The Blue Vanguard Vol.7

Yonsei Pharmacy Students

THE

BLUE

VANGUARD 2015

JUNE

Vol. 7 04 COVER STORY Rebate : A Hydra-headed Problem in the Pharmaceutical industry 16 PUBLIC SECTOR Bo-yeon Kim, 34 years in Health Insurance Review & Assessment Service 22 CAMPUS ISSUE Coming In and Out, Four Years Apart

SONG HEE MIN

EDITOR ’S NOTE

It is great pleasure to finally introduce the 7th edition of The Blue Vanguard magazine. This Blue Vanguard issue includes articles about international and national issues which will help to broaden reader’s knowledge on what pharmacy issues other countries are dealing with compared to our own country. Also, in this Blue Vanguard issue, pharmacists who work at pharmaceutical companies, public institutions, pharmacy schools, and local pharmacies granted us interviews and gave us meaningful advice. They will help readers to understand the various fields that are open for pharmacy student in the future.

In 2015, The Blue Vanguard made lots of changes to improve the quality of our magazine. First, we recruited new members for our design team. Secondly, The Blue Vanguard divided the work that needed to be done to improve organizational and operational efficiencies. Last but not least, we would like to express our gratitude to our advising professors, Professors Gyoon-hee Han and Jin-hyun Jeong.

Songhee Min

I

Editors

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Editor-In-Chief Songhee Min

Vice Editor-In-Chief Hyuna Lee

Senior journalists & Junior journalists Ahyoung Kim Byeonghun Lee Eunnie Kim Hosung Jang Yoojin Choi Yunkyung Heo

Bokyung Kim Heejo Lee Sungkyung Lee Woohyuk Choi

Editorial Office

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Designed by Hyunji Park Yeonhee Cha

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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CONTENTS ISSUE

EDITOR’S NOTE

4 COVER STORY 7 10

COLLEGE

CAREER

12 14 16 19 20 22 24 26 28 30

4

Rebate : A Hydra-headed Problem in the Pharmaceutical industry INTERNATIONAL ISSUE Pharmacists, Raise Your Voice NATIONAL ISSUE Long Long Argument : Generic Substitution

7

16

HOSPITAL Hospital Pharmacists on the Rise PHARMACY Sage Pharmacy : Woman’s Health Center PUBLIC SECTOR Bo-yeon Kim, 34 years in Health Insurance Review & Assessment Service PHARMACEUTICALS Interview with Human Resources of Daewoong PROFESSOR A Spring Picnic with Professor Sohee Kwon

20 24

CAMPUS ISSUE Coming In and Out, Four Years Apart STUDENT CLUB Freemed : Youth, Passion, and Life Value EXPERIENCE Special Experience : In the Korean Pharmacy Student’s Association COLUMN Exciting Drug Discovery Stories Over the Pharmacology Class BOOK REVIEW Entropy : Introduction to the Thermodynamic World EPILOGUE

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COVER STORY

Rebate :

A Hydra-headed Problem In The Pharmaceutical Industry BoKyung Kim

L

kimbk9512@yonsei.ac.kr

ast December, a rebate of 50 billion won, the largest amount of money on record, was uncovered. This rebate was provided for more than 900 doctors nationwide by Dong-Wha Pharm. Co., Ltd., one of the oldest pharmaceutical companies in Korea, which became well-known for their Fucidin ointment and Gaswhalmyungsu. Many people were shocked to learn that even a well-respected major company could not escape the practice of rebate.

On top of that, according to a survey in 2013 and 2014, 70% of public hospital retirees answered that they had received rebates more than once. The government and non-governmental organizations have strived to uproot the issue of rebate through regulatory actions since its practice started to become prevalent, with the introduction of the market price reimbursement system. In spite of their endless efforts, why is the custom of rebates hard to eradicate?

Reasons Why Rebates are Provided and Received

Definition of Rebate The dictionary defines rebate as, “an amount paid by way of reduction, return, or refund on what has already been paid or contributed.” In the pharmaceutical industry, rebate refers to money or economical benefits provided for doctors, who in return prescribe the specific drugs of that pharmaceutical company. The types of rebates vary.

The pharmaceutical sales representatives cater to doctors by paying them out of their own pockets or incentives (the most classical way), covering travel expenses and monthly housing rent, or gifting expensive designer bags or watches to their families.

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THE BLUE VANGUARD

The pharmaceutical companies prefer to provide rebates because increasing the sales of existing drugs through rebates is more profitable than developing new drugs. This is because drug development requires not only a lot of time but also an astronomical sum of money.

Moreover, the cost of generic drugs in Korea is too high in comparison to other OECD countries. To be more specific, in the case of the United States, where competition between generic drugs is fierce, the price of generic drugs is about 16 percent less of that of original drugs. On the other hand, in the case of Korea, the price of generic drugs exceeds about 80 percent of that of original drugs.

Considering the fact that most other countries’ prices of generic drugs is about 30 percent less of that of original drugs, the price of generic drugs in Korea is excessively expensive. Therefore most pharmaceutical companies don’t bother spending huge amounts of money to develop new drugs, and try to increase the sales of existing generic drugs to generate more profit. In addition, doctors can earn much more money through rebates than from the reimbursement they receive from health insurance policy and thus they are unwilling to forego rebates.

COVER STORY

Problems Caused by Rebates

Recently Implemented

Policies to Eradicate Rebates

The Board of Audit and Inspection announced that drug prices were inflated because of rebates and consumers were to pay the increased prices. The Department of Health and Human Services and Health Insurance Review & Assessment Services also made an announcement that a large portion of rebates included funds taken from the National Health Insurance. Specifically, according to the Korea Fair Trade Commission’s report in 2007, the cost of damage to consumers that originated from rebates estimated to be approximately 2.08 trillion won to 3.12 trillion won, and this amount of money corresponded to as much as 20 percent of the total drug cost. Considering the fact that the idea of rebates began to prevail with the introduction of the Market Price Reimbursement System in 1999, the amount of damage that accumulated for the past 15 years is assumed to be tens of trillions of won.

This cost has become a burden on patients and has had an adverse effect on the National Health Insurance, which always runs a deficit. Moreover, many patients have been deprived of their rights to be provided with the best healthcare service at a reasonable cost. Also, as pharmaceutical companies focus more on investing funds in providing rebates than developing new drugs, the total growth of the national pharmaceutical industry may decline.

- Dual Punishment System : A dual punishment system has been enforced since November 2010. While former laws only focused on punishing the rebate provider, this law focuses on reprimanding both provider and receiver. Moreover, a reward system for whistleblowers was also introduced and a rebate task force was newly established. This law received positive evaluation for the important role it played in diminishing the number of rebates.

- Two-Out System : The two-out system has been enforced since July 2014 and according to this system, drugs involved with rebates more than twice, become excluded from the health insurance coverage list. As those drugs cannot maintain price competitiveness, they cannot make a profit anymore.

- The Secret Ballot of Pharmaceutical Company CEOs : On February 26th of this year, the Korea Pharmaceutical Manufacturers Association (KPMA) decided to make the Pharmaceutical Board of Directors hand in a name of the pharmaceutical company suspected of providing rebates every quarter. Then the KPMA president gives the company mentioned the most often a strict warning. Besides giving a warning, other various policies to regulate companies are being considered. On April 14th of this year, the first secret vote is to be taken.

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COVER STORY

- Kim Young-ran Law : The Kim Young-ran law was introduced by the chairperson of the Anti-Corruption and Civil Rights Commission, Kim Young-ran, in 2012. The point of this law is to inflict punishment on public officials and their spouses if they receive more than 1 million won worth of gifts or money from pharmaceutical companies regardless of their intentions. Doctors working at the National Medical Center and public health doctors will be put under regulation. The Kim Young-ran law will be put into effect on October 2016.

Rebates : A Hydra-headed Problem Requiring Endless Effort It is an undeniable fact that the eradication of rebates, which have existed for a long time, is a hydra-headed problem. In addition, when considering the distinctiveness of the structure of the drug market, patients, who are the main consumers, do not have the right to choose their drugs, but doctors, who make up a small percentage of consumers, have the right to choose the drugs, making the uprooting of rebates almost impossible. However, the government should continuously make efforts to eradicate the issue of rebates, to provide patients with the best healthcare service, and to encourage the growth of the national pharmaceutical industry. Besides imposing strong regulations on doctors and pharmaceutical companies through the dual punishment and two-out system, the government should attempt to resolve the problem by addressing the root of the cause. Generic drug price cuts or increasing government grants for drug development may be a solution. In addition, promoting generic substitutions and ingredient-based prescriptions should also be considered. Above all, doctors and pharmaceutical companies should remind themselves of their sense of ethics and do what is best for the patients, rather than pursuing their self-interests.

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Further Information

- Generic Substitution : Generic substitution is the term applied to the substitution of a prescribed brand name drug for a different form of the drug with the same active substance. Because pharmacists can make substitutions for prescribed drugs, they can prevent doctors from prescribing the same few drugs excessively, and can promote the prescription of better drugs. In Korea, generic substitution has become legally possible, but it is hardly acted out. Recently, generic substitution has become a big issue, since the Ministry of Strategy and Finance announced that the government would more actively implement it in 2015.

- Ingredient-based Prescription : Ingredientbased prescription is the opposite of proprietary name based-prescriptions. It means that doctors prescribe the ingredient of the medicine, and pharmacists choose the appropriate drug with that prescribed ingredient and dispense the selected drug. It is enforced in Germany and some parts of the United States. In Korea, both methods are legally possible, but the proprietary name based-prescription is predominantly used. If ingredientbased prescription is mainly adopted, doctors would not select drugs anymore, and the rebates would disappear.

However, many people voice concerns that the rebates would then be offered to pharmacists instead.

- Market Price Reimbursement System : The Market Price Reimbursement System was introduced in 1999, followed by the Official Price Reimbursement System. According to this system, if hospitals or pharmacies buy drugs at a lower cost than the maximum price suggested by the government, a certain portion of the margin is provided to them as an incentive. It was implemented to cut down the drug prices, but rebates became much more prevalent through various routes.

This is because pharmaceutical companies catered to the tastes of hospitals and pharmacies by reporting false drug sales so that their clients could receive more incentives. Recently, the Open Market Price Reimbursement System was introduced in 2010, but it was abolished the second half of last year. Instead, the Incentives for Prescription and Compound Drug Price Cut was newly introduced. B

INTERNATIONAL ISSUE

PHARMACISTS, Raise Your Voices Eunnie Kim

The Patient Protection and Affordable Care Act (PPACA), or the Affordable Care Act (ACA), also referred to as Obama Care, was signed into law on March 23, 2010,

by President Barack Obama and upheld by the Supreme Court on June 28, 2012. The PPACA was enacted with three major goals in mind: to expand access, improve quality, and reduce costs of healthcare to millions of uninsured Americans. According to a survey conducted by The Commonwealth Fund (taken from July-September 2013 to April-June 2014), there were 9.5 million fewer adults who were insured after enrollment for health care coverage under the PPACA. Furthermore, 60% of Americans with new coverage visited a doctor or other healthcare provider, went to a hospital, or paid for a prescription, which means that 6 out of 10 Americans would not have been able to access or afford this care previously. Consequently, it is expected that as the number of insured Americans continues to rise, the demand for healthcare would rise proportionately as well. This new increase in demand would inevitably lead to changes being implemented all throughout the healthcare system, and as a healthcare provider, pharmacists cannot

eunniekim@yonsei.ac.kr

help but wonder what potential roles would open up to them and how much of a contribution they would be allowed to make in increasing the access of care to patients, reducing medication costs, and preventing illness.

With the implementation of the ACA, it was expected that an estimate of 30 million people would have access to medical care at the start of 2014. Consequently, this new influx of potential patients required the federal government and most states to make the necessary preparations to receive these patients, which undoubtedly strained the already overwhelmed primary care workforce. Thus, the need to increase the number of primary care providers has become exceedingly urgent with time. The need for primary care providers is imperative as the PPACA emphasizes that one of its main advantages is the increase in the availability of preventive care services, which include programs such as immunizations and wellness visits for patients enrolled in Medicaid and Medicare. Majority of the preventive care services outlined under the PPACA require the appropriate management of chronic conditions and such management requires patient-specific data that needs to be obtained

2015 VOL.7

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INTERNATIONAL ISSUE

from the patient medication histories, for prescription, over-the-counter, and nutritional supplements. Patients with chronic conditions seek out doctors, such as primary care physicians, who manage the complex medication regimens of these patients. However, they are unable to sufficiently review the cases of these patients thoroughly during the brief medical office visits. Thus, it would seem reasonable to leave the management of chronic conditions to the pharmacist, are already the healthcare providers with the most direct patient contact, and to allow them to make the decision related to medication regimens. With this said, pharmacists have the right to be legally recognized as healthcare providers under the Social Security Act. What Americans are highly unaware of is that pharmacists are well-trained and highly accessible healthcare professionals, fully capable of adjusting medications, ordering and interpreting laboratory tests, and coordinating follow-up care. Pharmacists are competent professionals who would be able to offer their skills to complement those of physicians in order to greatly improve the quality of the healthcare service provided to the patients, and to increase the productivity of the physicians.

Regardless, pharmacists are grossly underutilized. Even though patients would prefer to interact with their local pharmacists in discussing their medications or conditions rather than visiting a medical office, the state and federal laws are making it extremely difficult for them to do so.

In the United States, according to an article from Formulary Journal, pharmacists make up the third-highest number of licensed healthcare providers, falling behind nurses and physicians only by number. Unfortunately, policy makers, payers, and many other healthcare providers have failed to realize that pharmacists are not recognized as non-physician healthcare providers under the Social Security Act (Section 1861 for Medicare); consequently, this diminishes the ability of pharmacists to contribute their skills and services in order to improve patient outcomes. Currently, the non-physician providers

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THE BLUE VANGUARD

that are recognized under the Social Security Act include: audiologists, certified nurse midwives, certified registered nurse practitioners, certified registered nurse anesthetists, physician assistants, licensed clinical psychologists, licensed clinical social workers, physical and occupational therapists, and registered dieticians/nutrition professionals.

It should be noted that pharmacists undergo as much, sometimes even more, education and training to provide the services they do, as the currently recognized healthcare providers. All graduates of accredited academic pharmacy programs in the United States, as of 2004, earn the doctor of pharmacy degree (PharmD), after fulfilling the internship requirements and the different licensure requirements at both the federal and state levels, further ensuring their competency.

Thus, excluding pharmacists under the Social Security Act seems to be inconsistent with the legislative changes and policy initiatives that have impacted pharmacists over the years. When Pharmacists practice within the full scope of their licensure, and when they are included in the multiple models of patient care as a member of the healthcare team, the patients show vast improvement in their conditions.

The contributions made by pharmacists for the past thirty years have been recognized by the Veterans Administration (VA), Indian Health Service (HIS), and Department of Defense. The IHS Pharmacy Standards of Practice include a standard that is specific for the pharmacists’ ability to, “manage therapy/care for selected patients in whom drugs are the principal method of treatment,� which is now referred to as medication therapy management (MTM). The importance of MTM services have been acknowledged by Medicare Part D, and require that all providers of the prescription benefit to offer these services to the beneficiaries of Medicare Part D, which is predominantly provided by pharmacists.

Acknowledging pharmacists as healthcare providers, and giving them provider status, would not only improve the healthcare quality, safety, and costs of patient care, but

INTERNATIONAL ISSUE

would also curb the unintentional consequences that may occur if pharmacists continue to go unrecognized. These consequences were mentioned as an example in an article in Formulary Journal, “…this could reduce the profession’s access to healthcare information technology that is vital to ensure appropriate medication use and outcomes in patients cared for by pharmacists. Limiting pharmacists’ ability to access and submit clinical information obtained at the point of care…through electronic health records would severely diminish the delivery of effective and efficient care.” If pharmacists are not given provider status, it can impact patient outcomes negatively, and there could be an accumulation of unnecessary health-related costs, and pharmacists would be unable to effectively communicate with other healthcare team members, as well as patients.

Recognizing pharmacists as non-physician providers through form of legislature would allow licensed pharmacists to collaborate with physicians and other healthcare providers to provide optimal medication therapy to patients and more thorough delivery of patient-centered care. Thus, the American Pharmacist Association, the American Society of Health-System Pharmacists (ASHP), other coalitions of national pharmacy organizations, and supporters have joined together in order to promote patient access to pharmacists’ services by getting pharmacists recognized as healthcare providers, and be given provider status. The campaign for provider status is currently

ongoing. In 2014, the H.R. 4190 was introduced to Capitol Hill. If it had passed, the bill would have amended the Social Security Act so that pharmacists would be recognized as providers under Medicare Part B. Unfortunately, the bill did not pass. Currently, a new bill is being fast-tracked for 2015. According to an article in Pharmacy Practice News, this new bill, “includes some restrictions on pharmacist provider status, such as requiring the services to be delivered only in medically underserved areas.” The focus placed here would be on the unmet medical needs of Medicare beneficiaries, where pharmacists would be allowed to fill the gap. Joseph Hill, the director of federal legislative affairs, stated, “We believe this bill is really getting our foot in the door, and we decided to follow the path that the nurse practitioners took [to enable them to bill for their services].” Pharmacists are now taking action and will continue to do so to obtain recognition as healthcare providers who provide quality patient-care within their scope of practice.

After careful consideration of the issues on hand and after pondering what is at stake here, pharmacists must take a stand to fight for the status that is rightfully theirs.

Pharmacists across the United States, it is time to take a stand, and raise your voices. Pharmacists deserve to be legally and socially acknowledged as healthcare providers.

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NATIONAL ISSUE

Long long Argument : Generic substitution Heejo Lee

lhjo1990@yonsei.ac.kr

T

he issue related to generic substitution was repeatedly proposed. Unfortunately, due to the difference in position

of the physicians and pharmacists, and the lack of governmental support, this issue has been unresolved until now,

where it was brought up for discussion again. It is expected that exhausting debate over this issue will only further break the trust between pharmacists and physicians, and even now, the social cost caused by this conflict is increasing.

Therefore, I chose this subject in order to research the cause of the continuous debate about using alternative drugs and understanding the suggested solutions and supplementing the methods with additional information.

Recently, generic substitution has became an major issue in medical society. This issue has arise last year when MOSF proposed a plan to activate the generic substitution of drugs in the “2015 Economic Policy Directions.� At the 61st General Meeting on February 26th, the president of the Korean Pharmaceutical Association announced that the invigoration of the generic substitution would be a major priority during his terms. Dong Ic Choi, the member of NPAD is preparing a bill which will enables pharmacists to inform physicians of the changes made in the prescriptions indirectly through HIRA in order to reduce the burden of notifying physicians directly.

The invigoration of the generic substitution of drugs is needed to reduce medical expenses and secure the financial future of the national health insurance. According to the data provided by HIRA, the number of generic drugs that can be substituted is 237. It is expected that replacement of the most expensive medicine with relatively inexpensive medicine will save 300 billions won in medical finance. If no attempt is made to reduce its expenditure, the national health insurance will turn towards to deficit next year. The number of alternative dispensing is about 480,000, which is

If generic substitution is not implemented, patients must go to another pharmacy if that pharmacy does not carry the drug prescribed to them, even though that the pharmacy can provide an alternative medicine.

only 0.1% of the total number of dispensing in 2013. This is why generic substitution is always mentioned in the annual parliamentary audit. Vitalization of generic substitution is also needed to reduce the problem of disuse stock disposal in pharmacies. Because physicians frequently change the medicines they prescribe, most pharmacies become financially challenged due to the large amount of unused stock. If generic substitution is implemented, it might be possible to resolve the stock problem.

* MOSF : Ministry of Strategy and Finance, NAPD : New Politics Alliance for Democracy, HIRA : Health Insurance Review & Assessment Service

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NATIONAL ISSUE

Is each effect of the generic drugs compared to the brand drug, indeed different, as physicians claim? Couldn’t the reason for their strong objections against alternative medicines be due to their pride?

Nevertheless, physicians are against the vitalization of generic substitution. First of all, they are expressing their disagreement by stating that generic substitution violates the right of doctors to prescribe drugs to their patients.

Moreover, even though certain generic drugs have passed the Bioequivalence Test (BE Test), doctors are claiming that clinical effects are not all the same. They say that some patients could show inconsistencies in certain drugs and if pharmacists make modifications to prescriptions while compounding or dispensing drugs, that fact may be unknown to the prescribing physician, making it difficult to manage their patients. However, the last two claims made by the medical world is unpersuasive because generic drugs that have passed the BE Test mean that the KFDA has guaranteed the equivalency of the drug’s effects to that of the original drug, and pharmacists are obligated to report to the doctor of any modifications made to prescriptions.

Nevertheless, there are many doctors who are still against alternative medicine production. Consequently, it is reasonable to deduce that pharmacists will avoid dispensing alternative medicines when filling prescriptions, as pharmacists must keep a good relationship with doctors.

It is clear that generic substitution would be difficult to practice in reality because to do so, pharmacists must receive confirmation from physicians, who are usually unwilling to give it. This tendency is due to the regulation that states pharmacists must directly inform physicians if any changes made to prescription. This regulation is unlikely to be abolished any time soon because of the strong opposition of doctors. In terms of patient’s safety, if pharmacists prescribe other equivalent medicines, doctors should be notified immediately, therefore simply abolishing the regulation would be unrealistic. Thus, notifying physicians indirectly through HIRA using the

DUR system can be a solution. In the last parliamentary audit, Myoung Sei Son, the president of HIRA answered yes when asked by In Soon Nam, a member of NAPD, whether the installation of the notification system in the DUR system was technically possible. The bill that Choi is trying to propose is also based on this DUR system.

However, it is doubtful whether Choi’s proposal can actually vitalize the practice of generic substitution. The purpose of the proposal is to reduce the limitations faced by pharmacists when changing prescriptions with HIRA acting as a mediator between pharmacists and physicians. Doctors will still be informed of the changes made in prescriptions through this system, and therefore, it will not greatly effect how pharmacists will begin to make generic substitution changes to prescriptions. Even if it is possible to install the notification system, checking 400 million prescriptions every day and notifying hospitals through HIRA can result in a waste of administration labor and public finances.

Another obstacle to activating generic substitution is that patients lack the ability to recognize its necessity.

Patients often request medication as prescribed by their physicians because they don’t know much about generic substitution. Therefore, it is necessary to educate the patients on the meaning of generic substitution by advertising it at a national level. If patients know that they can choose among various available bioequivalent medicines, the inconvenience of going from one pharmacy to another to find a pharmacy that has the prescribed medicine will be reduced, and patients could buy drugs at a lower cost.

Once the patients and matter customers begin voicing the changes they want made on their prescriptions, conflict between pharmacists and physicians over this will reduce, and the practice will naturally be more accepted.

Generic substitutions are not advocated to activate the economy but to secure the financial future of the national health insurance and to help patients receive treatment at a lower cost. Although doctors and pharmacists differ in opinion on this issue, they share common attitude toward their patients, and they all work to improve their patients’ health. Therefore, solving the problems associated with the issues based on the patients’ need will reduce conflicts between doctors and pharmacists, and would be more beneficial to citizens. Because the issue has been controversial for many years, interest groups and the government must solve the problem wisely through the establishment and practice of the appropriate policies and bill. B 2015 VOL.7

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HOSPITAL

HOSPITAL PHARMACISTS ON THE RISE Woohyuk Choi

08choi31@naver.com

What comes across your mind when you think of a hospital pharmacist? A person who works in a confined and stuffy space? Or someone who simply dispenses drugs all day long without any challenging tasks? Whatever you might assume, it seems that these widely held stereotypes are now breaking down. According to a survey done by the Korean Academy of Social and Managed Care Pharmacy in 2014, pharmacy students have chosen ‘hospital pharmacist’ as their most desired occupation at 30%, while ‘pharmaceutical company’ came in second at 21.6%, and ‘community pharmacist’ was third at 19.7%. This is quite in contrast with the result of former pharmacy students who picked ‘community pharmacist’ as the most preferred occupation. It brings us to the question of how hospital pharmacists soared into the most popular pharmaceutical career in recent years.

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Unlike community pharmacists, hospital pharmacists have access to a wide range of medications. Hospital pharmacists and community pharmacists have legally the same scope of practice, but their roles change depending on the place they work. The environment does not easily allow community pharmacists to utilize the medical knowledge they acquired in the pharmacy school. Besides dispensing prescriptions, hospital pharmacists take on a wide variety of tasks. According to the Korean Society of Health-System Pharmacists(KSHP), approximately 18% of the work that hospital pharmacists conduct consists of non-dispensing responsibilities such as Therapeutic Drug Monitoring(TDM), reporting Adverse Drug Reactions(ADR), and managing Total Parental Nutrition(TPN) of inpatients. They even deal with narcotics for patients who feel intense pain according to the strict regulations placed by the Ministry of Food and

HOSPITAL

Drug Safety, police agencies, and public health centers.

In addition, a few hospital pharmacists take part of the Nutrition Support Team or Intensive Care Unit. Generally, Pharmaceutical Specialists who passed the Board of Pharmaceutical Specialties(BPS) exam participates in this medical crew, which also consists of doctors and nurses.

Contrary to popular belief, the hospital pharmacies have quite nice working conditions compared to other pharmaceutical work places. Hospital facilities are neat and clean because they have to meet rigorous standards of regular internal and external audit processes. Although large stocks of drugs and medical supplies may take up much space, pharmacists still have a space large enough to work freely. Also, hospital pharmacists have plenty of

at a tertiary care hospital is normally in the range of 40 million to 50 million won a year, and pharmacists at a general hospital is in the range of 30 million to 40 million a year. This is similar to the average wage of employed community pharmacists. It is more likely to earn more money if one opens a pharmacy; however, a private business always entails a lot of risks. Hospital pharmacists climb up the salary scale according to the number of consecutive years of service they provided, just like the government employees.

There is no need to take risks or feel pressure about the evaluation of their work performance. Furthermore, many large hospitals ensure welfare benefits including health insurance, hospital bill discounts, and in some cases tuition scholarships for their children.

“... in 2014, pharmacy students have chosen

”

‘hospital pharmacist’ as their most desired occupation ...

co-workers, which seems to be a very important factor to employees. Many hospital pharmacists say that the biggest merit of their job is the close relationships they forge with their colleagues. It was conspicuous via several interviews that they treat each other as family.

Meanwhile, the working hour of hospital pharmacists is similar to that of independent community pharmacists, from 8AM to 5PM. Some hospital pharmacists work on weekends or night shifts, from 5PM to 8AM, but usually get paid more for their labor.

To be frank, the salary is usually the numberone concern of many job seekers. It may vary among hospitals, but the starting salary of pharmacists working

Lee Gwang-sup, the president of KSHP, cited, “the extended field training curriculum enabled more pharmacy students to know the hospital pharmacy better.”

It seems like many students have already realized those attractive aspects of the hospital pharmacist. If you have not yet decided your future career, why don’t you consider becoming a hospital pharmacist? Those who do not like to work alone or those who want to have a stable job will be very suitable for this career. You can apply when there is a job posting, but males who have not yet completed his military duty cannot apply for the job. B

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PHARMACY

Sage Pharmacy : A Women’s Health Center.

Hyuna Lee

S

liana93@yonsei.ac.kr

age Pharmacy is a pharmacy geared towards women and is located in Ewha Womans University. It

provides healthcare for women of childbearing age. Sage Pharmacy was established by two pharmacists,

Gon Jin Song and Sook Hee Jung. Both graduated from Ewha Womans University. The word ‘Sage’ means knowledgeable and wise man. It peeps out the meaning of wanting to get out of the conventional role of

pharmacies and to suggest the solution for women’s health care. Sage Pharmacy has a very attractive interior design. It has a wide and classy space that gives a feeling of visiting a boutique. Also, Sage Pharmacy has

volunteered to be a practical training site for pharmacy students and graduates. It’s goal is to cultivate welltrained pharmacists, and to openly provide counseling for pharmacists who are interested in opening a pharmacy.

An Interview with Pharmacist Gon jin Song & Sook hee Jung Q1. What inspired you to open a pharmacy solely for women's health care?

Pharmacist Song : Actually I had never thought of opening a pharmacy at Ewha Womans University. I met Pharmacist Jung at a group meeting studying about natural way of maintaining health, and heard that it has been her dream of opening a pharmacy at her alma mater, Ewha Womans University.

After I decided to work with her, we opened the Sage Pharmacy at our school.

Pharmacist Jung : I worked at a pharmacy near the obstetrics department. Also, I usually dealt with prescriptions for internal medicine concerned with chronic disease. Then I thought that chronic diseases needed care starting from an early age for prevention. If pregnant women are healthy, their children will be healthy with no chronic diseases. So I thought that women of childbearing should be healthy because their health affects future pregnancies. Also, I had the opportunity to deliver

Pharmacist Gon Jin Song(Left), Pharmacist Sook Hee Jung(Right)

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a lecture about self medication to female students at Ewha Womans University.

Through this experience I began to become concerned more about female student's health care.

Q2. How do people React to Sage Pharmacy?

We are so grateful that people welcome and are curious about us. Many people who perceive pharmacies as a primary careprovider visits our pharmacy. It seems like we play a role in giving these patients first aid and guiding them to nearby hospitals or health center. Female students often ask questions about the side effects of a harsh diet. Some of the students willing to enter pharmacy school come by to get some advice.

Q3. What kinds of healthcare service are provided specifically for women of childbearing age?

First, we make pamphlets and short books containing health

PHARMACY

related information and locate them in front of the counter. We help pregnant women or any of those interested in self managing their health by providing general medication counseling pamphlets and guidelines for OTC drugs.

Moreover, we are implementing a hair test service to test the presence of heavy metals in one's body.

We educate people know how harmful heavy metal is for women.

It causes atomic dermatitis, rash, severe acne, hair loss, and habitual abortion. Then we try to suggest detoxification solutions with lots of neutralizing items and drugs for heavy metal.

Q4. I heard that how you displayed drugs to emphasize self medication. Tell us a little more about it.

As you can see, almost all of the OTC drugs are displayed outside the counter. It allows people to choose what they need among the many different kinds of OTC drugs. When people finally choose one and bring it to the

Pamphlets about health information are displayed at the counter.

counter, we check whether or not it is appropriate for them. Many pharmacist is not willing to display the OTC drugs in the front. In that case Patients do not have access to those drugs because the drugs are placed behind the counter. But we decided not to be like that and give patients the right to choose.

Q5. What helped you decide to make Sage Pharmacy a training site for pharmacy students and graduates?

In other countries, when pharmacy students go out on their rotations at a pharmacy, a preceptor, who guides students throughout the rotational blocks is designated to each student. In Korea, the new six-year curriculum of pharmacy schools require students to practice certain amount of time at a pharmacy. Therefore, the need for a preceptor pharmacy has risen.

In order to become preceptors, both of us took a Pharmacy Health Communication courses established by the Ewha Womans University for pharmacists.

Through the course, we recognized the importance of professional training of pharmacy students.

Since our pharmacy is located at Ewha Woman's University, we had a great opportunity to educate the pharmacy students of Ewha through practical training.

Q6. What do the trainees learn from Sage Pharmacy?

There are less opportunities to learn about prescription drugs because our pharmacy does not deal with them much. But we provide opportunities to study a

variety of OTC drugs and dietary supplements that cannot be seen in other pharmacies. We also let students make healthcare manuals and. POP (point-of-purchase) advertisement of products. Students can also learn how to use the POS (point-of-sales) machine.

Also, we allow the student trainees to take part in an open lecture near a public health center or give them a chance to dispense prescription drugs at another pharmacy near the obstetrics department. In addition, we are planning to provide an intern program for graduates of pharmacy school. Since students learn mainly about dispensing drugs during practical training, we will teach the graduates the nuts and bolts of pharmacy management like buying drugs at a low cost.

Most pharmacy schools mainly request pharmacies to teach students about the safety and efficacy of drugs, we are worried that the theoretical education that school offer might narrow the capacity of the students. B

2015 VOL.7

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PUBLIC SECTOR

Bo-yeon Kim, 34 years in Health insurance review & Assessment service SungKyung Lee

P

dltjdrud93@naver.com

harmacist Kim Bo-yeon joined the Health Insur-

ance Review & Assessment Service (HIRA) during

the open recruitment season. Kim started her career at

HIRA as a 5th-grade employee and became an executive director, the highest position an employee can reach. She

left that position and is now a full time evaluation member of firm of HIRA.

B

efore working at HIRA, Kim worked at a pharmacy right after graduating from pharmacy school.

Bo-yeon Kim’s Career

< In HIRA > 1981.04 – 2008. 06.17 - EDI system development team leader - Health insurance review & Assessment Service establishing task 2008.6.18- 2011.6.27 - Review & Assessment Manager 2011.9.1-current - HIRAS Full-time Evaluation Committee

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THE BLUE VANGUARD

After graduation, Kim was not dissatisfied with the un-organized and unsystematic practice of one on one prescription that she had to do everyday in spite of not having any experience in pharmacology. In fact, clinical pharmacology was not a subject pharmacists were familiar with at that time. It was a time when the practice of prescribing and dispensing drugs was not yet separated and was prior to the implementation of the Drug Dispensing and Prescribing Separation Policy. After watching her Chief Pharmacist study a master’s course at graduate school, she decided to take the same courses to learn about a more systematic way of prescribing drugs. During this time, she came across a job advertisement placed by Medical Insurance Federation in Donga Ilbo’s newspaper. She applied for a position thinking that this job could fulfill her willingness to contribute to the nation and learn a systematized way of prescribing drugs.

PUBLIC SECTOR

A

fter joining HIRA in 1981, she served at the company for 34 years and was responsible of the issues pertaining to the improvement of Koreaâ&#x20AC;&#x2122;s health insurance system and the pharmaceutical pricing and reimbursement policies.

Currently in Korea, there are 82,000 medical institutions and pharmacies. Since it is mandatory for all citizens of Korea to have health insurance, the demand for healthcare is high in Korea. In addition, 30% of the Korean health insurance budget, which is approximately 5 trillion won, is spent on pharmaceutical goods. Therefore, policies related to medicine are extremely important. Kim has been responsible for establishing and managing these policies.

Kim has been responsible for pricing medical drugs and establishing an effective way for pharmacists to receive their compounding fees, when the practice of Prescribing and Dispensing Drugs Separation Policy was separated in 2000.

S

he has invested a lot of her energy for the development of the Electronic Data Interchange (EDI) System.

While acting as the Supervisor of the EDI system development team for two and a half years, she worked on the computerization of health insurance data. Kim developed approximately 100,000 codes for medicinal drugs, medicinal ingredients and insurance fees, which were used to create a standardized form for claiming specifications and developing logistics that acted as guidelines for the computerized system. Previously, charges for drugs were processed manually and a printed form of the charges had to be sent through the post from different hospitals. Pharmacies, including other medical institutions, had to charge their patients on a monthly basis.

The difficulty and complexity of such manual approaches could often be witnessed at the HIRA headquarters based in Seocho when emergency vehicles had to wait in line. To ameliorate such national efficiencies, Kim slogged through the development of the EDI system.

Through the development of the EDI, 1.3 billion purchase specifications that were previously expressed in written form changed into a more efficient computerized form.

Furthermore, the system helped lay the groundwork for

a nationwide statistics of diseases in 5 million people inhabiting Korea. Such data is used for scientific research and for comparative purposes not only in the OECD, but also among different nations.

K

im has contributed to the creation of a method to efficiently manage the medical costs covered by health insurance through the Drug Economic Evaluation Policy.

As the head of both the salary management team and the drug management team, Kim was responsible for determining which drugs were to be covered by insurance and for evaluating a reasonable price for the selected drugs. Kim determined the allocation of the budget for medical practices, insurance registration for drugs, and medical care materials. She also adopted a system for the reassessment of the evaluations every three years.

She also adopted a process for setting up a standard for determining whether to provide insurance for a particular drug considering its cost-effectiveness. Furthermore, after supporting the policies regarding drug usage from the Ministry of Health and Welfare in 2006, Kim played a key role in rationalizing drug usage through the implementation of the health insurance price volume system. Through this, Kim contributed in efficiently managing the massive annual budget allocated to medicine.

Moreover, as the manager of the evaluation team, in order to prevent misuse of drugs, Kim implemented a system that assessed the prescription rate of antibiotics, antiinflammatory agents, and expensive drugs. The system Kim came up with contributed to reducing the number of prescription rate of antibiotics, and thereby alleviated the serious problem of antibiotic resistance among Koreans caused by the overuse antibiotics.

K

imâ&#x20AC;&#x2122;s contribution to the safe dosing of medicine through the DUR system.

Kim, while acting as the head of the drug management team, posted 162 medicinally prohibited components by analyzing 15,000 demand specifications through the DUR system. She permitted such information to be used during the prescription of drugs, which helped to prevent

2015 VOL.7

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PUBLIC SECTOR

the usage of drugs that were contraindicated in patients.

There were 613 combinations of drugs that were prohibited of concomitant usage, 118 ingredients that were strictly contraindicated in certain age groups, and 314 components that were prohibited to be used during pregnancy, were notified by the system.

K

im contributed to the advancement of drug distribution through the development of the General Drug Management System.

After being appointed as the first center manager of the Health Insurance Review & Assessment Serviceâ&#x20AC;&#x2122;s Medical Drug Management Information Center in 2007, Kim contributed to the advancement and transparent distribution of drugs. Kim systematically managed the production, supply, and consumption distribution process for 100,000 different items, and provided such information to the industrial world. This provided a crucial role in supporting the development of the drug industry and policies pertaining to drug distribution. She also developed nationally standardized bar codes for medicines that were previously different for all medical institutions. By encouraging wholesalers, manufacturers, and pharmacies to adopt this standardized policy, a much advanced system of drug distribution was created.

C

urrently, Kim is now responsible for improving the proper usage of drugs. She helps evaluate the abuse of antibiotics and other drugs, and also helps evaluate drug usage for chronic diseases including high blood pressure and diabetes.

Comparatively speaking, Koreans use more antibiotics than other countries. Nonetheless, contrary to common misconception, antibiotics have no effect on the common cold since the cold is mostly induced by viruses. For such reasons, Kim evaluates whether or not medical facilities are using antibiotics appropriately. Furthermore, Patients with high blood pressure and diabetes can avoid hospitalization if properly treated at clinics. However, compared to other OECD nations, the rate of hospitalization is high in Korea.

With the belief that the rate of hospitalization could be reduced through an increase in drug adherence, Kim is now

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THE BLUE VANGUARD

evaluating whether or not medical facilities are making an effort to help patients take their medication consistently.

K

im says that it is worthwhile to directly influence public health and policies associated with drug management in pharmaceutical companies, hospitals, and pharmacies, through the adaptation of the DUR system.

The high international reputation of the EDI system makes Kim happy. Kim exports such systems to Japan and the Middle East while supporting Africa, Vietnam and other developing countries. The biggest difficulty she encountered was mediating the different opinions among interested parties. Another difficulty was maintaining a balance of listening to the different opinions between the medical and pharmaceutical sectors, and between the government and the citizens. She also said that those who work in the government are in important positions since the policies the officials pursue directly impact 5 million Korean people. Kim said that if those who were professionals in the medicinal field participated in the creation of government policies related to medicine, a much better policy could be produced.

K

imâ&#x20AC;&#x2122;s advice to aspiring pharmacists â&#x20AC;&#x201C; Kim is concerned about the fact that only a few pharmacists work in the government sector involved in policy making. The scarcity of pharmacists who enter the Ministry of Health and Welfare through the civil service exam is one example. Furthermore, Kim says that those who are fluent in foreign languages are expected to be more competitive in the global market. Lastly, delving deeply and studying clinical pharmacology and societal pharmacology, and possessing a wider range of knowledge is also necessary for pharmacists, she says. Kim also mentioned that frequent career changes are unfavorable as it prevents pharmacists from appropriately learning the responsibilities for their jobs in depth. Patience is a virtue, she says. B

PHARMACEUTICALS

Interview with Human resources of Daewoong

T

Byeonghun Lee

bhleegen@yonsei.ac.kr

here is a large variety of jobs that pharmacy students can do after graduation. Many of them may dream of using their abilities at a pharmaceutical company. Pharmaceutical company is charming enough to students. Using their knowledge acquired at school, pharmacy students can work at many different department from R&D to marketing. What is it about pharmaceutical that students find interesting? This issue of the Blue Vanguard visited the human resources department of Daewoong Pharmaceutical to find out why.

Please Briefly Introduce Daewoong Pharmaceutical. ▶Daewoong is a ‘global health care group leading the improvement of quality of life. The company not only produces medical supplies, but also works to produce medical services. It also manage overall healthcare projects related to medical device, human organisms and medical IT. Daewoong is looking for potential employees who have the following characteristics: justice, fairness, ability to collaborate as a team player, ownership, open-mindedness.

Q. What are your Responsibilities at the Human Resource Department? ▶Human resources (HR) department recruits prospective employees and tries to enhance the capabilities through education. In addition, the HR rewards them based on a fair evaluation system and by consistently monitoring their outcome. In other words, we manage a ‘recruitment-arrangement-education-evaluation-reward-retirement cycle’. The interviewee who is a member of HR team has been predominantly responsible for recruitment Q. What Advantages Do Pharmacy Students Have Compared to Students of Other Majors? ▶Due to the nature of the healthcare industry, there are many places where the curriculum learned from pharmacy school is actually utilized. For example, in the R&D department, employees who know the flow of how new medicines get developed and the system of medical treatment are good at communicating with other institutions and carefully understand medical products. Pharmacy students who have already learned pharmacology, manufacturing and medical terminology at school and completed their practical training at a pharmaceutical company or hospital are at an advantage.

It is what differentiates pharmacy students from others. Applicants who majored in pharmacy would have a wide range of understanding about the industry and the consumers through their practical marketing experience.

Q. What Kind of Tasks Do Pharmacists Perform after Being Hired? ▶There are many roles pharmacists can take on. Since Daewoong has a program called CDP(Career Development Program) where the goal is to strengthen the ability of employees, and give them the chance to apply and work for another department. In other words, the important thing is that people need to be qualified to work at the department they choose.

Q. If Pharmacists Decide to Work at a Pharmaceutical Company, How Should They Prepare in Advance? ▶The most important factor Daewoong considers is not simply having the right qualifications, but having the right attitude towards learning and communicating. Therefore, do not just simply list your qualifications on your resume. The executives get to know the applicants through the job application letter. They are not interested in applicants who do not show the values they hold and the abilities they have. For those reasons, it is recommended you write your resume in great detail and really reflects who you are as a person. B 2015 VOL.7

19

PROFESSOR

A SPRING PICNIC with Professor

Sohee Kwon Songhee Min

songheemin@yonsei.ac.kr

P

rofessor Sohee Kwon received her bachelor’s and master’s degree in pharmacy from Sungkyunkwan University.

Then, she obtained doctorate degree in biochemistry from Basel University in Switzerland and completed her post-doctoral fellowship at Stower’s Institute of Medical Research in the USA. As a young researcher, she has broadened her knowledge in her field by studying abroad in two different continents. Through Blue Vanguard’s interview, Professor Kwon talks about her life in pharmacy school and studying abroad. We hope that readers can find some inspiration through her story.

“About Sohee”

Her journey from Pharmacy School to Professorship BV(Blue vanguard) : Tell us about your life as a pharmacy student

Professor Kwon : I threw my energy to both my

studies and extra-curricular activities. Studying hard was necessary to pass numerous exams and quizzes. In addition, I remember that I spent a lot of time involved in student clubs. When I was in pharmacy school, we had to learn about oriental medicine. As I studied oriental medicine, I discovered a newfound interest in oriental treatment and decided to join the acupuncture club. Club members could actually practice acupuncture on other club members. It was safe to do so because the treatment was only done on around the joints. Another club I was involved in had to do with medicinal herbs. During the weekend, we used to climb a mountain and gather medicinal herbs. Professors and graduate students helped us to find and distinguish the actual herbs. Thanks to their explanations, I was able to advance my knowledge beyond the textbook.

A word of Advice to pharmacy students:try to maintain a balance between your studies and extracurricular activities. If you put too much effort into studying, you will lose something. However, it is the same if you spend too much time on extraneous activities. Put your heart and soul into both of them. Then, you will feel a sense of accomplishment.

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THE BLUE VANGUARD

BV : What inspired you to become a professor?

Prof. Kwon : I entered pharmacy school because I was

interested in the life sciences and medicine. As I studied pharmacy, I kept on thinking about my future. Then, I realized that I like studying and teaching, which brought me to set my final goal, to become a professor. After setting my goal, I put all my effort into achieving it. I decided to study abroad in order to become a global researcher. First of all, to do so English proficiency was necessary, so I went to English language school every day at 7am before class.

In addition, I did my best to write a great research paper during my master’s program in Korea. As a result, my thesis was published in a well-known journal and I was accepted into the doctorate program at the highly esteemed Basal University. Then, I finished my doctorate degree in Europe and completed my post-doctoral fellowship in the USA. Since I completed my degree in both Europe and America, I was on my way to becoming a global researcher. Finally, I returned to Korea to begin my career as a professor, which was my final goal.

I want to ask you, “what is your dream and what steps should you take to achieve it?” Take some time to think about these questions as a university student. Everyone has different values and dreams, so create your own path.

In addition, don’t be afraid to talk about your dream. I had never been in a foreign country before studying abroad, but I decided to go in order to accomplish my dream. In your twenties, don’t be afraid to take that initial step to following your dreams.

PROFESSOR

“About Her Studies”

“Her Next Goal and Final Advice for Students”

BV : What are you working on now, in the epigenetic

I have two goals as a teacher and researcher. First as a researcher, I hope that my research will help others. As for developing new drugs, a lot of foundational research has to be done. I want to continue to the fundamental research which is applicable for developing new drugs. Second, as a teacher, my goal is to guide my talented pharmacy students and help them cultivate a great personality and deepen their knowledge. I hope that my students will have fun studying biology in my class. Also, I want to impart some valuable advice to my students, so that they would become warm-hearted pharmacists. This is my final advice for pharmacy students. As a pharmacist, maintaining a high level of knowledge is essential. In addition, since humans are social animals, building an upright character is also required. I hope that Yonsei pharmacy students will both build upon knowledge and personality in school, so they will receive a favorable evaluation in any field they may enter. B

From Epigenetics to the Development of New Drugs field? What do you think is the future of epigenetics?

Prof. Kwon : Epigenetics is the study of cellular and physiological trait variations that are not caused by a DNA sequence. Abnormal epigenetic regulation leads to severe diseases such as cancer, nervous system disorders and immune system diseases. In my laboratory, we are researching on epigenetic mechanisms and on finding a target for new drugs. Specifically, we do research on the epigenetic mechanism of protein complexes that modify chromatin and regulate gene transcription. Among epigenetic regulations, we mainly focus on the protein complexes that regulate acetylation and methylation of histones: HP1, HMTs & KDMs and HDACs. Currently, the protein complexes such as HDAC1, KMT1, KDM4 are found to be key proteins for regulating cancer. Therefore, we are developing inhibitors which have an anti-cancer effect. This leads to research in the therapeutic field.

We do research for the discovery and validation of novel epigenetic therapeutic targets and epigenetic regulation.

Practically speaking, it seems that developing a new drug is harder than before. However, the field of developing epigenetic drugs is very promising. For instance, epigenetic based diagnostic kits, anti-cancer drugs and medicines have been developed. I am certain that epigenetic medicines will take center stage in the pharmaceutical field.

“Enjoy studying and enjoy school activities.

Try to see the positive side rather than the negative side. Be an active and positive person who keeps on trying”

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CAMPUS ISSUE

COMING IN AND OUT, four years apart Interviewing a freshman and a graduate of yonsei university, college of pharmacy

Yunkyung Heo

ykheo107@yonsei.ac.kr

February 23 of this year, the first graduation ceremony was held at Yonsei University College of Pharmacy. Twenty-six students of the Class of 2009 have left the school and are now pharmacists. In the meantime, new students of the Class of 2015 have filled the void. The freshmen are now heading down the same path that the graduates have gone in the past four years. The Blue Vanguard has interviewed one of the freshmen, Chihyun Kim, and one of the graduates, Misun Park.

Looking Forward to the Upcoming Four Years

Thoughts on the Future of Pharmacists

1. What made you come to pharmacy school?

The technology that can substitute for the trivial routine work of pharmacists is developing at fast speed. More community pharmacies in Korea are trying to bring in ATCs (Automatic Tablet Counting and Packaging Machines). It is true that once these machines are used more widely, the demand for part-time pharmacists will reduce. However, this does not mean pharmacists will have to compete with these machines. They can use them to their benefit. In order to effectively utilize these machines without being 2. What do you most look forward to in the threatened by their replacement, pharmacists should not next four years? be complacent about their present status, but attempt to I have been looking forward to living in the dormitory establish more professional tasks that can only be done by the most. At the dormitory, I can be with friends for a long pharmacists and that cannot be replaced by machines.

time and work out since the fitness center is very close. But studying is quite tough here.

Four years ago, while I was struggling with the 118 different elements on the periodic table, I felt doubtful whether there would be any chance of using what I was studying once I graduated from college. Then I wanted to start studying something more at a professional level, something that I could actually apply to real life, which brought me to pharmacy.

3. What is your future goal?

I want to be a researcher at a pharmaceutical company. I will be able to use what I will be learning at school for the next four years.

Expectations From School I wish there were fewer exams and that the school provided more shuttle buses from Songdo to Sinchon.

Chihyun Kim

- 2011-12 Sogang University, College of Chemistry - 2013-14 Korean Combat Police

- 2015 Yonsei University, College of Pharmacy

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THE BLUE VANGUARD

CAMPUS ISSUE

Looking Back the Past Four Years 1. What made you come to pharmacy school?

I wanted a specialized job. When asked what I do, instead of saying where I go to for work, I wanted to be able to say what I actually did. Before coming to pharmacy school, I worked at a company that treated LCD, after studying chemistry for four years at Yonsei University. As a researcher at the company, I actually did not have a chance to apply what I had learned from college directly to my work, which was very discouraging for me. Therefore, I decided to go to pharmacy school at the age of 28. Although it might have been quite late to start studying something new, I found out that pharmacy suited me much better than did chemistry.

2. What was the best experience during your four years at the college of pharmacy?

The best experience was being part of the Blue Vanguard. Since I was one of the founding members of the Blue Vanguard, my fellow Blue Vanguardians, and I had many issues to overcome since the beginning is always the hardest. However, seeing the lower classmen doing a great job, in continuing what we started, even better than what we had done, I feel very proud of what we had achieved.

3. What is your current goal?

A few days ago, I met a 60-year-old lady who brought prescriptions from five different departments at the hospital.

She asked me how she could alleviate her stomach irritation caused by excess use of medication. Unfortunately, I could not answer her question with confidence. Before I met her, I actually did not think it is necessary to memorize every case of drug interactions since there were databases that I could look at whenever I needed information. However, I realized that patients would not wait until I looked it up in the database; therefore, I should know what patients ask for in order to help them right away. My current goal is to study more about drug interactions and to be able to help patients and offer health advice.

Thoughts on the Future of Pharmacists A pharmacist should be a person whom the physicians, nurses, or patients can trust and seek professional advice about medication. Unfortunately, in Korean society, pharmacists are not yet highly recognized as a specialized health care provider. In order to be professional pharmacists, they must persistently study. While physicians are well aware of the medications that are only related to the disease they are specialized in, pharmacists are those who have basic knowledge on overall medications, and therefore pharmacists should be those whom anyone can seek general advice on drugs.

Expectations From School I have always liked the way how the professors tried to communicate with the students. I hope that easy communication is maintained between the professors and the students.

Moreover, the graduates and the school should try to further promote our school, the College of Pharmacy at Yonsei University. Since our program does not have a long history, it is not well known to the public. We should now work on promoting ourselves to public.

B

Misun Park

- 2003-07 Yonsei University, College of Chemistry - 2009-14 Yonsei University, College of Pharmacy - 2015 KyungHee University Medical Center

2015 VOL.7

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STUDENT CLUB

Freemed

Youth, passion, and life value Ahyoung Kim pharmay@yonsei.ac.kr

Freemed was established by a group of young passionate students who wanted to deliver affordable medical support for people at the blind spots in healthcare and spread the importance of human life. After the establishment of Freemed, they have medically supported the people in our community such as the homeless, foreign workers, children with cancer and from low-income families, and expectant mothers in undeveloped countries. Since Freemed was registered as a NPO (non-profit organization) in 2012, Freemed expend their efforts to create practical values. Now Freemed is working on three projects, which will be discussed further.

Freemedical Clinic:

Freedmed gives the hope of life to the homeless.

The Freemedical Clinic opens every Saturday at 6pm at exit number nine at Seoul Station, and serves the homeless with full medical services. They recruit an outreach team that can check the health conditions of the people who live around Seoul Station.

Since the environment where the homeless resides is more prone to infect exposed wounds and various diseases, their treatment needs to be given quickly to prevent it from

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THE BLUE VANGUARD

getting worse. Freemed helps the homeless to live healthier lives by providing accessible medical services.

Also, Freemed keeps patientsâ&#x20AC;&#x2122; medical records which help to treat them more carefully based on their latest check up. Furthermore, Freemed analyzes the records thoroughly to provide better medical consultations to patients. Freemed has prepared several cultural events at the office to relieve the physical and psychological conditions of homeless.

Their latest event was called Fortune Cookie. They gave out fortune cookies and a Freemed brochure to the homeless who had finished their treatment while they wrote down their New Yearâ&#x20AC;&#x2122;s wishes on a post-it. After the event, they hoped that they would be consoled by the short phrase included in the brochure.

STUDENT CLUB

MHI:

Health Education:

Maternal Healthcare Initiative Freemed helps children to live healthFreemed makes special memories of moth- ier lives. er and children in developing countries.

Because of the massive loss of blood and the unsanitary environment of developing countries, countless pregnant women get infected and may die. Freemed provides a medical kit for prenatal diagnosis for the mother who suffers from various pregnancy complications in Kajiado, Kenya. The medical kit for prenatal diagnosis helps to find dangerous cells which cause the complications in pregnancy during the early pregnancy stage.

Freemed has a corporate with the Ministry of Health and Sanitation located in Kajiado, Kenya, to provide medical services and education to mothers and children. In the field, Freemed teaches about the supplies provided by Freemed and discuss the construction of the infrastructure necessary for an ideal medical environment. Since Kenya lacks medical facilities, Freemed provides an emergency ambulance service to improve Kenyan accessibility to medical facilities. Also, Freemed tries to improve the medical teamâ&#x20AC;&#x2122;s ability while educating the citizen and promoting the awareness of the importance of sanitation of public areas, such as the church and marketplace.

Freemed health education is specialized on topics of mental health, sexual health, and family stability which children of low-income families are susceptible to.

Through the education, we hope to develop the childrenâ&#x20AC;&#x2122;s ability to deal with these difficulties better.

The health education team consists of professors and assistant professors. Professors are involved in the mentoring system for the children and assistant professors help the children to better understand the topics of the lectures. They pay close attention to the children who have negative opinions for this program, so that child could be given special attention.

Furthermore, professors collect the information of the children who attend this education program. Therefore, they can give these children customized healthcare based on the information collected. Freemed provides the medical records to the teacher in charge of children so that they may live a healthier life.

The students who major in pharmacy are already participating in Freemed. They are involved in MHI activities, filling prescriptions at the Freemedical clinic, and giving lectures on the correct ways of taking medicine. Freemed recruits new members annually on March and September. B

2015 VOL.7

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EXPERIENCE

Special Experience : In The Korean pharmacy Studentsâ&#x20AC;&#x2122; Association Hosung Jang yourself28@yonsei.ac.kr

268 THETHEBLUE 26 BLUEVANGUARD

EXPERIENCE

After being elected as the president of the student council of the pharmacy school at Yonsei University last year, I joined a committee in the Korean Pharmacy Students’ Association.

JeonYakHyup is Korean for the Korean Pharmacy Students’ Association and all Korean pharmacy students are required to join. This committee festivals is run in collaboration by each pharmacy school president.

It involved in a variety of activities, ranging from conference to festivals.

In this section, I want to share my special experiences as a member of this committee to the readers.

as the chairman of the student council of pharmacy of STUDENT COUNCIL : I first met all 35 presidentsAfter of allelected the pharmacy Yonsei University last year, I take a role in the Korean Pharmacy Stuschool in Korea on December 2013, at a meeting held at Sookmyung in Womdents’ Association.

This en’s University. This meeting was held so the presidents could get to know onecommittee’s name is JeonYakHyup.

JeonYakHyup short for Korean pharmacy student’ association in Koanother and to be formally introduced to JeonYakHyup predecessors. Almost rea easy styletowhich must be joined if you are a pharmacy student in Korea. every president had on extroverted personality, so it was get close.

This committees is would run by each school president and include a variety of In fact, before I participated as the Student Council, as other students activities, think, I also thought JeonYakHyup merely as a place of festival.ranging I did notfrom knowconference to festivity. In this section, I want to share my special experience much about it. Through the education I received on that day, I realized that it to readers as a member of this committee. is the Student Council that needs to deliver the meanings and purpose of JeonYakHyup to other pharmacy students.

JEONDAEHOE : On January 2015, all the representatives of pharmacy schools nationwide gathered for a conference. The name of this conference was JeonDaeHoe, which means the National College of Pharmacy Student Conference. Annually, the conference is conducted over two nights and three days, and is proceeded by a talent show, lectures, meetings, and other various programs.

Attendees form a group, play games together, and get to know each other better. Our group was composed of representatives from Chungbuk, Gacheon, Duksung Women’s and Sungkyunkwan University. Through this group, I naturally was able to hear other schools and share information.

AS A DIRECTOR OF THE EDUCATION POLICY IN JEONYAKHYUP : In JeonYakHyup, each school president was to be in charge of one of many programs and I was the director of the education policy. Since the introduction of the corporate pharmacy became big issue in Korea at that time, JeonYakHyup decided to create the educational resource about the corporate pharmacies for students. To make this educational material, we had to read about five different international journals and articles for days. Thanks to the good people who were able to help us, the educational resource was successfully created and distributed to all pharmacy students in Korea. B

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COLUMN

Exciting Drug discoveries Within pharmacology

L

Yoojin Choi

yoojin6a@yonsei.ac.kr

ast year, during my sophomore year of pharmacy school, I took a course on pharmacology, which is mandatory for all pharmacy students. There are a vast amount of drugs in the pharmacology textbook and as pharmacy students, we were engrossed in simply memorizing these drugs for the exams. Consequently, we could not gain interest in those medicines. Recently, I read a book called Introduction to Pharmacology. This book tells the story of how 23 different drugs were discovered. Reading each story for each drug, I wanted to know more about these drugs. Knowing that most students would have felt the same way about pharmacology as me, Iâ&#x20AC;&#x2122;d like to introduce three most interesting drugs in the book to the Blue Vanguard readers. Even freshmen who have yet to learn pharmacology, will get a preview and the chance to realize how exciting pharmacology is. Let us now dive into the exciting world of drug discoveries of three drugs, nitroglycerin, glucocorticoid and the statins.

Novelâ&#x20AC;&#x2122;s Usage of Dynamite to Cure His Cardiovascular Disease Nitroglycerin has two faces as an explosive and medicine. Alfred Bernhard Novel made a Dynamite by chemically mixing nitroglycerin and diatomite. Then, how did the medical effects of nitroglycerin become known? At the factory that produced nitroglycerin, factory operatives complained of severe headaches and palpitations. At this point, scientists suggested using nitroglycerin as a therapy for angina*. But it took about 20 years for nitroglycerin to become one of the first-line therapies for angina. One reason for this was doctors and patients were reluctant to use dynamite as medication.

In addition, the therapeutic effect of nitroglycerin varied significantly depending on the route of administration.

While the medicinal effects immediately emerged when absorbed through the sublingual vessels, nitroglycerin was totally ineffective when swallowed like other tablets.

This was due to the first-pass effect of the liver. Later, the mechanism of nitroglycerin was identified and it is still widely used for first-aid medicine to relieve pain of angina attack. * angina : chest pain caused by reduced blood flow to the heart muscle. It is because the coronary arteries become reversibly narrow.

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THE BLUE VANGUARD

COLUMN

How Mold Prevents Arteriosclerosis

Jaundice and Rheumarthritis

Cholesterol is essential for synthesizing the cell membrane and various hormones.

But excessive amounts of cholesterol results in arteriosclerosis and other vascular diseases. Now, the first-line therapy for arteriosclerosis is the statins and almost all patients with cardiovascular disease take statins. Statin was discovered by the Japanese biochemist, Akira Endo. He studied in U.S.A and learned that cholesterol was the main causative factor of arteriosclerosis. In the mid-1960â&#x20AC;&#x2122;s, after he returned to Japan, he made a bold hypothesis that certain types of mold would disturb the lipid synthesis of other organisms by producing certain chemicals, as some molds made penicillin to block cell wall synthesis of some organisms. After about 2 years of the experiment, Endo extracted ML-236** from Penicillin citrinum. As a matter of fact, ML-236B was discovered by the Beecham Group*** prior to Endoâ&#x20AC;&#x2122;s discovery of ML-236. Since little antimicrobial effect was found, Beecham discarded this chemical. So, Endo was able to register a patent for compactin. With a few chemical transformations of compactin, many different kinds of statin medicines, including lovastatin and simvastatin, were released in the pharmaceutical market.

The idea of using glucocorticoid for inflammatory diseases derived from the clinical observations made by an American physician, Philip Hench. He observed that if jaundice occurs in patients with rheumarthritis, symptoms of rheumarthritis improved. Furthermore, he discovered that rheumatic symptoms were relieved in pregnant women. Jaundice is a disease caused by the accumulation of bile acid in the blood, and in pregnancy, serum sex hormone concentration levels are elevated.

Hench thought that bile acid or sex hormones might relieve rheumatic symptoms and administered bile acid to the patients. But it was ineffective. After time passed, chemical structure of cortisol was identified, and Hench compared the structure of cortisol with that of bile acid and sex hormones. He realized that the three substances shared common structures, and that cortisol was an active ingredient that relieved the symptoms of the inflammation.

Hench was awarded the Novel Prize for physiology or Medicine along with his laboratory co-worker Edward Kendall and Swiss chemist Tadeus Reichstein****. Since then, glucocorticoid, another name for cortisol, has been used as immunosuppressant for the relief of inflammation.

Over the weekend, how about reading Introduction to Pharmacology to enter the world of drug discovery? Twenty more interesting stories are waiting for you! B

** ML-236 which Endo discovered had three subtypes, A, B and C. It is also called compactin *** Beecham Group, a British pharmaceutical business founded by Thomas Beecham, now part of GlaxoSmithKline **** Hench collaborated with Kendall, and Reichstein in their work on the hormones of adrenal cortex which culminated in the isolation of cortisone and the discovery of its therapeutic value in the treatment of rheumatoid anthritis.

2015 VOL.7

29

BOOK REVIEW

Introduction to the thermodynamic world

D

Heejo Lee

lhjo1990@yonsei.ac.kr

o you know the Law of Thermodynamics? Most pharmacy students would have studied the First and the Second Law of Thermodynamics while preparing for PEET, or maybe some students would have learned the concepts in thermodynamics class. Now, I would like to recommend a book called, “Entropy” written by Jeremy Rifkin. In this

book, Rifkin discusses the problems of modern society and offers alternatives that might resolve them by using the Law

of Thermodynamics. Although this book was written about 35 years ago, the content still seems to be future-oriented and the writer’s ideas are worth thinking about. In addition, most readers who read this article will become well-acquainted

with the natural science but not as familiar with the humanities or sociology. I hope this book would help the readers encounter a variety of areas other than the sciences.

We are often deluded by the fact that technological development keeps the order of a society. However, a state of disorder is caused by huge energy that is absorbed into modern society. And as more energy is needed to withstand the state of disorder, a more intense chaos is created. As the development of technology progresses, the gathering, processing, and using energy resources, becomes more inefficient economically and environmentally. For example, as the yield of agricultural products increase due to the developments made in technology, it might be efficient in terms of time, but not in terms of energy. Moreover, an improvement of transportation system causes an increase in ecological disorder.

Urbanization has ultimately resulted in financial bankruptcy due to an increase in entropy, and the result of military system expansion is, according to Rifkin, “…beating the plowshares of future generations into present swords or warheads.” From an educational perspective, an increase in entropy can occur, for example, when students cram for exams due to unpreparedness.

Rifkin suggests that the entropic world view is based on the idea of conserving finite resources to overcome this problem. For instance, problems caused by urbanization can be solved by reducing the size of the city, which can be achieved by reducing fossil fuel energy with solar energy, introducing organic farming, and using bicycles instead of cars. Moreover, according to the entropy cased in perspective, adopting a new education system that focuses on adopting a broader approach to acquiring knowledge can help to resolve any issues regarding education. As the writer says, “We need to conserve, as best we can, the fixed endowment that has been left to us, and to respect, as best we can, the natural rhythm that governs the becoming process, and to express our ultimate love for all life that preceded us and all life that will follow.”

Some examples in the book focuses solely on the increase of entropy. We cannot express in words how people would enjoy a more convenient life due to the decrease in entropy. This may weaken Rifkin’s opinion. However, overall I agree to his opinion. I was especially impressed by his statement about education. “Within 24 hours of the tests, chances are good that little or none of the data has been retained. What has been retained, however, is a massive hangover which often lingers on for several days.” This paragraph points out the limitations of Korean education.

Although this book is about sociology, we can read it easily since we, as pharmacy students, already know some knowledge about entropy. I hope students read “Entropy” and begin to think about the problems presented by the author.

B

30

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