore before falling into a sweet dream.

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S-Skin

Take care of your skin wisely!

Your facial skin is one of the best indicators of your health due to its sensitivity. It responds to your mood, stress level and changes in the environment. Thus, it needs your peculiar attention. S-Skin wants to help you achieving it. It is made up of a microneedle patch and a portable device that can help analyse your skin, give you solutions and even suggest products that you’ll be able to use. Through the LED light, it can measure your skin’s dryness, hydration, redness, or melanin and then save the information on the app so you can track its changes.

TempTraq

Monitoring temperature easily If you have a small child, you know how difficult it is to measure the sweet little baby’s temperature. There are always some movements, plush animals or bodily fluids involved. Now, the struggle is over. TempTraq offers a patch-like smart device, which monitors body temperature 24/7. It continuously senses, records, and sends temperature data to mobile devices so caregivers can keep track without unnecessarily disturbing the child. It is amazing due to its double effect: it will calm the mom down, while letting the baby sleep.

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UK PHARMACEUTICAL EXECUTIVES RANK HIGHEST FOR INTERNATIONAL AND GENDER DIVERSITY; MORE PROGRESS NEEDED IN PHARMA AND MEDTECH SECTORS OVERALL New research published by Heidrick & Struggles (Nasdaq: HSII), a leading provider of executive search, leadership consulting and culture shaping worldwide, has found that Country Managers and European Heads in the UK pharmaceutical sector are far more internationally diverse than their French and German counterparts.

In stark contrast to France, where only 7% of these executives have international backgrounds, almost three-quarters (70%) of UK executives come from outside Britain. In Germany, a third (33%) of senior roles are held by non-German nationals. Additionally, all British pharma executives surveyed have moved at least once to a foreign country for work, a quarter have lived in two foreign countries and almost a third (31%) in three or more.

“In a highly connected, technology-driven operating environment, pharma executives in the UK are increasingly mobile and rely on international experience to secure top positions in the field,” says Niren Thanky, Partner in Heidrick & Struggles’ London office and a member of the Global Life Sciences Practice.

In the pharmaceutical sector the UK is also the most gender-diverse, with women filling almost four out of 10 (38%) of Country Manager positions compared to only 15% in Germany and 14% in France.

Younger executives and those with significant experience outside pharma are also conspicuous by their absence from the leadership ranks.

Seven out of 10 pharmaceutical Country Managers (71%) have no experience outside the pharmaceutical sector and three-quarters (74%) were promoted internally after spending almost 18 years spent in the same company.

Across the three countries, two-thirds of the pharmaceutical executives surveyed (67%) have a master’s degree, largely in science disciplines (66%), and a similar proportion (67%) also have an advanced degree, usually an MBA (65%).

French executives have the most master degrees, with a total of 86% of them holding one, but it is also the country with the fewest advanced degrees, with only 57.1% of its executives holding one. In contrast, 76.9% of UK executives have an advanced degree.

The medtech sector also lacks diversity. The typical profile of a Country Manager in medtech is a 52-year-old man with a non-science background. Whilst he or she has experience outside the sector, they have still spent an average of 17.4 years in their current company.

He or she does not necessarily have international experience, but has strong sales and marketing skills.

In medtech, however, France leads the way with almost a quarter (22%) of Country Managers being women compared to just 10% in Germany and the UK. One company, Janssen, is notable for its gender diversity, with two-thirds of Country Manager roles being held by women.

Medtech is even less gender-diverse than pharma, with men filling almost nine out of 10 (88%) of Country Manager roles. However, the sector is less conservative than the pharmaceutical industry and more readily attracts executives from other sectors.

However, the overall pattern across the UK, France and Germany shows that at this level, the pharmaceutical industry is still largely dominated by middle-aged men.

The typical Country Manager profile is a 50-year-old man with a science background who has spent an average of 17.8 years in his current company. He has strong international experience and sales and marketing skills.

Half the executives surveyed (49%) were recruited from other sectors and half also have a non-scientific background.

“The pharmaceutical and medtech sectors are already in the midst of disruption. Companies in these sectors need to adapt faster to outpace their competition,” says Thanky.

“While it is encouraging to see that UK firms fare better when it comes to international and female diversity as well as bringing in talent from outside the sector, more progress is needed - and fast - if the pharmaceutical and medtech sectors are to handle the accelerating pace of disruption they will face over the next few years. In general, hiring trends remain too conservative.”

Gamechangers 42

“Seeking greater diversity in the form of gender, experience and thinking is essential at senior levels, given that this population of executives are the ‘feeder’ talent for regional, global and executive committee positions within traditional pharmaceutical and medical device businesses,” adds Thanky. “Ultimately this will create a richer pool of candidates for CEO succession.”

The study is the first of its kind to compare the profiles of Country Managers and European Heads in the pharmaceutical and medical technology sectors in the UK, France and Germany. It examined the nationality, gender, age, education, experience and skills of 65 executives in 16 major pharmaceutical companies and 39 executives in 11 medtech groups across the three countries.

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Niren Thanky PARTNER Niren Thanky is a Partner in Heidrick & Struggles’ London office and a member of the global Life Sciences Practice, focusing on searches for senior executive leaders in the pharmaceutical, biotechnology, medical device, diagnostic and healthcare services sectors.

Prior to joining Heidrick & Struggles, Niren was a consultant with an AIM listed executive search company where he helped build their life sciences practice.

He has several years of pharmaceutical industry experience spanning strategic PR, marketing and discovery research.

As a PR consultant at Chandler Chicco Agency (now part of the global inVentiv Health Group), he worked across several client-service teams, developing competitive product PR strategies for the top five global pharmaceutical companies. He was seconded to work at Merck Sharpe & Dohme, an international pharmaceutical company, to help launch a novel cholesterol-lowering drug in the UK market. Prior to working in PR, Niren was an associate scientist at the Infectious Disease Research Institute in Seattle, WA, US, where he worked on a novel discovery vaccine development program.

Education: Niren holds a Wellcome Trust-funded PhD in infectious diseases and a BSc degree in biochemistry, both from Imperial College London. He is also an associate of the Royal College of Science.

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Healthcare marketers focus on emotion and interactivity to reach millennials They’ve been called the most social-media savvy generation, ardent individualists, and dreamers who seek fulfillment in ways their predecessors can’t fully understand.

Depending on how they’re defined – and there’s no consensus definition – millennials are the nation’s largest living generation. The U.S. Census Bureau defines millennials as those born between the years 1982 and 2000, numbering 83.7 million. Healthcare marketers are finding new ways to reach this group, focusing on their priorities and targeting the communications channels that have the most impact.

Millennials are a distinct generational category because of their openness to a range of different types of media.

Though they are seen to be a digital-first generation, analysts note that what actually sets them apart is their openness to multiple channels. “Compared to any other age group, whether it be Generation X or baby boomers, millennials are open to many different sources of input,” said Jenny Cordina, a partner at consulting firm McKinsey who works on healthcare issues.

In addition, Cordina said, a much smaller proportion of millennials have access to a primary-care practitioner compared with other population groups. As a result, they look to their providers much less often for medical advice than previous generations, seeking information from a variety of sources, including their insurers, websites, and trusted contacts. They are also much more likely to look to social networks to share information about their health.

Cordina said that any marketing campaign needs to go beyond just digital.To healthcare marketers, millennials are seeking a sense of authenticity.“For the greatest generation, they did what the doctor told them to do. Baby boomers would research things, but millennials are looking for something completely different,” said Mark Shipley, a healthcare marketing strategist and CEO of Smith & Jones, a marketing and communications agency focused on hospitals and health systems, noting that millennials seek inspiration, connection and convenience.

Only 41% of millennials said they view a doctor as the best source of health information, compared with 68% of respondents from other generations, according to a new survey of 2,400 adults by GHG / Greyhealth Group and Kantar Health.

And 30% of millennials consult blogs and message boards for health information, compared to just 13% of nonmillennials, the survey found. Millennials also are craving content that is helpful or entertaining rather than a straight sell, Shipley said.

They are also more likely to be receptive if the messaging aligns with their values as well. They want to feel a sense of community by sharing their thoughts and reviews on social networks; and their desire for convenience translates to use of nearby services with minimal wait times. As a result, marketers agree that an effective healthcare marketing strategy for millennials is one that fosters ongoing communication.

“There’s been a shift from buying credibility to earning it,” said Mario Muredda, president of Harrison and Star, noting that messages to millennials need to be constantly evolving.

Social media, particularly Instagram, is being increasingly used in healthcare marketing. A recent example is an FCBled campaign for Teva’s emergency contraception pill, Plan B-One Step. The #perfectlyimperfect campaign brought Dr. Diana Ramos, obstetrician-gynecologist, together with MTV stars Carly Aquilino and Nessa Diab on a tour across U.S. college campuses. Female college students answer a quiz on emergency contraception and post a photo of themselves with a friend on Instagram with the #perfectlyimperfect hashtag, with the goal to break down social stigmas associated emergency contraception.

“Millennials are the newest group to contraceptive use,” said Martha Suarez, senior vice president and group managing director at agency FCB. “They skew higher in unintended pregnancies, and the goal for the brand is to address the lack of knowledge of this product.”

Suarez adds that having a presence on the most relevant communications channels, in this case Instagram, was crucial.

“We have to fight to get into their environment, even if that means their Instagram feed on their phone,” she said. “We can’t expect that market to come to us.”

Original Source: AdvertisingAge

How healthcare marketing is moving beyond the pill Technology is drastically changing how companies engage with consumers, and the healthcare industry is not immune.

Health and pharmaceutical companies are under immense pressure. U.S. healthcare costs are astronomical. The U.S. National Health Expenditure was $3.2 trillion in 2015, amounting to 17.8% of the Gross Domestic Product.

The high cost of treating chronic conditions, like obesity, diabetes, and heart disease, is often cited as a key factor in that figure.

Gamechangers 44

And the current healthcare system rewards providers based on the number of procedures they perform and medications they prescribe.

In an effort to fix the system, the industry is shifting to focus on preventative care. Rather than just treating diseases as they occur, health and pharma companies are seeking to educate people on how to lead healthy lifestyles that will stave off chronic conditions. In addition, they’re looking to get people to take their medication, when necessary.

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“Beyond-the-pill” digital initiatives are a big part of this industry shift. They’re geared towards putting patients first and using technology to regularly engage them. “Beyondthe-pill” offerings range from smartphone apps that tell people when it’s time to take their meds, to connected devices that monitor users’ health, analyze the data, and offer personalized recommendations. eMarketer recently published a comprehensive look at “beyond-the-pill” programs in the recent report: “US Healthcare Beyond the Pill: Digital Tech and New Partnerships Bring New Life to the Industry.”

In addition to providing an overview of the current state of the health and pharma industry, the report also covers specific companies and their “beyond-the-pill” programs, including Biogen, Novo Nordisk, Medtronic, Novartis, and many more.

While “beyond-the-pill” programs are still in the early stages, people appear ready for them. Numerous surveys, like the one below, have found that patients regularly turn to digital resources when they have health questions.

For marketers, “beyond-the-pill” initiatives provide new opportunities to build brand loyalty with customers and providers, which can lead to increased revenue.

“We’re seeing pharmaceutical providers looking for ways to drive engagement and loyalty beyond patent expiries, when generic competitors come into the space,” NewsCred’s Mike Bower, Director of Sales, Health, and Pharmaceuticals, tells eMarketer.

“It’s never been harder than current day to be Big Health or Big Pharma in the United States,” says Bower. “The negative PR storm that’s swarming around it is making it especially difficult to build engagement and trust among your membership or your consumer base, or the doctors with whom you’re trying to engage.”

Original Source: NewsCred

The best in B2C pharmaceutical and healthcare content marketing Today’s consumer is accustomed to having access to the information they need at any moment and being connected to others no matter location. The impact that this hyperconnectivity has had on various industries and consumers is immeasurable and has been one of the most transformative innovations in recent years. One industry that has felt the impact of this connectedness is healthcare. Patients around the world are connected to each other and can find communities to support them no matter what crisis, treatment or therapies they are undergoing. While the patients have benefited greatly from this new sense of communities, the corporations that provide the vital drugs and care that people need have never felt further away.

• 61% of patients look unfavorably on the brands they depend on for their medications (Patient View, 2015) • 9 in 10 Americans believe pharmaceutical and drug companies are generally dishonest (Harris Interactive, 2013) • Only 23% of people claim to have confidence in the US healthcare system (Gallup, 2014)

For marketers, “beyond-the-pill” initiatives provide new opportunities to build brand loyalty with customers and providers, which can lead to increased revenue.

“We’re seeing pharmaceutical providers looking for ways to drive engagement and loyalty beyond patent expiries, when generic competitors come into the space,” NewsCred’s Mike Bower, Director of Sales, Health, and Pharmaceuticals, tells eMarketer.

To regain trust, the best pharmaceutical and healthcare companies are turning to content marketing.

Today’s consumer constantly searches for information online and those searching for healthcare information are no different. 72% of internet users say they looked online in the past year for health information, and 65% of people claim the internet is the first source they turn to for health and wellness information. Pharmaceutical and healthcare companies have a huge opportunity to be the go-to-source of information people around the world are searching for.

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Traditionally, pharmaceutical and healthcare companies have shied away from embracing digital media because of the many restrictions and risks involved for their business. However, Ray Chepseiuk, Commissioner at the Pharmaceutical Advertising Advisory Board, said “digital media, even though it has some risks involved, is a tremendous opportunity for pharmaceutical companies to reach out to newer target audiences and help build that trust by providing useful information that helps them.”

The companies that have embraced content marketing have found great success in establishing trust with their customer base. We reviewed various health and pharmaceutical brands to find out who’s doing content marketing right. We found that the pharmaceutical and healthcare companies that are succeeding in content marketing are using their digital presence to: • Create an emotional connection with their consumers • Build communities for their consumers • Make it easy to access clear health and wellness information Let’s take a deeper look at brands that are doing it right.

Sharing Mayo Clinic

• Patient communities sharing their experiences • Physician specialists discussing patient care, innovations, and new treatments • Students of Mayo Clinic Research Center sharing their perspectives • Other Mayo Clinic professionals discussing the future of healthcare and wellness “Sharing The Mayo Clinic” is built to ease the struggles of patients by creating an emotionally receptive space where they can share their experience and help others. The Mayo Clinic builds community by sharing the stories of real patients and connecting their experiences with millions across the Internet to inspire, comfort and provide solidarity. The blog is a wealth of information that is both educational and inspirational for people suffering from disease.

Keeping their content relevant and relatable is am important component to Sharing’s success. By leveraging usergenerated content where appropriate, the site is able to reach readers at an entirely different level and engage on a personal and relatable level. Readers know that they are connecting with other real people’s stories, which instantly makes the content more emotional and therefore more authentic. These authentic stories are then brought to life through multiple platforms including video. Using video to further connect with patients allows readers to see the faces and hear the voices of the real people behind the stories.

Some videos also feature hospital staff, introducing patients to clinic locations across the country. This approach gives the clinic a community feel where friendly faces are waiting to get to know and help other patients.

Oscar Blog by Oscar Health Insurance

According to a recent study by Kantar Media, 47% of patients reported that reading stories online from fellow patients made them feel positive about their own treatments and outcomes. The Mayo Clinic’s Sharing blog has tapped into that exact sentiment to provide stories that emotionally resonate with their community. The site is an online destination for patients, doctors and families to go to for hope, inspiration and comfort.

Sharing’s goal is clearly stated on their website, and similar to Get Old, is clearly customer focused. “Each year, more than 500,000 unique patients from every U.S. state and nearly 150 countries come to the Mayo Clinic for diagnosis and treatment. These patients and their families and friends, and 50,000 employees and students are part of a global Mayo Clinic community. The goal for the Sharing Mayo Clinic blog is to provide a virtual place for this community to connect and share their experiences.”

The site is centered around the Mayo Clinic community, which is woven together with stories from patients, families, friends and mayo clinic staff members. Topics include: • Physicians and researchers telling stories about their research

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Oscar’s company mission statement “to serve as an insurer that guides customers through the health-care system’s awful complexities,” is inherent in everything Oscar does with their blog being no exception. The Oscar blog was designed with this mission statement in mind and the site mirrors its corporate mission with simple design, clean lines and accessible graphics. The blog features three content pillars: • Oscar RX • We are Oscar • Product Features Oscar’s blog connects to digital natives through its design and intuitive platform. The blog deliberately mirrors Oscar’s corporate aspirations to simplify the complexity of healthcare. Oscar builds community by making customers the hero in all of their content.

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Through patient and doctor profiles and testimony, they foster community on both their blog and social channels.

Through OscarRx, the blog provides easy to understand health and wellness information for any reader. Their articles are holistic in approach and feature practical tips for busy, young professionals to stay healthy.

Original Source: NewsCred

The menopause at work The menopause affects the lives of many workingwomen in the UK. Hot flushes and night sweats can cause a lack of concentration and fatigue, leading to a loss of confidence and poor decision-making. Stress at work can make these symptoms worse. If workingwomen are struggling with their menopausal symptoms, it’s essential that they speak to their employer to see if they can make some changes to their working environment.

In the Winter 2016-17 issue of The Menopause Exchange newsletter, Norma Goldman, founder and director of The Menopause Exchange, discusses the menopause at work.

She looks at the impact of menopausal symptoms on work and which measures can help to make the workplace environment as comfortable as possible.

“It’s important that women are open about their symptoms and any workplace issues, but some are too embarrassed to bring up the topic of the menopause,” says Norma Goldman.

“Employers need to be prepared to help women cope more effectively with their symptoms at work and to make changes if necessary, such as improving ventilation and providing electric fans.”

The Menopause Exchange, which was established in 1999, is completely independent and is not sponsored by any companies.

It provides impartial, easily understood information to women and healthcare professionals. The Menopause Exchange quarterly newsletter contains articles written by top medical experts, such as gynaecologists, GPs, consultants, specialist menopause nurses, pharmacists, dietitians, complementary practitioners etc.

Original Source: Menopause Exchange

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EY M&A Outlook and Firepower Report 2017

Will payer leverage and post-election optimism shift dealmaking into a higher gear?

Payer pressure is growing across a wide spectrum of the health care sector. Price increases have been blunted by election-year rhetoric and competition in key global pharmaceutical markets. Continued portfolio rationalization, a professed preference for bolt-on deals, and lower target company valuations continue to sharpen global appetites for acquisitions into 2017. A distinct firepower advantage combined with suddenly friendly political and tax climates in the US should allow big pharma to seize the M&A agenda.

More than any other time in the past several years, big pharma companies have the firepower advantage necessary to execute on the acquisitions they require to bolster revenue and drug pipelines. And more than any other time in the past several years, those deals are necessary. Big pharma and biotech’s race for inorganic growth has intensified as payers continue to push back on price increases for older drugs and dampen the growth trajectory of newer therapies, especially in increasingly crowded disease areas. Biopharma targets remain less expensive than during their 2015 peaks. M&A has averaged above US$200 billion over the past three years — impressive heights which we deemed the “new normal” in last year’s report. But even so, 2017 could be a banner year for dealmaking, well exceeding this level as industry and political forces converge.

The surprise 2016 US election and UK Brexit results will do little to alter the fundamental strategic drivers of M&A. The seemingly permanent shift toward a more active biopharma deal environment is a consequence of the global biopharmaceutical industry’s structural evolution toward externalizing R&D and an acute response to the power exhibited by US payers in the past few years. That power has gradually begun to resemble the force historically wielded by counterparts in Europe, and has been enabled by encroaching bio-similars on both sides of the Atlantic. It also reflects divestiture strategies put in place to shed underperforming or undersized businesses while refocusing on disease areas where companies can realistically compete for a leadership position. But the expected pro-business regulatory and tax environments ushered in by the year’s geopolitical forces, in particular the possibility of repatriating at least US$100 billion in cash to the target-rich US, may help to unleash more of the industry’s considerable fi repower. The expectation that US pharmas may benefit from any reforms may spur European and other global competitors to accelerate their own dealmaking agendas.

Report: https://goo.gl/WLGvG7 Gamechangers 48

R EPO RTS

EY M&A Outlook and Firepower Report 2017

Will payer leverage and post-election optimism shift dealmaking into a higher gear?

Payer pressure is growing across a wide spectrum of the health care sector. Price increases have been blunted by election-year rhetoric and competition in key global pharmaceutical markets. Continued portfolio rationalization, a professed preference for bolt-on deals, and lower target company valuations continue to sharpen global appetites for acquisitions into 2017. A distinct ďŹ repower advantage combined with suddenly friendly political and tax climates in the US should allow big pharma to seize the M&A agenda.

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More than any other time in the past several years, big pharma companies have the firepower advantage necessary to execute on the acquisitions they require to bolster revenue and drug pipelines. And more than any other time in the past several years, those deals are necessary. Big pharma and biotech’s race for inorganic growth has intensified as payers continue to push back on price increases for older drugs and dampen the growth trajectory of newer therapies, especially in increasingly crowded disease areas. Biopharma targets remain less expensive than during their 2015 peaks. M&A has averaged above US$200 billion over the past three years — impressive heights which we deemed the “new normal” in last year’s report. But even so, 2017 could be a banner year for dealmaking, well exceeding this level as industry and political forces converge.

The surprise 2016 US election and UK Brexit results will do little to alter the fundamental strategic drivers of M&A. The seemingly permanent shift toward a more active biopharma deal environment is a consequence of the global biopharmaceutical industry’s structural evolution toward externalizing R&D and an acute response to the power exhibited by US payers in the past few years. That power has gradually begun to resemble the force historically wielded by counterparts in Europe, and has been enabled by encroaching biosimilars on both sides of the Atlantic. It also reflects divestiture strategies put in place to shed underperforming

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or undersized businesses while refocusing on disease areas where companies can realistically compete for a leadership position. But the expected pro-business regulatory and tax environments ushered in by the year’s geopolitical forces, in particular the possibility of repatriating at least US$100 billion in cash to the target-rich US, may help to unleash more of the industry’s considerable firepower. The expectation that US pharmas may benefit from any reforms may spur European and other global competitors to accelerate their own dealmaking agendas.

Definitions The growth gap is the difference in the sales growth of a biopharma company or biopharma subsector (e.g., big pharma) relative to overall drug market sales. It is based on IMS Health’s global drug market forecast and analysts’ estimates of company sales.

The EY Firepower Index measures a company’s ability to do M&A based on the strength of its balance sheet. Together, a company’s market capitalization, cash equivalents and debt capacity provide the “firepower” for deals. Thus, a company’s firepower increases when either its market capitalization or its cash and equivalents rise — or its debt falls. For more details about the methodology and the assumptions underpinning the EY Firepower Index, please see the Appendix on page 18.

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Exhibit 1. Diabetes: analysts lowering growth projections

Diabetes branded prescription drug sales (US$b)

50

40

30

20

10

0

-10

2010

Growth

2011

2012

Legacy

2013

2014

2015

2016E

Growth: impact of analysts’ revisions

2017E

2018E

2019E

2020E

Legacy: impact of analysts’ revisions

Source: Datamonitor and EY analysis.

Growth: prescription drugs with positive CAGR; Legacy: prescription drugs with negative CAGR

Pricing pressure The timing is fortuitous for pharma. Although 2016 marks the first time in several years that big pharma’s growth gap has not materially expanded, a significant gap remains. In fact, while big pharma has returned to growth in 2016, its growth rate is just shy of the overall market’s.

Evidence of payers’ impact was easy to find in 2016. As companies struggle to boost market share in diabetes, for example — a market already accustomed to contracting with payers — pricing has eroded more quickly than expected across multiple diabetes drug classes. Eli Lilly & Co. grew Humalog US volume by 10% in the third quarter, but normalized sales for that fast-acting insulin actually declined 1%. Lilly then announced in December a deal with Express Scripts to provide major discounts in an effort to increase share. Diabetes competitor Novo Nordisk cited on its third-quarter call the “competitive environment in the US within both diabetes care and biopharmaceuticals” as the reason it wouldn’t hit its 10% operating profit growth target (which it cut to 5%). Other newer diabetes drugs are battling the global payer head winds, including emerging markets, whose slowing economies are constraining health care spending.

So analysts’ forecasts for both older (legacy) and new therapies have been ratcheting down. Revised projections for legacy diabetes drugs, namely insulins, are expected to decline faster than predicted a year ago. Similarly, global growth expectations for new diabetes drugs also have dampened. The net effect: 2020 projected sales have declined by around 15%, or roughly US$7 billion, with this sobering outlook, increasing the urgency for inorganic growth (see Exhibit 1).

Similarly worsening forecasts can be found across multiple therapeutic areas, including central nervous system, respiratory and autoimmune disease. Companies are fighting to keep their therapies on payer formularies and increasing rebates to retain volume or gain acceptance by health technology assessment bodies in Europe. Payers globally have been pushing back harder than ever.

Drug distributors like McKesson and Cardinal Health posted poor quarterly results and increasingly cloudy 2017 forecasts, setting off additional alarm bells for pharma investors. Cardinal warned investors that drugmakers’ responses to pricing criticism would see branded pharma price increases that were more modest than previously expected.

Will payer leverage and post-election optimism shift dealmaking into a higher gear? |

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Biosimilars, now established in emerging market countries — with domestic pharmaceutical manufacturers, most notably in China — are poised to capture share and are pressuring margins in developed markets as well. And fears affecting Europe a year ago have spread to the US, with several new entrants expected to arrive in 2017.

These biosimilars will compete with several iconic biotech brands. Worries about formulary exclusions and increased rebating pushed biotech valuations more than 10% lower and big pharma valuations 5% lower in October alone. The week before the November US election, valuations bottomed out, down 21% on the year.

Although valuations regained some ground in the immediate aftermath of the election, pricing power may not rebound.

Last year in this report, we predicted this emerging payer strength could translate into an additional US$100 billion revenue growth gap by 2020. In 2015, according to Decision Resources, revenue from legacy pharmaceutical products (those products with negative CAGR) was expected to decline 9% annually through 2020. But if that revenue erodes faster, say by 13%, the result could be a US$50 billion revenue shortfall in 2020 compared with projections made in 2015.

Likewise, if the industry’s products with positive revenue CAGR (“growth” products) grow more slowly than expected (at perhaps 14% compared to 2015’s 17% projection), it would result in an additional US$50 billion revenue decline by 2020.

Analysts’ forecast revisions for more recent drug launches over the past year also help illustrate emerging gaps. New sell-side analyst projections from five leading investment banks in late 2016, across a significant slice of the industry’s growth products, incorporate more modest growth than a year ago: 7% versus last year’s expected 10%. Extrapolating across all growth products suggests that in less than a year, analysts have shaved about US$25 billion off their own 2020 revenue projections.

Even in therapeutic markets where biopharma companies have had relatively strong pricing power, such as oncology or rare diseases, continued growth may become difficult. National payers have decided against paying for the breakthrough cystic fibrosis treatment Orkambi in the UK, Ireland, Canada, and Australia, citing insufficient cost-effectiveness (negotiations are continuing). Meanwhile, worldwide spending on cancer drugs had already reached US$100 billion in 2014, according to IMS. Eventually, payers’ cost-cutting strategies will impact cancer drug sales in the US, too.

Finding the drug price “white space” can hedge against payers’ ability to limit growth, but may require pharma to pursue higher-risk, global market opportunities like Alzheimer’s disease. This quest may also drive future M&A as companies compete for the best assets in key therapeutic areas where drug sales currently represent a smaller portion of total related health care costs.

Exhibit 2. Biopharma M&A: big pharma poised to dominate

Announced M&A (US$b)

250 200 150 100 50 -

2007

2008

Big pharma

2009

2010

Big biotech

2011

2012

Specialty pharma

Source: Datamonitor and EY analysis.

Includes all announced acquisitions with financial terms disclosed.

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2013

Generics

2014

2015

2016

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Who’s buying (and selling) what?

Heading into 2017, we expect dealmakers to return to the table in earnest. From 2014-16, yearly M&A totals averaged around US$200 billion, but as a group, big pharma spent on average only 10% of its firepower each year. The strategic drivers and deal conditions are set. In a global poll by EY in mid-October, we saw early signs of this uptick: 43% of life sciences executives claimed to have five or more deals in the works, as opposed to just 6% in our mid-April poll (see EY’s 15th Capital Confidence Barometer at ey.com/ccb).

As of 31 December, total M&A volume exceeded US$200 billion in 2016, in line with the previous two years and signaling a new plateau after nearly a decade averaging well below US$100 billion (see Exhibit 2). Big pharma led the industry surge, with focused growth in more narrowly defined businesses and therapeutic areas continuing to shape the M&A landscape. The largest deals in 2016 also illustrate the industry’s diverging viewpoints with regard to focus and diversification. Bayer’s proposed Monsanto acquisition further diversifies the conglomerate away from pharmaceuticals and

solidifies its position at the top of the agricultural biotech table.

Shire seized Baxter spin-off Baxalta after a lengthy chase that began in 2015, strengthening its leadership in rare diseases.

And Pfizer’s acquisition of Medivation signaled the big pharma’s determination to bulk up its oncology portfolio.

Divestitures remain a major part of the mix. Over the past four years, asset selling by large companies has accounted for about a quarter of all M&A, highlighted by swaps like the US$25 billion Sanofi/Boehringer Ingelheim transaction in June 2016. That deal saw Sanofi’s animal health business exchanged for Boehringer’s consumer unit and cash. In the weeks following the US election, several potential divestitures have been mooted in press reports that represent around US$50 billion in potential deal valuations, suggesting that shedding non-core assets and business units may feature among 2017’s trends as well. In late December 2016, Novartis announced it would out-license US rights to three COPD treatments to Sunovion Pharma, avoiding a bruising battle with that respiratory market’s incumbents.

Heading into 2017, we expect dealmakers to return to the table in earnest. The strategic drivers and deal conditions are set.

Will payer leverage and post-election optimism shift dealmaking into a higher gear? |

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Big biotechs surprisingly remained mostly on the sidelines during 2016, keeping their considerable firepower in check.

On the whole, big biotechs have a greater bias toward organic growth than big pharma. But much of this inactivity can be ascribed to discipline: the handful of big biotechs most expected to pull the trigger on large deals often cited overheated target valuations. But biotech and big pharma valuations fell steadily throughout the year — before the USdriven post-election bounce — as drug pricing concerns gained momentum.

This trend may offer further clues to 2017’s outlook. The last time biopharma valuations experienced such acute

declines was during the 2008 financial crisis. This pronounced downturn was quickly followed by a handful of 2009 megadeals: Pfizer bought Wyeth, Roche bought Genentech, and Merck & Co. bought Schering-Plough. So there’s a precedent for big pharma ramping up dealmaking in 2017, and potentially dominating M&A share for several years.

Unlike in 2008, the factors affecting valuation and firepower declines in 2016 are industry- and business model-driven: pricing pressure, specialty pharma inversion consequences and competition in key markets. Nevertheless, market dynamics advantage big pharma and a small handful of big biotechs.

A considerable force in M&A over the past few years, the specialty pharma set has depleted its firepower and appears likely to remain on the sidelines for 2017.

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Exhibit 3. Found, now lost: specialty pharmas inversion firepower largely depleted 120

Market capitalization (US$b)

350

100

300 80

250

60

200 150

40

100 20

50 0

6

2007

2008

US-based

2009

2010

OUS-based

2011

2012

2013

2014

2015*

2016*

Specialty pharma Õrepower (US$b)

400

0

Firepower

Companies headquartered in the US are considered US-based; companies headquartered outside the US are OUS-based. *After Allergan completed its acquisition of Actavis in March 2015, there were no US-based specialty pharma companies left in our index.

The right vertical axis calibrates the yellow trend line for the value (in US$b) of firepower year-to-year; the left vertical axis calibrates the market capitalization values (in US$b) represented by the light and dark gray bars.

Source: S&P Capital IQ, EY analysis and company financial data. From 2007-15, market capitalizations calculated as of 31 December.

For 2016, market capitalization calculated as of 30 November.

Specialty pharma may sit one out Big pharma’s firepower share gains have come as the specialty pharmaceutical sector lost share. Specialty pharma equity valuations have fallen by 34% on average during 2016. And after a marathon of inversion-fueled M&A from 2013 through 2015 — accounting for over half the biopharma deal volume in that period — specialty pharma’s firepower is depleted. No fewer than six of the largest 10 specialty pharmas have exhausted their firepower, and several are considering divestitures to repair their debt-laden balance sheets that pushed the sector’s debt-to-equity ratio to 67%. Only Allergan, fresh from its sale of its generics business to competitor Teva Pharmaceuticals for US$40 billion, could pursue substantial M&A. Until specialty pharma can replenish its firepower, it is likely to remain on the sidelines for 2017.

Will payer leverage and post-election optimism shift dealmaking into a higher gear? |

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Falling firepower Falling equity valuations and debt raised to fuel previous years’ M&A have resulted in a roughly 20% industry-wide firepower decline. Specialty pharma firepower (down 62%) and big biotech firepower (down 24%) account for about half the decline. Big pharma (down 17%) now nearly equals its largest share of industry firepower in four years (see Exhibit 4). Total firepower for US-based big pharma companies has fallen by 5% from 2015 through 2016; for Japanese pharma and European big pharma the declines have been even greater, 13% and 29%, respectively. Big biotech maintained its firepower share at the expense of debt-laden specialty pharma, among which only Allergan and a few smaller players have firepower (See box: “Specialty pharma may sit one out”). Despite the overall decline, capital allocation priorities favor continued M&A among industry’s largest players.

That M&A is necessary. Most big pharma and some big biotechs have forecast growth through 2020 below the IMSprojected 4% global revenue growth rate for the sector. Put plainly, they have growth gaps (see also “Definitions” on page 2). Pricing pressure on new therapies has impeded recovery from the industry-wide patent

cliff that began several years ago. Companies with growth gaps and shrinking firepower are in the most challenging positions (see Exhibit 5).

While mean firepower declined roughly 17% from 2015, most big pharma companies have relatively large firepower reserves to pursue the M&A necessary to close their growth gaps.

Some companies, including Bristol-Myers Squibb Co. (BMS), have lost firepower as equity valuations fell. Others, including AbbVie, spent firepower on M&A, generating stronger growth outlooks that make firepower declines less relevant. Still others, including AstraZeneca (AZN) and Novartis, face greater challenges in that they need more growth but have declining firepower. A small minority — such as Johnson & Johnson, Merck & Co. and Allergan (after divesting its generics business to Teva) — have increased firepower in 2016, which will give them an advantage when competing for acquisition targets.

And as 2016 waned, Allergan announced it was acquiring LifeCell for nearly $3b while Johnson & Johnson appeared ready to deploy some of its industry-leading firepower: the Swiss biotech Actelion confirmed in late November that it was approached by J&J about a possible transaction.

Exhibit 4. Firepower falls as big pharma gains share

1,200

Firepower (US$b)

1,000

800

600

400

83% 81%

78%

76%

77%

75%

70%

65%

65% 69%

200

0

2007 2008 2009 Big pharma Big biotech

2010 2011 2012 2013 2014 2015 2016 Specialty pharma/generics (%) Big pharma share indicated on yellow bars

Source: S&P Capital IQ and EY analysis.

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Exhibit 5. Firepower dynamics: relative positions drive M&A possibilities

30%

Incyte

Sales growth forecast (CAGR 2015–-20E)

Vertex

20%

Shire

BioMarin

Alexion Regeneron

Celgene

Actelion

10%

AbbVie BMS

Roche Global growth

Eli Lilly

Novo AZN

0%

Bayer

Takeda

Novartis

Abbott

-50%

Eisai

SanoÕ

J&J

Amgen

GSK PÕzer

-40%

Pharma companies

Merck

Astellas Daiichi

Gilead

-10% -60%

Allergan Biogen

Biogen

-30% -20% -10% 0% 10% % change in Õrepower (2015 to 2016) Biotech companies

20%

30%

40%

Size of bubble is based on relative market capitalization

Source: IMS (30 November 2016), S&P Capital IQ (30 November 2016) and EY analysis.

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Exhibit 6. More for less: decline in big pharma firepower is less than targets’ valuations

Average big pharma Õrepower and targets' valuations (US$b)

60 50 40 30 20 10

9

-

2010

2011

Big pharmas' Õrepower

2012

2013

Big biotechs/specialty pharma valuation*

2014

2015

Nov/16

Small-to-mid-cap biotech and specialty pharma valuation**

*24 big biotech and specialty pharma companies **50 small- to mid-cap biotech and specialty pharma companies Source: S&P Capital IQ and EY analysis.

With big pharma in the driver’s seat, it’s worth examining the universe of targets the subsector might pursue. For the first time in several years, larger growth targets that few could afford now appear within reach. Big pharmas’ average firepower now exceeds the average valuations of big biotech and specialty pharma targets, which have fallen by 30% over the past year. Ultimately, this may spur big biotechs to pursue defensive M&A, and as a group they’re poised to participate meaningfully in 2017.

Whether or not they can afford megadeals, most large companies have stated preferences for bolt-on deals. These small-to-mid-cap biotech and specialty targets remain plentiful, and their valuations fell significantly in the past year (see Exhibit 6). Even big pharmas with dwindling firepower can be in the competitive mix for some of these targets. In 2016, more than a third of the M&A dollar volume came from this group: Baxalta and Medivation were joined by Anacor (acquired

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by Pfizer), Dyax (acquired by Shire) and Meda (acquired by Mylan). In 2017, we won’t be surprised to see small- and mid-cap biopharmas representing more than half of all deal volume, as falling valuations and pricing pressures combine to forge M&A in pharma’s battlefield markets.

Ten acquisitions from our basket of 50 possible biopharma target companies (ranging from US$1 billion to US$50 billion in market value, with an average value of US$10 billion, shown as the light gray line in Exhibit 6) would reach US$100 billion in deal volume. Using average revenue projections for these targets, big pharma would be able to add roughly US$30 billion by 2020 to help close growth gaps. And considering the prospect for repatriating more than US$100 billion during 2017, these projections could be conservative.

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Using average revenue projections for these targets, big pharma would be able to add roughly US$30 billion by 2020 to help close growth gaps.

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Laggards in the space may choose to pursue asset swaps or divestitures in favor of doubling down in therapeutic areas where they can more aggressively — and more realistically — pursue leadership opportunities.

Crowded therapeutic battlefields There’s a lot of pressure in highly competitive therapeutic areas like diabetes and autoimmune disease. One quick way to lose formulary positioning? Raise prices in crowded markets such as those that have multiple therapeutic alternatives.

Companies are finding that they have to put large rebates on the table to maintain formulary positions and maximize patient access to their respective drugs, yet the large rebates are clearly impacting net selling price.

Commentary from companies on the pricing pressures helped set in motion the biopharma-wide swoon we saw ahead of the US election in November. These discussions are less common in certain areas like oncology, but even that therapeutic area could be affected.

Within the immuno-oncology area, we see significant portfolio overlaps. For example, there are 20 different PD-1 antibodies in clinical development (including related targets like PD-L1), according to clinicaltrials.gov. Not only does this put a strain on clinical trial infrastructure, but there could be limited bandwidth for winners and eventual payer pressure. Laggards in the space may choose to pursue asset swaps or divestitures in favor of doubling down in therapeutic areas where they can more aggressively — and more realistically — pursue leadership opportunities. GlaxoSmithKline (GSK) did this in 2014 when it divested its oncology business to Novartis, picked up Novartis’ vaccines unit and entered into a joint venture around the Swiss pharma’s consumer portfolio. Others may find willing buyers in the market incumbents that have lost early immuno-oncology battles and face declining share in part due to generic and biosimilar competition or insufficient pipelines (see Exhibit 7).

Pfizer’s Medivation acquisition leaves few acquirable standalone, revenue-generating oncology businesses that can move the needle at a top-20 cancer company. Hence the few remaining significant oncology targets have naturally become the subject of intense M&A speculation as 2016 draws to a close.

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Exhibit 7. Oncology: attractive and increasingly crowded 120

100

Roche

20%

Celgene HĂ•r]j Novartis

Oncology branded prescription drug sales (US$b)

12%

80

BMS 29%

Merck

9%

J&J Amgen

8%

60 10%

AbbVie

7%

4%

AZN 6%

Eli Lilly

12%

40

6%

Astellas

6%

Incyte

5%

Takeda

4%

Bayer

5% 2% 5% 8%

20

3%

2%

4%

4% 3% 3%

1% 2%

7%

0

2015

Others

3% 2% 2%

1%

5%

2020E

Source: Datamonitor (30 November 2016) and EY analysis

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Growth gaps expanding?

The marketplace reaction to biopharma companies’ thirdquarter earnings calls suggests investors did not fully appreciate the industry’s pricing problems. And market forecasters may only now be beginning to discount biosimilars’ potential impact on payer pressure, which may eventually accelerate market erosion in classes that have several competitors vying for share. “In fact, where biosimilars have launched, we’ve already seen about a 26% volume share of branded Remicade switched to biosimilars of infliximab, and so we believe that actually the marketplace on a global basis is really beginning to become more comfortable with the introduction of biosimilars,” Pfizer Essential Health Group President John Young commented during the company’s third quarter earnings call.

And payer leverage is not only evident in mature markets like anti-TNFs. One reason that growth gaps remain is payer pressure in newer markets as well. In the cardiovascular space, Pfizer Chairman and CEO Ian Read cited payer pressure as one reason the company abandoned its phase III PCSK-9 inhibitor bococizumab, which was in line to become the third entrant

in a class once expected to top out at US$20 billion in annual sales but where the first two entrants are having trouble getting out of the gate. The market landscape for lipid-lowering agents is evolving, and success will likely depend on proving long-term efficacy and durability. What’s more, “we have also recently seen payers establish access restrictions to the class, which has meaningfully dampened our initial expectations for the market potential,” Read noted during the Pfizer call.

Payer enthusiasm for competition-driven formulary exclusion or pricing pressure begins even before a new drug class makes it to market. This may dampen projections for potential new blockbuster therapies, especially when multiple new entrants with comparable safety and efficacy profiles approach the market simultaneously, as in the case of anti-PCSK-9s. This could further drive M&A as companies vie to capture assets with demonstrable safety, efficacy or speed-to-market advantages over the competition.

The marketplace reaction to biopharma third-quarter earnings calls suggests investors did not fully appreciate the industry’s pricing problems.

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Exhibit 8. Strategic divergence

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0%

10% Pharma

20% Vaccines

30%

40%

Consumer

50% Animal health

60%

70%

80%

90%

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100% Other

Focused: companies with pharma sales greater than 70%. Includes AstraZeneca, AbbVie, Merck, Eli Lilly, Novartis, Pfizer, Boehringer Ingelheim, Roche and Sanofi.

Diversified: companies with pharma sales less than 50%. Includes Abbott, Bayer, GSK and Johnson & Johnson.

Other: includes Crop Science (Bayer), Nutrition (Abbott) and Alcon (Novartis).

Source: Datamonitor, using pro forma 2017 sales.

Firepower unleashed — record M&A in 2017?

As the probability of revenue shortfalls increases across the industry, even companies with ostensibly solid growth prospects may pursue M&A to guard against downside scenarios. From a macro perspective, the biopharma industry enjoys M&A momentum. There had been pent-up demand for deals in a holding pattern going into the presidential election, but the deal chatter in the waning weeks of 2016 indicate much firepower could soon be unleashed in 2017 based on these drivers: • The payer growth gap has become a reality. As therapeutic battlefield competition intensifies and pricing pressure mounts, the payer growth gap has moved from concept to reality. Last year’s theoretical worries have become this year’s reduced revenue outlooks.

• Finding growth in traditional strongholds is becoming increasingly difficult. Yesterday’s breakthrough innovations in disease areas, such as autoimmune disease and oncology, have become today’s crowded therapeutic battlefields, forcing the industry to seek therapeutic “white spaces” in underserved areas of increasingly high health care system expense. Therapeutic areas like Alzheimer’s disease remain high-risk, but pharmaceuticals represent only about 1% of this US$250 billion health care cost sink. Better disease biology understanding and clinical trial design informed by improved diagnostics may eventually help reverse pharmas’ fortunes in this and other drug development graveyards.

• Plenty of firepower remains unspent. Even if falling firepower is likely to limit some players that were active on the M&A stage over the past few years, those that had saved firepower are now poised to act. Big pharma and big biotech, which have on average spent only about 10% of their firepower on M&A annually over the past several years, may participate more meaningfully in 2017.

• US political climate becomes more favorable. Now that the election is over, regulatory and tax reform could create a positive dealmaking environment, offsetting lost firepower by freeing cash trapped overseas to deploy for growthboosting M&A. Comprehensive tax reform could also narrow the tax rate gap between companies that didn’t invert and those that did — creating more competitive tension on the M&A playing field, while providing prospects for accretive deals to move forward. In general, Republican Congressional majorities are viewed as more business-friendly, and biopharma CEOs and boards may have more confidence to pursue deals. Capital has remained inexpensive thanks to low interest rates, but those rates have begun to rise.

• Waning ex-US advantages. Pharmaceutical companies with ex-US tax domiciles have enjoyed a dealmaking advantage over their US counterparts. US tax policy reform may lessen or erase that benefit and global pharmas seeking US market growth may opt to accelerate M&A plans moving into 2017.

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Certain companies may alternatively or in parallel pursue further diversification away from the pharma core business.

GSK, Merck KGaA, Bayer and others have already done so, as they’ve sought growth opportunities in adjacent life sciences business areas (see Exhibit 8). Non-core businesses may be the road less traveled for most of pharma, but they are projected to account for around US$150 billion in sales in 2016 out of a total of US$500 billion. We expect transactions in most, if not all, subsectors in 2017.

November that the pharmaceutical industry acknowledge the math as it adapts to a value-based pricing environment. A drug price can’t grow by 11% unless it’s causing overall costs to decrease by 12%, he noted. “The reality is that in the next few years, these costs will put unsustainable pressure on the Medicare program.” The US president-elect Donald Trump evidently agrees. “I’m going to bring down drug prices. I don’t like what’s happened with drug prices,” he told TIME magazine in December, prompting a biotech market swoon.

Those companies with a relatively smaller US pharma footprint have in some cases strategically limited their exposure to these emerging US pricing concerns. GSK anticipated the current US pricing dynamic earlier than most companies.

“There are tremendous market forces at work in terms of the way in which the US market is changing, who’s making the decisions, who’s controlling the lives,” CEO Andrew Witty noted on the company’s third quarter earnings call. “The fact that we’ve absorbed so much pain on pricing over the last three years actually puts us in a more interesting zone” as GSK’s respiratory franchise battles generic competition, he noted.

The likelihood that prices won’t increase to the extent investors had once envisioned will only heighten the industry’s need for inorganic growth. Crowded therapeutic areas must consolidate, abetted by increased asset swapping, as companies strive to “own the disease” with a comprehensive portfolio approach to better prepare for payer negotiations. As we’ve seen with oncology, even disease areas where pharma has traditionally enjoyed a relatively free hand with pricing are not immune. With drug costs as a percentage of overall costs already high in oncology, it’s not difficult to see why.

Successful M&A going forward will require more rigorous industry pricing analysis. Independent of who becomes the next US president, payer pressures in the form of competitive rebating and formulary exclusions will continue. Some of those companies that have been saving firepower for a rainy day may look out the windows and see storm clouds.

Acting administrator for the Centers for Medicare & Medicaid Services Andy Slavitt suggested during an industry talk in early

Adding it all up, divestitures, therapeutic battlefield consolidation and activity in remaining unmet therapeutic needs might easily drive the US$200 billion in deal volume that the biopharma industry has enjoyed over the past few years, even without such favorable M&A conditions. But 2017, with unprecedented payer pressure, a deal tail wind from macro forces, and an unusually full M&A pipeline, is likely to push biopharma dealmaking to new heights.

2017 and beyond: a new page for biopharma’s M&A playbook Entering 2017, biopharma companies should consider pre-emptive measures to address growth challenges.

• Prepare to move quickly. US tax reform and a friendly political climate will likely emerge in 2017. US companies must now figure out how to best utilize offshore cash to fulfill their M&A aspirations. Waiting for legislation creates a competitive disadvantage and may result in lost opportunities. Ex-US companies should anticipate these moves, take pre-emptive measures and accelerate M&A decision-making.

• Deal premiums require firepower reserves; find them now. Winning a competitive deal in desirable growth categories may require incremental firepower. Consider proactively divesting or asset swapping to facilitate dealmaking.

• Focus on the downside. Anticipating future growth gaps in strategic franchises highlights the need for M&A. Rising deal pipelines across the industry reflect this forward thinking.

• In to win? Evidence of increasing payer pushback in key pharma therapeutic areas heightens the risks for second-tier players. Companies on the margins may look to gain share through M&A — or divest ahead of the competition to lock in more favorable terms. This is true within the biopharma space as well as for companies with businesses in adjacent business sectors weighing the benefits of diversification.

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Unprecedented payer pressure, a deal tail wind from macro forces, and an unusually full M&A pipeline, is likely to push biopharma dealmaking to new heights in 2017.

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Appendix: Methodology and definitions The EY Firepower Index measures companies’ capacity to fund transactions based on the strength of their balance sheets. It has four key inputs: 1. Cash and equivalents 2. Existing debt 3. Debt capacity, including credit lines 4. Market capitalization The following assumptions are the underlying factors for the EY Firepower Index: • A company will not acquire targets that exceed 50% of its existing market capitalization.

• The debt/equity ratio of the combined entity created by a transaction cannot exceed 30%. (Equity is measured on a market value basis.)

While some pharma companies have made acquisitions that go beyond these upper limits, our intent is to apply a uniform methodology to measure relative changes in firepower. The EY Firepower Index measures the capacity to conduct M&A transactions financed with cash or debt. It does not measure the ability to conduct stock-for-stock transactions. However, increases in a company’s stock price do boost its firepower under the EY Firepower Index’s formula. That is because increased equity enables companies to borrow more to finance transactions.

While the EY Firepower Index and this report focus on M&A, we acknowledge that licensing will remain an important business development strategy. However, in assessing the growth gaps of big pharmas, M&A is more relevant than in-licensing, since acquiring companies with commercialized products has a more immediate effect on a pharma company’s revenue gap than does in-licensing pipeline assets.

In this report, we include the following companies in the big pharma category: • • • • • • • • • •

Abbott Laboratories Inc. AbbVie Inc. Astellas Pharma Inc. AstraZeneca plc Bayer AG Bristol-Myers Squibb Company Daiichi Sankyo Company Ltd. Eisai Co. Ltd. Eli Lilly and Company GlaxoSmithKline plc

• • • • • • •

Johnson & Johnson Merck & Co. Inc. Novartis AG Pfizer Inc. Roche Holding AG Sanofi Takeda Pharmaceutical Co. Ltd.

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We include the following companies in the big biotech category: • • • • • • •

Alexion Pharmaceuticals Inc. Amgen Inc. Baxalta plc Biogen Idec BioMarin Pharmaceutical Inc. Celgene Corp.

Gilead Sciences Inc.

• • • • •

Incyte Corp.

Novo Nordisk A/S Regeneron Pharmaceuticals Inc. Seattle Genetics Inc. Vertex Pharmaceuticals Inc.

We include the following companies in the specialty pharma/ generics category: • • • • • •

Alkermes Allergan plc Endo International plc Jazz Pharmaceuticals plc Mylan Inc. Perrigo Company

• Shire plc • Teva Pharmaceutical Industries Ltd. • UCB • Valeant Pharmaceuticals International Inc.

Four companies in the specialty pharma/generics list have generics businesses (Allergan, Endo, Mylan and Teva).

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Contacts Pamela Spence EY Global Life Sciences Industry Leader pspence2@uk.ey.com +44 7979 708469 Twitter: @pamelaspence_EY Glen Giovannetti EY Global Biotechnology Leader glen.giovannetti@ey.com +1 617 374 6218 Twitter: @GlenGiovannetti Jeffrey Greene EY Global Transaction Advisory Services Leader, Life Sciences jeffrey.greene@ey.com +1 212 773 6500 Twitter: @JeffreyRGreene Andrew Forman (principal author) EY Global Transaction Advisory Services Sector Resident, Life Sciences andrew.forman@ey.com +1 732 516 4698 Twitter: @FormanAndrew

Acknowledgments Our sincere thanks to EY Global Life Sciences Transaction Advisory Services Leader Jeff Greene for guiding the report’s strategic direction and providing industry insights based on his years of experience, and to the principal author of the report, EY Global Life Sciences Transaction Advisory Services Senior Manager Andrew Forman, for providing in-depth analysis of the industry trends and developing the report’s key themes. Thank you also to Harish Kumar, Shivam Jaitly and Jasraj Sokhi from EY Global Delivery Services Group for their important contributions and help with the analysis and exhibits. And special thanks to Chris Morrison, contributing writer and report editor, for his invaluable role in creating this year’s report and in shaping the narrative.

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Digital Health: Total Convergence Healthca

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Integrating technology to solve the worldâ&#x20AC;&#x2122;s healthcare challenges The current challenge in digital healthcare is no longer purely about technology. Companies have to figure out how to initiate entire healthcare ecosystems to adopt new technology-enabled ways of meeting the innumerable challenges faced in healthcare.

Digital health hubs: Scaling up digital health solutions for the world The interactions between technology and healthcare ecosystems in different parts of the world are creating digital health hubs with distinct areas of specialisation and focal points that have formed in response to local healthcare challenges. Clearstate examines how the geographical dispersion of innovations and testing of digital health solutions will be critical to the implementation of high-impact solutions on a global scale.

Digital divide: Locating technologyâ&#x20AC;&#x2122;s value proposition in different markets Digital health instantiates itself uniquely in different countries and markets, each of which faces its own particular set of healthcare challenges. The value offered by digital healthcare lies in the way in which companies can apply recent breakthroughs in science and technology to different healthcare challenges to bring value to users. We examine how companies are extending their reach to new patient pools and markets by growing telehealth use in different settings and geographies. We also look at data-driven solutions that can be used to create smarter, more efficient and more precise healthcare delivery and better patient experiences.

Digital adoption will prompt a radical rethink of existing customer segments Digital technology is creating new market spaces in healthcare. New customer segments, such as internet hospitals, have emerged. Digital technology has also reshuffled the delivery points of the various medical services, in a way that will create opportunities in decentralised and near-patient products and services. Patient pathways and journeys will need to be remapped in response to patient demand for technologically enhanced products and services.

Report: https://goo.gl/7sd8bf Gamechangers68

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The pharm engaged aceutical indust ry in distributi researching, dev is comprised of ng compan eloping, ies drugs hav drugs for huma manufac investme n tur e an eno nt requir health, rmous po or veterinary use 1 ing and U.S. pat ed to bri pro sitive inf . New ent term ng a pro lives, inc sperity and eco lue duct to is 20 yea at least reasing nomic pro nce on global ma five yea rs, and life spans, preventin ductivity drugs are rket. The rs of the time reducing g surger by saving eligible between market exclus Advances ies suf for ivity dep Drug Ad in medic and shortening fering, ending ministratiopatent validity and hav ine ho on spital and U.S have elim pharmace n e bro . Food and inated dea stays. utical ind (FDA) approval. under con ught other life developm dly dis The ust -threaten tro ent of new ry is heavily dep nearly eve l. Drug therap ing condit eases str eam endent y molec of older on the breakthro ry facet of health is now an integr ions drugs tha ules to replace expiratio al part of care, and ughs pro the revenu t are app n of non-c mise to roaching designed of their patent e ommunic revolutio new the ter to cover able dis nize the Generic past and ms. Pricing of new eases. treatment drugs are future R& Understa drugs is that con copies of D nding Pha tain the innovative expenditures. rmaceuti sam identical pharmace cal Indust in streng e active ingred For the uti ry cal Pro ien adm th, s sak ducts ts dosage inistra form and and are ‘pharmace e of simplicity expiratio tion. In the Un and route of ited Sta n or a suc refers to uticals’ (or ‘drugs unless otherw tes a manu ise innovative ’, ‘medic facturer cessful challen , upon either pat derived ines’) in noted, and gen ge of rel can pro meets FD and bio thi eric pro evant pat ent duce a logicallyA approv prescript ducts, che s report ents, derived Generic al and bio generic drug as ion micallyproducts compan lon below for -based and ove equ g as ivalence , and ies typica earn pro r-the-cou a breakd standard 3 it lly foc fits sectors: own of nter pro s. pharmace and distrib , requiring efficie us on high vol du um utical pro cts. See nt produ ution cha ction me es to duct ins. 4 Pharmace thods Generics uticals (bio medicine tha s) are def pharmaceutical known as t are sold under use in the ine s, “commod the che are often diagnosis, d as any substa drugs, mical nam ity generi preventio nce intend manufac cure, mit n and com tured by cs.” Commodity e are food) int of disease or any igation, treatm ed for pet more tha gen end ent or marketed e mainly on pri n one com erics substance ce. body. 2 Dru ed to affect the by a dru typically g compan “Branded gen pany structure (other than gs are pro erics” are comma tablets, y or un du fun der ced nd higher ction of generics. capsules, its in forms the prices tha own label and vials, oin and sus such as pensions. pills, tments, n non-b rand powders , solution Biologics s (biotech Innovative biopharm dru aceutical gs, biological developed (originator) che drugs, such as mically-de s) includ through vac e both hu rive extensive ma componen cines, therapeut a wide range of R&D and d drugs are products ic protei patents, ns and animals. clinical synthesize ts, tissues, etc. ns, blood reg The In contra intellectu ulatory data pro innovator rel trials in and blo d dru gs, st od and can ies on al proper tection be thorou which have a we to chemically and oth ty rights from livi ll-defined er forms ghly ver (IPR) to ng ifie of justify the structure plant) and material (huma d, biologics are n, ani derived are vastly This cas larger and mal, microorga e study nism or is par more com plex in U.S. Depar t of a larger Top 2016 ITA Marke tment of Pharm aceutical Commerc ts Report. For s Top Ma additional e | Intern rkets Re conten ational t, please port Trade Ad vis 1 ministra tion | Ind it www.trade.gov/ top ustry & Analysis markets.

The pharmaceutical industry is comprised of companies engaged in researching, developing, manufacturing and distributing drugs for human or veterinary use.

New drugs have an enormous positive influence on global health, prosperity and economic productivity by saving lives, increasing life spans, reducing suffering, preventing surgeries and shortening hospital stays.

Advances in medicine have eliminated deadly diseases and have brought other life-threatening conditions under control.

Drug therapy is now an integral part of nearly every facet of healthcare, and new breakthroughs promise to revolutionize the treatment of non-communicable diseases.

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