Pf Magazine October 2018

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POWER LIST WHO IS SHAPING THE PHARMA & HEALTHCARE SECTOR? October 2018 PHARMAFI E LD.CO.U K


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WELCOME

HEAD OF CONTENT

Emma Morriss emma.morriss@pharmafield.co.uk SPECIAL EDITIONS EDITOR

Amy Schofield amy@pharmafield.co.uk C R E AT I V E D I R E C T O R

Emma Warfield emma@pharmafield.co.uk COMMERCIAL DIRECTOR

Hazel Lodge hazel@pharmafield.co.uk D I G I TA L M A R K E T I N G E X E C U T I V E

Emma Hedges emma.hedges@pharmafield.co.uk NEWS DESK

Hannah Alderton newsdesk@pharmafield.co.uk M A R K E T I N G A S S I S TA N T

Adam Fisher adam@pharmafield.co.uk FINANCIAL CONTROLLER

Fiona Beard finance@e4h.co.uk P f AWA R D S

Melanie Hamer melanie@e4h.co.uk PUBLISHER

Karl Hamer karl@e4h.co.uk pharmafield.co.uk | e4h.co.uk @pharmafield | @pharmajobsuk HEAD OFFICE

Spirella Building, Bridge Road Letchworth Garden City, Hertfordshire SG6 4ET United Kingdom The content of and information contained in this magazine are the opinions of the contributors and/or the authors of such content and/or information. Events4Healthcare accepts no responsibility or liability for any loss, cost, claim or expense arising from any reliance on such content or information. Users should independently verify such content or information before relying on it. The Publisher (Events4Healthcare) and its Directors shall not be responsible for any errors, omissions or inaccuracies within the publication, or within other sources that are referred to within the magazine. The Publisher provides the features and advertisements on an ‘as is’ basis, without warranties of any kind, either express or implied, including but not limited to implied warranties of merchantability or fi tness for a particular purpose, other than those warranties that are implied by and capable of exclusion, restriction, or modification under the laws applicable to this agreement. No copying, distribution, adaptation, extraction, reutilisation or other exploitation (whether in electronic or other format and whether for commercial or non-commercial purposes) may take place except with the express permission of the Publisher and the copyright owner (if other than the Publisher). The information contained in this magazine and/or any accompanying brochure is intended for sales and marketing professionals within the healthcare industry, and not the medical profession or the general public.

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Welcome.

his month, we bring you the first ever Pf Power List. We wanted to know who is walking the walk as well as talking the talk; and making a difference to pharma and healthcare? Our Pf Power List is divided into six categories: politics, new technologies, outstanding best practice, changemakers, exceptional leaders and women leading the way. It makes for interesting reading. We’re keen to know who you would put on your power list; who you feel is making their mark on healthcare and pharma, either highly-publicised or under the radar? Drop us a line with your suggestions and we’ll consider them for the next Pf Power List. Moving from people making their mark on the industry, you can’t get away from the mark Brexit is likely make. To keep you up to date on thoughts around the UK’s exit from the European Union, we have an article exploring the impact Brexit and the European Medicines Agency’s (EMA) relocation will have. With the EMA due to relocate to Amsterdam before 29 March 2019, we asked a roundtable of experts what impact they felt this and Brexit are likely to have. They discuss regulatory implications, operational considerations, pharmacovigilance and more. In this issue, we also look at the role artificial intelligence is already playing in the industry. It’s not as far off as people may think. Finally, with developments in blood cancer treatments repeatedly hitting the headlines over the summer, our therapy focus explores the different types of blood cancers and recent developments. From new treatments to NICE approvals, things are moving quickly. I hope you enjoy this issue of Pf. Drop us a line, let us know and also share your power list suggestions. Next month, we bring you our Sales Excellence Special Edition and in the December issue we’ll be looking forward to 2019. If there’s something you want us to cover or would like to share, please do get in touch at hello@pharmafield.co.uk

Pf Magazine is published monthly. For a free U.K. subscription visit www.pharmafield.co.uk/subscribe

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CONTENTS

CONTRIBUTORS

04 N E WS

Bringing you the essential headlines

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C OV E R S TO RY

The Pf Power List are making an impact on the market

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POLITICS

Is prevention heading back up the NHS agenda?

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COFFEE BREAK

Roald Dahl’s specialist children’s nursing programme

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F E AT U R E

What impact will Brexit and the EMA relocation have on pharma?

A M A N DA B A R R E L L

D E B O R A H E VA N S

Amanda is a freelance health and medical education journalist, editor and copywriter. She has worked on projects for pharma, charities and agencies, and has written extensively for patients, healthcare professionals and the general public. Pf Power List, page 10

Deborah (FRPharmS FFRPS FRSPH) is Managing Director of Pharmacy Complete, a training and consultancy company working with pharmacy and industry. She can be contacted by email: deborah@pharmacycomplete.org. Pharmacy’s role in vaccinations, page 21

C L AU D I A R U B I N

C O L I N WAT S O N

Claudia is a Director at Decideum, one of the UK’s leading consultancies in healthcare policy and market access. She has over 10 years’ experience in healthcare advocacy and communications, supporting global pharmaceutical companies and small patient groups with integrated public affairs strategies. NHS long-term plan, page 14

Colin has over 30 years’ experience within the pharmaceutical, outsourcing and vaccines industries and held senior positions across sales, marketing and general management before launching his own consultancy business. The AI time is now, page 32

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P H A R M ACY

Pharmacy’s growing role in vaccinating the public

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T H E R A PY A R E A

Developments in blood cancer treatments

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P H A R M ATA L E N T

MSD’s Priyanka Trehan loves her job because…

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T EC H N O LO GY

How AI is making its way into pharma and healthcare

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M OV E R S & S H A K E R S

Who is on the move?

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CAREERS

How to get a pay rise

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MAGA ZINE

October HAVE YOUR SAY: If you’d like to share an idea for a feature or collaborate with us on a captivating advertorial, please get in contact. GET IN TOUCH: hello@pharmafield.co.uk @pharmafield

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THE TUR NHS NS

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NICE.

ACCESS DENIED

AC Q U I S I T I O N

BAYER’S BIGGEST BUYOUT Bayer successfully completed the biggest acquisition in its history when it completed the acquisition of Monsanto for $63 billion dollars including debt in June. The integration of Monsanto into the Bayer Group can also now begin following the completion of the divestment by Bayer to BASF of certain crop science businesses with a total sales volume of around €2.2 billion. One of the requirements of the U.S. Department of Justice was that Bayer and Monsanto remain separate companies and continue to operate separately until completion of these divestments to BASF, and that has now taken place. Bayer expects that the acquisition will make a positive contribution to core earnings per share starting in 2019, with a double-digit percentage from 2021 onward. From 2022, annual contributions of $1.2 billion to EBITDA before special items are planned from synergies. Bayer has said that it will also further strengthen its commitment to sustainability.

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he first and only licensed disease-modifying treatment ocrelizumab for people with early Primary-Progressive Multiple Sclerosis (PPMS) will not be made available on the NHS. In clinical trials ocrelizumab has shown it could delay the need for a wheelchair by seven years in people with early PPMS. Ocrelizumab is licensed for both relapsing-remitting multiple sclerosis (RRMS) and PPMS in over 65 countries globally, with over 50,000 people having been treated. PPMS affects around 10,000-15,000 people in the UK and people with this highly disabling form of MS often end up in a wheelchair. The Department of Health and Social Care does not allow medicines to have different confidential prices for different indications which meant NICE could not consider the indication-specific price offered by Roche. Failure to resolve this technicality between NHS England and NICE means that people with PPMS are denied access to the treatment. In the Phase III clinical trial ORATORIO, ocrelizumab was shown to slow disability progression and reduce signs of disease activity in the brain (MRI lesions) in people with PPMS, compared with placebo, with a median follow-up of three years.

DEMENTIA

Diagnosing dementia developments Eli Lilly and Company and Avid Radiopharmaceuticals, a wholly owned subsidiary of Lilly, have announced that a Phase 3 study of flortaucipir F 18, a Positron Emission Tomography (PET) imaging agent, met its two primary endpoints, defined as predicting brain tau pathology and predicting Alzheimer’s disease diagnosis. The study, referred to as A16, enrolled a total of 156 end-oflife patients with dementia, mild cognitive impairment, or normal cognition who underwent flortaucipir PET imaging. Subsequently, 67 of these patients were evaluated post-mortem. The study met pre-specified endpoints

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with flortaucipir demonstrating statistically significant sensitivity and specificity for detecting tau pathology of Braak Stage V/VI, a pathological staging scale for tau neurofibrillary tangles. Flortaucipir also demonstrated statistically significant sensitivity and specificity for detecting a high level of total Alzheimer’s disease neuropathologic change (combining both tau and amyloid plaque densities), using the National Institute on Aging and Alzheimer’s Association neuropathology criteria. The company plans to disclose more detailed study results at the Clinical Trials on Alzheimer’s Disease meeting in Barcelona.


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G OV E R N M E N T

NO DEAL BREXIT GUIDANCE

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he Government has published its technical notices on how to prepare if the UK leaves the EU with no deal. It includes guidance for health, pharma and medical suppliers in a no deal Brexit scenario. The notices include a section on regulating medicines and medical equipment such as: batch testing medicines; ensuring blood and blood products are safe; how medicines, medical devices and clinical trials would be regulated; submitting regulatory information on medical products; and quality and safety of organs, tissues and cells. The Secretary of State for Health and Social Care, Matt Hancock, has also written to all NHS organisations, GPs, community pharmacies and other service providers; pharmaceutical companies; and suppliers of medical and clinical consumables. His letter to NHS organisations and service providers sets out what the health and social care system needs to consider in the period leading up to March 2019, including the continued supply of medical products in the event of no deal, and business continuity plans. In his letter to pharmaceutical companies, he asks suppliers to increase their medicines stocks by at least six weeks on top of their usual buffer stocks, and ensure plans are in place to air freight products with a short shelf life that cannot be stockpiled. Finally, his letter to medical devices and clinical consumables states that separate contingency plans are being developed, stock holding at a national level will be increased, and further information will be provided. The Department of Health and Social Care has also published additional guidance for the pharmaceutical and medical devices industry on its medicines supply contingency planning programme.

A P P R OVA L S

Once a day Merck (MSD) has announced that the U.S. Food and Drug Administration (FDA) has approved two new HIV-1 medicines, DELSTRIGO and PIFELTRO. They are indicated for the treatment of HIV-1 infection in adult patients with no prior antiretroviral treatment experience and are administered orally once daily with or without food. The FDA approvals of DELSTRIGO, the once-daily fixed-dose combination tablet as a complete regimen, and PIFELTRO, a new non-nucleoside reverse transcriptase inhibitor (NNRTI), are based on findings from the pivotal, randomised, multicentre, double-blind, active controlled Phase 3 trials, DRIVE-AHEAD and DRIVE-FORWARD, evaluating the efficacy and safety of DELSTRIGO and PIFELTRO, respectively, in participants infected with HIV-1 with no antiretroviral treatment history. DELSTRIGO demonstrated sustained viral suppression through 48 weeks, meeting its primary endpoint of non-inferior efficacy. Of the 21% of study participants with a high viral load at baseline, 77% in the DELSTRIGO group and 72% in the EFV/FTC/TDF group achieved HIV-1 RNA <50 copies/mL at Week 48. PIFELTRO demonstrated sustained viral suppression through 48 weeks, meeting its primary endpoint of non-inferior efficacy compared to DRV+r, each in combination with FTC/TDF or ABC/3TC. Of the 20% of study participants with a high viral load at baseline, 77% in the PIFELTRO group and 74% in the DRV+r group achieved HIV-1 RNA <50 copies/mL at Week 48.

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Quick doses G S K announces that the European Commission has granted marketing authorisation for Nucala (mepolizumab) as an add-on treatment for severe refractory eosinophilic asthma in paediatric patients aged six up to 17 years. • N I C E approves I P S E N ’s once-daily tablet, CABOMETYX® (cabozantinib) as a first-line treatment for adult patients with Advanced Renal Cell Carcinoma with intermediate or poor risk per the International Metastatic Renal Cell Carcinoma Database criteria. • K I TE , a Gilead Company, announces that the European Commission has granted marketing authorisation for Yescarta® (axicabtagene ciloleucel) as a treatment for adult patients with relapsed or refractory diffuse large B-cell lymphoma and primary mediastinal large B-cell lymphoma, after two or more lines of systemic therapy. • The European Commission approves N OVA R TI S’ Kymriah® for the treatment of paediatric and young adult patients up to 25 years of age with B-cell acute lymphoblastic leukaemia that is refractory, in relapse post-transplant or in second or later relapse; and for the treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma after two or more lines of systemic therapy. • JA N S S E N receives European Commission approval of Darzalex® (daratumumab) as frontline treatment for newly-diagnosed patients with multiple myeloma who are transplant ineligible. • N I C E has issued a positive recommendation for K YOWA K I R I N I NTE R N ATI O N A L’s Crysvita (burosumab) within its marketing authorisation, for treating X-linked hypophosphataemia in children and young people with growing bones in England and Wales.

A P P R OVA L S .

RADIO AIRWAYS

PRESCRIBING

REGULATION CHANGE

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ealth and Social Care Secretary, Matt Hancock, has said he will support the hundreds of GPs and pharmacies still to make the move to electronic prescribing. As well as financial savings for the NHS of up to £300m by 2021, switching to electronic prescribing has benefits for patients including less time spent waiting in pharmacies and GP practices; repeat prescriptions can be collected from the pharmacy instead of having to visit the GP first, and removing the worry about losing paper prescriptions. There has already been growth in the use and availability of electronic prescribing by the majority of GP surgeries, from less than 1% in June 2010 to 63% in June 2018. More than 6000 GPs are already able to upload prescriptions electronically, which can be downloaded by a pharmacist, saving time for staff and patients. However, thousands of paper prescriptions are still issued each year – due to current regulations limiting the circumstances in which electronic prescriptions can be issued. Changes to these regulations will be made later this year, to expand electronic prescribing for nearly all prescriptions. Pf View: With Matt Hancock's strong tech background, this expansion of electronic prescribing has to be positive news for a modern NHS.

NICE draft guidance says a potentially life-changing treatment for some adults with severe asthma is safe and effective enough for use on the NHS, depending on commissioning arrangements. Bronchial thermoplasty for severe asthma takes place under sedation or general anaesthetic and short pulses of radiofrequency energy are applied to the airway wall. Two further sessions of treatment with three week intervals then complete the procedure. It reduces the smooth muscle mass lining the airways, decreasing their ability to constrict. Having the procedure may decrease the severity and frequency of severe asthma attacks – thereby improving quality of life.

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New data on this procedure allowed the independent committee to change their recommendation and to allow this procedure to be carried out under standard arrangements rather than special arrangements. However, it can only take place in specialist centres which have on-site access to intensive care. Pf View: This life-changing treatment made national news headlines offering hope to those living with severe asthma. Hopefully in future the recommendation will improve access for more patients.


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NHS.

IT’S PERSONAL

NHS England Chief Executive, Simon Stevens, has announced that children and young people in England will receive a ground-breaking cancer treatment, the first in what is expected to be a rapidly expanding class of personalised cancer therapies available on the NHS. NHS England’s commercial deal with the manufacturer Novartis is the first in Europe and comes less than 10 days after the treatment was granted its European marketing authorisation. It represents one of the fastest funding approvals in the 70-year history of the NHS. The landmark deal means young people with a form of leukaemia are set to receive CAR-T (a chimeric antigen receptor T-cell) therapy within weeks, after NICE also green-lighted the treatment for entry into the reformed NHS Cancer Drugs Fund. The Tisagenlecleucel form of CAR-T, also known as Kymriah, is the first in a wave of treatments in a new era of personalised medicine and part of the NHS’s long-term plan to upgrade cancer services.

Unlike other forms of treatment, CAR-T therapy is specifically developed for each individual patient and involves reprogramming the patient’s own immune system cells which are then used to target their cancer. It has been shown in trials to cure some patients, even those with advanced cancers where other treatments have failed. Tisagenlecleucel, which costs around £282,000 per patient at its full list price, is licensed to treat patients up to 25 years old with B cell acute lymphoblastic leukaemia (ALL) that is refractory, in relapse posttransplant or in second or later relapse. Patients in trials had an average age of 11. Pf View: CAR-T has been in the headlines a lot recently, so it’s welcome news that children will be able to access such ground-breaking technology thanks to pharma and the NHS working together.

CLINICAL TRIALS

CLINICAL TRIALS.

IN THE BLOOD

Roche has announced pivotal data from the phase III HAVEN 3 study, which evaluated Hemlibra® (emicizumab) prophylaxis administered every week or every two weeks in adults and adolescents aged 12 years or older with haemophilia A without factor VIII inhibitors. The data were published in the New England Journal of Medicine. Data from the HAVEN 3 study showed that Hemlibra prophylaxis administered subcutaneously every week or every two weeks significantly reduced treated bleeds by 96% and 97% respectively, compared to no prophylaxis. Results also showed that 55.6% of people treated with Hemlibra every week and 60% of people treated with Hemlibra every two weeks experienced zero treated bleeds, compared to 0% of people treated with no prophylaxis. In an intra-patient comparison of people who previously received factor VIII prophylaxis in a prospective non-interventional study and switched to Hemlibra prophylaxis, Hemlibra demonstrated a statistically significant reduction of 68% in treated bleeds, making it the first medicine to show superior efficacy to prior factor VIII prophylaxis treatment, the current standard of care.

Slowing MS A promising drug has slowed brain shrinkage in progressive multiple sclerosis (MS) by nearly half, according to new research led by Cleveland Clinic. Very limited therapies are currently available for this disabling form of the disease. The definitive results of the phase 2 trial, published in the New England Journal of Medicine, showed that the drug Ibudilast decreased progression of brain atrophy in progressive MS patients by 48% versus placebo. The two-year SPRINT-MS study was conducted at 28 sites with 255 patients. Progressive MS is associated with gradual worsening of symptoms and increasing disability. It commonly follows relapsingremitting MS, for which there are more than a dozen approved treatments. However, none of these therapies has consistently demonstrated efficacy in slowing disability progression in patients with progressive MS, particularly those without evidence for active inflammation. Ibudilast, an oral drug with activity on several biologic pathways with potential relevance to progressive MS, was approved in Japan in 1989 for use in asthma and stroke. It is also being studied in the U.S. for potential treatment of drug addiction and motor neurone disease.

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ARTIFICIAL INTELLIGENCE

Follow the code

A new code of conduct for artificial intelligence (AI) and other data-driven technologies will allow NHS patients to benefit from the latest innovations. Speaking at the NHS Health and Care Innovation Expo Conference, Health Minister Lord O’Shaughnessy announced the initial technology partnerships Code of Conduct for Data-Driven Health and Care Technology. The code encourages companies to meet a gold-standard set of principles that will protect patient data and make sure only the best technologies are used by the NHS, to bring real benefits to patients. The code of conduct will ensure the NHS and taxpayers get a good deal on future partnerships with technology companies; allow the Government to work with suppliers to guide the development of new technology, so products are suitable to the NHS in the future; set clear guidelines on how NHS patient data is protected; and allow the best data-driven technologies to introduce benefits to patients and staff faster. The code has 10 principles setting out how the Government will make it easier for companies to work with the NHS and what the NHS expects in return. The aim is to make it easier for suppliers to develop technologies to tackle issues such as dementia, obesity and cancer. AI technology is already being used across the NHS to improve the early diagnosis of heart disease and lung cancer; reduce the number of unnecessary operations performed due to false positives, help research by better matching patients to clinical trials; and support the planning of care for patients with complex needs.

AC Q U I S I T I O N S .

IN A SPIN

INVESTMENT

STARTER’S ORDERS Six new startups have won funding and expert support from Bayer. ‘Changing the experience of health’ is the focus of the startups, which the Bayer G4A team has included in the Accelerator programme this year. The young companies came out ahead of more than 1800 competitors from 100 countries. They have 100 days in which to intensively drive the further development of their products and solutions with expertise and investment from Bayer. The company is providing them with offices in Berlin, pharmaceutical executives and industry experts as mentors and €50,000 in funding for each project. The startups that applied are developing digital solutions that cover the entire value chain within healthcare. Also this year, a patient jury was asked to rank startups according to the impact that their solutions would have on patient experience.

This year’s winners are: Agamon (Israel, GB): A healthcare intelligence platform that can be used to compile and structure health-related data from various sources in order to derive new information. Cyclica (Canada): A cloud platform that aims to use artificial intelligence and biophysics to accelerate drug development. KinAptic (USA): An accelerated learning system for virtual reality stroke rehabilitation using electric stimulation that analyses and detects neural signals to stimulate nerves.

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ovo Nordisk has acquired Zilyo, a University of Bristol spin-out company based at Unit DX science incubator in Bristol to accelerate glucose responsive insulin. Ziylo has been pioneering the use of its platform technology – synthetic glucose binding molecules – for therapeutic and diagnostic applications. The acquisition gives Novo Nordisk full rights to Ziylo’s glucose binding molecule platform to develop glucose responsive insulins. The development of glucose responsive insulins is a key strategic area for Novo Nordisk in its effort to develop this next generation of insulin which would lead to a safer and more effective insulin therapy. A glucose responsive insulin would help eliminate the risk of hypoglycaemia, which is the main risk associated

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OME (GB): Personalised health coaching that uses extensive data analyses to compile individualised health programmes (nutrition, sleep, physical activity) in order to prevent disease. S-There Technologies (Spain): A smart device that analyses health data through urine in the toilet and gives patients insights into their health. Zencorlabs (Germany): A smartphone software and device that uses artificial intelligence to warn patients of heart failure.

with insulin therapy and one of the main barriers for achieving optimal glucose control. Thus, a glucose responsive insulin could also lead to better metabolic control and reduce the burden of diabetes for people living with the disease overall. Prior to closing the acquisition, certain research activities have been spun out of Ziylo to a new company, Carbometrics. Carbometrics has entered into a research collaboration with Novo Nordisk to assist with ongoing optimisation of glucose binding molecules for use in glucose responsive insulins. Carbometrics has licensed rights to develop non-therapeutic applications of glucose binding molecules, with a focus on developing continuous glucose monitoring applications.


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INVESTMENT

Pioneering discoveries

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zeria Therapeutics Limited, a newly formed drug discovery company, has announced that it has successfully raised £4 million in Series A fundraising from the £70 million CRT Pioneer Fund, managed by Sixth Element Capital LLP (6EC), a UK-based fund manager. Azeria, a spin out created by 6EC and Cancer Research UK’s commercial partnerships team, is the world’s first pioneer factor drug discovery company developing breakthrough treatments for hormone resistant breast and prostate cancer patients, where there are significant areas of unmet clinical need. The investment will be used to build on

P R I VAT E H E A LT H C A R E .

A MEASURE OF QUALITY

the discoveries made by founder Dr Jason Carroll, a world leading expert in pioneer factors in cancer at his lab at the Cancer Research UK Cambridge Institute at the University of Cambridge. Using its proprietary drug screening platform, Azeria is developing a pipeline of small molecules designed to selectively inhibit pioneer factors. Azeria is initially targeting the essential pioneer factor FOXA1, which has been shown to be pivotal in the tumour development and maintenance of oestrogen-receptor (ER) positive luminal breast cancer and is also thought to be critical in the development of prostate cancer.

The Private Healthcare Information Network (PHIN) has published initial performance measures for over 1000 consultants working across private healthcare in the UK. Altogether 5000 consultants, collectively undertaking an estimated 50% of admitted private healthcare in the UK, have been actively involved in working with PHIN and hospitals to check data on their private practice and improve data quality. Over 1000 consultants completed the process by approving their performance measures for publication on PHIN’s website ensuring there is now more validated information about individual consultants available in the public domain than ever before for people considering private healthcare. The move follows a market investigation by the Competition and Markets Authority which required more information to be made public on the performance of private hospitals and consultants. With over 750,000 episodes of care delivered on a private basis each year, PHIN is undertaking the largest data validation exercise directly involving consultants across the UK.

A P P R OVA L S

Melanoma appraisal Novartis has announced that the first BRAF-targeted treatment for post-surgery stage III melanoma patients, the most aggressive type of skin cancer, is to be made available for NHS patients in England and Wales following appraisal by NICE. Tafinlar ® (dabrafenib) in combination with Mekinist® (trametinib) has been recommended as a cost-effective treatment option for the adjuvant treatment of adult patients with stage III melanoma with a BRAF V600 mutation, following surgery. Based on the clinical trial results, which showed the drug combination reduced risk of melanoma returning or death by over 50%, the NICE approval comes just days after the European Medicines Agency granted approval of the drug’s use in the EU. The rapid decision is testament to the cost-effectiveness of the treatment. Over 500 people in the UK are diagnosed with BRAFmutated stage III melanoma each year. Stage III melanoma means that cancer cells have spread into skin, lymph vessels or lymph glands close to the melanoma but they haven’t spread to more distant parts of the body. Until now, there were no reimbursed drug treatments that offered clear benefits for these patients following surgery. As a result, nearly half (44%) of those with BRAF V600 mutated melanoma suffer a recurrence within a year after surgery, with the risk that the cancer progresses to an incurable state. Dabrafenib + trametinib will be routinely available on the NHS with immediate effect. The combination treatment is an oral therapy that can be taken at home, consisting of five tablets a day (two dabrafenib twice daily and one trametinib once daily). Previously, post-surgery radiotherapy was the only NICE reimbursed treatment option and it was only used in specific cases. As a result, for the majority of post-surgery patients in the UK, a ‘watch and wait’ approach to see if the cancer progresses to the next stage was the accepted standard of care.

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POWER LIST WHO IS SHAPING THE PHARMA & HEALTHCARE SECTOR? WORDS BY

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ur industry is moving: rapid medical advancement, an ever-changing NHS and the evolution of digital health are combining to transform pharma and healthcare beyond all recognition. 10 | PH A R M A FI EL D.CO.U K

Amanda Barrell

As we stand on the cusp of new possibilities, we recognise those who are leading the change. Here’s Pf ’s roundup of the people making a difference today and shaping the industry of tomorrow.


COVER STORY

NEW TECHNOLOGIES

& TECHNIQUES

MAHESH NAITHANI Founder & Chief Executive Officer, Pharmaspectra, formerly Medmeme Pharmaspectra is a continuously updated online repository of global medical data. Nominating Mahesh, the team at Tala PR and Communications said: “The internet has opened a world of data gathering possibilities, but we cannot make sense of this data unless it is sequential, verifiable and contextual. “Pharmaspectra provides a unique central place in which to capture, contextualise and analyse all relevant scientific data, including meeting presentations, publication abstracts and the results of clinical trials.”

POLITICS

INFLUENCING FROM THE TOP

MIKE THOMPSON Chief Executive of the Association of the British Pharmaceutical Industry

Mike Thompson, who started his career as a marketing trainee with Unilever, has become the voice of the industry as the UK moves towards Brexit. An ABPI spokesman said: “He has led the pharmaceutical industry’s work to prepare for the UK’s exit from the EU. “By representing the industry at the joint industry/Government ‘EU Relationship Group’, he has ensured its priorities have been regularly at the forefront of the UK Government’s policy announcements and preparations.”

DR MARTIN MYERS Consultant Clinical Biochemist, Lancashire Teaching Hospitals More than two decades of ‘continuous innovation’ in his Lancashire role led to Martin being appointed Senior Clinical Advisor for Pathology in the NHS Improvement Getting it Right First Time Programme. David Thorn, Managing Director at Blue River Consulting, nominated Martin Myers, who has an MBE for services to healthcare. He praised Martin’s work on “multiple programmes of rapid technological innovation” as well as for “championing change” and “inspiring colleagues to break inertia in delivering integrated pathways”.

DR SARAH WOLLASTON MP and Chair of the Commons Health and Social Care Select Committee

Former GP Sarah Wollaston has not been afraid to use her platform to talk about how Brexit could impact the NHS and pharmaceutical industry. In a recent blog, she said: “If you were about to undergo surgery, you would expect to know what the operation involved and to be informed about all the risks and benefits. It's called informed consent. “Brexit certainly is major surgery with far-reaching consequences and the Government is about to proceed without informed consent.” The Conservative MP was recently listed as one of politico.eu’s 40 Brexit Troublemakers.

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OUTSTANDING BEST PRACTICE

EXCEPTIONAL LEADERS

SANTHERA PHARMACEUTICALS

LIZ CROSS Nurse Practitioner, Attenborough Surgery, Hertfordshire NHS England has called antimicrobial resistance one of the most significant threats to patient safety. Liz’s scheme at Attenborough has seen the nurse practitioner service cut antibiotic prescribing by 25%. All patients with an acute cough are offered a finger prick C-reactive protein blood test. Antibiotics are only prescribed if the test indicates a bacterial infection. The programme, which has also reduced re-attendance rates and costs, is being rolled out across the clinical commissioning group area and won an NHS Innovation Challenge Prize.

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HASEEB AHMAD Vice-President of the Association of the British Pharmaceutical Industry, and UK Country President and Managing Director UK and Ireland at Novartis

HEATHER BRESCH Chief Executive Officer, Mylan

CHANGE MAKERS

Patient centricity has become a buzz word in the industry, but rare disease specialist Santhera has shown how to reap the benefits. “Rare diseases present unique challenges and adopting a patient-centric perspective is important. “The path chosen by Santhera to tune in to patients’ needs is by engaging in disease awareness campaigns and working with patient advocacy groups and representatives,” said the company, which employs patient advocacy heads in Europe and the USA. This approach has led to the approval of the first treatment for rare eye condition Leber hereditary optic neuropathy.

When the ABPI announced Haseeb Ahmad’s vice-presidency in August, he was described as a “recognised… leader who enables winning performance by working collaboratively”. During his 20-year career, he has headed up the American Chamber of Commerce Pharma Group and led MSD in Greece through the country’s economic crisis. Nominating Haseeb, Ashfield’s Managing Director, Pierre Van Werperen, said: “Haseeb is absolutely and obsessively committed to bringing new and innovative medicines to patients, increasing access and driving the agenda. He is a great leader and motivator.”

Heather Bresch, who started her Mylan career as a data-entry clerk, has also been Director of the Association for Accessible Medicines since 2016. She has held firm in her decisions, even when they sparked outrage – Mylan increased the price of its EpiPen 15 times between 2009 and 2016 to invest in product improvement and public education. Talking about being called in front of Congress to defend the move, she told CNN: “I wasn’t going to be apologetic for operating in the system that existed. I decided to put my effort and energy into talking about what needed to be fixed, and how broken the system was.”

ADELE PATERSON Chief Executive Officer, International Healthcare Partners

Last year, International Healthcare Partners delivered more than two million treatments to communities blighted by conflict, disaster or poverty. Adele’s team of 10 work with pharmaceutical companies to get donations of long-dated health products to those who need them. One of the group’s main schemes is providing essential health packs, which contain


HEATHER BRESCH PORTRAIT BY MYLAN N.V. - MYLAN, CC BY-SA 4.0, HTTPS://COMMONS.WIKIMEDIA.ORG/W/INDEX.PHP?CURID=64467520. LIZ CROSS PORTRAIT SOURCED FROM TWITTER. DR WASIM BAQIR PORTRAIT SOURCED FROM HTTPS://WWW.YOUTUBE.COM/WATCH?V=4GTAS2SZ0YY

COVER STORY

WOMEN

LEADING THE WAY

EMMA WALMSLEY Chief Executive Officer, GlaxoSmithKline Sitting at number two in Fortune Magazine’s ‘Most Powerful Women International’, Emma Walmsley was one of very few women holding a top spot in pharma. Not only is she forging a path for other women and starting to redress the balance at the top of the industry, she’s making many changes which will shape the company’s future path.

Since taking the reins in March 2017, Emma has replaced more than 50 top GSK executives and renewed the company’s focus on R&D. “I believe that is why a company like GSK should exist, and hopefully should endure, because we discover and develop medicines that make a meaningful difference,” she told Fortune in an interview earlier this year.

CHRIS FOX Vice President and General Manager for the UK and Ireland, Amgen Chris Fox, who took on the role earlier this year, has cemented her commitment to gender equality in science, technology, engineering and maths (STEM). In Women’s Business Council report, Balance the SySTEM, Chris wrote: “Amgen is working hard to maximise career opportunities for all within their business: 50% of their leadership team in the UK are female. But importantly, over a third of these female leaders have more than a decade of experience within the company.” Nominating Chris, Ashfield Managing Director Pierre Van Werperen, said she was “amazingly inspiring”.

800 treatments donated by 15 pharma companies. These can be accessed by UK and European medics and international nongovernmental organisations when they are needed. Adele told Pf earlier this year: “We work with these companies to ensure donations are made well in advance of a response, so packs are ready to go the moment they are needed.”

DR WASIM BAQIR National Pharmacy Lead for Care Homes, NHS England

“She is driven in her vision to move Amgen ahead with their fundamental research and understanding of molecular science,” he added. Chris commented on her nomination, saying: “I’m proud to be among such esteemed company. The thing about ‘leading the way’ is that you can only be as great as the people you’re leading the way for, whether that be teams, a whole organisation, or the next generation of talent who are inspired to take hold of the baton and continue the race – especially women. “The potential we all hold to change the face of healthcare is immense, and I’m thrilled for Amgen’s fantastic work to be recognised in this way.”

Dr Wasim Baqir leads awardwinning projects in care home medicines optimisation and work in broadening the role of pharmacists in care delivery. Before being seconded to NHS England, Wasim was the lead pharmacist for the Northumberland Vanguard. He led an integrated team of pharmacists, pharmacy technicians, doctors,

nurses, social care and other professionals to develop and test services. He also led the award-winning Northumbria Shine Project, a programme of structured patientcentred medication reviews in care homes. One in five medicines were stopped because they were no longer needed, were unsafe or the patient made an informed decision not to take it.

M AG A ZI N E | O C TO B ER 2018 | 13


WORDS BY

Claudia Rubin

NHS LONG-TERM PLAN:

Growing importance of prevention medicine “The challenge now is for the NHS to respond to this changing landscape and to focus on preventing as well as treating the conditions which are causing the greatest disease burden across our nation.”

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T

his statement on prevention, delivered alongside the publication of Public Health England’s (PHE) new Health Profile for England report by its Director of Health Improvement, illustrates a decisive shift taking place at the heart of NHS strategy. If we are to prevent the onset of diabetes, avert mental ill-health and avoid multiple chronic co-morbidities, public health priorities like these must become more entrenched within the NHS. The Health Profile for England is PHE’s most comprehensive report yet into the state of health of people in England today and in the future. It was timed to inform the development of the NHS long-term plan, to aid policymakers in understanding where to prioritise resources in order to prevent ill health. With almost every NHS speech now considered a major one – the new Health Secretary’s first outing at the Conservative Conference is no exception. A look back at what has been said elsewhere recently indicates that this report may have greater impact on policy development than it would previously have done.

P R E V E NTI O N AG E N DA Public health, long considered a distinct policy realm with its own (meagre) budget, had been viewed rather dismissively by the far bigger NHS beast, as rather parochial in its focus, concerned principally with persuading people to kick bad habits. Belatedly and rather sensibly though, and with senior leadership now championing its reach into the traditional NHS domain, prevention healthcare may become a term with which we are all to become more familiar. What challenge does the prevention agenda present to industry? Is there an opportunity for industry to demonstrate that contained within this narrative is an implicit call for a rethink in the access to medicines space? What can it teach us about how to drive through reforms to methodology used in medicines assessment and reimbursement? We know that a focus on public health – preventing people from developing some of the diseases, or at least postponing the age at which these conditions become prevalent, is key to creating the kind of headroom in the NHS budget that would


POLITICS

allow it to embrace innovation and extend the reach of personalised medicines. But to what extent does it also present a new angle for the medicines access reform agenda? VA LU E S - BA S E D H E A LTH C A R E If we are (rightly) asking the NHS to make strategic and spending decisions based upon future projections of the healthcare burden, to what extent should its armslength bodies, such as the National Institute for Health and Care Excellence (NICE) for example, be doing the same? Understanding the future burden of a rare disease, and the costs to patient, caregiver and society of that future burden is typically very challenging in the rare disease space. Health economic models presented to NICE struggle to show how treatments can lower the cost of cardiac, respiratory or neurological co-morbidities. For example, consider the future of HIV care. Well over 90% of people on treatment in the UK are virally suppressed – their HIV is undetectable and untransmittable. The aim now is about improving wider health outcomes; making new treatments available so that people living with HIV are not unnecessarily exposed to an increased risk of cardiovascular or renal disease. Or in chronic pain, does this new focus strengthen the case for treating more, treating earlier, if it prevents other ill-health developing? We know that we are short on measures for making a value judgement on a product that is likely to have a beneficial impact on the mental health of the patient, let alone the caregiver. Value-based healthcare, which involves taking a whole system approach and longterm view of where to focus resources, has been a growing concept within NHS in recent years. As the integration agenda takes shape too, the NHS may begin to have the structure for prevention healthcare to take hold.

“ If we are to prevent the onset of diabetes, avert mental ill-health and avoid multiple chronic co-morbidities, public health priorities must become more entrenched within the NHS” LO R D P R I O R One important figure who certainly agrees that the prevention narrative has not received due attention over the last few years is the incoming Chair of NHS England, Lord Prior. Sitting squarely within his commitment to integration, he acknowledges that prevention medicine has faltered. In his confirmation hearing before the Health and Social Care Select Committee, Lord Prior compared the new NHS 10-year plan to the last of its kind – the Five Year Forward View (FYFV) – speculating that where the first document was a vision, this piece is more about implementation – making the changes (including, whisper it, legislative ones) needed to bring the vision forward. But it is also about recognising the failures of the FYFV, including an undervaluing of the role of prevention healthcare.

N E W D I R E C TI O N Any new direction, of course, needs the energised involvement of the Secretary of State. The NHS 10-year plan is the result of Jeremy Hunt’s determination to secure a long-term funding settlement. His successor, whose strengths and focus initially seem to lie elsewhere, must maintain close oversight. With five years of funding attached to this plan, its strategic importance cannot be overstated. But with no specific medicines access piece in the document, industry can seek to own and shape the prevention medicine narrative, especially given the focus of pharmaceutical and med tech innovation on the value their products bring to reducing healthcare deterioration costs. Claudia is a Director at Decideum. Go to www.decideum.com

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Blooming MARVELLOUS Sophie Dziwinski, Head of Programmes at Roald Dahl’s Marvellous Children’s Charity, works hard to ensure seriously ill children have access to specialist nurses. INTERVIEW BY

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Emma Morriss


COFFEE BRE AK

hen most people think of Roald Dahl they think of his written works, however he was a man of incredible creativity and determination. His legacy is carried on through Roald Dahl’s Marvellous Children’s Charity and its specialist children’s nurses. What’s the history behind the charity? There was so much more to Roald Dahl than his stories. His incredible life was also affected by serious illness, tragedy and loss. It was these personal experiences of illness – of his own and his close family – which spurred Roald Dahl to help seriously ill children and their families. Roald Dahl believed in taking practical steps to improve the lives of those around him. His creativity and determination even helped to develop pioneering medical treatments, such as the Wade-Dahl-Till valve, which has been used to help thousands of children with hydrocephalus. He also generously gave his time and money to help seriously ill children and their families, including many he never met. Following his death in 1990, his widow, Felicity, set up Roald Dahl’s Marvellous Children’s Charity to continue this part of his legacy. Up until 2013, the Charity focused on supporting children with specific brain and blood conditions, but today it has expanded to focus on all serious chronic illnesses, including rare diseases. What’s the aim? And how are you progressing to achieving that? The aim of the charity is to ensure that every seriously ill child has the best possible healthcare. We strive to achieve this by creating and funding specialist children’s nursing posts within the NHS. We focus on placing expert nurses who specialise in conditions that we feel are underfunded and misunderstood, in the areas of greatest need or deprivation across the UK.

We believe innovation is essential, so we support our nurses through knowledgebuilding and encourage them to think imaginatively about how best to perform their roles, providing funding for nurse-led initiatives that we believe will improve the lives of the children in their care. How many nurses have been placed? The first Roald Dahl Children’s Nurse Specialist post was funded in 1992 at the Alder Hey Children’s Hospital in Liverpool. This post was the first-ever Epilepsy Nurse Specialist in the UK. In July 2018, we proudly announced that our 70th Roald Dahl children’s nurse started in post during the week of the NHS’s 70th birthday. What support do they give? Our Roald Dahl Nurses provide holistic care and support to seriously ill children, young people and their families at home, in school, in the community, and in hospital. They play a critical and complex role, working directly with the patient and family as their key point of contact and link between them, the consultant and the hospital. Our nurses give expert advice and assist with care coordination, advocacy, training and education of parents, teachers, children and young people, and healthcare professionals. The practical and emotional support our nurses provide, as well as their specialist knowledge, makes a huge difference for families. They know the child and family well, often from birth and certainly from diagnosis, providing personalised support during what can be a challenging time for families. Where possible, we encourage our nurses to make the often-frightening aspects of a child’s healthcare, less alarming. Whether by sympathetic explanation, play therapy, or a dash of humour. Often the trust families have in their Roald Dahl specialist nurses makes all the difference. How does someone become a Roald Dahl nurse? Our Roald Dahl nurse posts are predominantly at a Band 7 level, these are nurses who are experienced, senior clinicians with expert knowledge and passion in their specialist area. The new posts are advertised through the NHS Jobs website, individual NHS Trusts, the charity’s social media

“ Our Roald Dahl Nurses provide holistic care and support to seriously ill children, young people and their families at home, in school, in the community, and in hospital” platforms and website, as well as through our network of Roald Dahl nurses and supporters. How do you cover the costs of the nurses? We fundraise for the costs of the nurses through community fundraising, corporate partnerships, Trusts and Foundations. We are particularly indebted to the Roald Dahl Charitable Trust for their financial support. The Trust’s funds come from royalties paid on sales of Roald Dahl’s work, and its support often makes up around half of our fundraised income. We fund each nursing post for two years, with a three-year commitment from the NHS Trust to continue the post. After five years, our nurses have proved the value and impact of their service as they have become key members of their teams. What else does the charity do? The charity also provides Marvellous Family Grants to families in hardship with children with long-term conditions. These grants are often described as a lifeline for families, funding practical items such as specialist equipment, travel costs for family members to visit their child in hospital, and art, music and play therapy which is not available on the NHS. Our nurses can apply on behalf of their families for this extra support. What are the aims for the future? The charity is aiming to recruit more specialist paediatric nurses and to strengthen its focus on innovation with the relaunch of the Marvellous Nurse Inventing Room. This scheme supports nurses if they want to test and trial new healthcare initiatives and helps them to disseminate and implement their findings. Everything we do, now and in the future, is aimed towards supporting our Roald Dahl nurses and listening to the voices of the children and young people we look after, in our mission to improve the healthcare of seriously ill children. Go to www.roalddahl.com/charity

M AG A ZI N E | O C TO B ER 2018 | 17


Brace for impact BREXIT & EMA RELOCATION With the European Medicines Agency (EMA) relocating to Amsterdam before 29 March 2019, Pf sought the views of industry leaders to discuss the impact this and Brexit may have on pharma in the UK.

E XPE RT PAN E L

PAU L B R O O K S Executive Director, Regulatory Affairs Professionals Society (RAPS)

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DAV I D H U K I N Head of Pharmacovigilance, Quanticate

CO L I N N E W B O U L D Director of Regulatory Affairs and QP services, Wasdell Group


F E AT U R E

Q.

What are the current regulatory implications of Brexit? PAUL BROOKS: Clarity on the operational trade and regulatory post-Brexit environment is urgently needed. It remains unclear whether the UK will fully align its regulations and regulatory processes for pharmaceuticals and medical devices with those of the EU, with reciprocal acceptance by other EU Member States (pre and post market), and this is undermining future regulatory planning and confidence. UK agencies, including the Medicines and Healthcare products Regulatory Agency (MHRA), have been proactive in helping the industry negotiate this tricky landscape. They have, historically, been very visible in Europe, ensuring that EU regulations have been pragmatic, favourable to innovation and forward-looking while protecting patient interests. All stakeholders have benefitted from MHRA’s engagement in Brussels. The absence of MHRA’s perspective on future EU regulation negotiations could also leave a vacuum in available regulator expertise that will certainly be noticed.

Q. What would happen if the UK became a ‘third country’?

COLIN NEWBOULD: There is a lot of uncertainty surrounding the full impact of Brexit. Should the Government press ahead with a ‘hard’ Brexit, it is likely the UK will become a third country operating under World Trade Organisation rules, which could have significant repercussions for the pharmaceutical industry, particularly with regards to the regulatory landscape. The most obvious implication would be the requirement for EU and UK batch certification. For a product to be certified for the EU market, it would potentially need to be retested on importation from the UK,

DAVID HUKIN: One of the key considerations for the pharma industry when it comes to Brexit is pharmacovigilance (PV). The current situation is that, from 30 March 2019, PV activities which must take place in an EU member state (or other EEA territory) will no longer be able to be conducted in the UK. On 17 July 2018, Parliament voted on an amendment tabled by Phillip Lee MP to require the Government to negotiate an agreement with the EU for the UK to participate in and align with Europe on medicines regulations and framework. The Government opposed this amendment, however Parliament voted in its favour. This is significant for PV and access to medicines in general as it could mean the UK remains much more tightly aligned to the EU than in other areas. What that means regarding the licensing of medicines and alignment/cooperation on a range of PV factors is still unknown. COLIN NEWBOULD: The impact of the MHRA leaving the EU could result in significant divergence in approaches to medicine regulation. For many years, the UK has not only been a very strong and well-respected agency within the EU, it has also supported the inspection activities of the EMA regularly. It is important that the industry takes the time to fully understand the potential impact of Brexit so as not to put undue pressure on regulatory departments and ensure it is well prepared for all the ramifications of leaving the EU.

unless the relevant regulatory bodies agree to grant mutual recognition agreements. Likewise, the UK may need to grant licenses for exported products. Implementing any additional measures to incorporate these requirements could have a noticeable effect on lead times, necessary resource and as a result overall cost.

M AG A ZI N E | O C TO B ER 2018 | 19


F E AT U R E

— we help people achieve healthy skin

IT’S NOT ABOUT SKIN CONDITIONS It’s about the people living with them

WE UNDERSTAND … that the more you know the easier it is to take control in challenging situations … and living with a skin condition is no exception. We see the challenges you, your family and your friends face as our own, why? Because at LEO Pharma we have many decades of experience in developing care options and resources for people living with a range of skin conditions. So we understand what it’s like. As a global company dedicated to dermatology, with our UK/Ireland operations based in Berkshire, our mission is to help people achieve healthy skin and this focus stems from listening to people living with skin conditions. Want to know more about us? Visit www.leo-pharma.co.uk

www.leo-pharma.co.uk LEO Pharma, Horizon, Honey Lane, Hurley, Berks, SL6 6RJ © LEO · LEO Pharma · UK · December 2017 ALL LEO TRADEMARKS MENTIONED BELONG TO THE LEO GROUP · UK/IE/MAT-13867

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Q.

How will pharma businesses operate in a post-Brexit Europe?

COLIN NEWBOULD: At Wasdell, we have invested a lot of time into developing a strategic approach to Brexit that will allow us to continue working at a global level and continue to meet EU current good manufacturing practice standards as an absolute minimum. We are currently actively engaging with our customers to ensure as little impact on their supply chains as possible. We already have short, medium and long-term plans in development to incorporate safety stock, change contractual derogated responsibilities, move customers to alternative importation sites where necessary, and prepare our new facility in Ireland ahead of it becoming our EU headquarters. It is also worth mentioning that Brexit is creating opportunities as well, for example it has become vital that businesses review the complexity of their regulatory filing process and their supply chains, which ultimately could help to improve operations in the long run. Providing companies take a well-thoughtthrough strategic approach to Brexit they should be able to minimise any potential impact on supply. DAVID HUKIN: There is very little time to prepare for what the pharmaceutical industry will look like post-Brexit and it is likely that it will affect companies and sponsors at a wider business level. As we move forward, it is vital that the industry carefully monitors output from the EMA and UK MHRA to guide their strategy. The concerns surrounding Brexit and its impact on the wider industry mean that it will be all too easy for companies to take their eye off the ball when it comes to ensuring they meet the new PV regulations, so it is vital that departments ensure the necessary changes are made.

The Parliamentary vote to remain part of the EMA is a promising sign that this could be simpler than previously thought. We trust that the ongoing talks between the UK and EU will be constructive and keep patients at the forefront of discussions, ensuring access to new medicines is not delayed and the huge efforts towards PV harmonisation, improving patient safety, are not undone. However, it is possible that the UK will walk away from the negotiating table with no deal and no arrangements, transitional or otherwise, for the continued cooperation on the regulation of medicines and PV. PAUL BROOKS: Currently, there are too many variables to be able to accurately predict what the future holds for UK pharmaceutical and medical device companies post-Brexit. It is similarly difficult to forecast what the wider economic and logistical impacts will be on the pharmaceutical and medical device industries within the UK and the EU, as well as manufacturers outside the EU and UK wishing to place products onto the UK market and via the UK into Europe. Manufacturers with strong regulatory resources, intelligence and structure will be much better prepared to navigate the changing regulation landscapes, and these well-prepared companies will, no doubt, position themselves as the most competitive in the market. As the healthcare product industry is not able to fully prepare for all the possible outcomes of Brexit as it stands, it’s imperative that it realises the increasing importance of its regulatory workforce in monitoring, influencing (where possible), interpreting developments, preparing contingency plans and reacting by delivering successful regulatory strategies.


OPINION

Protecting the nation’s health

PHARMACY’S GROWING ROLE IN VACCINATING THE PUBLIC

F

WORDS BY

Deborah Evans

“ Community pharmacy makes a real difference in protecting the nation’s health”

lu is a major cause of harm to individuals, leading to around 16,000 attributable deaths last season (over 15,000 in over 65s) and it is a key factor in NHS winter pressures1. In 2017/18, peak admissions rates of influenza to hospital and intensive care units were higher than seen in the previous six seasons and preventing flu infection through vaccination protects individuals and also helps prevent secondary bacterial infections such as pneumonia1. Recent research 2 has demonstrated that vaccination averts between 180,000 and 626,000 cases of influenza a year and helps to avert between 5678 and 8800 premature deaths per year. The 2018/19 flu vaccination service has now started with most GP practices and community pharmacies now focusing their attention on targeting those at most risk. Last year saw record flu vaccination levels, with nearly 1.5 million more people getting the vaccination than last year. However, overall performance still falls below government targets for at-risk groups3 and over 65s 4 . NHS England has stated in its annual letter5 , that we should further improve vaccine uptake rates in all eligible cohorts. The long-term ambition for eligible adults is for a minimum 75% uptake rate; this ambition is considerable and we are some way off this target in the at-risk group.

Continuing to commission pharmacy makes sense and the sector has demonstrated its significant contribution in the national programme delivery. Last year, 77.1% of all community pharmacies in England administered 1,344,462 flu vaccinations to patients with an average of 150 per pharmacy6. In addition, many thousands of people not eligible for the NHS vaccination also received their flu jab privately from pharmacists in the community where they live or work. There is no doubt that pharmacy has played an important part in the service and yet, we still hear of GP practices and pharmacies ‘competing’ rather than collaborating in delivering the service. There are still many more people needing vaccinations than getting them and working together has never been more important. Perhaps collective targets and joint incentives could change this? With many pharmacists now able to administer vaccinations, the sector is starting to deliver a much broader range of vaccination services. In some localities, NHS England has commissioned additional vaccination services from community pharmacy including pneumococcal polysaccharide vaccine, meningitis (MenACWY), shingles and pertussis for pregnant women. Private vaccination services are expanding, particularly with pharmacies looking to reduce their reliance on a shrinking NHS funding package. They are getting involved in offering a full range of travel vaccinations including yellow fever, tick-borne encephalitis, rabies, hepatitis A and B, cholera, meningitis, typhoid, polio, diphtheria and tetanus, and other vaccines against conditions such as pneumococcus, shingles, chickenpox and human papilloma virus. There is no doubt that community pharmacy makes a real difference in protecting the nation’s health. Deborah Evans is Managing Director of Pharmacy Complete, a training and consultancy company working with pharmacy and industry. Go to www.pharmacycomplete.org or email deborah@pharmacycomplete.org 1 Surveillance of influenza and other respiratory viruses in the UK: Winter 2017 to 2018 Public Health England 2 An Economic Analysis of Flu International Longevity Centre (ILC) 3 https://fingertips.phe.org.uk/profile/public-health-outcomesframework/data#page/3/gid/1000043/pat/6/par/E12000004/ ati/102/are/E06000015/iid/30315/age/226/sex/4 4 https://fingertips.phe.org.uk/profile/public-health-outcomesframework/data#page/3/gid/1000043/pat/6/par/E12000004/ ati/102/are/E06000015/iid/30314/age/27/sex/4 5 National Flu Immunisation Letter 2018/19 NHS England, Department of Health and Social Care, Public Health England 6 Flu vaccination data for 2017/18, Pharmaceutical Services Negotiating Committee

M AG A ZI N E | O C TO B ER 2018 | 2 1


THE STATS

IT’S IN THE BLOOD

With new developments in blood cancer treatments, is it changing the future for people with the condition?

THE THIRD biggest cancer killer.

THE FIFTH MOST COMMON

CANCER. OVER 100 different types.

THE TYPE OF BLOOD CANCER A PERSON HAS CAN CHANGE AS CANCER DEVELOPS.

AROUND

WORDS BY

40,000

Emma Morriss

people diagnosed in UK each year.

B

lood cancer is used to describe any cancer that affects the blood, bone marrow or lymphatic system. There are three main blood cancer groups: leukaemia, lymphoma and myeloma. Leukaemia affects the white blood cells and there are two main types: • Acute leukaemias • Chronic leukaemias. Lymphoma is cancer of the lymphocytes, causing growths to form in the lymph nodes. There are two main types of lymphoma: • Hodgkin lymphoma • Non-Hodgkin lymphoma. Myeloma is cancer of the plasma cells in the bone marrow. Beyond these three main blood cancers, there are up to 100 different types of blood cancers and other related conditions. Gemma Peters, Chief Executive of the blood cancer charity Bloodwise, said: “Blood cancers are collectively the third biggest cancer killer in the UK, but we know that awareness of diseases like leukaemia, lymphoma and myeloma and their symptoms is startlingly low.”

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SOMEONE IS DIAGNOSED WITH BLOOD CANCER EVERY

D I AG N O S I S According to the 2017 Cancer Patient Experience Survey published in July 2018, it is taking longer to diagnose blood cancers than any other types of cancer. Bloodwise reported that that 35.6% of blood cancer patients who visited their GP with symptoms before diagnosis needed to go three times or more before being referred to hospital. Speaking at the time, Phil Reynolds, Policy Manager at the charity, said: “We have known for a long time that people with blood cancer can struggle to get a diagnosis and it often takes longer for GPs to refer them to hospital. People with myeloma in particular have to visit their GPs many more times on average before being sent to a specialist. “This can be explained by a number of factors, including a lack of awareness of blood cancer symptoms and the ease of which many symptoms can be confused with more common conditions.”

14 MINUTES. MOST COMMON TYPE OF CANCER AMONGST

children, teenagers and young people in the UK.

AROUND

240,000 PEOPLE ARE LIVING WITH BLOOD CANCER IN THE UK.

6 in 10

PEOPLE DIAGNOSED IN THE UK SURVIVE FOR 10 OR MORE YEARS. 20% OF TRANSFUSED RED BLOOD CELL UNITS ARE GIVEN TO

patients with blood cancer.

Source: Bloodwise and Anthony Nolan Trust.


F E AT U R E

DEVELOPMENTS IN BLOOD CANCER TREATMENT

With blood cancer being classed as the third biggest cancer killer, and the fifth most common type of cancer, increasing to the most common cancer amongst children, teenagers and young people in the UK, it’s positive to know that new treatments are being approved. Blood cancer is commonly treated with chemotherapy, chemo-immunotherapy, radiotherapy, biological therapies, steroids and stem cell transplants. In May 2018, the National Institute for Health and Care Excellence (NICE) recommended three blood cancer drugs, midostaurin, arsenic trioxide and brentuximab vedotin be made available on the NHS. Midostaurin, also known as Rydapt, is produced by Novartis. It is a first of its kind drug that targets a protein called tyrosine kinase FLT3, which is often damaged in people with acute myeloid leukaemia. According to NICE, around 160 adults a year in England and Wales, who test positive for the mutated FLT3 gene, will be eligible for this. Arsenic trioxide or Trisenox is produced by Teva. It is recommended as an option for adults with acute promyelocytic – where the person has fewer healthy blood cells than normal and is given intravenously. NICE estimates that around 140 people a year in England will be eligible for it.

The third drug, brentuximab vedotin, also known as Adcetris, is produced by Seattle Genetics. It was previously only available to people through the Cancer Drugs Fund. NICE says that its approval will mean that around 45 more people a year with a specific type of Hodgkin lymphoma called CD-30 positive will now have an automatic right to the drug. Meindert Boysen, Director of the NICE Centre for Health Technology Evaluation, said at the time: “For the past 30 years, treatments for leukaemia have changed very little. “With our positive recommendations for midostaurin and arsenic trioxide we are pleased to offer patients with leukaemia more treatments than ever before.” Dr Alasdair Rankin, Director of Research and Patient Experience at Bloodwise, said: “These drugs offer hope to patients with three different types of blood cancer – targeted therapies that for some reduce the chances of relapse and for others offer the chance of a long-term cure or the reduction of severe side-effects connected to traditional treatments.” Since then, there have been a significant number of announcements about blood cancer treatments.

BLOOD CANCER TREATMENTS IN THE NEWS NHS England announces groundbreaking new personalised therapy for children with cancer. NHS patients to benefit from Europe’s first full access deal on breakthrough CAR-T therapy. NHS England. September 2018 Janssen announces European Commission approval of Darzalex ® (daratumumab) as frontline treatment for newly diagnosed patients with multiple myeloma who are transplant ineligible. The Janssen Pharmaceutical Companies of Johnson & Johnson. September 2018

Positive phase III results for Roche’s Hemlibra for haemophilia A without factor VIII inhibitors published in New England Journal of Medicine. Roche. August 2018 Yescarta receives marketing authorisation for blood cancer. Kite. August 2018 Feedback encouraged to allow use of life extending treatment on NHS for those with blood cancer. CAR-T considered to be an exciting innovation which can cure some patients but very expensive. NICE. August 2018

Novartis receives European Commission approval of its CAR-T cell therapy, Kymriah® (tisagenlecleucel). Novartis. August 2018 NICE change in decision sees BESPONSA® (inotuzumab ozogamicin) recommended for relapsed or refractory acute lymphoblastic leukaemia (ALL) patients. Pfizer. August 2018 AbbVie presents data on Venetoclax for the management of blood cancers. AbbVie. June 2018

M AG A ZI N E | O C TO B ER 2018 | 2 3


F E AT U R E

PERSONAL STORY

Andrew Berthoud’s story

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ndrew was just three when he was diagnosed with acute lymphoblastic leukaemia in October 2012. His mum, Melody, used daily Facebook posts throughout his treatment to keep his family and friends up to date on how he was doing. “Andrew was just three and a half when he was diagnosed,” says Melody. “He spent the next three years and four months – almost his whole life again – going through treatment. “Andrew took his last chemo tablet on 20 February 2016. We filmed this moment that we could only dream of at the start and he spontaneously shouted: ‘I beat you, leukaemia!’ We’re so proud of him.

A NEW PATH TO YOUR SUCCESS Join the journey at iqvia.com/success

Copyright © 2018 IQVIA. All rights reserved.

2 4 | PH A R M A FI EL D.CO.U K

“Thanks to research, now nine in 10 children survive. But this isn’t enough. One in 10 children won’t survive, and I know that research is the only way to change that. I wanted to share my story so that people know that children and families can survive blood cancer.” The chemotherapy caused Andrew severe pain and nausea and Melody remembers that: “I didn’t know that cutting hair short makes it harder to pick out of food when it starts falling out”. The cycles of steroids Andrew needed to take during his treatment also had a big psychological impact on him, with Melody recounting that: “I didn’t know a three-year-old could be depressed”.

In England in 2016:

12,018 8208 4731 1717 2163

people were diagnosed with non-Hodgkin lymphoma people were diagnosed with leukaemia people were diagnosed with myeloma people were diagnosed with Hodgkin lymphoma people were diagnosed with myelodysplastic syndromes.

Source: Bloodwise


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UNLOCKING HIDDEN TALENT: Martin Anderson, Owner of Carrot Recruitment, explores the role of flexible resourcing in pharma.

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t’s a fact that many people in the pharmaceutical and healthcare industries still view the recruitment of permanent staff as the only route to attracting talent into their organisations. Whilst permanent recruitment is and likely will remain the core method of filling key field-based roles, more and more companies are now recognising that there is a largely untapped market of flexible talent available within the UK market. Indeed, some are already looking to proactively use this market to gain a competitive advantage within their sector. Over the past three decades or so, outsourcing for sales people has been largely limited to primary care roles, or as a stopgap to cover roles that may be temporarily vacant due to secondment or other reasons. More recently, this has evolved with a discernible increase in willingness to look

at non-permanent solutions for other roles, mainly to mitigate risk in what is an uncertain and volatile market that we operate in. Again, this has proved to be a successful vehicle for companies to launch and grow brands, or indeed to maintain brands whilst in-house resources are redirected to the newer molecules. Fast forward to the present and the need to find alternative ways to unlock hidden talent has never been more evident. With the continued R&D focus on medicines in specialty care, digital technology and innovative channels plus higher expectations from customers, in-field roles continue to evolve, and new roles are emerging. All this means that the capability set, and experience required to sustain success are also changing. When you also consider the needs of the workforce, and specifically millennials, it’s no surprise to learn that it’s becoming harder to attract and retain talent for the longer term.

“The need to find alternative ways to unlock hidden talent has never been more evident”

Enter Generation Y, the flexible worker, someone who has a strong desire to be successful and is impatient to get there. They will be solution focused and eager to prove their value both to their employer and the customer. They may possess lots of experience, or they may not, and as we all know, experience does not necessarily equate to capability. They will be highly driven and will have a very specific purpose, whether this be in a market access, medical or sales function. Complementing the existing workforce, they will flourish if given the appropriate balance of support and autonomy in delivering their objectives. Indeed, at Carrot, we are proactively identifying candidates such as these for our clients. We have a pipeline of individuals who are talented, motivated and will thrive in that flexible environment where they can make a difference. We have some fantastic examples of how this relationship has worked for clients and the candidate, either as part of a short-mid term project or indeed as a precursor to full employment based on finding the right fit. The foundation of success lies in the flexibility for all parties and matching the right talent to the right job at the right time. Carrot Pharma Recruitment is a specialist recruitment agency covering jobs in pharma, healthcare and biotech. With over 11 years of success in the pharma, healthcare and biotech industries, we are growing year on year. Carrot Flex is a flexible resourcing service within Carrot Pharma that provides key talent sourcing, vacancy management solutions and team build partnerships across a wide range of disciplines. To find out more, contact Martin on 01625 541 030 or email martin@carrotrg.co.uk. Go to www.carrotrg.co.uk

M AG A ZI N E | O C TO B ER 2018 | 2 5



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“Don’t keep battering away trying to increase sales, let In-Call Selling with Emotional Intelligence unlock your sales potential”

1.

S A L E S K N OW L E D G E

WORDS BY

Simon Toy

EMOTIONAL INTELLIGENCE

& the psychology of sales

M

any of you will have seen the excellent books The Challenger Sale or To Sell is Human and tried to incorporate their principles into your organisational sales approach. Indeed, with research revealing that fewer than 10% of sales professionals sell over 90% of products and services globally, we would be fools not to take the latest research regarding selling success seriously. A three-year meta-analysis of the latest psychological research has enabled Performance Associates to effectively identify the DNA of these top performing sales professionals. Seven competencies underpinning selling excellence have been identified and, following extensive research examining the psychology behind these core competencies, a further 61 subcompetencies were identified that prove instrumental in driving superior sales performance. Let me briefly outline the seven competencies, all of which respond to effective coaching, before drawing what I hope will be an interesting conclusion.

2 8 | PH A R M A FI EL D.CO.U K

Sales knowledge considers the extent to which someone understands the stages of the sales process and how well they can utilise each part of it. There is a very strong correlation between having a thorough understanding of the sales process and achieving sales success. However, two factors in the sales process correlate more strongly than the rest in the top 10% of sales people. Can you name them? #1 was found to be Planning and #2 Gaining Customer Commitment. A word of warning though, when executed badly, they actually correlate with a reduction in sales!

2.

E M OTI O N A L A DA P TA B I L I T Y Human to Human (H2H) is fast replacing Business to Business (B2B) as the buzz phrase in organisations. The reason for this can be traced to a phrase we often hear: “People buy from people” [“And even when they don’t, they still buy from people!”]. Emotional adaptability is the bedrock of selling with emotional intelligence, focusing on those ‘soft skills’ that we know make the difference in the sales environment. They fall into two camps: dealing with our own emotions [attitudes, beliefs, motivation, confidence etc.] and dealing with other people’s emotions, including reading expressions and micro expressions. Selling with emotional intelligence is a proven way of increasing sales; 8 to 12% annually. This is a skill that cannot be ignored in today’s highly-competitive markets.


SALES DNA

3.

SALES PERSONALIT Y Three of the ‘Big 5 Personality Factors’ have been shown to correlate significantly with sales success. So, should a high-performing sales person be more or less open to new ideas, compared to the average person in the street? Should they be more or less conscientious, have higher or lower levels of introversion or extroversion, worry more or less and even be more or less ‘likeable’? What can a sales person do if they don’t match the ‘ideal’? The good news is that all is not lost – as long as they can create their ‘ideal selling state’.

4.

R O L E C L A R IT Y A huge factor in determining your mindset is understanding (and accepting) the expectations of your role and how it fits into your organisation’s vision. How well a sales person understands exactly what their role demands, in terms of outcome and results, correlates directly with their sales performance. It links to their ability to stay motivated in a changing environment, remaining focused during change, taking responsibility for their own development and even dealing effectively with conflict when it arises.

5.

CO G N I TI V E A P TIT U D E In a sales context, cognitive aptitude considers a person’s verbal and numeric skills as well as their general knowledge. The ability to articulate clear links between your products and how they meet your customer’s needs (including financial needs) is essential, particularly if your product is not the cheapest option for them. This will require verbal and numerical dexterity as well as good knowledge regarding which factors affect our customer’s business. This turned out to be one of the strongest indicators of sales success.

6.

M OTI VATI O N & E N G AG E M E NT Having motivated and engaged sales people is a key driver of success in any organisation. When things do not go according to plan successful sales people raise a hand and take responsibility, they don’t ‘blame’ others, but rather adapt their approach. They are admired for their fair principles and positive view of how people should work together, exhibiting higher levels of trust with their managers and other team members. Their drive to achieve comes from their beliefs about what they are capable of and what they deserve based on the effort they put in. It is highest in top performing sales people who often enjoy their work, find personal development interesting and have an ability to remain logical and manage their emotions effectively to meet their objectives.

7.

O P TI M I S M , R E S I L I E N C E & LU C K Optimists have much higher levels of resilience and persistence than pessimists due to being more ‘hopeful’. As a consequence, optimists outsell pessimists by 37% year-on-year across all sales environments and 26% in pharmaceutical sales. The great news is that optimism is learnt, not innate. 25 years of research reveals that our opinions of whether we are lucky or unlucky are determined by our mindset rather than fate. Top sales performers tend to consider themselves as ‘lucky’ and, as with optimism, this can be learnt by ‘unlucky’ people.

“Having motivated and engaged sales people is a key driver of success in any organisation”

O

ur meta-analysis set out to try to discover whether there was a ‘sales DNA’ that was common to all top performing sales people. We had no preconceptions as to what we might find, but rather hoped that we could discover something to help all sales people learn from what research identified as ‘best practice’ in high performers. Of the seven competencies identified, what is most striking is that five of them rely heavily on the salesperson having highlydeveloped emotional intelligence (both ‘intra-personal intelligence’ and ‘inter-personal intelligence’, to quote Howard Gardner from his work on multiple intelligence). The significance of this is borne out in research that clearly indicates that emotional intelligence plays a critical role in sales success. Indeed, when supported by specialist incall emotional intelligence selling coaches, emotional intelligence trained sales managers and emotionally intelligent leadership, improvement can be dramatic. • Emotionally intelligent leaders can increase organisational growth by 7% and profit by 29% • Emotionally intelligent sales coaching can increase sales by 8 to 12% annually If you want to learn how Performance Associates can help you integrate emotional intelligence selling into your organisation’s sales process contact us. Simon Toy, Managing Director and Senior Consultant, Performance Associates. Drop a line to info@performanceassociates.org

M AG A ZI N E | O C TO B ER 2018 | 2 9


“ I NEVER LOSE SIGHT OF THE PATIENT AND HOW MY JOB CAN HELP TO MAKE PATIENT EXPERIENCES BETTER.” INTERVIEW BY

Emma Morriss

… SI NC E F E BRUA RY OF T H IS Y E A R I H AV E MOV E D I N T O A M A R K E T AC C E S S ROL E . Whilst this is the most challenging job I have had in my career so far, I truly love it! Working in a business unit that has a clear focus delivering on excellence in implementation, a key component of my job is ensuring that a positive market access environment is created that spans across the MSD portfolio. The excitement of supporting a local healthcare system never fades! The challenge is understanding how national health policies and changes are being interpreted and actioned at a local level. My job entails building collaborative relationships with all stakeholders that are involved in delivering care in North West London. The stakeholders and organisations that I interact with vary from clinical commissioning groups, GP federations, to academic health science networks, public health leads and acute trusts!

… BE I NG SUC C E S SF U L R E QU I R E S M E T O BE E QU I PPE D W I T H A S M UC H K NOW L E D G E A S P O S SI BL E . Reading articles, parliamentary papers, reports, seeking internal advice from departments such as Medical and External Affairs. Secondly and most importantly, it is listening carefully to what matters to our stakeholders, taking the time to understand their challenges and drivers and working with them to identify areas of collaboration. This doesn’t happen overnight, but I’m truly passionate about delivering better health outcomes and helping to reduce variances in care in North West London.

…T H E R E ’ S NO SUC H T H I NG A S A T Y PIC A L DAY. You only need to take a look at my diary! Working with such a wide spread of stakeholders that are either aligned to elements of our portfolio or service transformation means that each discussion is different. It’s a great feeling, knowing that I have the confidence and ability to talk to customers about our MSD strategy to individual disease areas, I love switching hats!

… I T ’ S NO T J UST A JOB , I T ’ S W H AT G E T S M E OU T OF BE D I N T H E MOR N I NG! It’s a key part of me and my life, it provides balance. I never lose sight of the patient and how my job can help to make patient experiences better.

…W E A R E A L L PAT I E N T S OF T H E N H S . They saved my life after a road traffic accident, and my nearest and dearest are patients in the NHS. It varies from my son being vaccinated to prevent illnesses to my mother-in-law fighting stage 4 cancer. The point is, I feel the same weight of responsibility as I imagine employees of the NHS do, and I have a role in helping to make it accessible to all. It’s our NHS!

… M A N Y OF M Y C OL L E AGU E S A R E I NSPI R AT IONA L . The examples of work that they do are just amazing. From working to identify and eliminate undiagnosed hepatitis C in collaboration with a wider NHS initiative, to helping with patient pathways in oncology. I want my son to be proud of me, leaving a footprint for him to follow, and this is what makes me proud of my work!

I love my job because… 3 0 | PH A R M A FI EL D.CO.U K


P H A R M ATA L E N T

Priyanka Trehan, Area Health Lead, MSD North West London, joint winner of the Account Project Pf Award 2018. … I T S AY S A LO T A B OU T A N ORG A N IS AT ION W H E N T H E Y H AV E LOYA L E M PLOY E E S . Soon after I completed my postgraduate education I joined MSD, that was 15 years ago. Throughout my time at MSD I have been in 10 roles, from the field to the office. MSD is an organisation that believes in employee development; my line manager will always make time to talk about areas that I would like to pursue in the business and helps to identify opportunities. Many employees work on career progression assignments, to get a taste of different parts of the organisation and build new skills. MSD actively champions diversity in the workplace, we are free to give back to communities through voluntary work and contribute to networks such as MSD for Mothers.

…OU T SI DE OF WOR K , I LOV E SPE N DI NG T I M E W I T H M Y FA M I LY A N D F R I E N D S . My five-year-old son is teaching me all about dinosaurs! My friends and family make me happy, in fact my best friend is having a baby soon and I can’t wait. They are my motivators. I love travelling and learning about the Indian arts world and from time to time to put paint to canvas. I’ve recently started boxing again and visit the gym on a regular basis and I did my first Pilates class last week!

… I T E XC I T E S M E NO T K NOW I NG W H AT ROL E I W I L L BE I N N E X T Y E A R! Honestly, the organisation makes me feel secure enough to know that I’ll be doing something important, that will allow me to gain a breadth of experience across the business. Priyanka's winner's interview at the Pf Awards 2018 is available online. Go to www.pfawards.co.uk/winners-interviews-2018/

“ I WANT MY SON TO BE PROUD OF ME, LEAVING A FOOTPRINT FOR HIM TO FOLLOW, AND THIS IS WHAT MAKES ME PROUD OF MY WORK!”

M AG A ZI N E | O C TO B ER 2018 | 3 1


THE AI TIME IS NOW An AI augmented future workplace is already happening

H WORDS BY

Colin Watson

3 2 | PH A R M A FI EL D.CO.U K

aving read many insightful articles and spoken to several experts on how artificial intelligence (AI) will significantly impact on the healthcare industry, I wanted to add to the conversation. Specifically, in terms of how advances in voice technology and chatbots will not only enhance patient care but also give pharmaceutical companies access to alternative providers and innovative services to support their brands.

“ T here will be a spectrum where companies naturally sit regarding their adoption of AI”

I N V E S TM E NT FAC T S A N D FO R E C A S T S It’s easy to think that AI is something that “I don’t need to worry about for a while”, “Doesn’t apply to my brand” or “Will be a while before it takes off”. However, if investment is ever a measure of how serious an industry is about making something happen, then the routine use of AI is already here. This is particularly true in the area of analysing big data to identify trends; with the ultimate goal of natural conversations with AI (‘hybrid AI’ systems) just around the corner. From an NHS funding perspective, the Academic Health Science Networks (AHSN) and SBRI Healthcare partnership has funded 87 companies with a total of approximately £35 million since 2013 in the digital/ICT/ mobile solutions category alone. One specific project in this category, related to the use of a chatbot/avatar for supporting young people with mental health conditions, attracted funding of just over £1 million. According to McKinsey Global Institute, the funding from the private sector is significant, with internal investment in AI by large corporations estimated to be between $18 billion and $27 billion in 2016 alone, while external investment (from venture capitalists, private equity etc) accounted for $8 billion to $12 billion. Bank of America Merrill Lynch has estimated that AI industry revenues will grow to $127 billion by 2025 from $2.1 billion in 2015, suggesting a compound annual growth rate (CAGR) of 51%. According to a recent report by Grand View Research, the global chatbot market alone is expected to reach $1.23 billion by 2025; a CAGR of 24.3%.


TECHNOLOGY

B U I L D C A PA B I L I T Y OR OUTSOURCE? I was recently asked whether I think the healthcare/pharmaceutical industry will attempt to build its own in-house capability or outsource its AI needs to companies who already have the expertise. Based on the evolution and use of outsourced services in the UK, there will be a spectrum where companies naturally sit regarding their adoption of AI. This is likely to be based on their culture, key strategic priorities, the speed at which they need to deploy the new technologies, the amount of data they hold and, of course, their budgets. Whilst there are new and emerging roles being advertised within pharmaceutical companies, such as data scientists and outcome research scientists (which have increased by 50% from 2016 to 2017), the dream team required to build and maintain a photorealistic chatbot-driven avatar, for example, extends to people skilled in: animation, photogrammetry, mathematics, social science, neuroscience, computer science, compliance, philosophy, statistics, linguistics and semantics to name a few. Developing, building, testing, optimising and deploying hybrid AI systems is certainly not straightforward and because there are companies which have invested significantly into this field of research and have long track records of delivering similar services in parallel industries, it would make sense to explore and engage with these organisations as a first step.

“ Developing, building, testing, optimising and deploying hybrid AI systems is certainly not straightforward”

A I A N D C U S TO M E R S E RV I C E In almost every article I’ve read, there is some mention of AI/chatbots and the rapid growth of voice as an interface being applied to either customer service, improving the customer experience or enhancing patient care. In May 2018, Google reported that 20% of mobile queries are now voice searches, which demonstrates how users are rapidly adopting this communication channel. Brad Young, Global CRM and GDPR Programme Director for Marketing, Sales and Service at Jaguar Land Rover makes some very interesting observations in his LinkedIn article regarding what he sees as the four stages of evolution of AI into customer service: evolving from enhanced enquiry help through to knowledge guru, personal assistant and finally, becoming our ‘best buddy’. Translating these four stages into the world of pharmaceuticals and healthcare, it’s easy to see that whether it’s a healthcare professional seeking information on a

product or disease area; a representative refreshing their knowledge on a clinical trial before a call; or a patient who wants some reassurance or to ask a question about a missed medication or a side effect, there is no doubt that AI, chatbots and avatars in particular, will play a significant role in providing a range of services which may historically have been sought from traditional service providers. After all, what could be more patient-centric or customer-focused than being available 24/7, 365 days a year providing accurate, tailored, non-judgemental, empathetic and compliant information? I very much see the use of AI as an augmentation tool; a tool for humans to use to enhance their personal and business lives. The question is not how quickly AI will evolve but more pertinently, how quickly people will evolve in our industry to embrace it and realise the benefits it can bring. Colin Watson is Director and Founder at CWC Consultancy. Go to www.cwcconsultancyltd.co.uk

M AG A ZI N E | O C TO B ER 2018 | 3 3


Is being easily influenced really that bad? Ryan Wooller, Head of Business Development at Star, discusses leadership and the importance of influence.

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ecently, I was talking with a client around the challenges of developing great sales leaders and the commercial impact they can exert within an organisation. I shared my experience of a programme I went through in my early career within the healthcare division of a global FMCG company (famous for fairy liquid, nappies and soap powder!). The programme was called ‘Creating Future Leaders’, and I joked with the client that the real key to success would have been to develop a ‘Creating Future Followers’ programme to ensure everyone followed the strategy. This got me thinking…

“Given the small margins that influence commercial success or failure, strong leadership is essential”

3 4 | PH A R M A FI EL D.CO.U K

We invest a significant amount of time and money learning in leadership and how to influence others, but rarely do we teach leaders how to be influenced by others. Why is this? Could it be a hangover from the impact of Dale Carnegie’s seminal How to Win Friends and Influence People? Could it be the influence of the current accepted wisdom on leadership? Of Harvard Business Review’s 10 Must Reads on Leadership, none focus on being influenced. If most of us were asked to define the essence of leadership I’m sure it would involve some element of exerting influence, and many leaders will take pride in their ability in this area. However, being influenced and having our actions shaped by others can seem far less admirable, and even a weakness. While I would find being described as ‘open-minded’ acceptable, I’m not so sure being described as ‘easily influenced’ fits with my own self-view. Leading Organisational Psychologist, Roger Schwarz, suggests that our unwillingness or inability to help others influence us prevents teams and organisations from achieving better impact. Schwarz believes that recent leadership and organisational practices such as ‘The Learning Organisation’, ‘Lean’ and ‘Six Sigma’, have attempted to address the premise that we get much better results if we hear from, and are influenced by, those who


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are in different positions and have different perspectives, rather than relying only on the thoughts of those in power. My colleagues and I continually challenge ourselves on how we can add value over and above the accepted benefits of basic outsourced service provision, and it strikes me that we are in the perfect position to share different perspectives and approaches that can make a commercial impact for our pharma clients. Service providers like Star are in the unique position of being exposed to a wide range of commercial challenges in the ever-evolving healthcare space, and importantly, to the commercial strategies and models that do and don’t work. If I should find myself back in the cut and thrust of a pharmaceutical organisation, I have often thought about how I could best leverage the diversity of thought and mutual influence that I now know exists outside of the pharma organisation and the typical consultancy services I once employed to increase my impact. Schwarz suggests that the two key questions to ask oneself are: 1) the extent to which you are willing to be influenced; and 2) the degree to which you are transparent about how others can influence you. If I apply this view to the types of discussion and interactions I have had with clients over the last few years, it is clear that those leaders who are the most willing and transparent on how they can be influenced are those that extract the highest value from us as a commercial partner. They are the leaders that share with me what will influence them and help me make my case. This, in turn, allows those leaders to make an informed judgement and decide whether or not our information, rationale and commercial solutions will increase their likelihood of making a commercial impact. Procurement processes are sometimes designed to frustrate open dialogue and block undue influence, and I wonder if this means individuals and organisations are missing half of what it means to be a leader? Given the small margins that influence commercial success or failure, strong leadership is essential.

WORDS BY

To paraphrase Schwarz, ‘If as a leader you want others to be open to your influence, you need to be open to theirs’. All it takes is an open and transparent conversation to allow leaders to make sound informed choices. For a conversation on how Star may be able to positively influence your commercial impact, contact Ryan Wooller, Head of Business Development at Star, at ryan.wooller@starmedical.co.uk. Go to www.starmedical.co.uk

“Leaders who are the most willing and transparent on how they can be influenced are those that extract the highest value”

Ryan Wooller M AG A ZI N E | O C TO B ER 2018 | 3 5


P H A R M ATA L E N T

MOVERS & SHAKERS

H E A LT H C A R E

LO R D P R I O R Lord Prior of Brampton has been appointed Chair of NHS England, replacing Professor Sir Malcolm Grant. Lord Prior has previously served as Parliamentary Under Secretary of State at the Department for Business, Energy and Industrial Strategy and at the Department of Health as Minister for NHS Productivity.

AG E N CY

DR MARK HOLBROOK Certara has appointed Dr Mark Holbrook to the newly-created position of Vice President of Quantitative Systems Toxicology and Safety. Prior to joining Certara, Dr. Holbrook was Director and Co-Founder of the drug discovery company, VAST Pharma Solutions. He specialises in pharmacology, safety pharmacology and toxicology consulting.

H E A LT H C A R E

D H I V YA O’ CO N N O R Dhivya O’Connor has been appointed Chief Executive of Children with Cancer UK. She has been with the charity since 2017 where she has been Chief Operating Officer and Chief Philanthropy Officer. Prior to this, she spent seven years at The Prince’s Teaching Institute, where she built and established the fundraising department.

PHARMA .

D R . K L AU S M O O S M AY E R

WHO’S GOING WHERE AND WHY THEY’RE GOING THERE. WORDS BY

Hannah Alderton

3 6 | PH A R M A FI EL D.CO.U K

Novartis has appointed Dr Klaus Moosmayer as Chief Ethics, Risk and Compliance Officer. He commented: “Society has high expectations of the pharmaceutical industry and rightfully so. I look forward to building on this strong foundation to create a truly world-class risk and compliance function.”


PHARMA

AG E N CY

DR K ARIMA BOUBEKEUR

K ARL WILSON

Tillotts Pharma has welcomed Dr Karima Boubekeur as Global Head of Innovation. Dr Boubekeur has over 30 years of experience in the pharmaceutical industry, where she has held several global leadership positions. Her responsibilities will include bringing Tillotts and parent company Zeria closer together to leverage both organisations’ expertise in research and development and business development and licensing.

earthware is delighted to announce the appointment of Karl Wilson to its leadership team as Client Excellence Director. Before joining earthware, Karl spent 13 years in various roles for Roche, including Business Operations Manager and Country Medical Leader. Prior to Roche, Karl held positions at MSD and Novartis.

AG E N CY

DAV I D H U K I N Clinical research organisation, Quanticate, has announced David Hukin as new Senior Director of Pharmacovigilance. Hukin has a PhD in Cell Physiology and Biophysics and 15 years’ experience in the pharmaceutical industry, with more than 14 years dedicated to the pharmacovigilance sector.

AG E N CY

DA N M CCO R M I C K

PHARMA

I A I N M AC K AY Iain Mackay will join GSK in January 2019 as their Chief Financial Officer, moving from HSBC where he is currently Group Finance Director. Emma Walmsley, Chief Executive Officer of GSK, said: “He is a strong leader with a track record of driving cost, cash and capital allocation discipline to deliver strategy.”

Dan McCormick, Senior Vice President of Global Strategy & Innovation joins Ashfield from Amgen. He will oversee the expansion of Ashfield’s multi-channel field and remote MSL service solution. Dan’s perspective is a culmination of experience spanning numerous sales, marketing and strategy roles. His knowledge includes valuable channel strategy insights and roadmaps for successfully implementing operating models.

M AG A ZI N E | O C TO B ER 2018 | 3 7


W

ith over 2 million students studying at more than 130 UK Universities, the graduate talent pool is not one to be overlooked. At CHASE, we’ve been running a dedicated Graduate Academy for almost 20 years, supplying talented graduates, on contract, to our pharmaceutical and healthcare clients and watching proudly as they rise through the industry ranks. During 2018, our graduates have secured roles in marketing, medical communications, customer service and pharmacy sales, as well as fuelling, within the pharmaceutical sector, the resurgence of the primary care sales representative.

CHASE GRADUATE ACADEMY:

DIVING INTO THE GRADUATE TALENT POOL W O R D S B Y Graham Hawthorn, Managing Director A N D Kate O’Neill, Graduate Recruitment Lead

3 8 | PH A R M A FI EL D.CO.U K

FU E L L I N G G R OW TH AC R O S S P R I M A RY C A R E We work with many leading pharmaceutical companies, and as a result quickly see changes impacting the front line. In the past 12 months, we have seen a significant rise in demand for primary care representatives, driven primarily by new respiratory products coming to the UK market. This took many by surprise, however at CHASE our graduate team saw this as a fantastic opportunity to place high calibre graduates into the industry. As a result, it is therefore no surprise that in 2018, we have placed more graduates into primary care representative roles than in any other year. With so many new contract pharmaceutical sales representatives being hired from this emerging talent pool, it is great news for the whole industry as it results in an injection of energy, enthusiasm and fresh mindsets. M A K I N G A M A R K I N M A R K E TI N G Yet graduates are not just fuelling the primary care resurgence; we see them grow and flourish in other positions too. For example, over the past 12 months, we’ve introduced graduates into exciting entry level marketing roles. These clients have specifically targeted our graduate talent pool as they were keen to inject a new dynamic into their marketing teams. Across the sector, and across functions, our clients have seen the positive impact of offering contract positions to highly motivated and driven graduates.


ADVERTORIAL

“ We have created a constant pipeline of engaged graduates with the right education, insights, and attitude to be successful in the pharmaceutical industry.”

TH E C H A S E A DVA NTAG E Over the past two decades, our Graduate Team has forged close relationships with many of the UK’s leading universities. These universities can see that we add real value and help students begin a career with leading pharmaceutical and healthcare companies. They love the fact we have a ‘Graduate Academy’; offer coaching sessions, industry advice and knowledge; and provide helpful resources and expertise. We invest our time not only in the immediately outstanding candidates, but also the people we see raw potential in – people we know we can help and support to achieve their goals. We help them unlock their potential. We take huge satisfaction from seeing these candidates secure new careers and achieve success. HIGH CALIBRE PEOPLE W ITH PA S S I O N Through the CHASE Graduate Academy, we have created a constant pipeline of engaged graduates with the right education, insights, and attitude to be successful in the pharmaceutical industry. Many of our graduates originate from a science background, however not exclusively. For example, we regularly place graduates with business, marketing and law degrees. Additionally, we work with many high calibre candidates with PGCE or teaching qualifications. What they have in common is a passion to get into the industry and the drive, determination and persistence to be successful. We work hard with them to make sure they are fully prepared.

Not all the graduates we work with have just finished university. We also target candidates a few years post-graduation who have worked within an alternate industry. These candidates bring a different perspective, more life experience and in many cases a well-tuned commercial awareness, as they will often have worked in customer facing sales, marketing or communications roles. G R A D UATE S A R E H E R E TO S TAY Over the past five years, we have witnessed a sustained year-on-year increase in the number of quality commercial graduates entering the industry. Over the past 18 months alone, our Academy has placed, on CHASE contract, over 100 graduates into commercial roles with pharmaceutical and healthcare clients. It is evident that graduates are becoming increasingly important both in terms of delivering day-to-day results, but also providing a future leader talent pipeline. The quality of graduates applying has never been higher and we are privileged to have a front row seat. We are confident that our industry is in good hands. Find out how CHASE graduates can add benefit to your business. Please contact Graham Hawthorn on 0131 553 6644 or email graham@chasepeople.com

CHASE GRADUATES AMY Amy graduated with a 2:1 in her Medical Science degree. She undertook a placement year within the industry, and had studied at the University of Birmingham. Amy is now working on a CHASE contract in a primary care sales role with one of our major clients. LO R N A A N D JACO B Working on CHASE contracts, both Lorna and Jacob have been successful recently in securing entry level graduate marketing roles with blue-chip clients. Lorna has a 1st class Business Studies degree and completed a 12-month marketing placement with a leading pharma company, and Jacob, who graduated with a 2:1 in Marketing had also completed a placement year working as a marketing consultant within the finance sector.

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P H A R M ATA L E N T

WORDS BY

Amy Schofield

TOP 5 TIPS FO R S E CU R I N G A PAY R I S E

Ella Patenall, Marketing & Editorial Executive at graduate recruitment firm, Inspiring Interns, says that although asking for a pay rise can be nervewracking, there are steps you can take to improve your chances:

1.

D O IT FAC E -TO - FAC E Meeting in person is likely to be far more persuasive than an email. The flexibility of the situation allows you to explain yourself better. It is also easier to gauge reactions and negotiate.

H OW T O G E T A

PAY RISE

You deserve to be rewarded for a job well done, but what’s the best way to approach the subject?

I

f you’ve been putting in the hours and exceeding your targets, then you might feel that it’s time that your dedication to your job was repaid in the form of a pay rise. According to Bart Turczynski, Content Team Lead at Uptowork career advice site, it’s all about how you approach the negotiations – and don’t assume that you’ll get one just because you think you deserve it: “Companies consider pay rises a privilege, not a right. You can always ask for a rise – it’s the negotiations that are tough,” he says. According to Bart, you can maximise your chances of successfully negotiating a rise if you approach the employer at the right time, for example: • After a successful project you led has been completed. • After you picked up someone else’s work, for example when a team member was away. • After delivering better than average results. “If you want a rise, you have to prepare a list of achievements. If your company does quarterly reviews, pitch the idea then,” he says. He has some advice for how to frame your request, and what not to do. “Don’t put it off for too long. Employers forget about wins and get used to improved performance fast,” he adds. “Don’t suggest it’s time for a rise too often; the request will lose its power.” Show your boss why you add value to the company, and how you will continue to do so. “When you ask, you want to show why it will make sense for the employer to spend more money on you,” Bart advises. “They know it’s about acknowledging your efforts, but they also expect the rise to help you maintain this pace.”

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2.

C H O O S E TH E R I G HT TI M E Perhaps you carried out a successful campaign or took on extra responsibilities. Demonstrating that you go above and beyond your role to solve a business problem will put you in a good light.

3.

D O YO U R R E S E A R C H Speak to those in your company doing your role or similar, use online salary checkers, explore job boards and speak to recruiters/hiring specialists to get an idea of the average salary for your role.

4.

FO L LOW U P If, for whatever reason, you do not get a pay rise, ask for another review in three months’ time. Use this time to demonstrate that you are hardworking, motivated and take the initiative.

5.

B E R E A DY TO N E G OTI ATE Negotiation is a good skill to have and is something you should be ready to do. How much scope is just and reasonable? What are you not willing to accept? Go to www.uptowork.com/blog and www.inspiringinterns.com


Looking for a bespoke recruitment solution? Whether you’re looking for brand exposure, or to post multiple roles – we’ve got the package for you. Getting up and running is easy – get in touch on 01462 476119 or hello@pharmafield.co.uk to discuss your online recruitment strategy.

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