The Blue Vanguard Vol.2

2012

NOVEMBER

Vol. 2 05 NATIONAL ISSUES Contraceptive Pills for Whom?

13 COVER STORY Can You Define the Value of Medical Service in One Way? 22 CAMPUS ISSUES Yonsei Atheletics Day

2012 vol.2

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Editor's Note The Blue Vanguard is published once a semester

by Yonsei Pharmacy students.

The second issue is published on Nov 2012.

Editor-in-chief Jane Suh Vice editor-in-chief Misun Park Journalists Senior Junior Youngsuk Yi Seolkyung Kim Jongsung Han Gayeong Heo Jiyoung Jung Yongjung Jang Soojin Lee Gyehee Yi Hyejin Cho Harin Lee Minju Kang Designed by The Blue Vanguard English advisor YIC CETS Sponsored by Sanofi-Aventis Korea Medtronic Korea Co., Ltd. Editorial office 103 C-dong, International campus of Yonsei University, Songdo-dong, Yeonsu-gu, Incheon city, Republic of Korea

Jane Suh

Let us celebrate the success of the second issue of The Blue Vanguard! It was not easy to start from scratch. Yet the first volume of The Blue Vanguard was successfully launched in celebration of the alumni association night on May 7th, 2012. A thousand copies of The Blue Vanguard were distributed to colleges of Pharmacy, university hospitals, KFDA in Korea, and organizations overseas. Following the event, The Blue Vanguard was interviewed and featured on May 23rd

by DailyPharm, which is the first Korean online news media dealing with Korea’s public health, medical and pharmaceutical issues.

We are excited to announce the recruitment of five new members this semester. Readers will be able to see the result of their enthusiasm as new journalists in this issue. As a result, the second volume of The Blue Vanguard now presents new sections such as introducing a research of College of Pharmacy, Yonsei University, and delivers more stories. With domestic issues, one might easily ask a question, among women, pharmacists, doctors, religious groups or human rights group, whose benefit should be prioritized? On the other hand, we should also be aware of international pharmacy news. Are medicines public goods or economical resources? In the cover story, this debatable issue is discussed as a matter of whether for-profit hospital should be authorized in Songdo and Jeju in Korea.

I am glad that now The Blue Vanguard conveys a greater variety of news for readers in many different fields. What we hope to achieve with this issue is for pharmacy students to be aware of the roles of a pharmacist in today's society and have consciousness as world citizens. We would like to communicate with colleges of pharmacy and public health-related professionals around the world through The Blue Vanguard. As editor-in-chief of The Blue Vanguard, I thank all readers for your support and attention. We also express gratitude to our sponsor, Sanofi-Aventis Korea and Medtronic Korea Co., Ltd.

Jane Suh 2

the blue vanguard

The Blue

Vanguard

CONTENTS 02 Editor’s column 04 National Issues

- Contraceptive Pills for Whom?

- The New DRG Policy - Generic Drug War after Expiration of Viagra

09 International Issues

- German Thalidomide Maker Gruenenthal Issues Apology - Can Novartis Save Glivec in India?

- Women and Affordable Care Act

13 Cover Story

- Can You Define the Value of Medical Service in One Way?

17 People

- Meet a Pharmacognosist in the Netherlands - Interview with Severance Director of Pharmacy

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28 28

22 Campus Issues

- Yonsei Atheletics Day - The 22nd National Association of Pharmacy Student Unions - Combined Bachelor’s and Master’s Degree Program

28 Global Network - Meet a Friend on the Street

30 Professor’s Reserch - Professor Sungjoo Whang

32 Column

- Pharmparazzi Make Pharmacies Nervous

35 Culture

- See the World through the Screen - Broaden Your View by Reading

37 Epilogue 09

38 Feedback 2012 vol.2

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National Issues

Birth Control Pills : a combination of estrogen and progesterone, two hormones that inhibit ovulation Emergency Contraceptive Pills : consist of progestin which prevents the fertilized egg from being implanted in the uterus, known as the “morning-after pills”

Contraceptive Pills for Whom?

The current categorization for the contraceptive pills will remain on hold for the next three years Misun Park misunpark@yonsei.ac.kr

E

novid, the world’s first oral contraceptive pill, celebrated its 52nd anniversary this year.

Contraceptive pills have great effects upon women’s lives by helping to prevent unwanted pregnancies and assisting working women in developing their careers while planning for family.

The pills have become one of the most essential items for modern people in spite of concerns such as irresponsible sex and a trend to make light of human life.

However, contraceptive pills have recently been involved in controversy following the Korea Food and Drug Administration (KFDA)’s announcement, on June 7th, to re-classify birth control pills as prescription drugs and, on the other hand, emergency contraceptive pills as OTC.

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What is your opinion on concerning the transfer of birth control pills from OTC drugs to prescription drugs?

17%

Male Agree Disagree

83%

29%

Female Agree Disagree

71%

What is your opinion on concerning the transfer of emergency contraceptive pills from prescription drugs to OTC drugs?

13%

Female

Male 87%

Agree Disagree

51%

49%

Agree Disagree

The Blue Vanguard surveyed 64students at Yonsei University

National Issues

pills. Religious groups, anti-abortion civic organizations, and the Korean Medical Association claimed that all contraceptive pills should be classified as prescription drugs while women’s organizations and the Korean Pharmaceutical Association claimed that all contraceptive pills should be classified as OTC.

www.sarpkingdawn.com

June 7, 2012, KDFA announced that it would re-classify 273 over-the-counter drugs(OTC) as prescription drugs and, on the other hand, 212 prescription drugs as OTC. This re-classification included that birth control pills, which were OTC for the last 41 years, would require a prescription. Additionally, emergency contraceptive pills, which require a prescription, would be available over the counter at pharmacies. However, the Central Pharmaceutical Affairs Council in the Ministry of Health and Welfare reversed its original decision two months later, announcing that it would maintain its current categorization regarding contraceptive pills for the next 3 years.

Contraceptive pills raise important questions to sensitive social issues such as women’s health, their social status, and bioethics.

As a result, on June 15th, various non-medical associations as well as medical associations joined the dispute in a public hearing about the re-categorization of contraceptive

The logical basis of people who argue that all forms of contraceptive pills should be prescribed by doctors are as follows. First, the safety of women should be priority. Many people who use contraceptive pills are not aware of the side effects. These pills could cause menstrual irregularity, nausea, and thrombosis (the formation of a blood clot in a person's heart or in one of their blood vessels). Also, the pills seriously harm patients with endometrial cancer and breast cancer. Doctors said only medical personnel can provide the public with accurate medical information.

Moreover, if people can have access to contraceptive pills more easily, they can become desensitized to the sanctity of life. Religious circles state that treating human embryos with chemical drugs is an abortive action. Lastly, the misuse of such pills could encourage irresponsible sex, especially for teenagers who can not yet make proper infromed decisions concerning sex.

On the other hand, the arguments from the organizations demanding to change contraceptive pills from prescription drugs to OTC drugs are as follows. First, contraceptive pills should be made more accessible since they have already been proven safe through the OTC system. Sex is still a

taboo subject in Korea, and women’s privacy should be respected. Many women are reluctant to visit medical clinics because they worry that they might appear promiscuous to others.

Also, many women prefer not to leave records of their prescription histories. Second, contraceptive pills are safer than abortion for those who had unwanted sex, such as victims of rape. Regrettably, as only a few medical institutions in Korea are available on the weekends, women can not be protected in a timely manner. (Experts recommend taking emergency contraceptive pills within 72 hours after sex because the remedial effect does not work after implantation) In addition, receiving a prescription means that it could be a financial burden to the national health care budget and family budget.

SAFETY versus

ACCESSIBILITY Whenever issues about law revision for medicines emerge, the values of health and safety have come into conflict with the values of accessibility to the public and convenience. For this time, however, women, as the main agents of pregnancy and child birth, should have a greater say in this debate about “the pill”, rather than other interested parties, like doctors and pharmacists. B 2012 vol.2

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National issue

The New DRG Policy : For whom is this policy intended?

Kang Minju mkang28@yonsei.ac.kr

R

ecently, the government enforced a policy on health care coverage called ‘Diagnosis Related Group (DRG)’. Implementing the DRG policy became a big social issue causing division between supporters and opposers. The Korean Medical Association strongly confronted with the government by refusing to operate on patients.

The DRG is the policy that provides budgeted medical treatments (or sets the treatment fees) according to the patients’ diagnosis results, regardless of the type of treatment, including tests, operations and administrations of medications. Korean government authorities first introduced the DRG policy in 1997 on a trial basis, giving the doctor options whether to implement the DRG in individual clinics or hospitals from 2002 to June in 2012. The reason why the DRG policy is receiving renewed attention is that from July 1st 2012, doctors no longer have an option but are obligated to follow this policy.

'Diagnosis related group(DRG)' vs 'Fee for service(FFS)' 'Diagnosis of related group' : the policy that provides budgeted medical treatment (or sets the treatment fees) according to patients’ diagnosis results regardless of kinds of medical services such as tests, operations and the administrations of medications, - Diseases covered by DRG policy: cataract operations, tonsillectomy, adenoidectomy, anus operations, herniotomy, appendectomy, Caesarean operation, adneelomy 'Fee for service(FFS)': If a doctor provides a service, total treatment fees are the sum of all service fees. In this policy, patients must pay for all of their treatments. Until now, ‘FFS’ has been the basis of the Korean medical insurance system.

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National issue

Depriviation of the patients' right to choose high-quality medical services Complications may arise because patients are not given essential treatments due to set fees

VS

Reduction of financial burden on patients

Doctors insist that equalized medical services lower the quality of medicine. They also insist that additional costs will be incurred because of complications caused by under-treatment. For these reasons, they oppose the DRG policy. However, It is clear that hidden behind these claims is the real reasons for the doctors opposition: they will make less money under the DRG policy than the past ‘fee for service’ policy.

On the other hand, the government which is enforcing the DRG policy insists that no health problems will occur because the DRG policy subdivides the classes of diseases according to the degree of severity, and determine the medical insurance fees according to the class. In the government’s view, the advantage of implementing the DRG policy is to prevent the doctor from overcharging for excessive medical service and to reduce the patient’s burden in treatment fee. Through these measures, the National health insurance will recover from financial degeneration. The unpalatable truth is that both the government and doctors more focused on financial benefits and loss although they appear to be concerned about the public health.

Dealing with simple diseases, patients don’t have to get expensive and high-tech medical service. During the trial period of the DRG, about 70% of small and medium hospitals adopted it. This figure proves that the DRG policy in the small and medium hospitals are practical

Prevention of decrease in medical service quaility through specialized hospitals and patients' monitoring

and effective in cost. On the other hand, if patients need more professional and high-tech but expensive medical care, they can choose to be treated in the large general hospitals which are usually based on ‘fee-for-service’ to deal with more serious diseases. Based on the ‘fee-forservice’ policy, doctors can provide high-quality medical service and develop medical technology. Like this, each policy has its own advantage. The best way to satisfy all related persons, especially patients, is perhaps by combining the two policies appropriately because until now, these combined policies worked very well and by maintaining them.

Will there be a positive outcome for the patients in the fight between the Korean Medical Association and the government? Although there are many related people in the center of this hot issue, the most important factor should be the patients. The Korean Medical Association and the government each have each reasonable opinions. What they need is to negotiate each opinion.

In this process, patients should come first. B 2012 vol.2

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NATIONAL ISSUES

Generic Drug War After Expiration of Viagra

Lee Soojin soojinlee88@yonsei.ac.kr

E

rectile dysfunction is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance. The erectile dysfunction pill market profit is greater than you can imagine.

Viagra, the bestseller of this market, has sold millions annually around the world. Pfizer, which is a global pharmaceutical company, has earned about 40 billion won from the sale of Viagra in Korea last year.

Pfizer developed sildenafil as a pharmaceutical compound and has held its substance patent in Korea since 1994. After that time, sildenafil is proved to be very helpful for patients with erectile dysfunction so Pfizer applied for a utility patent for sildenafil as an erectile dysfunction treatment under the brand name Viagra. However, the substance patent of Viagra expired on May 17th, 2012. This means other companies can produce generic versions of Viagra.

Even before the expiration of the patent, competition to gain an early edge had already started. Some pharmaceutical companies took the initiative of producing and packaging their own generic versions of Viagra in order to release them immediately after the expiration of the patent.

Since the effect of generic drugs is similar, pharmaceutical companies need to grab attention from possible customers to survive in the competitive market.

Many

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pharmaceutical companies tried using attention-grabbing and erotic names. However, the Korean Urological Association advised the pharmaceutical companies to abstain from using indecent names.

Another problem is proliferation of illegal advertisements. The sale of “Pal-pal tablet”, produced by Hanmi Pharmaceutical company, was banned for a month because of an advertisement which declares the drug’s exact price. Also, SK Chemical was prohibited from selling their version of Viagra for 3 months because it violated a law banning “public advertisement of prescription drugs”.

Viagra has been regarded as a controversial drug because a lot of people think it is a kind of sexual stamina booster instead of a treatment for erectile dysfunction.

Moreover, some men who do not have erectile dysfunction take this medicine even though it can be dangerous to them. Furthermore, lots of people mistakenly think that “the more they take it, the better it works”. With this dangerous thought, people have misused and abused Viagra.

As generic versions of Viagra are much cheaper than Viagra, problems of misuse and abuse could become serious. If men take even more Viagra than the standard dose, they could experience hearingimpairment or more serious erectile dysfunction. For patients who suffer

from cardiovascular disease, it can cause heart failure. This is also the same for generic versions of Viagra.

Misuse and abuse of these medicine could become more serious because generic drugs are sold at one third of the original price. While Viagra sells at about 12 thousand won per pill, generic drugs sell from 3,000 to 5,000 won per pill. Because generic drugs are cheaper, men might purchase more of the erectile dysfunction medicine.

However, there are advantages to launching many generic versions of Viagra. Those who split Viagra tablets into two due to their high price do not need to do so because new generic drugs can be purchased at a cheaper price. Also, the generic drugs could lead to the reduction of this black market. People who used to depend on illegal Chinese versions of Viagra no longer need to do so.

Although Viagra has been misused and abused so far, customers need to be wiser now.

Patients should not forget to be advised by doctors or pharmacists when taking these generic versions of Viagra. Pharmaceutical companies which produce the generic versions of Viagra should not confuse customers with misleading marketing strategies. Doctors and pharmacists, as well, should pay attention to prescribe and dispense these drugs not becoming swayed by pharmaceutical companies. B

global issues

German Thalidomide Maker Gruenenthal Issues Apology Hyejin Cho heajindayo@yonsei.ac.kr

regretted that the potential for thalidomide to affect the development of fetuses "could not be detected by the tests that we and others carried out before it was marketed."

O

n August 31, 2012, Gruenenthal Group which invented thalidomide held a ceremony in the western German city of Stolberg, where the company is based. Thalidomide, sold in the 1950s as a cure for morning sickness, was linked to birth defects and withdrawn in 1961. The drug’s name was ‘Contergan’ at that time. Harald Stock, Gruenenthal's chief executive, expressed his company's first apology in 50 years to thousands of people born with disabilities after their mothers took the drug.

In 1961, by the time the drug was pulled from the market, more than 10,000 babies worldwide had been born with a range of disabilities caused by the drug. This included shortened arms and legs, blindness, deafness, heart problems and brain damage. There are between 5,000 and 6,000 sufferers that still live with these serious health conditions. Mr. Stock said the company

Gruenenthal had previously paid some compensation to victims of the drug, many in Germany, and had voiced regret over the issue - but had not admitted liability. The reason is that the drug they sold had met the criteria of clinical test when it was developed. However, they realized that they had to express regrets to the victims.

Mr. Stock clarified his company’s position at the unveiling of a bronze statue symbolizing a child born without limbs because of thalidomide. "We ask for forgiveness that for nearly 50 years we didn't find a way of reaching out to you from person to person," he said. "We ask that you regard our long silence as a sign of the shock that your fate has caused us. We wish that the thalidomide tragedy had never happened. We see both the physical hardship and the emotional stress that the affected, their families, particularly their mothers, had to suffer because of thalidomide which they still endure day by day."

The Thalidomide tragedy serves as a grave lesson not only to pharmaceutical companies, but also to legal circles and governments. After this tragic incident, there have been groundbreaking efforts and improvements to tighten standards of obtaining permissions from FDAs and to minimize the risks and adverse effects of drugs.

Consequently, Gruenenthal pledged that they will continue to make persistent efforts to help the victims and their families. B

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GLOBAL ISSUES

Can Novartis Save Glivec in India?

Lee Soojin soojinlee88@yonsei.ac.kr

What is Trade Related Intellectual Properties(TRIPs) Agreement?

TRIPs Agreement Article 27, Section 1; Subject for patent - In all technology fields, any invention concerning substance or use can obtain a patent if the invention is new, progressive, and valuable in industry.

- According to the article, India can grant substance patents. It was retroactively applied from 1st January 1995.

In India since 1995, it has been impossible to produce generic version of a drug if the owner applied for the patent after 1995.

Indian Patent Law Section 3(d) - If a developer does not improve efficacy of the substance, it cannot be an invention to find a new formula of the substance.

S

ince 2006, there has been a dispute between Novartis, a global pharmaceutical company based in Switzerland, and the Indian government. Novartis developed a cancer targeting drug Glivec in 1993 and applied for a patent globally.

The first-generation of Glivec got a patent in 1993. Furthermore, Novartis developed beta-crystalline Glivec which is a changed form

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of the original Glivec. In India, Novartis applied for a patent for this second-generation Glivec in 1998.

To implement TRIPs agreement and the World Trade Organization agreement, Indian government granted substance patents after January of 1995. Novartis got a right to monopolize this beta-crystalline Glivec from 2003 to 2007.

Before Novartis applied for

the patent, ten pharmaceutical companies of India had produced generic versions of Glivec. As Indian government granted the substance patent in 2005, many Indian companies discontinued producing their products. In 2005, the Cancer Patients Aid Association, which is based in India, filed a suit to annul the patent.

The Chennai Patent Office

GLOBAL ISSUES

decided to annul the patent for Glivec on the basis of section 3(d) of the Indian Patent Law. It stresses an improvement of efficacy; only entirely new formulae are eligible for patent protection. It is intended to prevent the “Evergreen strategy”. This means that patent owners continue to have a right to monopolize a formula even after they make minor adjustments to it. However, Novartis protested against the decision and then they filed two lawsuits in the Madras High Court and the Intellectual Property Appellate Board based on TRIPs Agreement Article 27. But they ruled against Novartis. Finally, Novartis filed an appeal against the decision in India’s Supreme Court.

The upcoming decision of India’s Supreme Court will serve as a watershed to determine whether Novartis, a global big pharmaceutical company, will be protected from India’s pharmaceutical companies.

Global pharmaceutical companies are waiting the decision because it

will make a tremendous impact on sales of many global pharmaceutical companies in other countries as well as in India.

Novartis’s Move to Protect the Patent In this circumstance, Novartis announced that it will take the case to the WTO because Novartis feels a sense of crisis. India is a very critical pharmaceutical market for Novartis.

Novartis said that it requires patent protection to protect Glivec in the Indian market for a long time. If Novartis loses in the Supreme Court, it will confirm clearly that India is vulnerable to patent infringement.

“Pharmacy of the World” Is Threatened Glivec has been a trouble maker because Novartis unreasonably tried extending its patent in India in order to pursue maximum sales profit.

India, which is called the “Pharmacy of the world” as a supplier of cheap

generic medicine, has been regarded as a life challenging opportunity for patients in developing countries.

Doctors without Borders (MSF; Medecins Sans Frontieres) predicts that the effort to provide inexpensive generic versions of original drugs in India will be blocked. According to MSF, the bigger problem is that this practice is likely to spread internationally.

This Indian case has great implications for us. First, it aroused interest about the human rights of patients in developing countries.

Second, this case makes us think about protection of intellectual property rights for patent holder like Novartis. It is very difficult to take either the patients side or Novartis side, because both rights are important. Public hearings on the patent clause in question have been held for weeks since Aug 22.

The final decision will be announced in one or two months. B

"Because India is regarded as the pharmacy of developing countries, the importance of this case extends far beyond India," said Manica Balasegaram, director of Medecins Sans Frontieres' Access Campaign, in a statement.

2012 vol.2

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NATIONAL ISSUES

Women And Affordable Care Act Hahn Jongsung jshahn@yonsei.ac.kr Hahn Jongsung jshahn@yonsei.ac.kr

T

he Patient Protection and Affordable Care Act (PPACA), informally called the Obama Care, is a United States federal statute signed into law by President Barack Obama on March 23rd, 2010. PPACA is primarily aimed at decreasing the number of uninsured Americans and reducing the overall costs of health care. Additional reforms are aimed at improving health care outcomes and streamlining the delivery of health care.

PPACA requires insurance companies to cover all applicants and offers the same rates regardless of pre-existing conditions or gender.

This article examines how PPACA has an influence on women’s health care system in the United states.

There are three criteria. First, the PPACA promotes gender equity in insurance costs. Before the law, women could be charged more for insurance than men, largely because of the cost of reproductive health services like contraception and maternity care. In 2014, insurance companies will not be able to charge women higher premiums than they charge men imply because of their

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gender. Second, in the past the insurance companies could deny coverage to women due to preexisting conditions, such as being pregnant, having had a previous cesarean delivery, or having a history of cancer. However, under the PPACA, it will be illegal for insurance companies to discriminate against women with pre-existing conditions.

At last, PPACA of 2010 greatly expanded women’s access to free preventive services, particularly for sexual and reproductive health.

Preventive services for Women 1. Well-woman visits 2. Gestational diabetes screening 3. Domestic and interpersonal violence screening and counseling 4. FDA-approved contraception, including contraceptive education and counseling 5. Breastfeeding support, supplies, and counseling 6. HPV DNA testing for women aged 30 or older 7. HIV screening and counseling for sexually active women about sexually transmitted infections

On August 1st, health care plans were required to start covering preventive services for women no cost to them.

Despite these strong points of PPACA, there are oppositions to this law. First, they say that this law is a reverse gender discrimination because it provides most preventive health service only to women. Also, the provision getting the most attention is free contraception and contraceptive counseling. Earlier this year it sparked major controversy among religious organizations.

Many protested that they should not comply because it violates their religious beliefs. The Republican political party wants to repeal this law because of large budget problem and their opposition to Obama policy.

Although controversy still continues, most people agree that women's health decisions should not be made by politicians or health insurance companies.

Putting women in control of their own health care is more important than wasting time fighting political battles. B

Coverstory - The Establishing For-profit Hospitals

Against the establishment of for-profit hospitals!

e n i f e d u "Can yo medical service f o e u l a v the " ? y a w in one

Artwork by Jihye Lee iclickart™ www.iclickart.co.kr

2012 vol.2

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Coverstory

Can you define the value of medical service in one way?

Yi Youngsuk youngsuk_yi@yonsei.ac.kr

A

ccording to the current medical law, only non-profit organizations can operate hospitals, so forprofit hospitals are not allowed in Korea. During the past few years, the Korean government tried to change the policy to permit for-profit hospitals in Free Economic Zones such as Songdo International Business District and Jeju Special Self-Governing Province. Immediately, the political change resulted in a sharp division of opinions between the supporters and the opponents. The opponents are concerned that the changing of laws may result in lower quality medical services, especially in less profitable medical services and the accessibility limitation for the economicallychallenged homes. In this article, The Blue Vanguard will look into the supporters’ view and their limitations.

Current situation

S

ince 2003, the city’s plan of establishing an international hospital in Songdo, Incheon Free Economic Zone(IFEZ), was delayed.

Despite recent law revisions, this project was stalled due to the conflict between methods of managing the new international hospital.

However, the metropolitan city government of Incheon could not reach a final decision on it because of severe opposition from the public. Eventually, on September 11th, 2012, Incheon Governor Song, Young Gil, suggested at the Incheon City Council that the international hospital could be a form of a “combined non-profit hospital.”

* Non-profit corporations are distinguished from for-profit corporations in terms of capital stock fund-raising methods, right to pay dividends about profit, and claims to the residues.

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Coverstory

Classification of Hospitals in Korea Private clinics

Clinics operated by individual doctors. e.g. Dr. Kim’s Pediatric Clinic, Dr. Lee’s Ears-Nose-and-Throat Clinic

Public hospitals

Hospitals operated by the federal government, a local government or a public institution. e.g. The National Medical Center, Seoul National University Hospital, and etc.

Non-profit hospitals Hospitals operated by non-profit organizations including private universities. e.g. Seoul Asan Hospital, Gangnam Samsung Hopital, Yonsei Severance Hospital, and etc.

For Creating National Wealth

Why “For-profit Hospitals”?

A

s the case of Incheon International Hospital, the public opinions are in conflict over the debate on introducing for-profit hospitals. The supporters of forprofit hospitals consider medical service as a resource of the market economy. The opponents insist that the government should intensify the public welfare of medical service. At present, Koreans use medical services and pay comparably little thanks to the National Health Insurance System.

However, continuous complaints on the quality of medical service and worsening financial situation of the National Health Insurance pushed the Korean government to consider forprofit hospitals as an alternative.

I

n some ways, the logic of the supporters is simple. They focus on the value of medical service as a resource of market economy.

Therefore, they want to increase the quality and efficiency of medical service through introducing competition in the medical service industry and raising funds from big stock markets. After achieving these goals, they assume that the national competitiveness of medical service would be enhanced. In addition, it is directly connected to increasing national wealth by preventing outsource of medical services to another country and attracting foreign currencies for medical tours. For getting all of these benefits, it is essential to forprofit hospitals.

Remember Market Failure

H

owever, there are also some drawbacks in their view points.

First of all, medical service should not be evaluated as a measure of market economy. If we apply the principles of market economy to the medical service industry, it is likely to undergo market failure*. One of the factors of market failure is the information asymmetry between consumers and producers. The medical service industry is famous for severe asymmetry in such information. It is a highly specialized field, so it takes a long time and high cost to become health care professionals.

Patients usually have difficulty in understanding the medical services they received and evaluating them.

Therefore, it is possible that the medical service providers and the investors could make unfair profits.

* Market failure is a situation in which a market does not operate as it should, for example where the supply of a product is not related to the level of demand for it.

2012 vol.2

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Coverstory

As a result, for-profit hospitals can shirk from providing less profitable treatments and taking care of economically vulnerable families.

medical polarization between social classes. At the end, social polarization could cause a deeply divided society and hinder national development.

To Keep The Public Nature Of Medical Service

M

edical service is directly linked to the question of people’s lives or deaths. Therefore, medical accessibility has to be guaranteed to all people equally. However, it can be neglected when the medical service industry follows the logic of market economy by pursuing the efficiency through maximizing profit with minimizing cost. It will intensify

For-profit Hospital

Can You Define The Value Of Medical Service In One Way?

I

n conclusion, the conflict of allowing for-profit hospitals is the result from opposing views regarding the medical service. It is true that the medical service have more than one purpose. One purpose is to be a public goods for public health. And the other purpose is to be a resource of market economy. It is just the problem of values rather than the

Artwork by iclickart™ www.iclickart.co.kr

problem of facts. In this situation, we cannot evaluate the value of medical services based on one side only. However, we can measure the importance of values. Which is more valuable; money or human life? B

System

Non-profit Hospital

U.S.A.

Representative nation

Republic of Korea

Few clinics/hospitals contracting with private insurance company

Accessibility

Almost clinics/hospitals*

15.3

Ratio of individual medical cost in GDP(%)

6

6,401

Medical cost per capita($)

1,318

77.8

Life expectancy(years)

78.5

7

Infant mortality per 1,000 birth(person)

5.3 *OECD HEALTH DATA, OCTOBER, 2007

□ For-profit Hospitals vs Non-profit Hospitals The supporters of establing for-profit hospitals explain their opinion by giving examples of U.S.A.'s medical system. However, it makes people tilt their heads when specific figures of some medical issues are looked at. Is this enough evidence for changing current system of Korea?

* Korean health care system is consisted of a single insurer, National Health Insurance Corporation, and mutiple medical instituition.

Therefore, every clinics/hospitals must contract with NHIC, "Compulsive Medical Insurance Appointment System."

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PEOPLE

Meet a Pharmacognosist in the Netherlands An Interview with Young-Hae, Choi, Ph.D

Jane Suh kakijane@yonsei.ac.kr

Which career is right for me? Where should I start my career? Seoul?

Hong Kong? Would there be any career opportunities overseas for international pharmacy graduates? There must be so many questions in mind with the anxiety about the future. However, if you have a goal with patience, passion and hard work, a chance might come to you. You could end up doing what you want to do regardless of where or how. In this interview, The Blue Vanguard would like to introduce Professor Choi who works at Natural Products Laboratory in Leiden University in the Netherlands.

What do you do at Leiden University in the Netherlands?

I work at the Natural Products Laboratory in the Institute of Biology (The Institute of Biology Leiden is an international institute for research and education in biology at Leiden University). My main research is to identify and isolate substances which a plant produces in normal condition and under environmental change such as in a stress condition.

One of my goals is to find out if the substances are different, and specifically to identify where, when and through which pathway the chemical substances are produced from a plant on the cellular level.

Besides, it is commonly believed that water is the only solvent for plants, however, with the assumption that there will be solvent other than water, I search for that alternative.

What path did you take at the university to reach your current

position?

Life does not work out as planned. When I nearly finished my Ph.D in Korea, I started looking for an opportunity to gain work experience.

Around that time, I found a studyabroad program which sponsors post doctorates. Many applicants preferred going to the US, but I applied for a lab in the Netherlands to take a different path.

Why am I interested in my current research topic? I was working in the lab of Pharmacognosy in Seoul National University. I was always interested in botany and since I had been studying pharmacy, I could conduct research on plant chemistry, plant metabolism and related areas.

My research interest has not changed all that much.

How different is the research environment between Korea and the Netherlands?

There can be three factors to 2012 vol.2

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PEOPLE

Young Hae Choi, PhD Natural Products Laboratory Institute of Biology Leiden University consider.

First, the people.

Regardless of the scientific talents or skills, in Korea there are only Koreans. On the other hand, there are myriad of different people in Europe, which means Europe has more diversity. Second, equipment.

The access for equipment is similar though. Third, research funds. I think Europe provides researchers with more funding opportunities in comparison to Korea.

Speaking of the Netherlands, many might be wondering this question. What do you think about the policy of the Netherlands on Cannabis as a Pharmacognosist?

Cannabis is considered a medicine rather than a narcotic. It is known that Cannabis has less toxicity than tobacco. Cannabis-based substances are used for many kinds of researches especially on stroke. In general, the Dutch believe the regulation on marijuana in other countries is not based on scientific evidence but is a result of politics.

In which fields of pharmacy do the graduates of Leiden University work?

My lab used to belong to the School of Pharmacy but now it belongs to the institute of biology.

Too many schools resulted in too much competition. Now, it is divided

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into traditional School of Pharmacy where you can be trained to become a licensed pharmacist and research oriented pharmaceutical science center. It is not easy to open a pharmacy store here because the number of pharmacy stores is regulated in Europe. Only a limited number of stores can open within a certain area. A new pharmacist can only start practice and replace the position of the existing pharmacist when he or she quits.

In the Netherlands, there are three ways you can buy drugs: from a drug store, pharmacy, and a supermarket.

Drug stores supply non-prescription medications and pharmacies sell either only prescription drugs or over-the-counter(OTC) drugs. Also, you can buy some OTC drugs in supermarkets.

Since not all graduates can work in the pharmacies, there are other career options for them such as pharmaceutical companies, research centers and etc.

There are students who are considering international careers.

What international sectors can they try?

It should not be a matter of working “overseas”. It is all about what makes you passionate and what you enjoy studying. Do not go with the flow. It is tempting to study or work

in the popular fields, which are very competitive. A good thing about studying in a College of Pharmacy is that there are considerable amount of options. In fact, I saw a pharmacist studying Math for a Ph.D. degree. Do not limit your choice, and find what you love doing.

What words of wisdom would you like to offer to the pharmacy students?

You can not prepare perfectly since it is possibe to predict the future. Like I said, life may not work out as planned.

First, doing your best at present is the best key for your future. Second, I believe pharmacists are scientists.

If you do not enjoy your study or research, you have made a wrong choice. Third, English should not be your major concern. It should not be about the language but about the content of what you want to talk about. You should not feel pressure to be a native English speaker because it is impossible. As long as you can deliver your message, you do not have to be perfect in English.

In fact, the language of science is universal. I would say you should work more on “writing”. When it comes to speaking, if you live abroad, you will get the hang of it anyways.

Focus on the quality of content not the expression. B

PEOPLE

Interview with Director of Severance Pharmacy Kang Minju mkang28@yonsei.ac.kr Lee Harin hrlee102@yonsei.ac.kr

W

hen the College of Pharmacy curriculum was extended to six years, there were many changes. For example, a hospital training program has been added to the curriculum and pharmacy student can now learn more about role of a hospital pharmacist. Based on this change, many people expect that a hospital pharmacist's role would become more important. Therefore, many pharmacy college students want to know about the responsibilities of a hospital pharmacist. On August 17th, the Blue Vanguard visited the Severance Hospital and interviewed Hyun-Ju Seok, the director of pharmacy. And we asked about the role of a hospital pharmacist and what changes she expect after extension of College of Pharmacy curriculum.

Hyun ju Seok | Director of pharmacy, Severance Hospital

What do pharmacists do in the hospital? And please explain the structure of hospital pharmacy.

Hospital pharmacy is divided into two major teams, pharmacy affairs team and dispensing team. Pharmacy affairs team is composed of many different parts such as pharmacy information part, medicine management part,

specialized drug compounding part and clinical pharmacy service part.

Dispensing team is composed of many different parts such as outpatient dispensing part, in-patient dispensing part and dispensing for Je-jung room part. Pharmacists in dispensing team review the doctor’s prescriptions and then dispense the medication.

To help you understand better, I will explain what do some of the parts do in the hospital. Pharmacy information part is responsible for managing medicine especially narcotic drugs through electronic data processing. It also develops the programs for medicine preparation by contacting the computer center in the hospital. Specialized drug 2012 vol.2

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PEOPLE

preparation part mixes some anticancer drugs at specific ratio by evidenced therapeutic regimen. I established the clinical pharmacy services in 2005 in order to help patients by providing information.

In clinical pharmacy services, pharmacists provide information to the patients about taking medicine to improve the effects of pharmacologic therapies.

I knew you established the clinical pharmacy services. What led you to establish the clinical pharmacy services? And what kinds of work do the clinical pharmacy services do in the hospital?

When I was appointed as the Director of Pharmacy, the pharmacy department had a limited role in pharmacologic therapy. The main job of the hospital pharmacists was just to dispense medicine. I thought the hospital pharmacy should advise the patients about their medication. And at that time, we had a pharmacist with BCP certification on child cancers. However, without

a fundamental system, we could not support her speciality. I wanted to make a better environment for professionals where they can make the most out of their skills. For these reasons, I decided to establish the clinical pharmacy services.

Pharmacists in the clinical pharmacy services usually give information to the patients about their medicine to improve their treatment efficacy.

Pharmacists determine the *regimen and compound of anti-cancer drugs for the cancer treatment. We also assign some pharmacists to the intensive care unit. (*Regimen : specific ratio of drugs for a specific disease. This ratio is optimized to treat the disease.)

Many pharmacy students wants to work as hospital pharmacists.

What skills are important to hospital pharmacists?

It depends on their positions since each department requires different kinds of skills. Generally speaking though, I believe English is very important. All the medical

2012 Members in pharmacy, Severance Hospital

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terms you will use in the hospital are in English. Moreover, you will have to communicate in English when you participate in the international medical conferences.

Besides, you need to know how to handle computers. In many cases, much work will involve the usage of a computer.

It seems that a lot of hospital pharmacists keep up with their studies as they develop their career. How do they develop their skills and build up knowledge?

Some go to graduate school for advanced course of clinical pharmacy.

Others study for *The Board of Pharmaceutical Specialty(BPS) certificates by themselves.

Ever since one pharmacist earned a BPS certification in oncology, many pharmacists in the Severance Hospital formed a study group to earn their BPS certification.

Also, many pharmacists participate in medical conferences. (*Board of Pharmaceutical Speciality is a globally recognized certification.

There are five kinds of certificates in BPS ; Oncology Pharmacy, Nuclear Pharmacy, Pharmacotherapy Pharmacy, Psychiatric Pharmacy, Nutrition Support.)

How do you think the profession of the hospital pharmacist should change for the future?

First, I wish that hospital pharmacists develop their specialties in a specific area. Most doctors have their own areas of specialty, for example, ophthalmology or

PEOPLE

pediatrics. Likewise, it will be better for hospital pharmacists to have their own special fields. Today, there is a big difference in the degree of specialization between pharmacists and doctors. I think that we have to narrow the gap.

Secondly, these days, hospital pharmacists participate more and more in clinical roles beyond mere compounding medicine. For example, they study to determine more efficient drugs for a specific disease and check the prescribed medicine for patients in order to prevent adverse effects. However, it is only for a service to our patients without financial support of the government. If the government pays for our labor, more hospitals will make their pharmacists participate in clinical roles, which will lead to better treatment of patients. However, National Health Insurance is in a bad financial state, so paying for hospital pharmacists’ labor is not realizable.

Why does the gap in specialization between pharmacists and doctors exist?

In College of Medicine, students can learn the newest medical

knowledge because professors teach while working in university hospitals.

Also, for that reason, professors can deliver useful clinical knowledge to students directly. On the other hand, pharmacy professors who teach students and work in hospitals at the same time are rare. For this reason, it is hard for pharmacy college students to get up-to-date knowledge.

What is your professional philosophy?

I think that a pharmacist should make a commitment to provide services which are completely intended for the patients. However, some pharmacists are likely to forget that.

Some pharmacists only pursue financial profit. Others study hard for merely their own satisfactions rather than not to help the patient. As a result, they may not apply knowledge to practical uses like giving proper medicine ingestion guides even though they study hard. If pharmacists put priority on the patients, the service for patients would be better and prognosis of patients would also be improved. Furthermore, I think communication skills are

important to the pharmacists. When pharmacists deal with demanding patients and employees outside their departments like doctors, nurses or other officers, good communication skills may be useful.

Therefore, pharmacists should learn not only pharmacy but also effective communication skills.

Last question! Would you like to give some advice for students who are preparing hospital pharmacists?

I advise you to participate in club activities. I participated in a medical volunteering activity and a fraternal association during my university years. A medical volunteering activity will give you clinical experience, and it will be helpful especially when you work in a hospital. Also, the fraternal association broadened my views and helped me to build networks with other professionals. Although I didn't participate in an English club, I recommend that you do. I think that you can improve your English and meet various people through an English club. Finally, whatever job you may choose, if you work hard, you can achieve many things. Do your best. B

2012 vol.2

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campus issues

Yonsei Athletics Day

Gyehee Yi gyehee@yonsei.ac.kr

2

1 Students were divided in two teams; the Blue team and the White team. They performed in both team and individual events. <1>The competition commenced with a grand opening word from the Dean of Yonsei College of Pharmacy, YoungSoo Ahn. <2> HyunKang Kim, student council president, instructed a cheerful warm up exercise. <3> Every member, including professors,

activel

3

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actively participated. <4>Then Joyakdol(Yonsei College of Pharmacy dance club) performed â&#x20AC;&#x153;Gangnam Styleâ&#x20AC;? and the crowd went wild. Finally, the true competition began. <5, 6>The first sports event was a match of tug of war which ended in only 3 minutes. The victor was the Blue team by the score of 2:1. <7>The next game was the one-legged fight, and to win this, each team had to pro their king from the attackers of the other team. <8>The White team won by 3:0, by successfully protecting their king, Professor Sungjoo Hwang.

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5 <9>Students all participated in the 100m preliminary and the 100m finals. JeeYoung Park and JongRyul Jeon came in first. <10>The individual matches continued with an arm wrestling tournament. Competitors almost kissed the ground to win the game. The final winner from the female match was SeulYee Lee.

campus issues

6 10

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ly participa

12 13

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PHOTOGRAPH BY JAEMIN PARK

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<11>Turning to the male side, the professor, Wan Namgung, and the freshman JongRyul Jeon competed for the final match of arm wrestling. The victory was taken by JongRyul Jeon. <12>Next, came a team battle, called â&#x20AC;&#x153;the surfingâ&#x20AC;?. Each team selected one runner and two helpers to support the runners from both sides. The rest crouched down so that the runner could step on their backs and run until the runners pass the finish line. The White team took the victory. <13>The next individual match was held with a partner. Each male competitor had to select one female partner to carry on their backs and perform various missions. The last one to put down the female partner was JongRyul Jeon, who took three individual victories on this day. <14>The final match was a relay race, won by the White team. <15>Overall, the winning team was the White team who received the prize of fried chicken and Bossam(boiled pork).

They shared the food with the Blue team and doubled the pleasure. B 2012 vol.2

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campus issues

The 22nd National Association of Pharmacy Student Unions Gyhee Yi gyehee@yonsei.ac.kr

U

nder the keynote of “The leap of thirty five pharmacy schools; Let’s come together and move forward!” inauguration ceremony the 22nd National Association of Pharmacy Student Unions was held at WonKwang University Sports Center. The festival continued from the 4th of May, 2012, to next day.

At 6A.M. on the 4th of May, thirty four freshmen students of Yonsei College of Pharmacy boarded their bus with pounding hearts, looking forward to meeting students from other Pharmacy Schools around Korea. It took four hours from Yonsei International Campus to WonKwang University by bus. Upon arriving, Yonsei students were all thrilled to see the staff preparing for the event.

The festival was scheduled in two main parts; a booth event and the ceremony performance. The booth event was run as an outdoor fair since the weather was sunny.

Every school operated a booth, selling refreshments, offering Tarot card readings, and running games like coin tossing. The students promoted their booth by running around with holding promotional posters. Unfortunately, the revenue was not as high as expected. The Yonsei team just managed to break even. Maybe it was because their sausages were too salty.

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campus issues

PHOTOGRAPH BY JAEMIN PARK

The second part of the function started with an opening ceremony at 5 P.M. inside the sports center. The WonKwang University dance team put on welcoming performances. Then the new chairman gave a speech and his instatement was celebrated. Finally, the representatives of each school approached the center stage waving their big flags. All of the representatives stood together and swore the Dioscorides oath.

After the opening ceremony, students from each school performed concerts which were wellreceived by the crowds. Dawn came while the event progressed and soon the ceremony reached its end.

One of the Yonsei students commented that, â&#x20AC;&#x153;This gave me the chance to think about becoming a true pharmacist, and encouraged me to feel more attached to my school.â&#x20AC;? B

* Yon-Ko-Jeon refers to the joint festival between Yonsei University and Korea University.

2012 vol.2

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Campus issue

Combined Bachelor’s and Master’s Degree Program Seolkyung Kim kimsk90@yonsei.ac.kr

Yonsei University College of Pharmacy introduced a new program called “Combined Bachelor’s and Master’s Degree Program.” This program will be instituted from next year. Currently, a total of six years are required to complete undergraduate and graduate programs separately. The combined program saves 1 to 2 semesters. The change has been made for students who decide to enter graduate school early. College of Pharmacy makes an attempt to become a research-oriented university. This article examines the new program, its merits and demerits.

If students participate in this program, they can take classes which are offered for undergraduate students during their 3rd and 4th years. Students can take up to 6 extra credits for graduate classes per semester, and a total of 12 credits during the undergraduate program. These 12 credits are counted toward the undergraduate graduation requirement and are not included in the final GPA. In order to remain in the combined program, undergraduates must maintain a minimum of 3.75/4.30 GPA throughout the 7 semesters or 3.30/4.30 GPA throughout the 8 semesters. Only undergraduate

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students can apply for admission to the combined program if they have achieved over 3.30/4.30 after 4

semesters or over 3.50/4.30 during sophomore year with a reference from an advisor. Candidates can

Campus issue

apply for this program only once just after the 4th semester.

This program might be attractive to many students for several reasons. First, the greatest benefit is that students can save time and tuition fees. It is natural that most of the students want to graduate early. Six years are required to finish the bachelor’s course and additional two years to complete the master’s course. Students will finish undergraduate and graduate courses during seven to seven and a half years in this program. They also will be given scholarships at the graduate level. Second, undergraduate and graduate classes give feedback to each other, so students can understand the classes easily. By taking both undergraduate and graduate classes at the same time, students can learn general and broad concepts from undergraduate classes and also have a specialist’s point of view from graduate classes.

As a result, students can easily connect the contents which they

learn in both levels of study. Third, students can gain direct knowledge about graduate school life when they are undergraduates. They can form realistic expectations regarding the graduate program since they get to experience it in advance.

Although this program gives undergraduates many benefits, there are clear disadvantages as well. First of all, sophomore year might be too early for most students to make the important decision of whether they will go to graduate school or not. Two years in the undergraduate program does not leave students enough time to plan their careers. There are still their junior or senior years left in the undergraduate in which students may become willing to get a master’s degree. Secondly, it may be asked whether candidates can keep the minimum GPA required for continuing the program. Under relative grading policy (as opposed to absolute grading policy), there will be fierce competition between

the candidates who have to keep the minimum GPA of 3.30/4.30. It will be challenging for them to maintain this GPA and take graduate classes at the same time. Finally, some students may not obtain qualification for master’s degree. They question whether they can master writing graduate-level academic papers while handling laboratory apparatus during such a short period.

In summary, it is obvious that “Combined Bachelor’s and Master’s Degree Program” is a great opportunity. However, students think that some factors make it feel difficult for them to successfully complete the program. Adequate consideration of one’s own aptitude and career goal is necessary for the students who are interested in this program. The Blue Vanguard hopes that this new program will become well-established and provide effective learning opportunities for many students. B 2012 vol.2

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global network

meet a friend on the street 2nd stop

japan

Hyejin Cho heajindayo@yonsei.ac.kr

* Special thanks to Hitomi.

Could you introduce yourself?

Hello, my name is Nakamura Hitomi. I am a freshman majoring in Pharmacy at a womenâ&#x20AC;&#x2122;s university in Japan. Because chemistry was my favorite subject during high school years, I wanted to continue exploring the field of science in college.

While I was researching medicine, I became interested in pharmacy as a profession. I learned from one of my relatives, who happen to be a pharmacist, the values and stability of the profession. From then on, I set my goal to become one.

What is the College of Pharmacy curriculum like in Japan?

The College of Pharmacy curriculum changed from a 4-year program to a 6-year program several years ago. This year, we had the first group of graduates who completed the 6-year curriculum.

These graduates are now able to take active roles in hospitals

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and pharmacies. However, some universities feel that the current state of the 6-yearcurriculum â&#x20AC;&#x201C; the previous 4-year program plus field training â&#x20AC;&#x201C; is not satisfactory, and many changes have been made.

For instance, the university that I am attending is now emphasizing basic subjects such as biochemistry, physiology, and organic chemistry.

After the curriculum changed from 4 years to 6 years, has there been a change in popularity of pharmacy schools? With the number of graduates on the increase, are there any problems or changes?

I do not feel that there has been a plunge in the popularity of the pharmacy major after changing to the 6-year curriculum. If one has the will to become a pharmacist, I think the length of study really does not matter. However, my friend who wants to become a researcher

global network

would have gone to graduate school if the college curriculum had not been changed to 6 years. Now, she thinks it will be difficult to go to graduate school when she turns 26 after graduating. Therefore, I believe people who do not care about their age would still go onto graduate school.

In my opinion, the job of a pharmacist is a lifelong job that one is able to continue after maternity leave. Although the number of pharmacists is increasing, if we think about natural disasters, having many more medical personnel is better.

After graduation, what do pharmacy students usually do?

After graduating, the majority of the graduates work either in hospitals or pharmacies. In addition, there are also national and local government offices, research institutes, and pharmaceutical companies. Among my friends, the majority of them want to work as pharmacists in hospitals. I used to think that working as a hospital pharmacist would be ideal, but after receiving training in a community pharmacy, I felt more attracted to working in the community pharmacies rather than hospital pharmacies.

interested in becoming pharmacists, nurses, and doctors. I believe that many of them found the job of being a pharmacist appealing after listening to the lectures by visiting pharmacists.

In Japan, there are many drug store chains like "Matsumoto Kiyoshi". Are there resident pharmacists in those stores, and what do they sell?

In Japan, there are drugstores in various areas.

The closest drugstore in my hometown carries cosmetics, detergents, bath preparations, toothpastes, and drinks. These stores also carry overthe-counter medication. There are some medicines that cannot be purchased without the guidance of a pharmacist, so they are employed in these drug stores, and are identified by their name plate. For example, â&#x20AC;&#x2DC;LOXONIN Sâ&#x20AC;&#x2122; can be purchased without prescription but with the guidance of a pharmacist. This is why there is a pharmacist all the time. B

Is College of Pharmacy popular choice for high school students in Japan?

My high school had the policy of emphasizing the science track.

However, many female students in the science track changed to the liberal arts track. During the junior year, only one third of the female students remained in the science track. Among the science track students, the majority of them were 2012 vol.2

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Professor's Research

Professor Sungjoo Whang:

A Pioneer in Pharmaceutics Hahn Jongsung jshahn@yonsei.ac.kr

P

rofessor Sungjoo Whang grew up in a rural area. He decided to go to pharmacy school at Seoul National University because he wanted to become a pharmacist.

“While at the university, I was sick of subjects that required memorization.

I usually liked math, so I started to study physical pharmacy which has a mathematical background.” After graduation, he secured a position at the Chong kun dang pharmaceutical company, where he participated in manufacturing pills and formulating ointments and parenteral injections.

at Hanmi pharmaceutical company, and received an investment grant of one hundred million won. With this money, he bought some equipment and began his research.

In 2003, his research was chosen as an NRL (National Research Lab), and with government support he started to write his thesis. However, it was difficult to commercialize supercritical technology because of expensive equipment prices and lack of investments. Nevertheless, he finally patented the technique of supercritical fluid assisted nano particle formation and nanoliposome mass production process. “Now there is a new direction of research for finding drugs that can be processed efficiently using this technology.“

National Recognition

Pioneering Work After finishing his post doctorate fellowship in America, he came back to Korea and started to study about supercritical technology. He made a presentation on this technology

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His supercritical fluid assisted nano particle formation technique was selected as one of '2010 Excellent Basic Science 100 Achievements'. He is now part of the committee for the Pharmaceutical Society of Korea, and also serves as vice-president of the Korean society of Food, Drug, and Cosmetics regulatory science (KFDC).

“KFDC, which is composed of Korea Food and Drug Administration(KFDA)

officials, handles any legal problems in the industry. Issues like patents or policies regarding the price of medicine are important in the pharmaceutical industry.

So I think that integrating this study of administration is good for students of pharmacy.“

Formulation Research His lab focuses on the development of incrementally modified drugs by competently designed formulation. A formulation is a mixture or a structure such as a capsule, a pill, a tablet, or an emulsion, prepared according to a specific procedure. Formulations are a very important aspect of creating medicine, since they are essential to ensuring that the active part of the drug is delivered to the correct part of the body, in the right concentration, and at the right rate. Factors to consider in formulation are a drug's physical and chemical properties.

Competently designed formulations for particular applications are safer, more effective, and more convinient than any of their components used singly. Professor Whang developed the Ultracet ER which applies a new formulation to an original drug. The

Professor's Research new formulation is a bi-layered form which is composed of an immediate release layer and a sustained release layer. When the Ultracet ER is taken, immediate release layer releases the drug, and as times goes by the sustained release layer is absorbed into the blood stream. This lenghtens the drug's operating time, which reduces administration frequency.

Whereas the original single layered drug must be taken four times a day, the Ultracet ER only has to be taken two times a day, which is convinient for patients. And also, because a small amount of drug is released constantly, the concentration of the drug is not raised suddenly, which makes the drug much safer.

SASD

phases do not exist. Supercritical fluids provide a number of ways of achieving formation of small particles by rapidly exceeding the saturation point of a solute by dilution, depressurization or a combination of both.

These processes promote nucleation or spinodal decomposition over crystal growth and yields very small and regularlysized particles.

When seeing particles under the microscope, size reduction and increase of sphericity in SASD processed particles are observed. Also, SASD makes particles with narrow size distribution and improved dissolution rate. With all these properties, drugs processed by SASD can be absorbed well, which achieve improved bioavailability. B

Professor Whang explains how to operate SASD process to students.

(Supercritical-fluid Assisted Spray Drying) Not only does professor Whang's lab focus on formulation research but also his lab works to retain new platform technologies for the manufacturing process. The representative technology is SASD. Generally, drugs with high molecular weight are hard to be absorbed into the body's blood stream. To enhance efficiency of the drugâ&#x20AC;&#x2122;s absorbability, small particle size is required. However, the commonly used grinding process â&#x20AC;&#x201C; spray drying process â&#x20AC;&#x201C; has limitations such as denaturation of particle, broad particle size distribution, and nonsphere formation. His nano particle formation with supercritical fluid technique could overcome these limitations. A supercritical fluid is any substance at a temperature and pressure above its critical point, where distinct liquid and gas

SASD Operation Process In the mixing chamber, supercritical carbon dioxide and drug solution are mixed evenly, and this mixture is sprayed out by a nozzle. By spraying out mixture with heated compressed air, drug particles could be made as very narrow and even particle size distribution. Primary particle is generated by pneumatic atomization, and then with additional split, smaller secondary particle is formed by decompressive atomization which achieved by depressurization of carbon dioxide.

2012 vol.2

31

general article

Pharmparazzi Make Pharmacies Nervous Jeong Jiyoung jiyoung2@yonsei.ac.kr

“Jingle-jingle” A patient visits the pharmacy for a prescription drug. A community pharmacist goes into the dispensary to fill up the prescription. Then, the patient asks the counterperson, “How should I take the drug?” The counterperson answers, “Take the drug 30 minutes after each meal.” A few minutes later, the pharmacist approaches the counter and hands over the prescription drug to the patient.

After a few weeks, the pharmacist gets a ticket for violating the Pharmaceutical Affairs Act. Do you know the reason? It is because the counterperson gave the instructions on how to take the medicine. Actually, the customer is not a seriously ill patient. He has other intentions.

When the pharmacist is out, he asks the counterperson the instruction about taking the medicine on purpose. Then, the customer reports the pharmacy for violation. Recently, many community pharmacists have gotten tickets for violation in this way. It happened mostly in Pusan and

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general article

there were over 50 pharmacies reported. Two people made a team and went around in Pusan. They usually made up inevitable situations to catch the violation. People like them are called “Pharmparazzi.”

“Pharmparazzi” is a mixed word using pharmacy and paparazzi. In July 2002, the Ministry of Health and Welfare introduced a bounty system.

In Article 90 of Pharmaceutical Affairs Act, there are several regulations which offer rewards. The regulations are various from preparing the medicine to selling it. If someone reports a violation of a pharmacy, the person receives about 200,000 won per violation as a reward. As some people have reported violations as their jobs, they have been called pharmparazzi.

Why was the bounty system introduced? Firstly, pharmparazzi could play an important role for a better pharmacy system. Although the word “pharmparazzi” comes from “paparazzi”, the aim of pharmparazzi is different from that of paparazzi.

Paparazzi follow famous people in the hopes of photographing them in unguarded moments. The pictures just provide gossip.

However, pharmparazzi watch the pharmacies which violate the Pharmaceutical Affairs Act. Therefore, pharmacies will follow the law and people can get better medical care.

Secondly, there are still many community pharmacists who need improvement. In other words, their ignorance about medicine is a serious problem. Although the pharmacists are supposed to be experts about medicine, they sometimes confuse prescription drugs with OTC (over-

http://news.unn.net/news/ http://www.dslrnewsshooter.com/

the-counter) drugs. For instance, in the case mentioned at the beginning of this article, the pharmparazzi used the fact that “canesten cream” is an OTC ointment and “canesten plus cream” is a prescription ointment.

Even though they look very similar, the pharmacists should be able to tell the difference.

secretly. Second, most pharmparazzi take pictures for money or specific reasons, not for better public health.

In fact, in the case mentioned at the beginning of this article, pharmparazzi did it for revenge.

Because their family’s pharmacy was

Although the bounty system has been introduced for good reason, there are many problems. First, the most serious problem is people who intentionally trick pharmacists to catch them.

Pharmparazzi sometimes orchestrate unavoidable situations to catch the violation. For example, pharmparazzi tend to pose as emergency patients and say that they lost their prescriptions. Also, they visit the pharmacies when the pharmacists step out. And then, they take pictures using hidden cameras or record the conversation 2012 vol.2

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general article

fined for violation, they wanted to show that their pharmacy was not the only pharmacy which violated regulation. Like this, many of the pharmparazzi abuse the bounty system for personal reasons. Some might think that the reason does not matter as long as it brings about good results. However, pharmparazzi who have impure motives are likely to use mean methods. The Korean Pharmaceutical Association will not stand by individual undercover pharmparazzi any more.

The Association is preparing to take legal actions. Third, some regulations are vague. So, there are unfairly charged community pharmacists who want to keep the regulations but do not know specific ways. For example, in Implementing Regulations of Pharmaceutical Affairs Act, OTC drugs and prescription drugs should be separated on pharmacy shelves.

However, the specific way is not

described in the law. It makes the pharmacists confused. Besides this, there are many regulations which need to be more specific.

Overall, there are still many things that need improvement in the pharmacy system. However, the bounty system cannot be the final solution. In the Korean Pharmaceutical Association, there is a conscientious monitoring team, which was established to eradicate illegal acts of pharmacies. Kim Daeup, the manager of the team says that the Korean Pharmaceutical Association has already monitored pharmacies about violations and feels that the pharmparazzi are not needed anymore. However, it is hard for people to feel the change. They are suspicious of whether the Korean Pharmaceutical Association can make the pharmacy system more conscientious.

Can pharmacists be experts with only licenses?

Many pharmacists think, â&#x20AC;&#x153;I am an expert because I have a license.â&#x20AC;? However, the license is necessary but that is not enough.

It means that he or she should not only have in-depth knowledge of medicine, but also needs to understand patients and provide them with the best pharmaceutical care. Pharmacists should always educate themselves with up-to-date medicine information. Pharmacists should have integrity and do their best to be true experts. B

Violations according to Pharmaceutical Affairs Act which qualify for rewards if reported -

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If someone other than a pharmacist prepares medicine If a pharmacist prepares medicine outside the pharmacy dispensary If a pharmacist prepares medicine without following the prescription If a pharmacist refuses the preparation of medicine without rational reason If a pharmacist colludes with a doctor If a pharmacist does a substitution of prescription without the agreement of a doctor If a pharmacist does not tell the substitution of prescription to the patient If a pharmacist sells the medicine outside the pharmacy If a pharmacist sells the prescription medicine without prescription

the blue vanguard

documentary

SEE THE WORLD THROUGH THE SCREEN Gayeong Heo

Big Bucks, Big Pharma:

Marketing Disease and Pushing Drugs

Duration : 46 min Date Produced : 2006 Producer : Roint Ridberg Released by The Media Education Foundation

Pharmacists: Unsung Heroes

Duration : 57 min Date Produced : 2005 Producer : Parenteral Drug Association Foundation for Pharmaceutical Sciences, Inc. (PDAF)

GYHeo@yonsei.ac.kr

Be careful! Don't be fooled by drug marketing!

What first-aid ointment do you usually use when you have a cut? Madecassol or Fucidin? Why did you choose that ointment? If you chose a treatment just because of a strong impression that a new skin will form with a blow from the wind just like the Korean advertisement, you should consider once again. “Big Bucks, Big Pharma” will show you how pharmaceutical companies entice us to buy their products. According to “Big Bucks, Big Pharma”, there are a lot of surprising company strategies which persuade the consumers in to buying their products. This documentary discusses problems regarding the health industry’s dependence on for-profit companies. It will be a good chance to think about what we can do as wise consumers.

For the pharmacy students from around the world You can probably guess from the title, “Pharmacists: Unsung Heroes” that the documentary praises the lifelong labors of pharmacists. Yes, this documentary is about the education, training and daily work of American pharmacists. You might be wondering why a documentary about pharmacist in America is relevant to you in Korea. However, these days, the Korean health care industry follows America’s system in strengthening a pharmacist’s special clinical role. You could find out why we have a 6-year curriculum. Also, “Pharmacists: Unsung Heroes” will be good for students who want to know how pharmacists work in their fields. In fact, this film is used for pharmacy classes in American universities such as Stanford University. By watching this, you could gain self-confidence as an aspiring pharmacist. B 2012 vol.2

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Book Review

Broaden Your View By

Reading Yongjung Jang yjjang323@ yonsei.ac.kr

The Truth About the Drug Companies: How They Deceive Us and What to Do About It

By Marcia Angell

As future pharmacists, how well

do you know about the pharmaceutical industry? Beware.

What you know might not be enough. The Truth About the Drug Companies : How They Deceive Us and What to Do About It. (2004, Random House) gives a glimpse of the dark side of the pharmaceutical industry and how drug companies deceive governments (mainly the United States government) and consumers.

A common excuse for the high price of drugs is usually that the research and development (R&D) costs are expensive. However, Angellâ&#x20AC;&#x2122;s analysis demonstrates that companies are using far more money on marketing than R&D. The cunning marketing tactics described in this book make the reality look even gloomier.

Another problem is that drug companies earn excessive profit for newly developed drugs, but they are not really worthy of it. In reality, most of the research processes for developing these new drugs are not entirely carried out by drug companies but by research centers supported by public funds.

In conclusion, the author makes a good point that although the current situation is regrettable, there is hope to make the industry better if drug companies could let go of some of their privileges. Anyone who would like to find out more about this dark reality reads this book.

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the blue vanguard

Well Informed Medication can Cure, but Uninformed Medication can Kill

By Yoon Jung No, Se Hyun Park, Sun Hee Yoon, Jin Hye Choi

Why should we drink plenty

of water when we take pills and how much water is enough? Is it okay to take medicines that have passed their expiration dates?

Well Informed Medication can Cure, but Uninformed Medication can Kill (2012, Sangak Bihang) gives the answer to not only to these questions but also some questions that one might not even have pondered about. Four Koreans co-wrote this book in hopes of helping people to take their medicine more safely and use the pharmacy more efficiently.

This book guides the readers on what to ask and how to ask questions in order to get the proper medication one needs. This book also offers explanations in regard to some common knowledge that people should be aware of. It explains the proper usages of fever reducers, antibiotics, vitamins and dietary supplements.

Furthermore, it informs the reader on how to prevent misuse and abuse of medicine.

In brief, this book is a manual on how to take medicines. It is a good idea to have this kind of book at home to look up questions whenever something is unclear on taking medicines. As an old saying goes: It is better to be safe than sorry. B

epilogue

The Blue

Vanguardians

Publishing The Second Edition...

Hyejin Cho I felt writing and designing the articles have become easier than the first edition. We did it once again!

Minju Kang It's awesome to publish the 2nd edition!! I hope our magazine go well in the future.

Gayeong Heo Joining the Blue Vanguard was the best choice in my life as a pharmacy student.

Jiyoung Jeong It's our 2nd magazine but it was still difficult for me to write an article.

However, I enjoyed the whole process. I am so proud of the Blue Vanguard!!

Jongsung Han The Blue Vanguard's 2nd edition is coming!! Really?? Wow~

Harin Lee It was an exciting experience. Thanks to all our members!

Youngsuk Yi Our 2nd edition!! With the Blue Vanguard, every moment makes me amazing. I'm loving it~lol

Yongjung Jang Participating in making this magazine was a very exciting experience. This sure will not be the last!

Seol Kyung Kim I feel really excited and am very proud of the Blue Vanguard. I hope that many people get useful information from our magazine.

Gye Hee Yi Thrilled to see the 2nd edition and now I am looking forward to seeing next editions! I appreciate your kind attentions to the Blue Vanguard.

Soojin Lee The Blue vanguard will be constantly renewing.

Misun Park My second daughter has born! Isn't she adorable??

2012 vol.2

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feedback

monitoring The Blue Vanguard I study the healthcare system in some parts of the world that includes South Korea. This magazine by pharmaceutical students is part of my resource to understand the Korean healthcare system especially on updates in the pharmaceutical field. I hope the board members will continue to develop this magazine as much as possible to disseminate healthcare and pharmaceutical information.

Dr. Ashok Krishna Perumal, Unit for National Health Financing, Planning and Development Division, Ministry of Health Malaysia It is very fascinating and neat to read and has various interesting information such as Europe's pharmaceutical markets, simple ways to decide health care, and an interview with a public pharmacist. Especially, the article which deals with problems Korean drug companies face due to FTA between Korea and the United States was helpful. I had known the Korean drug companies would have been in trouble due to FTA, but not exact reasons for this. However, after reading this article I found out that the reasons very clearly.

On the other hand, I want to suggest one thing to make this magazine more academical. What about adding references at the last page of the magazine? It would be useful to search the information the magazine covers.

I want to recommend this magazine not only to pharmaceutical students but also to general publics. It is nicely readable and has lots of attractive articles. It would be useful for all people interested in pharmaceutical issues.

Ji-Hee Son, Sookmyung University, College of Pharmacy Freshmen The magazine was filled with diverse contents related to current issues so it was very fascinating. As a student studying pharmacy, I was most interested in the article about the upcoming changes of national examination for pharmacists and the one about a â&#x20AC;&#x2DC;smart drugâ&#x20AC;&#x2122; named Ritalin. Also, I was impressed by the big ambitions and the distinct educational goals of Yonsei University College of Pharmacy. I would look forward to hear more about the latest news about Yonsei University and other interesting information through The Blue Vanguard.

Sungkyunkwan university, College of Pharmacy Freshment It is very meaningful to issue an English magazine in Songdo International Campus. The content and design are sophisticated and organized. I liked the interviews from foreign students and first impression surveys as well as the medical issues. However, the Korean font does not go well with the rest of the magazine. It would have been better if the font were more sophisticated. Congratulations on your first step, and I look forward to seeing more improvements!

Kyung-hee Cho, Director of Pharmacy of Kangbuk Samsung Hospital

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