Yonsei Student Pharmacist
Vol. 3 06 INTERNATIONAL ISSUES Midwives for expecting mothers in New Zealand 15 COVER STORY Drug cost facing another fall? 32 PROFESSOR'S RESEARCH Interview with JangIk Lee
Editorâ€™s Note The Blue Vanguard is published once a semester by Yonsei Pharmacy students. The third volume is published on May 2013. Editor-in-chief GaYeong Heo Vice editor-in-chief Gyehee Yi Journalists Senior Sophomore Jane Suh Seolkyung Kim Misun Park Yongjung Jang Yougnsuk Yi Harin Lee Jongsung Hahn Onyoo Kang Jiyougn Jung Hyungmi Yoon Hyejin Cho Minju Kang The Cub Journalists - Freshmans Designed by The Blue Vanguard English advisor SangEun Eunice Lee (YIC CETS) Chan-hee Kim (YIC CETS) Prof. Roy Burlew Prof. Sharman Horwood Prof. Mike Kim Sponsered by Seoul Pharma Editorial office room #30, floor B1, Underwood Memorial Library, International Campus of Yonsei University, Songdo-dong, Yeonsu-gu, Incheon city, Republic of Korea
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At last, the third volume of The Blue Vanguard is completed! We have come a long way. First of all, the second volume of The Blue Vanguard was successfully launched. A thousand copies of The Blue Vanguard were distributed to colleges of Pharmacy, university hospitals, Korean Pharmaceutical Association, KFDA, alumnies in the pharmaceutical companies, and organizations overseas. In addition to distribution of the second volume, the first volume was distributed at the Admission Information Session of the college of pharmacy, Yonsei University. We were delighted to help many students who were preparing the admission. There are many changes in The Blue Vanguard. New leaders of The Blue Vanguard were elected. Two sophomores and seven cub journalists were recruited. You can see their wonderful first achievement in this volume. In addition to change of members, the magagine have some changes. We decrease the font size to incorporate more informations in The Blue Vanguard. Font type was changed to increase readability. Also, we clearly defined our class of readers as pharmacy students. The Blue Vanguardians do their best to provide the latest and good quality news to pharmacy students. How the policy of new Government effect to the pharmaceutical industry? In the cover story, we discuss about the usage-dependent drug cost policy. Furthermore, impressive movements in Korea to improve health care and to prevent a rebate are discussed in the national issue. Several cases of other nations comparing with Korea are introduced in the international issue. Students can have indirect experience with three interviews. What we hope through this issue is for pharmacy students who have busy life to have time to think about todayâ€™s role of pharmacists. The Blue Vanguard always welcome your feedback. Next semester, we are planning to establish the English Advisory Council of Blue Vanguard. Respect the next edition of the bigger Blue Vanguard with the Council and our new journalists. At last, as editor-in-chief of The Blue Vanguard, I thank all readers and contributors for their support and attention. We also express gratitude to our sponsor, Seoul Pharma. Finally, we felt enormous gratitude to professor Jinhyun Jung.
The leap of health care system in America Midwives for expecting mothers in New Zealand Taking another look at the NHS Is it certain that free’ is best?
Seoul city’s new idea, Seipu pharmacy ‘Hello Gene Service’ is Released Now, let us catch rebates by ourselves
Drug cost facing another fall
Interview with the director of regulatory affairs
Spring of Yonsei Dreaming the Hogwarts?
Yonsei, we make new history!
Meet a Friend on the Street
4 6 8
10 12 14
Straight answers to natural cosmetics
Broaden your view by Reading See the world through the Screen
the leap of health care system in america Seolkyung Kim email@example.com The American health care system has been private-centered for quite sometime. In the U.S., if somebody catches
a cold, 90 dollars (equal to 100,000 won) will be required for a single treatment. In one well known case, a man whose finger was cut off had to pay 60,000 dollars (equal to 67 million won) to reattach it. In contrast, in Korea, it costs 5,000
won to treat a cold and 200,000 won for an operation on a severed finger. It seems obvious that the medical treatment
should have a public character. Unfortunately, the health care system is based on free market systems in America because of the lobbying efforts of insurance companies, pharmaceutical companies and politicians. President Obama
has been making a great effort to reform this unfair system since 2009. Finally, in March 2010, the "Patient Protection and Affordable Care Act", which is frequently called "Obamacare", passed the Congress. With the advent of the times
of the new health care system, this article attempts to examine the past insurance policy, the new insurance policy in comparison with the old policy regarding the merits and the defects.
There have been various kinds of the private medical insurance in America. For instance, the HMO (Health Maintenance Organization) system is based on a profit-making system. With this system, anyone can establish a company and provide medical insurance. Their members are only able to use insured services at approved medical institutions which have contracted with the insurance company. In addition, there are also many medical insurancelike systems such as FSAs (Flexible S pending A ccount) and H ealth Saving Accounts. All of these forms of insurance have something in common: they are run by private insurance companies. However, the U.S. government also provides certain forms of public medical insurance, Medicare and Medicade. Medicare is for elderly
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citizens over 65 or physically challenged, and it is funded by the U.S. government. Medicade is made for the lower-income groups and the state government operates it. They account for 15% and 8% of the total spending respectively. The cost of the public medical insurance comprises a larger proportion of tax spending,
when it is compared to that of defense or social security. The problems with this system are the huge expenses of the public insurance systems and people who are in the blind spots in the health security system. Free market system tends to only maximize industry's profits. Most private insurance companies
a v o i d a c c e p t i n g l o w e r- i n c o m e groups and elderly citizens, so the government has to take responsibility for these people under Medicare and Medicade. The extravagant medical expenses aggravate the lack of government funding. To make the situation worse, the number of elderly citizens is increasing. Furthermore the people who don't have any insurance accounts for 16%, 46,000,000 people, in total. For these reasons, President Obama instituted the medical insurance reform, Obamacare. The point of Obamacare is that all Americans are obligated to have the private medical insurance and they must pay for the services except for government subsidies which are provided differentially by region, age, income and family member. People who do not have the medical insurance have to pay a fine. Meanwhile, Medicaid will be extended. Basically there are plans to set up "Health Insurance Exchange" in each state. Moreover, Obamacare covers basic benefits including the ambulance service, hospitalization, childbirth, post-natal care, psychological treatment, drug
addiction treatment, prescription drugs and rehabilitation. Even if the health care products are generally cheaper than others, they include most of the medical services. There are critical differences between the past and the new health security systems; First, the guaranteed insurance coverage regardless of medical history, region or age. Second, insuring obligation. People who cannot afford to purchase the insurance are able to buy it by receiving the government aid. It is expected that up to 30,000,000 Americans who do not have the health care system will have insurance from January 2014. As a result, about 95% of Americans will receive medical insurance benefits and also net liabilities will decline to 200 billion dollars for the next 10 years from 2012 to 2021 according to the Congressional Budgeting Office. Even though Obamacare appears to be a beneficial key to solution, some people are opposed to it. According to a public opinion poll by NBC and the Wall Street Journal, 35% of the respondents agreed with the new policy while 41% disagreed. They contend that Obamacare has
some serious problems. First, Obamacare promotes the private medical insurance, not public insurance. People may select the most inexpensive service for economic reasons, and they may be provided with limited service. Although it is not in their best interests, they pay manageable fees consistently. Shamus Cooke, who is a labor agitator working in the medical field has argued that â€œObamacare just provides new customers for insurance companies.â€? Second, some people may suffer a loss, especially middle and higher-income classes. Lowerincome class will be insured and they will produce lots of medical expenses. Unless medical expenses decline, it is obvious that someone must provide funding beyond the lower-income group. The estimated additional cost is 1.7 trillion dollars from 2012 to 2022. The elderly population has been a worldwide trend and the U.S. is no exception. An increase in medical expenses will become a major disaster and people who are in the blind spots in medical system will suffer. In this sense, Obamacare is the first step to the right path. However, it cannot be a perfect solution to all the problems in the medical system. In order to settle the new policy successfully, the U.S. government must find solutions to decrease medical expenses and insurance premiums. In addition, a mature sense of citizenship is required from insurance companies, pharmaceutical companies and politicians. They should consider ways to meet the needs of American citizens with regard to the public health care. B
Midwives for expecting mothers in New Zealand Gyehee Yi firstname.lastname@example.org
ost pregnant women are interested in making the experience of childbirth more comfortable and less painful. Many procedures have been developed for them, such as underwater childbirth, home birth, cesarean section, and epidural birth. Of all these methods, the cesarean section is the most commonly used one in Korea; in fact
it is the third country in the world to use the C-section most frequently according to the WHO. The main reasons for the
frequent usage of cesarean section are that the mothers fear the pain of childbirth and that some medical specialists, urge mothers to undergo cesarean sections in order to make a quick buck for the hospital. On the other hand, there has been constant effort and research to increase the proportion of natural childbirth overseas.
According to the WHO research on 2006, the caesarean section rate reached 37.7% in South Korea, which follows closely behind Mexico (39.9%) and Italy (39.7%) among OECD countries. It is three times higher than New Zealand(14.0%), which has the lowest rate.
Cesarean Rate among OECD countries, WHO, 2006
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The WHO warns about the risks of Cesarean sections, such as potential breast feeding problems, urinary wounds and uterine infections, and haemorrhage. However WHO states that C-sections should be done only as a life-saving measure when there is a risk of fetal or maternal death.
Childbirth under Cesarean Section
“How did the Midwife system begin?”
The midwife system in New Zealand was established in 1990 to maximize the proportion of natural births and to decrease the mortality rate of newborn babies. The midwife respects the mother’s wishes, who holds the primary right to decision making regarding her childbirth. This corresponds with mothers’ desires to learn more about the process of childbirth, helps them to decide on the method of childbirth they would like to undergo, rather than being treated as a patient under the care of a doctor, in which case her options are limited.
“What does a midwife do?”
During Pregnancy a midwife conducts the whole process of
childbirth, while the government supports all the hospital fees, including ultra sound, regular check-ups and the actual childbirth. Additional examinations such as blood tests, ultrasounds, and diabetic tests are arranged by the midwife. The mother may visit the midwife clinic but when it is difficult for mothers to go to the hospital, the midwife may make a home visit. The midwife will also organize the time and date of exams. Prenatal classes are available from the 25th week of pregnancy, and they provide many benefits such as, learning the breathing techniques for childbirth. A midwife will visit once a month until the 30th week of the pregnancy. From the 31st to the 37th week, the midwife visits fortnightly. At the 38th week, she makes weekly visits. On every visit, the mother will go through a urine test (for proteinuria and diabetic status), a blood pressure test, a general health condition check, and tests to check fetal heartbeat and possible deformities. When severe conditions such as toxemia are diagnosed, the midwife arranges appointments with specialists. Nearing the birth, the midwife explains the various methods of childbirth and about the possibility of abnormalities with the expecting mothers. They discuss and determine the methods of delivery such as hospital or home deliveries and water bath deliveries. Like all the other doctors and specialists, the midwife fully explains all possible conditions and methods and lets the mother decide. Accordingly, during this period, the midwife emphasizes the importance of natural childbirth and breast feeding. When the birth starts, the mother meets
the midwife at the appointed place(the home, clinics or public hospitals) and she receives one om one care for at least 24 hours, even after the mother gives birth. At the same time, the midwife can independently perform some simple medical operations such as perineum incisions and suturing. They may prescribe analgesics if needed. However when abnormalities with delivery is suspected, the midwife calls for standby specialists to execute an emergency operation. After childbirth, counseling is mandatory for emotional stability. Midwives also arrange gatherings with other mothers to prevent post-natal depression. For six months after childbirth. Midwives also provide parenting education such as instruction in bathing and the changing of diapers to both the husband and the wife.
“How about in South Korea?”
soon as the pregnancy is confirmed, mothers visit gynecologists, and most of them- 99% give birth in the hospital. The government provides 500,000won for the childbirth itself and 1,500,000won everytime for mothers who undergo in-vitro fertilization or artificial fertilization. Mothers can receive congenital anomaly tests and nutritional supplements (5 pills of iron supplements) for free. They have to visit gynecologists to obtain information about childbirth. Every consultation requires a fee and this might be a huge financial burden for some mothers. On that account, they sometimes gather information individually by joining internet groups related to childbirth. After birth, postnatal care centers are not easily accessible for every mother since they cost almost two-million won for two weeks. Are there any policies established to help mothers in Korea? Whenever a new government comes to power, they offer policies on various issues. However pregnancy support is not a major issue for them, though it deserves much more attention. The situation in Korea is quite different from New Zealand but the Korean government should initiate these systematic policies to faster better healthcare for expecting mothers. We should broaden the range of benefits for mothers and develop a respectful attitude towards maternity. Just as childbirth is the start of a new life, improving maternal care policies would be the start of Korea’s transformation into an advanced welfare country. B 2013 vol.3
Taking Another Look at the NHS Is it certain that ‘free’ is best? Hyungmi Yoon email@example.com
NHS, held responsibility for the British, ‘From the Cradle To the Grave’.
The Stafford scandal humiliated the NHS.
February 6, David Cameron, the Prime Minister of the United Kingdom,
apologized for the maltreatment of patients at the Stafford hospital. A public inquiry revealed that up to 1,200 patients had wrongfully died at the Stafford hospital, between 2005 and 2008.
Based on the testimony of scores of witnesses, patients in the wards
lay and helplessly suffered from starvation and thirst so that some of them had to drink the water in flower vases. When hopeless patients’ requests were ignored, they had to be left in filthy rags. Some received
wrong medication; some had none at all. Receptionists decided whether patients were in critical condition and inexperienced interns were
responsible for critically-ill patients. Furthermore, nurses rushed to empty
the hospital beds without regard to patients recuperation. This scandal brought genuine shame to the NHS, as it was due to the unreasonable financial savings policy of the NHS administrators.
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The National Health Service (NHS), publicly funded healthcare systems in the United Kingdom, was founded as a result of the Beveridge Report of 1942. This report aimed to provide a social insurance system that could ensure a minimum standard of living in Britain ‘from cradle to grave’. Highly popular amongst the public, the report formed the creation of the National Health Service which guranteed the beginning of the national-wide free medical care. On 5 July 1948, at the Park Hospital (now known as Trafford General Hospital) in Manchester, Aneurin Bevan, the Minister of Health, marked the official
opening of the National Health Service and stated, “We now have the moral leadership of the world”. The services were initially funded through general taxation and National Insurance funds. Ever since the NHS, everyone in the UK can get medical treatment regardless of his or her financial condition. The National Health Service is a prideful product, which shows that a socialistic public system can be maintained in a capitalistic nation. ‘From the cradle to the grave’, the NHS is now part of the British life, the one which shoulders the responsibility for their health. At this point, we have to ask the question: Is the NHS the perfect health care system?
Chronic problems render British health care vulnerable.
After the Stafford scandal, the NHS internal problems came to the surface. Firstly, fundamental problems within the NHS originate from the two conflicting goals: reducing the financial burden and promoting health care quality. If hospital trustees meet certain criteria, they would be reclassified as a ‘Foundation trust’, which is an independent public benefit corporation and is free from central government control. In order to become a ‘Foundation trust’, a hospital has to be legally constituted, well-governed, and financially viable. Mid-Staffordshire NHS Foundation Trust, which manages both, Stafford and Cannock Chase hospitals, was awarded the NHS ‘foundation trust’ status on 1 February 2008. In order to achieve
How to prevent repetition of Stafford scandal
the prestigious ‘foundation status’, Stafford hospital forcibly dismissed 160 employee and the remaining staff had to overwork to cover shorthandedness. Hospital budget cut occupied hospital members’ attention away from patients and standards of care on the wards. Both achieving ‘foundation status’ and providing indepth quality medical services are excessive orders for any hospital. Secondly, since the medical service is free, patients demand to receive unnecessary medical treatments which waste national tax revenue. In the nation in which medical system is charged, the problem is the physicians’ overtreatment. On the other hand, in the United Kingdom, the problem involves patients’ unnecessary demands for treatment and uninspired physicians’ low-priced care. It is another type of moral hazard prevalent in the UK, in that patients want to get health care blindly just because it is free, and physicians practice poor and perfunctory care because their income is determined by the number of patients they receive, not the quality of the care they give. Consequently, it causes ridiculously long waiting time for elective surgeries and low-quality health care by physicians, which only aggravates the illness of patient.
Although the NHS has many challenges to overcome, it seems promising because it has the power to overcome these difficulties itself. Different from other countries, the NHS has made the death rates of the each hospital known to the public. The investigation on Stafford Hospital was issued because of its abnormally high mortality rates. The fact that the NHS has a self-administered check system such as opening the death rate and starting the probe by itself shows a possibility for improvement. Along those lines, the program that examines whether the health care system functions well should gain a firm foothold. Furthermore, hospitals should know that reckless cost-cutting and lack of nursing staff can result in an awful patient suffering just as it was. Therefore, the NHS and hospitals have to maintain an acceptable balance between the overall quality of health care and the finances of the NHS. On a difficult and fast-moving day for the health service, the NHS has to show it has learnt a lesson from what happened at Stafford. The chart below is the five mandatories of NHS. NHS has to remember them and practice them. B
Seoul City’s New Idea,
Seipeu Pharmacy GaYeong Heo GYHeo@yonsei.ac.kr What is the best way to promote public health? Health Improvement Cooperation Pharmacy (HICP)* is a new concept
suggested by the City of Seoul as part of the ‘36.5 Public Health Master Plan’
(July, 2012). HICP means that pharmacies will participate in health improving projects such as the management of personal drug record, a smoking cessation program, and a suicide prevention program within the Public Health Center.
Seoul City did a pilot project at Jung-gu, Seoul from March to September, 2012. The outcome of the pilot project was found to be extremely successful. In the What is Seipeu Pharmacy? It means that minutely and comfortably usable health care program at the local pharmacy. Seipeu is consisted of ‘se’, ‘i’, ‘peu’ which is the first word of Korean meaning. Seipeu pharmacy designated by city of Seoul has above mark. How to be a Seipeu Pharmacy? Volunteer pharmacies which satisfied qualifications below. - Pharmacy which has more than 1.5 pharmacists. Pharmacy which has consultation area. - The number of Prescription filled is more than 100. Now, fifty Seipeu pharmacies are working in 4 -gu. What Seipeu Pharmacy do? - Quit smoking program - Preventing suicide program - Exhaustive management of drug history.
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Smoking Cessation Program, 55.5% of its participants succeeded in quitting smoking. Participants filled out a survey that showed they were satisfied with
this program. Therefore, the City wants to expand this policy and make it available to the entire city. The City publicly announced that HICP will begin in
April, 2013. However, doctors and some scholars are strongly opposed to the implementation of HICP. Therefore, city of Seoul started another pilot project at
4 -gu(Dobong-gu, Gangseo-gu, Guro-gu, Dongjak-gu) and newly named HICP to Seipeu Pharmacy. Now, fifty Seipeu Pharmacies are working.
What is the positive effects of Seipeu Pharmacy? There are several reasons why the city of Seoul had decided to use the local pharmacy to carry out the public health improvement program. First of all, the local pharmacy has good accessibility. For the success of the public health improvement program, accessibility of the execution corporation is very important. For example, Antismoking Cession participants need to keep their smoiking in check regularly. Also, residents
who are at suicidal risk come to the execution corporation voluntarily and checks their statuses regularly. With this in mind, first local pharmacies are located in the transportation hub of the town, making it easily accessible to its residents. This means that the local pharmacy has better accessibility than the Public Health Center, where there is only one per gu. Second, the local pharmacy has psychological
accessibility. In fact, many people do not want to go the hospital unless they have severe diseases. Most of smokers and melancholiacs have negative opinions about being they treated as patients. On the other hand, the local pharmacy is out front. For example, most pharmacies are located on the first floor, and the clear glass doors of the entrance allow passersby to look in. Anyone can enter the pharmacy without special reasons. Third, the local pharmacy has time accessibility. In hospitals, the consultation time per patient is less than 5 minutes because of other waiting patients. In comparison, the local pharmacy has enough time to consult the patients. In addition, citizens can go to pharmacies after work because the local pharmacy opens longer than the Public Health Center. Secondly, Seipeu Pharmacy can prove to be an efficient system for the government. Nowadays, the focus of public health issues is changing from the treatment of diseases to the improvement of personal health. Therefore, increasing the population England (similar with other EU) one of 3 level pharmacy service ( Basic, Further, Consolidation ) Consolidation: commision from PCTs** - including anti-smoking, medicinal therapy, mild cases management
America MTM : management for suitable medicinal therapy - including health record authority, lifestyle suggestion with doctors
Japan Home medical service : drug management in personal house Sports pharmacist : doping prevention, health management School pharmacist : education of drug obuse, self healthcare
of elders, the national health cost is improving. If the health improvement program works well within the local pharmacy, social costs originated in smokers and suicide could be decreased. In addition, preventing overuse and missuse of drugs, social costs about drugs can be decreased. Furthermore, using the local pharmacy that is set up already, a new organization does not need to be created and save labor costs by hiring more health care people. Also, Korea can use the abilities of pharmacists in widened ways. Third, a public health improvement program via the local pharmacy is a worldwide trend. Many countries – England, USA, Australia, Taiwan, and Germany – have a similar kind of system. The data on left side presents the type of system other countries have. You can see in the data that these systems have been very successful and the countries are satisfied with the system they are implementing.
Pharmacists staged a festive welcome to the City Seoul’s new attempt to improve the quality of healthcare for its residents. Recently, many pharmacists have been worrying about the reduced role of the pharmacist. In addition, as a result of the separation of pharmacy and clinic, the hollowing out phenomenon caused by the increased prescription dependency of pharmacy finance is serious. Therefore, pharmacists agree that Seipeu Pharmacy has many positive outcomes in the expansion of the function of pharmacies and to set up independent pharmacy finance. Also, pharmacists expect that Seipeu Pharmacy will provide further opportunities be a good chance
to emboss the role of pharmacists to citizens. However, some people insist the necessity of self-purification effort to do the role of Seipeu Pharmacy. For example, pharmacists need to raise their abilities as an expert. Pharmacists need to be more cautious when selling cigarettes; it would be quite contradictory for them to sell cigarettes while concurrently promoting an antismoking campaign.
Negative opinion of others
Despite the possible positive effects this new program may bring, some barriers have stopped the enforcement of Seipeu Pharmacy. First, the medicinal law in Korea does not allow medical treatments to be given without a doctor’s order. If pharmacists treat smoking, they may need to take the smoker’s medical history and this would be in violation of the law. Also, many doctors and some scholars insist that smoking is an illness caused by an addiction to nicotine. Therefore, they think that nicotine treatments that are already being provided by pharmacies violate medicinal law. Some scholars also worry about the confusion which may occur through the changes made in the medical systems.
Conclusion Seoul government’s new attempt in promoting healthcare is will provide a more cost-efficient programby making use of pharmacies. As the result of HICP’s pilot project was successful and received positive responses from citizens, the policy expanding to nationwide will also bring positive outcomes. However, to execute Seipeu Pharmacy, the medical personnel’s sincere considerations and wise judgments are needed. B
*Health Improvement Cooperation Pharmacy(HICP) is journalist’s personal translation. There is no official word. **PCTs : Medical service comprehensive organization of England
‘HELLO GENE SERVICE’ RELEASED the changing of the pharmaceutical paradigm Harin Lee firstname.lastname@example.org
Over the past few decades, the pharmaceutical industry relied on coincidence for the right chemical synthesis necessary for the development of new drugs to occur at some point during the trial-and-error process. The companies had not considered the role of genes in drug reaction. However, as the Human Genome Project was completed in 2001, it became possible to take genes into account in the development stage of pharmaceutical
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production. In response to this change in pharmaceutical paradigm, Youhan, a pharmaceutical company in Korea, newly launched a genome analysis service. Youhan had joined hands with Theragen Etex, a bioventure company. Together, they developed this service. Youhan took charge of marketing and Theragen Etex took charge of the analysis of genetic information. They announced the launch of ‘Hello Gene Service’, which
would officially be available through several medical institutions by January 30 of 2013. This service consists of a number of inspection items including cancers, cardiovascular diseases, brain diseases and general diseases that commonly occur among Korean. The service involves a simple blood test that predicts an individual’s susceptibility to certain diseases. By knowing the test results, the examinee will be encouraged to adjust his or her diet as well as lifestyle in order to reduce the risk of some diseases. In order to help these examinees, Youhan plans to establish a professional consulting service as well, as a supplement to ‘Hello Gene Service’ ‘Hello Gene Service’ attracts public attention as it has benefits reaching beyond simple prediction of susceptibility. Firstly, the service plays a monolithic role in promoting customized drugs. Until now, there had been side effects in certain drugs because the genes that code for enzymes associated with drug metabolism differ from one individual to another. Even if they did not suffer from side effects, many patients had to continue with ineffective drug therapy. With this new service, drugs can be customized in
order to minimize side effects and achieve high efficiency. Secondly, this service can contribute to the beginning of the construction of a Korean genetic information database. This database will serve as a foundation in the study of disease-related genes. Nevertheless, ‘Hello Gene Service’ also has some problems. Above all, there is an argument over the reliability of the results of ‘Hello Gene Service’. This service predicts susceptibility by simply examining genetic information, while disregarding environmental factors. Moreover, there is no long-term information about whether or not the diseases really occur in accordance with the test results. In addition, ‘Hello Gene Service’ may cause some social problems. When an examinee is claimed to be susceptible to certain disease, he or she could be under much emotional pressure and this may lead to a tendency towards overtreatment. Furthermore, if the genetic test results of individuals leak to insurance companies, insurance subscribers may suffer disadvantages from the insurance providers. ‘Hello Gene Service’ has many merits and it also has a few worrisome shortcomings. Regardless of the controversy, it is true that ‘Hello Gene Service’ achieves a great amount of significance as the first nationally available service based on a new paradigm of medicine. For the betterment of ‘Hello Gene Service’ and many other future utilizations of genetic technology firms and administrations should continue to seek for solutions. B
NOW, LET US CATCH REBATES BY OURSELVES Harin Lee email@example.com What is a rebate? A rebate refers to the act of giving back to the buyer some part of the amount paid or the money itself due to the cost of the business. In the pharmaceutical industry, many pharmaceutical companies provide doctors or pharmacists with some money or other economic benefits in order to get them to choose their products. Rebates have been a chronic problem within the pharmaceutical industry. Because of rebates, some doctors or pharmacists tend to select drugs according the amount of the rebate, rather than the drugs’ competency. Patients are taking action in order to eradicate rebates. ‘Patient Class Action’ was founded in December 28 of 2013 by Consumers Korea and Korea Organization For Patient Group. They had the aim of preventing financial waste within the National Health Insurance system and helping patients by obtaining reimbursement for rebates which were paid unjustly. Since a portion of the price of a drug is paid by patients and the other portion is paid by the National Health Insurance in Korea, increased drug prices harm both the patients and the National Health Insurance system. Therefore, if the National Health Insurance’s financial burden grows continuously, the government will increase health care costs and this means that people will be paying the overall price resulted by the dishonesty of pharmaceutical companies. In order to prevent such injustice, ‘Patient Class Action’ throws itself into eradicating rebates with devotion.
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In order to accomplish their purpose, ‘Patient Class Action’ is recruiting people who will file civil lawsuits against the pharmaceutical companies who make Zofran and Plunazol. They also sent in a petition for count to return the cost increased by the rebate of Stillen, Gaster, and Opalmon made by Dong-A Pharmaceutical; Ganaton and Nutriflex made by JW Pharmaceutical; Zofran made by GSK; Plunazol made by Daewoong Co. LTD.; and Cancidas and Cozaar made by Korea MSD. Furthermore, they held a press conference on January 1 of 2013 to request media attention. Additionally, ‘Patient Class Action’ plans to sue the pharmaceutical companies who were caught issuing large amount of rebates and boycott the drugs made by the pharmaceutical companies who are exposed to rebates more than three times.
Until now, doctors and the government have grappled with the problem of rebates and have proposed solutions. However, it is the first time that patients themselves have decided to take action in order to eradicate rebates. This event is meaningful in regard to the fact that patients, who are the end consumers and end victims, have made their first move. Of course, some people still have concerns regarding issues related to this action. For example, some worry about the effectiveness of boycotting since the right to prescribe belongs to doctors and patients cannot select drugs in the case of prescription drugs. In spite of these concerns, many people hope that ‘Patient Class Action’ obtains the desired results and contributes to the development of a sound pharmaceutical culture. There is much attention towards the development of the event. B
Drug Cost Facing Another fall A new pathway the government is seeking: Usage-Dependent Drug COST Policy Yong Jung Jang firstname.lastname@example.org
Changes that the Government is Planning:
In the year 2013, citizens shaw
only a 1.3% increase on costs for their national healthcare insurance program. However, it was the lowest increase in ten years with the exception of 2009 when there was no increase at all due to the economic crisis. One of the main reasons for the small increase is that the health insurance system is estimated to be in the black for 2012 and 2013 (2.2 billion won and 1.7 billion won respectively). What has led to this result? One of the main factors appear to be the savings from the Drug Price Reduction policy (DPR policy), adopted in April of last year. Within six months of the policy’s adoption, DPR policy resulted in saving of 636 billion won for the health insurance program. This is only the result of applying the policy for six months, but it already comprises 28.9% of the surplus for 2012’s health insurance budget. However, the government seems dissatisfied. The goverment has expressed its concern about the need to further lower the total medicine fee of the health insurance system. In order to do this, the government is planning to change the existing policy, the UsageDependent Drug Cost policy (UDDC policy). How is this policy going to be renewed? What sorts of problems are expected? Also, is counting down drug prices the best way to improve the financial efficiency of the health insurance system?
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From the original policy, the government is planning to change two parts: the criteria for drugs involved and the price’s maximum reduction rate. First of all, instead of just controlling new drugs, the government wants to include existing drugs. They are planning to add drugs where the usage increase rate does not reach 60% but command annual expenses over 10billion won into the criteria. This means that popular drugs will now be under the policy’s effect. Yong Ik Kim, a lawmaker who support this change said “Since popular drugs take up a large portion of the drug cost covered by the health insurance system, it is necessary to change the policy and include these products in the criteria.” Indeed, from 2008 to 2011, among the thirty topselling drugs, only two products had their prices lowered as a result of the usage-dependent drug policy. If the criteria were to be expanded, 40.5 billion won could be saved annually. Secondly, maximum reduction rate of drug prics would be changed. Currently, the maximum reduction rate is 10%. By increasing it to 15% and 20%, 1.5 billion won and 11 billion won could be saved. To sum up, by adjusting the target drugs and the price reduction rate, the National health insurance service expects to save 50 billion won annually.
What is the Usage-Dependent Drug Cost Policy? Main purpose Since 2009 this policy checks the application of the drug priceusage agreement. When a new type of drug does not fulfill its original quota agreement, the policy renegotiates the price, often lowering it. This helps prevent increases in the total medicine cost of the health insurance system by limiting excess profits earned by the pharmaceutical companies. Policy content until now Medicines that are managed under this policy have to meet the following criteria: the amount of the drug consumed must exceed the amount agreed upon while negotiating its price (30% increase rate) or the drug must have received health insurance approval without negotiation and have increased in usage compared to the year before by 60%.
Difference between the DPR policy and the UDDC policy DPR policy Since 2012, to all drugs that are covered by the Health Insurance System. UDDC policy Since 2009, only apply to new drugs.
Industries loss of will due to redundant reduction
Problems Pointed Out by the Pharmaceutical Industry The Korean Pharmaceutical Manufacturers Association (KPMA) officially announced their concern through a press conference on January 14th. They argued that adding existing drug into the criteria would work against the policy’s primary purpose, which was to regulate new drugs that might cause unexpected losses for the health insurance system. In addition, they specifically criticized three aspects of the prospective policy: overlapping reductions, the vast range of subject drugs, and the policy’s oversight and application.
Through the DPR policy, many of the drug prices have been lowered already. Won Sun Jang, team manager of the Fair Drug Price Policy team of the KPMA pointed out that the main problem with the extension of the UDDC policy lies in the redundant reduction rather than in the increase of the maximum reduction rate. (Drug prices have already been lowered up to 53.55%. due to the DPR policy) . Implimenting an additional policy to restrict the drug price is in opposition to what the government promised last year, a boost in the pharmaceutical industry. The unnecessarily large range of subject drugs In order to discover drugs qualifying for the policy, almost every drug in the market has to be monitored. This will surely lead to huge administrative costs. Also, if popular products were included in the policy’s effect, the incentives for the
pharmaceuticalcompanies to develop products would be weakened. For example, company A worked hard to develop a drug, sell it and the drug became a top seller. What does it get back for this result? Normally, the company will be rewarded with a high profit. However, with the enforcement of the UDDC policy, what they will get is a price reduction. If this happens, what company would be willing to invest in the development of an innovative drug that would help save lives? The operation method Other countries such as France, Australia, Belgium maintain a policy similar to the UDDC policy but via a payback system which is preferred by the industry. By operating payback systems, the total drug price of a certain drug category is reduced, not the individual drug price. Also, in the policies of these countries generics* are ruled out of the criteria to encourage its sales. This also differs from the Korean policy which lacks encouragement for generics.
•Two different ways of Usage-Dependent Drug Cost policy. Cost Reduction System Methods
-Determine a prospective usage
-Determine a target value of the
amount for each drug and compare
whole drug cost or each drug group
the usage to the real amount
depending on their remedial effect.
-Support the welfare of citizens
-Easier to adopt because companies
through drug cost reduction
prefer this way. -Can carry out a various types of paypack system according to usage rate.
Effect of Reducing Drug Cost
-A continuous effect
-A periodical effect at the time of the payback.
*generics: copy drugs of original drugs which patent has been expired. 2013 vol.3
Direction of Improvement Making Changes Considering Industry’s Demands
Through a press conference, KPMA conveyed their thoughts of improvement about the UDDC policy. First, KPMA advised the government to include only new drugs in the policy and enforcing the policy only 3~5 years after the drugs’ release. This is because the drug sales need time to equilibrate since it has the possibility of rapidly rising in usage. Without this adjustment period, companies will lose the chance to recouperate their R&D expenses. Furthermore, KPMA requested exceptions for drugs that have already been discounted by the DPR policy. Also they wanted the industry to be able to choose between a price reduction policy and a payback policy among the UDDC policy. Last but not least, the association pointed out the need for a systematic complement to estimate the expected usage. Before fulfilling these specific requirements, it seems advisable for the government to explain more about the unclear purpose and goal of the UDDC policy. It appears to be aimed primarily at reducing drug prices and securing the future of the health
Main Plans of Change
insurance system. If so, it begs the question; is cutting back drug prices the only way? It is advisable to do a thorough search for other ways to reduce health insurance expenditures. If the additional drug price reduction is absolutely necessary, the government should at least clarify the amount of expenditure it is aiming to reduce. Without this information, the pharmaceutical industry would feel like it is going through an endless, unpredictable storm. The government has not yet officially announced the primary purpose and the aim of the redesigned UDDC policy. Until now it has just been making suggestions. If it is determined to really push forward this policy reform, the government should discuss it fully with the pharmaceutical industry and propose a justifiable reason, a proper management plan, and a specific goal. Talented students are flocking into the medical field. The pharmaceutical industry can become an engine for future growth. With this in mind, the government should help the industry to retain its power for growth. B
Key points of the KPMA’s demands •Include only new drugs
•Adding existing drugs into the original
•Give exceptions for drugs that have
already been discounted by the DPR
•Raising the maximum reduction rate from
10% to 15~20%
•Give chance to choose between a price reduction policy and a payback policy among the UDDC policy
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Interview with the Director of Regulatory Affairs
Hyejin Cho email@example.com Jiyoung Jung firstname.lastname@example.org
Head of Regulatory Affairs
s many paradigms have changed in the medical industry, it is getting difficult for pharmaceutical companies to survive. Therefore, many pharmaceutical companies and the Korean government are now focusing on developing new medicine. Under this situation, pharmacists are expected to play important roles. The Blue Vanguard would like to introduce the roles of pharmacists in pharmaceutical companies. On January 25th, we visited HANDOK pharmaceutical company and interviewed EunYoung Choi, the director of Regulatory Affairs.
What do you do at an RA Department in a pharmaceutical company? ‘RA’ is an acronym for Regulatory Affairs, and they are mainly requesting, receiving and maintaining permissions of products such as pharmaceuticals, quasi-drugs, and medical devices. Unlike an ordinary company, when a pharmaceutical company runs a business, they must obey the regulations such as the Pharmaceutical Affairs Law, Medical Appliances Act. Therefore, the RA department mainly plays an advisory role during progress of manufacture, importation, sales and marketing. Would you recommend several departments in pharmaceutical companies available for the graduates of the College of Pharmacy? Except for financial, management
support, secretaries, and legal teams conducting the ordinary business tasks, there are three major departments that a pharmacist is able to display expertise. First, the Research and Development Division includes a research institute, business development, RA, clinical research, and Medical Affairs (MA) – the department prepares for academic research paper to completing Sales and Marketing activities scientifically to great extent. This division particularly focuses upon discovering new products and conducting clinical trials, and finally receives the permission to sell the products and provide medical information. Second, Production Division - Quality Control (QC)1 , Quality Assurance (QA)2 - involves to manufacturing pharmaceutical products.
Third, the Sales and Marketing Department is the PR department which sells the products. At least two years’ experience is required when recruiting new employees in the marketing department. Medical Representative (MR - they are in the sales team) has become important in providing details on the products. They provide the precise description of the product’s features so that doctors know whether or not the products are suitable for their patients. In order to do that, background knowledge in Pharmacy is necessary. I guarantee you that pharmacists will be able to work well within a MR team, if students are well educated during the college years. 1 the process of meeting products and services to consumer expectations 2 the process or set of processes used to measure and assure the quality of a product
What should pharmacy major students do for future career? You do not have to worry too much and remember you are not alone in this. Meet your seniors who are currently working in this field. A lot of students have a superficial view of the careers, but students should keep asking seniors what they are doing, what kind of difficulties they have, and how they do with it. Internship program during vacation periods might be a good opportunity to experience the “real-life” working environment. Furthermore, when you earn your pharmacist license, you will be able to learn on the weekends as a managing pharmacist at the community pharmacy. Holding a Job Fair might be one way. From these three or four fields – governmental offices, pharmaceutical companies, hospitals, and community pharmacy, choose interesting fields and invite seniors. If possible, invite those who are in senior positions with in those fields of expertise, and hold briefing sessions. What do you think is the most important factor to be a successful
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professional? I value the ‘trust’ most. Speaking of trust, trust is also one of the five values that Handok pursues. It is because the RA team has to cooperate with other departments within the company, and also has to submit the articles that must convince the Ministry of Food and Drug Safety (MFDS) regarding the quality of a product. Since the staff at MFDS should work in compliance with the law as a civil servant, it is important for us to understand the situation of the other party, as well as to reach an agreement that can be beneficial to each other. Sometimes, challenging and achieving attitudes are necessary, and it is important to create a mutual relationship where both parties eventually trust each other while working in harmony. In addition, it is important to predict accurately. Since it is necessary in order to specify what labels to publish concerning several indications. The second reason is that the schedules of other departments are determined according to the permission schedules of the RA team.
What do you think about the many changes that happened in the pharmaceutical industry recently? In the pharmaceutical industry, there have been a variety of changes such as the medical fee cut and the dual punishment system regarding rebate. They make it difficult for pharmaceutical companies to survive. However, I think that it is a natural progression to some extent. There are some professional jobs that require people to obtain licenses. Pharmacists are one of the team. Most pharmacists consider themselves as experts only because they have licenses. Actually, many of them could easily enjoy a successful life without too much effort. In my opinion, however, it is not fair. Even though they have licenses, they still need to compete with each other. It should be natural that the one who works hard succeeds, and the others do not. Recently, several policies have been introduced. It is true that those policies made it difficult for pharmacists to survive in the pharmaceutical industry, but it is
a desirable direction. In this way, the pharmaceutical industry will hopefully become a fair industry and keep up with global standards. Does Handok develop new medicines? What are the prospects of this company? In Handok, we are trying to develop new medicines. However, as the second runner, we have many difficulties. Therefore, we are focusing upon open innovation. Open innovation is a management strategy which involves collaboration between pharmaceutical companies and universities, venture businesses or laboratories. In open innovation systems, universities, venture businesses or laboratories first research new substances. When the research progresses, pharmaceutical companies adopt this research and conduct clinical trials. We are developing new medicines this way. The future seems uncertain, but not totally bad. As you know, the development of new medicines is very difficult because it takes a long time and costs a lot of money. Furthermore, there is no guarantee of success.
However, there are positive aspects. First of all, the government will be more supportive. They announced that they recognize the importance of the pharmaceutical industry, so we expect to receive help and support from the government. I also believe that Koreans have strong enthusiasm for the better future. Sometimes they surprise the whole world by succeeding in something that seems impossible to achieve. I believe this enthusiasm can be the driving force for the pharmaceutical industry, so I expect a brighter future for the pharmaceutical industry.
Lastly, what words of wisdom would you like to offer to pharmacy students? These days, many people tend to regard personal happiness as the best value. In my opinion, however, that kind of thinking will make it difficult for them to succeed. To become an expert in one area, ceaseless efforts and full commitment are demanded. If you devote yourself faithfully, there will be good results. B
What is the goal of your life? It is the most difficult question for me. This would be the chance to reconsider my life. First, I want to be a caring person. I want to achieve my goal of helping people who need my help. Next, I will try diligently in any kind of work. Even if some experiences seem irrelevant to my goal at the moment, I believe it will be helpful some day in the future. Actually, I was able to come to this position because of a variety of experiences. 2013 vol.3
Yonsei Kang Onyoo email@example.com
et another spring came after winter and a new semester of Yonsei College of Pharmacy began. New freshmen joined the family of Yonsei College of Pharmacy. Joining our Damimban(Proffesor and students group) and clubs, they have brought vitality and freshness. All students of Yonsei College of Pharmacy started new semester with new classes, books, and new dreams.
Freshmen orientation was held on Febrary 15th, 16th and 17th in Pocheon.
â—€ Students played games and had a chance to make a new relationship.
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▲ One freshman was guessing the meaning of a ▲ Students showed their talents by dance, musical, drawing while playing charades in a group activity.
and other performances.
Colorful drinks are called Ye o n y a k j u . Students wrote their hope of this semester on a star-shaped paper, making constellations with them. Students selected one star and give the Yeonyakju to the writer of one. Each students selected a star and gave Yeonyakju to the star’s owner.
S t u d e n t s took a group photo in front of the accommodation with the winter mountain of Pocheon behind them.
After Semester Began On the April 5th, Professors and students planted trees in front of Yakhakgwan(Building of College of Pharmacy). The trees were later clothed with blooming flowers.
On March 28th, Professors, freshmens and sophomores went on a field trip to Daewoong Pharmaceutical Coorperation.
National Association of Pharmacy Student Unions held an athletics meeting on the 30th of March. Basketball team of Yonsei made it to the finals.
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campus issue On the 22th of March, there was a pep rally of Yonsei University and Korea University in outdoor theater of Sinchon campus.
Waving the flag of Yonsei Colleege of Pharmacy, students showed their school spirit.
Blue waves and red waves competed against each other.
All freshmen participated in the Residentioal College(RC) program. Some sophomores and juniors joined the RC as Residential Assistants(RAs). Students live in dormitory together, bringing them closer. B 2013 vol.3
DREAMING THE HOGWARTS? YONSEI, WE MAKE NEW HISTORY! Seolkyung Kim firstname.lastname@example.org Hyungmi Yoon email@example.com
- HOUSE THEME * AVISON HOUSE
-Silent & Cozy
* ARISTOTLE INT’L HOUSE
-The Good Life
* ALLEN INT’L HOUSE
-Global, Multicultural, Diversity
* UNDERWOOD HOUSE
-Creating New Yonsei Style
* BAEK YANG HOUSE
-Dynamic & Creative
* YOON DONG-JOO HOUSE
-Intellect & Practice
* MUAK HOUSE
-Music & Harmony
* YONGJAE HOUSE
-Truth, Freedom & Union
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Yonsei Opens a New Educational Venue for Freshmen in Songdo! I n t h e s p r i n g o f 2 0 11 , t h e Residential College (RC) was founded at Yonsei International Campus (YIC) in Songdo. The college aimed to create an environment where learning and living converge, so that the freshmen could obtain an all-round education in order to become global leaders. For past two years, only six majors have participated in RC programs: Pharmacy, Pre-medicine, Pre-dentistry, Integrated Technology of Engineering, Underwood International College, and Openmajor. However this year, about 2000
students who constitute half of all freshmen students are participating in this program for one semester, and from next year, all freshmen have to come to Songdo, in order to attend to this program for one whole year. As mentioned above, the fundamental goal of Residential College is all-round education. The college expands the concept of dormitory from only a place for living into a place for experiencing and learning. The RC program basically consists of five elements; an advanced education model, a dormitory which is connected with a learning place, a multi-cultural community, diverse communal activities, and global leadership education. The world’s prestigious universities such as Harvard, Yale, Princeton and Oxford
have long histories with Residential College programs. Yonsei, following this new paradigm of education, encourages students to experience diverse activities including music, sports and art with peers who live in the same place for 24 hours. It can promote studentsâ€™ creativity and sensitivity, which are hard to attain from other universities. Moreover, through meeting many people, who have different grownup environments, students can better understand cultural differences and learn how to understand others.
Eight Unique Houses and Programs are Waiting for Students.
Each freshman is randomly assigned to one of the eight houses that constitute the Residential College: Avison, Aristotle, Allen, Underwood, Baekyang, Yun Dongju, Muak and Yongjae. These eight house communities offer students the chance to meet others from a variety majors and also feel sense of belonging to their houses. All of these eight houses have six common programs. Art performances, aimed at enhancing the creativity of students, are held three times per semester ("Performing Arts Series"). Playing sports game will be held at May ("Sports League"). Students can transform recommended books into other kinds of art, such as a movie or play ("Reading Project"). There are also chances to talk about social issues ("RC Forum"). Students and professors make a newsletter that
is designed to introducing programs and pictures to parents of students ("RC Newsletter"). At the end of the semester, gifts are prepared for the House which has the highest total points ("Best House"). In addition, each house prepares various kinds of specialized activities. Students can experience lots of activities and enjoy these programs. It is obvious that the Residential College Program is a challenging education paradigm for universities in Korea. Yonsei University is planning to accept the entire freshmen class next year, therefore the progress of the current RC experiment is excessively important. The Blue Vanguard hopes that Residential College program should serve as an opportunity for Yonseians to make new history, and for the students to acquire a creative and innovative education. B
Meet a Freind On The Street Jongsung Hahn
ormer dean of the shool of Pharmacy (SOP) at University
of California Sanfrancisco (UCSF), Koda-Kimble, visited SOP at Yonsei university in fall 2011, and delivered
a speech on the importance of the clinical pharmacy.
UCSF’s vision, curriculum, and lab study, I visited UCSF last winter while
I was travelling in Sanfrancisco. I was
fortunate to meet a Korean pharmacy student studying at SOP of UCSF.
Could you Introduce yourself to the reader of the BlueVanguard? Hi. My name is Soonmyung Lee, and I am a senior student majoring in Pharmacy at UCSF. I came to the United States to study twentyone years ago, and I already have a master’s degree in computer science with specialization in bioinformatics from another university.
what do you think is the greatest advantage of UCSF’s program? UCSF attentively listens to student feedback to improve their curriculum each year. For the past three years I have been studying at UCSF, and many of the courses that I took during my Pharmacy year 1 (P1), P2 and P3 have been cancelled, combined or overhauled for the newcomers based on the course evaluations filled out by students after completion of the course. Constant changes in the course curriculums show that UCSF administration tries their best to provide the best education possible to students. Moreover, it also indicates that UCSF is not afraid of any changes, which is valuable character to have for the school that teaches the professions who have been and will be able to adapted to rapid change.
Special thanks to Soonmyung Lee. (Second person from the right in this picture)
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What kind of specific track does the UCSF SOP offer to the student? There are three different tracks at the UCSF SOP: Pharmaceutical Care, Health Services & Policy Research, and Pharmaceutical Sciences. Pharmaceutical Care emphasizes the development of clinical pharmacy practice skills in a variety of acute, ambulatory, and long-term care settings. Health Services & Policy Research highlights policy, management, and economic issues. Pharmaceutical Sciences underlines the research foundations, research design, research skills, biostatistics, and pharmacogenomics. UCSF is famous for the clinical pharmacy. Would you tell us more about role of clinical pharmacy in U.S.? Clinical pharmacy began over 50 years ago in the U.S. when doctors had started to realize that pharmacists had a deeper understanding of the drugs than they did. For the sake of treating the patients safely and accurately, doctors set their pride aside and started to consult pharmacists when dealing with drug regimens to avoid potential side effects and drug-drug interactions.
In recent years, clinical pharmacists have become an integral part of every hospital specialty departments, such as cardiology, infectious disease, transplant, HIV, pediatric, and many more. At these departments, clinical pharmacists oversee the drug regimens of the admitted patients until they get discharged. Ambulatory care clinics also have been a success story of utilizing clinical pharmacists. These clinics specialize in managing the patients with chronic diseases, such as diabetes, HIV/AIDS, hyperlipidemia, deep vein thrombosis/pulmonary embolism, and congested heart failure. In these clinics, pharmacists are in charge of adjusting the dosage of the drugs and discontinuing or adding the drugs under the protocols of co-working doctors. I heard that UCSF launched automated pharmacy(e.g.,robotic pharmacy), then how do you think the roll of a pharmacist will change? I think Robots will liberate community pharmacists from dispensing duties, so that pharmacists will be able to provide services that were used to be done at hospitals in the near future. Community pharmacists have been already giving immunization shots to patients for several years now. Soon, pharmacists will begin to offer more chronic disease management services, such as A1C/Blood glucose, cholesterol, blood pressure, and INR screenings to patients. Based on these screening results, pharmacists will also be able to adjust, discontinue or add drugs under the protocols of the co-working doctors. As a matter of fact, Walgreens, the largest pharmacy chain in the U.S., is currently training
their pharmacists in order to roll out the A1C and cholesterol screening services. Would you share your opinion on Koreaâ€™s new 2+4 year program in Pharmacy education? I believe it was the right move for the Korean pharmacy schools to adopt 2+4 year program in order to train highly qualified and globally competitive pharmacists. There are three reasons to support my assertion; first, the number of drugs has been slowly but steadily increasing for several decades. Second, the complexity of drug regimen and the side effects have become alarmingly complicated. Therefore, cramming all these important materials on top of the basic science courses into four years would be simply impossible. Lastly, experiential learning is absolutely necessary in the healthcare industry. This not only closes the gap between the school and the workforce, but it lets the students to explore their career options within the field of pharmacy. I hope that Korean Doctor of Pharmacy (PharmDs) will take on the challenge of improving the pharmacy profession by using their additional education they received through the 2+4 year program as their weapons and shields, just as the American PharmDs did in the 1960s.
Is there anything to say to students of pharmacy who will read this article? I know that American PharmDs did not go on a strike, hold a demonstration, or fight with doctors and nurses to expand their scope of practice into the clinical pharmacy. Instead, pharmacists proved to other healthcare providers that they are an important part of the healthcare system by providing useful drug information. I hope Korea pharmacists will go on that way, too. B
Automated pharmacy (www.ucf.edu)
Straight Answers About Natural Cosmetics Does Your Skin Like Homemade Natural Cosmetics? Misun Park firstname.lastname@example.org “Don’t eat, yield to your skin.” As
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you can see it from this catch phrase of a popular cosmetic company, the Korean cosmetic market is now dominated by products with more natural ingredients. Almost every cosmetic product includes the word “natural” on its ingredients label, as if not being natural means the product is harmful to its users. Nonetheless, are the cosmetics that allegedly have such ingredients really natural? To answer these questions, the Blue Vanguard reporter called Korea Food and Drug Administration (KFDA) on February 6th. Surprisingly, however, in answer the public servant replied, “there is no definition and regulation regarding
natural cosmetics.” Then what does the term “natural cosmetics” mean? The absence of legal terms and regulations means that the consumers of so-called natural cosmetics are susceptible to deceit. SEPHORA, the beauty-retail with the largest distribution network in the U.S., defines “natural cosmetics” on their own as cosmetics without chemical preservatives, artificial dyes, and synthetic perfumes” How many cosmetic products can be qualified as 100% natural under this definition? The answer is none. On the basis of the four major principles of manufacturing cosmetics (safety,
stability, effectiveness, usability), artificial additives are essential and unavoidable for the cosmetics to have a shelf life of more than a few months (The Secret of Korean Cosmetics, Heeyeon Ku). If we regard the ingredient as 100% purely natural, it should include only natural ingredients, without any pesticides or artificial additives.
The Distrust of Existing Chemical Cosmetics
Worried by the increasing onset rate of atopy dermatitis, mothers with infants are especially interested in products made from natural ingredients. The mothers’ focus on the natural is rooted in the belief that natural things are safe and the widespread fear of the harmful effects of chemical preservatives, artificial dyes and surfactants. Among those chemical products, parabens are considered most hazardous. The studies on the toxicity of parabens are rather controversial so far. Some argue parabens may cause severe side effects, such as the decrease in sperm count and an increase in the incidence of breast cancer. On the other hand, some studies refute such arguments by claiming that it cannot be acquired through the skin, and thus applying it to the skin will not taint the user’s system. According to KFDA “Standard Table of Cosmetic Hazardous Components”, parabens of less than 0.4% of one-component and 0.8% of multiple components are safe. However, even if all of the cosmetic companies now follow this regulation, there is another problem. In Korea, “All Components Indication System of Cosmetics” was implemented
October 8th, 2008. The components are listed in order of volume on packaging containers for cosmetics. But, components that consist of less than 1% can be listed in order regardless of their volume. For this reason, consumers can not calculate the total volume of such ingredients. That means that Korean women who frequently use makeup do not know how many chemical additives have been applied to their skin in the cosmetic.
Are Home-made Cosmetics a Better Alternative?
Even though Korea has many selfcosmetic specialists who claim they are knowledgeable, the government has no regulations on home-made cosmetics that would control them. Moreover, it is difficult for women to check whether or not the recipes for home-made cosmetics on blogs or in books have a good theoretical basis. For example, it is very difficult to manufacture cosmetics using Vitamin C. Vitamin C is regarded as a great anti-oxidant substance because it is chemically unstable in the body. But many self-cosmetic specialists tell us that we can make whitening cream with lemon that would supply lots of Vitamin C to our skin. However, there is no proof that home-made vitamin C serum is absorbed effectively through the skin. Many researchers still have difficulty finding the formulation for as much dermal absorption of Vitamin C as possible. To keep your valuable skin healthy, you need verified help from genuine experts, not from self-proclaimed experts who have only scratched the surface in their knowledge of cosmetics. Meanwhile,
natural preservatives are neither effective nor long-lasting compared to chemical preservatives. These products with natural preservatives can be easily contaminated by microorganisms. It is possible that consumers will then put on more bacteria while trying to avoid artificial substances.
The Cosmetics Consumers Should
What should we do to keep our skin beautiful when there seems to be no perfect solution? Unfortunately, common chemical cosmetics still seem threatening and home-made cosmetics make mostly make-believe claims. Here is the answer. Firstly, find cosmetics which contain less chemical ingredients known to be harmful to humans. You can get information on allergic ingredients and hazardous substances from the KFDA website. Then, choose the product that suits your skin type. Allergic ingredients differ with each individual. Therefore, you should carefully listen to your body’s voice, not other people’s opinion. Thirdly, raise your voice to let companies know that you want excellent cosmetics through qualified manufacturing processes. Cosmetic companies will listen and create what will be valued in the marketplace. Recently, some cosmetic companies have tried to reduce the amount of chemical preservatives in their products while they still claimed that such substances were not harmful. We should be more proactive as consumers and be critical of the cosmetic market for the sake of beautiful skin. B
An Interview with
JangIk Lee GaYeong Heo GYHeo@yonsei.ac.kr Gyehee Yi email@example.com Scholarship 1984 Bachelor of pharmacy, Seoul Univ. 1986 Doctor of pharmacy, Seoul Univ. 1996 Pharm.D. Univ. of Minnesota, College of Pharmacy 2001 Ph.D. Univ. of Pittsburgh, School of Pharmacy
For the students of College of Pharmacy, Yonsei University,
Professor JangIk Lee embodies the College’s central thought that believes that the pharmacist’s role as a bridge between basic sciences and hospital clinic. As you can see from his career, he
experiences the process of drug development at a pharmaceutical
company, a pharmacy, a laboratory and the FTA. Because of his
vast experience, many students who start their first steps as pharmacists wish to seek his wisdom. Unfortunately, he is one
of the busiest professors among the facility. For other pharmacy students, Blue Vanguard interviewed Professor Lee.
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1983-1983 Chairman of Student Council at College of Pharmacy, Seoul Univ. 1986-1992 Senior Fellow, Lucky Biotec Laboratory 1992-1993 Management Pharmacist, SinBaek Pharmacy 2001-2001 Clinical Pharmacology Fellow, US FDA 2001-2004 Clinical Pharmacology Reviewer, US FDA 2004-2008 Senior Clinical Pharmacology Reviewer, US FDA 2008-2011 Secondary Clin Pharm Reviewer/Acting Team Leader, US FDA 2011-2012 Adjunct Professor, College of Pharmacy, Yonsei Univ. 2011-2012 Scientific Investigator, US FDA 2012-Now Full-time faculty Professor, College of Pharmacy, Yonsei Univ.
Research Area - Regulatory Sciences - Clinical Pharmacology - Clinical Pharmacy
Q: What do you do in your office? I have two offices, one in Songdo Campus and the other one in the Clinical Service Center at Sinchon Severance Hospital. In Songdo, I usually check the emails, on news about new drug developments, some inquiries from the pharmaceutical companies, and other news from school. At the hospital, I study clinical tests that pharmaceutical companies requested. I attempt to identify and evaluate the efficacy, bioequivalance, ADME pathway, and DRUG-DRUG INTERACTION by checking the effects of the drugs on humans. Q: What is regulatory science that you do? The Korean equivalent term for “Regulatory Science” leaves the impression that it is a discipline which suppresses and restricts the object. However, it, in fact, refers to a disciplinary research that studies the process to promptly approve a good medicine. That is why I wish to translate the term to mean regulation rather than restriction. Regulatory affairs actually deal with the project management of the entire process. For example, when scholars of regulatory science report animal test results to Ministry of Food and Drug Safety (MFDS), they first need to decide where to consign the animal test, how to organize the data, and finally where to execute the clinical trials. Regulatory science tries to define new regulations and criteria in developing new drugs and establish new regulations based on the interpretation of the produced data. That is why I want to call it as a “science system” rather than a “regulatory science”. Q: It seems like a complicated field requiring a vast professional knowledge, what kind of background knowledge is necessary? It is. It requires knowledge beyond the undergraduate level. Above all, the most important thing is that whether the new substance is safe to humans or not. Side effects inevitably follow medicine, so risk-benefit analysis is important and so that the benefit outweighs the risk. This is clinical pharmacology and 70~80% of it comes from the knowledge in pharmacokinetics. Q: As a researcher who completed both PharmD and phD, what do you think is the role of pharmacists in large projects such developing new drugs? Of course, doctors play the main role in finding out
the clinical outcome data in the process of developing new drugs. Although in Korea, clinical physiology is dependent on persons with medical degrees, in the US, sixty percent of clinical physiologists have pharmaceutical background. Not everyone would agree but I strongly believe that health care is like an orchestra. All members should perform their roles in harmony. The leader is unquestionably a doctor. The leader should know the roles of each member and lead them well. In the orchestra, a pharmacist is like the First Violin. In the absence of the conductor, the First Violin should lead the rests. In order to do so, experienced pharmacists are necessary. Doctors and pharmacists are in conflict with each other in Korea and I think this atmosphere is damaging the harmony. Q: What made you resign from FTA, and return to Korea? To be honest with you, more than ten universities offered me tempting positions. There were several reasons why I refused them. First, at that time, I did not want to give up the attractive job I had at the FTA. But one of the main reasons for refusing them was that those universities were not ready to organize appropriate conditions for research and education. I’m interested in teaching both clinical pharmacy and regulatory science. In these field, studying cannot simply rely on the book. Students have to care for patients in actual situations in order to properly learn the clinical pharmacy. Pharmacy students study Pharmacotherapeutics in order to cultivate a basic knowledge of caring for patients. However most of those pharmacy schools either didn’t have the hospital or didn’t maintain a cooperative relationship with the hospital even if they had one. In contrast, the doctors in Severance Hospital were very positive and cooperative in establishing the School of Pharmacy at Yonsei. They are looking forward to seeing the contribution that pharmacists will make to the Severance hospital in the future. The goal of Yonsei Pharmacy College coincided with mine, which helped me decide on my return to Korea. Q: What kinds of skill are helpful out in the society? Whatever you do, the most important thing is the interpersonal skill. These days, as the interdisciplinary studies are a trend, the interpersonal skill is becoming more important. The funny thing is, in the US, people establish friendships after conducting business, while in Korea they become friends first, and then conduct the 2013 vol.3
business. On that account, it takes long to complete a business transaction, and there are many problems such as school relation, kinship and regionalism. I believe we should seek ways to amend for these through interpersonal skill. Q: I can see that you had been the president of student council in your personal history record. (He seems more like a quiet man to his students) I’m from the countryside. I actually came to Seoul for the first time when I entered Seoul National University. Back then, president DuHwan Jeon established a new regime, right after the former president, JeongHee Park, had been assassinated. At that time, I realized that only those who utilized their power, and those who took advantage of the law, could succeed. That society was very different from the ideal society I learnt at schools. I thought that if this vice was to stop, someone had to do something. Therefore, at that time, my primary goal in life was to drag Jeon, DuHwan from the position of power, and never to appoint a president like him again. That is how I came to participate in a student movement, and to be elected as the president of the student council of the pharmacy department. I thought that the movement was kind of a mission as a student. I think such efforts became the foundation of the cessation of military junta. Q: Can you share the history of how you became a Professor? After college, I worked in the genetic engineering research team of LG Life Science. When the team copied the medicines from foreign pharmaceutical companies, I took part in applying for a license in Korea. I was the one who first received the approval of the biosimilar products in Korea. But at that time, the pharmaceutical education was chemistry-centered education. We never learnt anything about physiology, anatomy, or pathology. Nevertheless, it is impossible to take part in the new drug development or clinical trials, just by learning Pharmacology, in itself. So I thought I had to know more about the patients prior to new drug developments. That is why I studied abroad and completed Pharm D. After that, I wanted to teach students and, at the same time, develop new drugs. However, Pharm D was unacknowledged in Korea, so I had to complete a PhD in Clinical Pharmacology. This is how I became to study both clinical pharmacy and clinical pharmacology.
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Q: What is your goal as a Professor? Overthrowing the military dictatorship had been my only goal during my college years, but my goal changed while I was studying in the U.S. I wanted to change the society in a positive way, not in a negative way like through a violent demonstration. Actually, I didn’t like the fact that I graduated from the School of Pharmacy. As I worked in a local pharmacy for nine months, I developed doubts about living as a pharmacist, who is merely concerned about money. I thought that the only way to contribute to a society was helping patients by developing new medicines, and also that only those who actually prescribed and used the medicine to patients can develop good drugs. The best way of using medicine was to become the Pham D. At that time I would study all day, every day, except when I was eating. I thought I would teach these what I studied when I return to Korea. Q: Any words of wisdom to Pharmacy students? To give a practical advice to pharmacy students, I would say, study hard! Pharmacy students should base their fundamental goal on becoming a good pharmacist. A pharmacist is not just a person producing medicine, but is a member of the health care system. You may be qualified to graduate the university even with the GPA of C+, but if the First Violin is C+, that orchestra would not be a good one. To stand in the center of Health care system as a pharmacist, you have to become a competent pharmacist first, and then worry about how to use your ability by interacting with many people in the field. B
The Health Care System of the advanced countries Through the failure of America’s health care privatization and the success of Northwest Europe’s public medical service…
Minju Kang firstname.lastname@example.org
Duration : 120 min Date produced : 2007 Producer : Michael Moore
merica is one of the richest countries in the world. Also, Americans pay the highest amount of insurance fees in the world. Then, can the U.S. government provide ordinary U.S. citizens with the world best healthcare service as American dreamers once imagined? There are some cases which would show realities of the American health care system. While Rick cut down the wood, he cut the tops off his middle and ring fingers. He doesn’t have health coverage. So, the hospital gave him the option. It would cost 60,000 U.S. dollars for his middle finger while it would cost 120,000 U.S. dollars for his ring finger. Rick had no choice but to choose the ring finger and the middle finger might be threw out to the garbage dump. Then, How about remaining 250 million people who are under the health coverage? The documentary movie ‘Sicko’ showed us the shocking and terrible truth of the health insurance system in America, which is said to provide the world’s best and advanced medical services. How would you feel if you were in the same situation mentioned above? If you think this story seems absurd, you should watch ‘Sicko’. It may provide you more details about the American health care system.
Condition of happiness ; visit to the welfare states
ublic welfare has drawn the attention of Koreans recently. New Park Geunhye government plans to implement many welfare policies. Before we buckle down to entering age of public welfare, we have to look into the health care system of other countries providing successful public medical services. Then, we can avoid terrible future like above cases in America. What kind of health care systems do advanced countries have? In particular, Northwest Europe countries are well known Duration : 50 min for the successful public welfare. ‘EBS Docuprime <condition of happiness, visit to the Date produced : 2013 welfare states> may provide answers to this question. Producer : EBS docuprime All people in Northwest Europe have the rights to maintain healthy life. In Sweden, you don’t have to be afraid of being disabled person and giving up your life. The Sweden government will make an every effort for you. The Sweden government supports the costs of employing caregiver for the sick person and the large house where the sick person conveniently use wheelchairs. Being the disabled does not reduce your quality of life in Sweden even though it changes your life’s directions. I’m certain that you are surprised by watching this documentary. What seemed impossible before watching this documentary has been already implemented in reality in several countries in Northwest Europe. These welfare models cannot be applied directly for Korea. But, on the basis of these models, we should make suitable policy for us. B 2013 vol.3
Broaden your view by
Youngsuk Yi email@example.com
The good pharmacists
William N. Kelly and Elliott M. Sogol/William Ned Kelly Consulting, Incorporated/2010
ho is a good pharmacist? If someone merely knows medicine well, is he or she a good pharmacist? This book, “The Good Pharmacists,” can answer these questions. Many pharmacists work in a variety of pharmaceutical fields, but most of them work with other healthcare specialists and patients. Especially, a pharmacist is the last person whom patients meet during the medical process. From this point of view, a good pharmacist needs to be
more patient than any other healthcare professionals. It is insufficient for a good pharmacist to be a specialist only in medicine. It is just basic. People can easily access to any type of information by searching on the Internet. Patients gather drug information easily but it can sometimes have people exposed to wrong source of information. Now, they might not only require more and specific information, but also question the medical personnel. This book, “The Good Pharmacist”,
will help you to be a good pharmacist. It talks about characters, virtues, and habits of a good pharmacist, based on the authors’ five years of research on pharmacists in the U.S.A. Through this research, the authors identify features of a good pharmacist and explain them with real cases. With this book, “The Good Pharmacist,” you can define the meaning of a pharmacist and build your own image of a good pharmacist. B
Myung-jak Scandals* Ji-won Han/Paperstory/2012
hat do you think about the arts? Who is your favorite artist? How do you feel if someone suggests that you go to a museum or a classical concert hall? I guess most people find it boring or do not have any interest in art presentations. It is not that a surprising situation to most of us. It is ubiquitous apathy towards art among the young generation of nowadays. “Myung-jak Scandals(the scandals of masterpieces),” provides a new approach to “the classics” to people like us.
The author talks about secrets of art pieces, including behind the scenes stories about the artists and the social situation of their time. Furthermore, the author extends the boundaries of the classics, beyond what we already know. She includes pop songs(songs of Beatles), Korean songs(songs of Jae-ha Yoo), photographs, and architecture as well as classics. It is important to make people curious about something in order to let people have an interest in the arts. This book is successful in achieving that point. It fascinates readers
by revealing the rumors, so-called “scandals,” about artworks. After that, it makes readers want to discover the reasons for these scandals. At last, readers will realize the way these artists express their feelings on canvas, manuscript papers, lenses, and space. This book, “Myung-jak Scandals,” brings you closer to “the classics”, so you can appreciate many masterpieces without hesitation. After reading “Myung-jak Scandals,” you can answer the above questions with confidence. Classics are not boring topics for us anymore. B
*Originally, the “Myung-jak Scandal” is an educational program broadcast on KBS1 from 8th January, 2011 to 20th May, 2012.
the blue vanguard
We, Blue Vanguardians have a super power! I am proud of all of us!
We already made the 3rd issue! Isn’t it wonderful?
I am thrilled to complete this edition like seeing my first baby. I am so proud of our third issue. Thanks to all who helped us publishing the Blue Vanguard volume 3.
I got great and wonderful experience from writing my first article!
It was my first time with Blue Vanguard. I hope to take a role to make our article more beautiful.
Go the Blue Vanguard!!You are the most memorable thing in my university life!!
I would like to send a big thanks to the members who worked hard to complete this 3rd edition!!>.<
The Blue Vanguard! be the first, be the best. You will be on my mind forever.
It was the last edition that I participated in. In Korean, this is the most suitable word, “Si-won-supsup!!!”
Wow!! I am glad to publish our third issue and I expect to next semester working with our new members^^
Our Blue Vanguardians, Professor Mike Kim, Professor Sharman, CETs teachers, Jun-Mo, Matthias, last but never the least, Michael. Thank you all so much for helping me finish this edition.
Finally,it is the 3rd and the last edition to our 1st student pharmacists! But, we are still a blue vangaurdian and ever after. Go, the Blue Vanguard!!!!
We are getting better liitle by little. Writing articles in English will be the one of the most precious experiences I’ve ever had.
Monitoring The Blue Vanguard
eing a member of Blue Vanguard gave me an opportunity to interpret the newsletter with a different perception. All the columns and articles really inspire me. Considering how the newsletter is written by people with a very busy schedule, the quality of work was very impressive. I was extremely amazed. Amongst all the sections, I was deeply touched by the ‘Professor’s Research’ column. After reading this one, it actually helped me to have a better understanding about what kinds of work our professors do and appreciate their work. The article especially conveyed strong and deep ideas. I was often very curious about the works that our professors were involved outside of school. And the newsletter clearly provided a chance for all the students to get a sense of what types of work our professors are doing other than the great lectures. I am looking forward to reading the next edition of Blue Vanguard and for the next publication, we will surely try our best to produce a better edition. Ah Young Kim, Yonsei University, College of Pharmacy Freshmen
iverse contents and attractive designs add zest to the magazine. I heard about the Blue Vanguard for the first time when I was writing applications for college of pharmacy. The Blue Vanguard was a great motivation for me to apply to Yonsei University. The magazine helped me to picture the life here, at Yonsei. Especially, the article about an interview with the director of the Severance Pharmacy really inspired me. It illustrated the definition of the ‘clinical pharmacy,’ in which I was interested the most. I hope the Blue Vanguard, a magazine full of life and adventure, can continuously inspire many other students just like it did to me. I can’t wait to be part of this! Yun Kyung Heo, Yonsei University, College of Pharmacy Freshmen
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INTERNSHIP The Cub Journalists* Summer break is not only the best time to enjoy yourselves outside of school but also a great opportunity to gain some experiences through internships. Let us introduce some internships that are offered by pharmaceutical companies. We hope that these internships will take you a step closer to achieving your dream of becoming a pharmacist. B 1. Mundipharma Korea
4. Johnson&Johnson Korea
2. GSK Korea
5. Quintiles Korea
1) Job Title Consumer Marketing Intern 2) Qualification Undergraduate students in their second or third year at College of Pharmacy in Seoul or Gyunggi 3) Recruiting Period : 2013/5/13~26 4) Working Period : 2013/7/1~8/23 5) Homepage : www.mundipharma.co.kr
1) Job Title Drug/Vaccine Marketing Intern, Consumer Marketing Intern 2) Qualification Undergraduate students in their third or fourth year, or graduate students from local or foreign university 3) Recruiting Period : 2013/5/6~22 4) Working Period : 2013/7/1~8/23 5) Homepage: www.gsk-korea.co.kr
3. Pfizer Korea
1) Job Title Office experience for each divison 2) Qualification Graduates of a four-year university, or graduate students who are planning to graduate in 2013 or 2014 3) Recruiting Period : 2013/5/13~26 4) Working Period : 2013/7/1~8/23 5)Homepage: http://pfizercareers.com
1) Job Title Sales Planning Intern 2) Qualification Undergraduate students in their third or fourth year, or graduate students 3) Recruiting Period : 2013/4/29~5/12 4) Working Period : 2013/7/1~8/23 5) Homepage: www.jobs.jnj.com
1) Job title Clinical Research Intern 2) Qualification Undergraduates or graduates of Pharmacy, Oriental Pharmacy, or Nursery. Graduates of 2013 or 2014 3) Recruiting Period : 2013/5/13~24 4) Working Period : 2013/7/1~26 5) Hompage: www.quintiles.com
* The Cub Journalists Ah Young Kim firstname.lastname@example.org Byung Hoon Lee email@example.com Ho Sung Jang firstname.lastname@example.org Jai Young Cheon email@example.com Suji Hong firstname.lastname@example.org Yoo Jin Choi email@example.com Yoon Kyung Heo firstname.lastname@example.org
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